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Picibanil is a lyophilized, nonreplicating biological preparation derived from the low-virulence Su strain of group A *Streptococcus pyogenes* after penicillin and heat treatment. It functions as a nonspecific immunostimulatory anticancer agent, activating innate immune signaling through the Toll-like receptor 4 and MD-2 pathway, promoting cytokine production and dendritic-cell maturation. In the Fukushima Medical University pancreatic-cancer program, picibanil was administered intratumorally with separately prepared immature dendritic cells before surgery in patients with resectable pancreatic cancer. ([academic.oup.com](https://academic.oup.com/jnci/article/95/4/316/2520610))
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