Pancreatic ductal adenocarcinoma (PDAC) is one of the most common malignant tumors of the pancreas. Preclinical studies show that it evades the immune system with immune checkpoints and promotes tumor development. V-domain Ig suppressor of T cell activation (VISTA) is a new immunecheck point from the B7 family and is highly expressed in cancer cells. Overexpression of toll like receptor 4 (TLR4) in pancreatic adenocarcinoma is associated with inducing tumorigenesis, tumor growth and resistance to chemotherapy. Naloxone is an opioid and inhibits TLR4-ligand association. In this study, we investigated the connection of TLR4 and downstream pathway with immune-check point VISTA in pancreatic cancer proliferation. We rst collected pancreatic cancer-related datasets using the GEPIA2 and UALCAN databases. Based on the data obtained the effect of different concentrations and incubation times of Naloxone were used on PANC-1 cells proliferation. Combination of Naloxone and VISTA-siRNA were applied, and effect of both Naloxone and combined reatment on TLR4, Interleukin 1 receptor associated kinase 4 (IRAK4) and VISTA gene expression were analysed in pancreatic cancer cells. As a result of analysis with Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR), gene expression levels of TLR4, IRAK4 and VISTA were signi cantly suppressed and cell proliferation was signi cantly reduced. We found that administration of Naloxone and VISTA-siRNA in combination to PDAC cells suppressed signaling. Therefore, we considered that the relationship between VISTA and TLR4 signaling pathways and the other possible associated signal molecules may be an important marker in determining the response of immune checkpoint inhibitors in cancer treatment.