Thakur Ravi, Mullen Nicholas J, Mehla Kamiya, Singh Pankaj K
Department of Oncology Science, University of Oklahoma College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE, USA.
Trends Cell Biol. 2025 May 26. doi: 10.1016/j.tcb.2025.04.007.
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with a dire prognosis. Standard-of-care chemotherapy regimens offer marginal survival benefit and carry risk of severe toxicity, while immunotherapy approaches have uniformly failed in clinical trials. Extensive desmoplasia in the PDAC tumor microenvironment (TME) disrupts blood flow to and from the tumor, thereby creating a nutrient-depleted, hypoxic, and acidic milieu that suppresses the function of antitumor immune cells and imparts chemotherapy resistance. Additionally, recent seminal studies have demonstrated crucial roles for metabolic crosstalk - the exchange of metabolites between PDAC cells and stromal cell populations in the TME - in establishing and maintaining core malignant behaviors of PDAC: tumor growth, metastasis, immune evasion, and therapy resistance. In this review, we provide a conceptual overview of metabolic crosstalk and how it evolves under various selection pressures in the TME, analyze the landscape of proposed tumorigenic metabolic crosstalk pathways, and highlight potentially druggable nodes.
胰腺导管腺癌(PDAC)是一种侵袭性恶性肿瘤,预后极差。标准护理化疗方案仅能带来有限的生存获益,且伴有严重毒性风险,而免疫治疗方法在临床试验中均告失败。PDAC肿瘤微环境(TME)中广泛的促纤维增生反应会破坏肿瘤的血液流入和流出,从而形成营养物质匮乏、缺氧且呈酸性的环境,抑制抗肿瘤免疫细胞的功能并赋予化疗抗性。此外,近期的重要研究表明,代谢串扰——即PDAC细胞与TME中基质细胞群体之间的代谢物交换——在建立和维持PDAC的核心恶性行为(肿瘤生长、转移、免疫逃逸和治疗抗性)中起着关键作用。在本综述中,我们提供了代谢串扰的概念性概述及其在TME中各种选择压力下的演变方式,分析了所提出的致瘤性代谢串扰途径的概况,并突出了潜在的可药物靶向节点。