Abstract: Pancreatic cancer is insidious in onset, highly aggressive, and associated with an extremely poor prognosis.Currently, surgical resection remains the primary means of prolonging survival in patients with pancreatic cancer; however, the majority of patients lose the opportunity for surgery at the time of diagnosis.Irreversible electroporation (IRE) is a non-thermal ablation technique that not only achieves local tumor ablation but also reverses the highly immunosuppressive tumor microenvironment.The combination of IRE with chemotherapy and immunotherapy is expected to yield improved clinical outcomes.This paper systematically reviews the latest clinical evidence on IRE combined with chemotherapy and immunotherapy, with a focus on the potential mechanisms by which IRE remodels the immunosuppressive microenvironment of pancreatic cancer.It also explores future directions for optimizing combination treatment strategies, aiming to provide new perspectives and a theoretical foundation for the treatment of pancreatic cancer.

Key words: irreversible electroporation, nanoknife, pancreatic cancer, chemotherapy, immunotherapy