The pancreatic cancer microenvironment: A true double agent

Abstract

The tumor microenvironment in pancreatic cancer is a complex balance of pro- and anti-tumor components. The dense desmoplasia consists of immune cells, extracellular matrix, growth factors, cytokines, and cancer associated fibroblasts (CAF) or pancreatic stellate cells (PSC). There are a multitude of targets including hyaluronan, angiogenesis, focal adhesion kinase (FAK), connective tissue growth factor (CTGF), CD40, chemokine (C-X-C motif) receptor 4 (CXCR-4), immunotherapy and Vitamin D. The developing clinical therapeutics will be reviewed.

Changes in total lymphocyte count and neutrophil‐to‐lymphocyte ratio after curative pancreatectomy in patients with pancreas adenocarcinoma and their prognostic role

“…Inflammation also plays an important role in the propagation of cancer, including initiation, progression, and metastasis . Under conditions of tumor cell microenvironment, many inflammation‐related cells and mediators would be responsible for the progression of residual cancer cells by facilitating lymphangiogenesis or metastasis of cancer cells . NLR in the blood is a useful indicator to reflect the immune status of the host associated with inflammatory responses.…”

A 3D bioinspired highly porous polymeric scaffolding system forin vitrosimulation of pancreatic ductal adenocarcinoma

“…2 The high disease mortality is due to (i) the lack of symptoms which leads to late stage diagnosis, 3 (ii) the high metastatic likelihood 4 and (iii) the high resistance to currently available treatment options. 5 The latter can be partly attributed to the disease's complex tumour microenvironment (TME), [6][7][8][9] which consists of intense extracellular matrix (ECM) brosis (desmoplasia) 6,[10][11][12] that can contribute to the disease's progression and inhibition of apoptotic pathways, both increasing treatment resistance. [13][14][15] Classically used systems for studying pancreatic cancer are either 2D in vitro systems or animals.…”

PD-1/PD-L1 Blockade: A New Promising Therapy for the Treatment of Pancreatic Cancer?

“…[16][17][18] First, one of the most peculiar characteristics of pancreatic cancer is that the tumor cells represent only 20% of the tumor mass, while the remaining 80% is constituted by desmoplastic stroma. 19 This stroma is characterized by high infiltration of cells with immune suppressive activity such as myeloid-derived suppressive cells (MDSCs), 20 T-regulatory cells (T regs ), 21 and tumor-associated macrophages (TAMs). 22 They reduced the anti-tumor functionality of CD8 + T-cells determining an impairment of tumor recognition and destruction.…”