Thus, more effective treatment strategies for pMMR LAPC are urgently needed.<h4>Case presentation</h4>We present a 65-year-old female diagnosed with LAPC (cT4N1M0, Stage III), confirmed pathologically as pancreatic ductal adenocarcinoma with pMMR status and a high programmed death-ligand 1 (PD-L1) combined positive score (CPS) of 30. Here, CD274 is linked to pancreatic ductal adenocarcinoma.