Pancreatic cancer, a highly lethal cancer, has the lowest 5-year survival rate forseveral reasons, including its tendency for the late diagnosis, a lack of serologicmarkers for screening, aggressive local invasion, it...Pancreatic cancer, a highly lethal cancer, has the lowest 5-year survival rate forseveral reasons, including its tendency for the late diagnosis, a lack of serologicmarkers for screening, aggressive local invasion, its early metastaticdissemination, and its resistance to chemotherapy/radiotherapy. Pancreaticcancer evades immunologic elimination by a variety of mechanisms, includinginduction of an immunosuppressive microenvironment. Cancer-associatedfibroblasts interact with inhibitory immune cells, such as tumor-associatedmacrophages and regulatory T cells, to form an inflammatory shell-like desmoplasticstroma around tumor cells. Immunotherapy has the potential to mobilizethe immune system to eliminate cancer cells. Nevertheless, althoughimmunotherapy has shown brilliant results across a wide range of malignancies,only anti-programmed cell death 1 antibodies have been approved for use inpatients with pancreatic cancer who test positive for microsatellite instability ormismatch repair deficiency. Some patients treated with immunotherapy whoshow progression based on conventional response criteria may prove to have adurable response later. Continuation of immune-based treatment beyond diseaseprogression can be chosen if the patient is clinically stable. Immunotherapeuticapproaches for pancreatic cancer treatment deserve further exploration, given theplethora of combination trials with other immunotherapeutic agents, targetedtherapy, stroma-modulating agents, chemotherapy, and multi-way combinationtherapies.展开更多
文摘Pancreatic cancer, a highly lethal cancer, has the lowest 5-year survival rate forseveral reasons, including its tendency for the late diagnosis, a lack of serologicmarkers for screening, aggressive local invasion, its early metastaticdissemination, and its resistance to chemotherapy/radiotherapy. Pancreaticcancer evades immunologic elimination by a variety of mechanisms, includinginduction of an immunosuppressive microenvironment. Cancer-associatedfibroblasts interact with inhibitory immune cells, such as tumor-associatedmacrophages and regulatory T cells, to form an inflammatory shell-like desmoplasticstroma around tumor cells. Immunotherapy has the potential to mobilizethe immune system to eliminate cancer cells. Nevertheless, althoughimmunotherapy has shown brilliant results across a wide range of malignancies,only anti-programmed cell death 1 antibodies have been approved for use inpatients with pancreatic cancer who test positive for microsatellite instability ormismatch repair deficiency. Some patients treated with immunotherapy whoshow progression based on conventional response criteria may prove to have adurable response later. Continuation of immune-based treatment beyond diseaseprogression can be chosen if the patient is clinically stable. Immunotherapeuticapproaches for pancreatic cancer treatment deserve further exploration, given theplethora of combination trials with other immunotherapeutic agents, targetedtherapy, stroma-modulating agents, chemotherapy, and multi-way combinationtherapies.
