Autoimmune pancreatitis is a rare condition of pancreatic inflammation with two classic subtypes. The emergence of a third subtype, ICI-induced pancreatitis, highlights the need for knowledge of each type to ensure accurate diagnosis and treatment. Abbreviations: AIP—Autoimmune pancreatitis; AIP-1—Type 1 autoimmune pancreatitis, also known as lymphoplasmacytic sclerosing pancreatitis (LPSP); AIP-2—Type 2 autoimmune pancreatitis, also referred to as idiopathic duct-centric pancreatitis (IDCP); AIP-3—Type 3 autoimmune pancreatitis, also known as immune checkpoint inhibitor (ICI)-induced autoimmune pancreatitis; IgG4-RD—Immunoglobulin G4-related disease.

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most challenging malignancies to treat, largely due to late diagnosis, limited surgical options, and profound resistance to systemic therapies, all of which contribute to a five-year survival rate of approximately 9%. The dense, hypoxic, and immunosuppressive tumor microenvironment (TME) of PDAC plays a critical role in immune evasion and therapeutic failure. As conventional immunotherapies have shown limited efficacy in PDAC, attention has shifted toward local interventions capable of remodeling the TME to enhance immune responsiveness. Endoscopic ultrasound (EUS)-guided ablative therapies have emerged as promising strategies to overcome these barriers. A range of modalities—including irreversible electroporation, microwave ablation, photodynamic therapy, and cryoablation—are under investigation. Among these, radiofrequency ablation (RFA) stands out as the most promising therapy as it not only induces direct tumor cytoreduction but also promotes antigen release, triggers immunogenic cell death, and may work synergistically with systemic therapies such as immune checkpoint inhibitors and adenosine pathway blockade. This review aims to explore the evolving role of endoscopic ablative therapies with a focus on RFA as a potential platform for immune activation in pancreatic cancer.

Cholangiocarcinoma is a rare, highly aggressive malignancy of the hepatobiliary tract with poor prognosis, often diagnosed at advanced stages when curative surgical resection is not feasible. Management increasingly relies on advanced endoscopic interventions to address malignant biliary obstruction and improve clinical outcomes. Beyond conventional biliary stenting, adjunctive endoscopic ablation therapies have emerged as promising strategies to improve both stent patency and survival. This review comprehensively examines the evolving role of radiofrequency ablation and photodynamic therapy in the treatment of unresectable cholangiocarcinoma. Radiofrequency ablation utilizes localized thermal energy to induce coagulative tumor necrosis and offers advantages including procedural simplicity, favorable safety profile, and cost-effectiveness; however, its efficacy may be limited by tumor size, location, and proximity to critical structures. In contrast, photodynamic therapy employs light-activated photosensitizers to selectively induce cytotoxicity in malignant tissue, demonstrating superior outcomes in prolonging both stent patency and overall survival across multiple studies and meta-analyses. Photodynamic therapy’s ability to treat more diffuse and peripheral lesions represents an important advantage, though its use is limited by photosensitivity reactions and shallow tissue penetration. Ultimately, endoscopic ablation therapies represent valuable adjunctive options in the multidisciplinary care of patients with unresectable cholangiocarcinoma. As technological advances continue and more comparative data emerge, optimized patient selection and individualized integration of these therapies hold potential to significantly improve outcomes in this challenging malignancy.

Objectives: Many patients with cancer receive chemotherapy alongside glucagon-like peptide-1 receptor agonists (GLP-1 RA) to manage type 2 diabetes or obesity. However, both GLP-1 RA and platinum-based chemotherapies can cause upper gastrointestinal (GI) adverse effects (AE) such as nausea and vomiting. This study aimed to evaluate the impact of GLP-1 RA use in patients receiving platinum-based chemotherapy, focusing on GI AE incidence, risk factors, and treatment outcomes. Methods: This single-center study retrospectively reviewed patients who were treated with a platinum-based therapy and concurrent GLP-1 RA and developed symptoms of upper GI AE. Results: The study included 200 patients. Upper GI adverse events occurred in 126 patients. Compared with patients without GI AE, patients with GI AE received fewer doses of platinum therapy (median: 2.5 vs. 5, P <0.0001) and had higher all-cause mortality (40.5% vs. 25.7%, P =0.034), shorter follow-up (median: 1.5 vs. 2.7 y, P <0.0001), and a higher rate of hypothyroidism (35.1% vs. 20.6%, P =0.025). GI AEs were treated with 5-HT3 receptor antagonists in 123 (99.2%) patients and corticosteroids in 5 (4.0%). GI AE symptoms lasted a median of 42.5 days; 92.7% achieved clinical remission of GI AE. Twenty-one (16.7%) patients required hospitalization for GI AE, of whom 4 required rehospitalization. Platinum analogs were discontinued in 72 (57.1%) patients and resumed in 57 (79.2%). GLP-1 RA was discontinued in 11 (8.7%) patients. Conclusions: Most patients receiving GLP-1 RA and platinum-based chemotherapy developed mild GI AE that responded to conservative management.