肿瘤微环境在胰腺癌免疫治疗中的作用:现状与未来展望。

The Role of Tumor Microenvironment in Pancreatic Cancer Immunotherapy: Current Status and Future Perspectives.

机构信息

Tumor Microenvironment, Metastasis and Experimental Therapeutics Laboratory, Basic and Translational Cancer Research Center, Department of Life Sciences, European University Cyprus, Nicosia 2404, Cyprus.

Apoptosis and Cancer Chemoresistance Laboratory, Basic and Translational Cancer Research Center, Department of Life Sciences, European University Cyprus, Nicosia 2404, Cyprus.

出版信息

Int J Mol Sci. 2024 Sep 3;25(17):9555. doi: 10.3390/ijms25179555.

Abstract

Pancreatic cancer comprises different subtypes, where most cases include ductal adenocarcinoma (PDAC). It is one of the deadliest tumor types, with a poor prognosis. In the majority of patients, the disease has already spread by the time of diagnosis, making full recovery unlikely and increasing mortality risk. Despite developments in its detection and management, including chemotherapy, radiotherapy, and targeted therapies as well as advances in immunotherapy, only in about 13% of PDAC patients does the overall survival exceed 5 years. This may be attributed, at least in part, to the highly desmoplastic tumor microenvironment (TME) that acts as a barrier limiting perfusion, drug delivery, and immune cell infiltration and contributes to the establishment of immunologically 'cold' conditions. Therefore, there is an urgent need to unravel the complexity of the TME that promotes PDAC progression and decipher the mechanisms of pancreatic tumors' resistance to immunotherapy. In this review, we provide an overview of the major cellular and non-cellular components of PDAC TME, as well as their biological interplays. We also discuss the current state of PDAC therapeutic treatments and focus on ongoing and future immunotherapy efforts and multimodal treatments aiming at remodeling the TME to improve therapeutic efficacy.

摘要

胰腺癌包括不同的亚型,其中大多数病例包括导管腺癌 (PDAC)。它是最致命的肿瘤类型之一,预后不良。在大多数患者中,疾病在诊断时已经扩散,完全康复的可能性不大,死亡率增加。尽管在检测和管理方面取得了进展,包括化疗、放疗和靶向治疗以及免疫疗法的进步,但只有约 13%的 PDAC 患者的总生存率超过 5 年。这至少部分归因于高度纤维组织增生的肿瘤微环境 (TME),它作为一种屏障限制灌注、药物输送和免疫细胞浸润,并导致免疫“冷”状态的建立。因此,迫切需要揭示促进 PDAC 进展的 TME 的复杂性,并阐明胰腺肿瘤对免疫疗法的抵抗机制。在这篇综述中,我们概述了 PDAC TME 的主要细胞和非细胞成分及其生物学相互作用。我们还讨论了当前 PDAC 的治疗方法,并重点介绍了正在进行和未来的免疫治疗努力以及旨在重塑 TME 以提高治疗效果的多模式治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d75/11395109/7d0703479df3/ijms-25-09555-g001.jpg

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