胰腺导管腺癌:肿瘤微环境与新型治疗策略开发中的问题。
Pancreatic ductal adenocarcinoma: tumor microenvironment and problems in the development of novel therapeutic strategies.
机构信息
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the Russian Federation, 20, Bld 1, Delegatskaya Street, Moscow, Russia, 127473.
Koltzov Institute of Developmental Biology, Russian Academy of Sciences, 26 Vavilov Street, Moscow, Russia, 119334.
出版信息
Clin Exp Med. 2023 Jul;23(3):619-643. doi: 10.1007/s10238-022-00886-1. Epub 2022 Sep 9.
Diagnosis and treatment of carcinoma of the exocrine part of the pancreas is a serious problem for modern medicine. Despite the identification of a large number of aberrant mutations in pancreatic ductal adenocarcinoma (PDAC), attempts to create effective therapeutic agents based on identified genetic or epigenetic variations have not been succesful. The role of the tumor microenvironment (TME) in tumor progression is currently a popular topic. Cancer-associated fibroblasts (CAFs) and extracellular matrix (ECM) are the main components of the tumor stroma and play an important role in the proliferation, invasiveness and metastasis of cancer. However, the mechanisms underlying the effect of CAFs and ECM on cancer progression are still unclear. Recent studies on stromal components and blockage of signaling pathways have brought some optimism to this area. New information on the role of TME will lead to the development of targeted therapies or combinations with modern chemotherapy for PDAC.
胰腺外分泌部癌的诊断和治疗是现代医学的一个严峻问题。尽管在胰腺导管腺癌(PDAC)中已经鉴定出大量异常突变,但基于已鉴定的遗传或表观遗传变化来创建有效治疗剂的尝试尚未成功。肿瘤微环境(TME)在肿瘤进展中的作用目前是一个热门话题。癌相关成纤维细胞(CAF)和细胞外基质(ECM)是肿瘤基质的主要成分,在癌症的增殖、侵袭和转移中发挥重要作用。然而,CAF 和 ECM 对癌症进展影响的机制尚不清楚。最近对基质成分和信号通路阻断的研究为这一领域带来了一些乐观情绪。关于 TME 作用的新信息将导致针对 PDAC 的靶向治疗或与现代化疗联合治疗的发展。