Ito Z, et al. - Pancreatic ductal adenocarcinoma (PDA) patients treated with multiple major histocompatibility complex class I/II-restricted, Wilms’ tumor 1 (WT1) peptide-pulsed dendritic cell (DC)-based cancer vaccinations (DC/WT1-I/II) in combination with chemotherapy were evaluated for the predictive markers of overall survival (OS). From 7 eligible PDA patients, researchers examined the plasma levels of soluble factors derived from granulocytes. Compared to the 4 non-super-responders (OS <1 year), the remaining 3 super-responders (OS ≥1 year) showed significantly decreased low plasma matrix metalloproteinase-9 levels throughout long-term therapy, significantly lower neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, and granulocyte-to-lymphocyte ratio after 5 DC/WT1-I/II vaccinations and 3 cycles of gemcitabine, and relatively weak cytoplasmic WT1 expression in the PDA cells. These outcomes suggest the possible predictive value of prolonged low levels of a granulocyte-related systemic inflammatory response after the early period of therapy and low cytoplasmic WT1 expression in PDA cells as markers for OS in PDA patients receiving WT1-targeting immunochemotherapy.