Li Ming, Zhou Renyu, Qiu Yu, Peng Yulong, Liu Minting, Zhang Xiaotan
Department of Pathology, First Affiliated Hospital of Jinan University, School of Medicine, Jinan University, Guangzhou 510632, China.
Key Laboratory for Regenerative Medicine of the Ministry of Education, Division of Histology and Embryology, School of Medicine, Jinan University, Guangzhou 510632, China.
Chin J Cancer Res. 2025 Jun 30;37(3):466-486. doi: 10.21147/j.issn.1000-9604.2025.03.13.
Pancreatic cancer, particularly pancreatic ductal adenocarcinoma (PDAC), is one of the most lethal malignancies, which is characterized by a complex tumor microenvironment (TME) that fosters immune evasion and treatment resistance. Recent genomic advancements have unveiled diverse molecular subtypes of PDAC, providing insights into targeted therapies and precision medicine. This review synthesizes the current understanding of PDAC's molecular characterization and immunosuppressive TME, as well as emerging therapeutic strategies, including innovative approaches targeting key molecular pathways such as kirsten rat sarcoma viral oncogene homolog (KRAS), epidermal growth factor receptor (EGFR), and immune checkpoints. Despite advances, challenges remain in overcoming treatment resistance and inherent heterogeneity of pancreatic cancer subtypes. We highlight the need for multidisciplinary collaboration to enhance early diagnosis and develop individualized therapeutic protocols, paving the way for improving the outcomes of this aggressive cancer. This integrated perspective underscores the urgency of transforming the innovative research into pancreatic cancer management.
胰腺癌，尤其是胰腺导管腺癌（PDAC），是最致命的恶性肿瘤之一，其特征是具有促进免疫逃逸和治疗抗性的复杂肿瘤微环境（TME）。最近的基因组进展揭示了PDAC的多种分子亚型，为靶向治疗和精准医学提供了见解。本综述综合了目前对PDAC分子特征和免疫抑制TME的理解，以及新兴的治疗策略，包括针对关键分子途径（如 Kirsten 大鼠肉瘤病毒癌基因同源物（KRAS）、表皮生长因子受体（EGFR）和免疫检查点）的创新方法。尽管取得了进展，但在克服胰腺癌亚型的治疗抗性和固有异质性方面仍存在挑战。我们强调需要多学科合作以加强早期诊断并制定个性化治疗方案，为改善这种侵袭性癌症的治疗结果铺平道路。这种综合观点强调了将创新研究转化为胰腺癌管理的紧迫性。
