Pan Da, Li Xinyue, Qiao Xiao, Wang Qiqi
Department of Gastroenterology, Wenzhou Central Hospital, Wenzhou, China.
Department of Gastroenterology, The Dingli Clinical College of Wenzhou Medical University, Wenzhou, China.
Front Immunol. 2025 May 15;16:1582305. doi: 10.3389/fimmu.2025.1582305. eCollection 2025.
Pancreatic cancer is projected to become the second leading cause of cancer-related death by 2030. Conventional interventions including surgery, radiotherapy, and chemotherapy provide only modest survival benefits, underscoring an urgent need for more effective therapies. Although immunotherapy has revolutionized the management of several solid tumors, its clinical benefit in pancreatic cancer has so far been disappointing. Mounting evidence indicates that a highly immunosuppressive tumor microenvironment (TME), dominated by tumor-associated macrophages (TAMs), myeloid-derived suppressor cells (MDSCs), and regulatory T cells (Tregs), drives immune evasion, tumor progression, metastasis, and chemoresistance through complex cytokine and chemokine networks. This review summarizes current knowledge of these immunosuppressive mechanisms and provides emerging strategies aimed at re-educating or depleting these cellular constituents to enhance the efficacy of immunotherapy in pancreatic cancer.
预计到2030年，胰腺癌将成为癌症相关死亡的第二大主要原因。包括手术、放疗和化疗在内的传统干预措施仅能带来有限的生存益处，这凸显了对更有效治疗方法的迫切需求。尽管免疫疗法已经彻底改变了几种实体瘤的治疗方式，但迄今为止，其在胰腺癌中的临床益处一直令人失望。越来越多的证据表明，由肿瘤相关巨噬细胞（TAM）、髓源性抑制细胞（MDSC）和调节性T细胞（Treg）主导的高度免疫抑制性肿瘤微环境（TME），通过复杂的细胞因子和趋化因子网络驱动免疫逃逸、肿瘤进展、转移和化疗耐药。这篇综述总结了目前对这些免疫抑制机制的认识，并提供了旨在重新教育或清除这些细胞成分以提高免疫疗法在胰腺癌中疗效的新兴策略。
