PD-1 Combined With Chemotherapy and PULSAR in LAPC and Local Recurrence Patients

This trial is testing a treatment combination for locally advanced pancreatic cancer — immune checkpoint therapy (anti-PD-1), chemotherapy, plus a special radiation approach called PULSAR (which delivers radiation in intermittent pulses rather than daily doses). The goal is to see if this combination can shrink tumors enough to allow surgery or improve survival. **You may be eligible if...** - You are 18 or older - You have locally advanced pancreatic cancer confirmed by biopsy or cytology, OR pancreatic cancer that has come back locally (not spread to distant organs) after surgery - You have at least one measurable lesion - You are in generally good physical condition (ECOG 0–1) - Your estimated survival is at least 3 months - You are willing to potentially undergo surgery after treatment **You may NOT be eligible if...** - Your cancer has spread to distant organs (metastatic) - You have previously received PD-1/PD-L1 immunotherapy - You have serious bleeding, active infection, or major organ failure - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.