Cambridge Research Institute, Cancer Research UK.
Clin Cancer Res. 2012 Aug 15;18(16):4266-76. doi: 10.1158/1078-0432.CCR-11-3114.
Pancreatic ductal adenocarcinoma (PDA) is a common and lethal malignancy resulting in more than 250,000 deaths per year worldwide. Despite extensive efforts, cytotoxic and targeted therapies have provided only limited efficacy for patients with PDA to date. One contributing factor to the failure of systemic therapies may be the abundant tumor stromal content that is the characteristic of PDA. The PDA stroma, aptly termed the tumor microenvironment, occupies the majority of the tumor mass, and consists of a dynamic assortment of extracellular matrix components and nonneoplastic cells including fibroblastic, vascular, and immune cells. Recent work has revealed that the PDA stroma supports tumor growth and promotes metastasis and simultaneously serves as a physical barrier to drug delivery. Accordingly, methods that alter stromal composition or function, for instance interference with the vasculature via Notch/Hedgehog pathway inhibition or relief of vascular compression by hyaluronidase, are under active investigation. Here, we will review our current understanding of the PDA tumor microenvironment, and highlight opportunities for further exploration that may benefit patients.
胰腺导管腺癌 (PDA) 是一种常见且致命的恶性肿瘤,导致全球每年有超过 25 万人死亡。尽管进行了广泛的努力,但迄今为止,细胞毒性和靶向疗法仅为 PDA 患者提供了有限的疗效。系统治疗失败的一个因素可能是丰富的肿瘤基质含量,这是 PDA 的特征。PDA 基质恰当地称为肿瘤微环境,占据了肿瘤大部分的质量,由一系列动态的细胞外基质成分和非肿瘤细胞组成,包括成纤维细胞、血管和免疫细胞。最近的研究表明,PDA 基质支持肿瘤生长并促进转移,同时也是药物输送的物理屏障。因此,改变基质组成或功能的方法,例如通过 Notch/Hedgehog 通路抑制干扰血管,或通过透明质酸酶缓解血管压迫,正在积极研究中。在这里,我们将回顾我们对 PDA 肿瘤微环境的现有理解,并强调可能使患者受益的进一步探索机会。
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