Background: Pancreatic cancer remains a highly fatal malignancy among the most common cancers. Multidisciplinary systemic treatment is the vital method to prolong the survival of patients with locally advanced and advanced disease. Case presentation: We report a patient presented to the hospital with upper abdominal pain with occasional diarrhea for 6 months, diagnosed as locally advanced pancreatic cancer (LAPC). The patient was detected carrying with BRAF p.N486_P490del mutation and positive

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... GFR expression, receiving induction sequential chemotherapy of gemcitabine plus nab-paclitaxel and modified fluorouracil plus leucovorin, oxaliplatin and irinotecan, combined with nimotuzumab, followed by consolidative carbon ion radiotherapy. After the sequential treatment, the efficacy evaluation was partial response and progression-free survival was at least 20 months. Conclusions: LAPC patients with non-V600 BRAF mutation and positive EGFR expression might benefit from induction sequential chemotherapy combined with nimotuzumab and consolidative carbon ion radiotherapy. It is possible for patient with locally advanced disease to obtain better local control and further survival.