Would you consider using immunotherapy off-label in metastatic pancreatic cancer with high PD-L1 expression?  

This is an interesting question. PD-L1 expression confers a poor prognosis in pancreas cancer and expression was historically thought to be low, however, more recent data suggests otherwise (Zheng, JNCI, 2017) however, analogous to other diseases there are many limitations related to antibodies used...