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Updated: Jan 26, 2026

Isolation of Proximal Fluids to Investigate the Tumor Microenvironment of Pancreatic Adenocarcinoma
Published on: November 5, 2020
Therapeutic challenges and current immunomodulatory strategies in targeting the immunosuppressive pancreatic tumor
Chin-King Looi1, Felicia Fei-Lei Chung2, Chee-Onn Leong3,4
1School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia.
Background:
Pancreatic cancer is one of the most lethal type of cancers, with an overall five-year survival rate of less than 5%. It is usually diagnosed at an advanced stage with limited therapeutic options. To date, no effective treatment options have demonstrated long-term benefits in advanced pancreatic cancer patients. Compared with other cancers, pancreatic cancer exhibits remarkable resistance to conventional therapy and possesses a highly immunosuppressive tumor microenvironment (TME).
Main Body:
In this review, we summarized the evidence and unique properties of TME in pancreatic cancer that may contribute to its resistance towards immunotherapies as well as strategies to overcome those barriers. We reviewed the current strategies and future perspectives of combination therapies that (1) promote T cell priming through tumor associated antigen presentation; (2) inhibit tumor immunosuppressive environment; and (3) break-down the desmoplastic barrier which improves tumor infiltrating lymphocytes entry into the TME.
Conclusions:
It is imperative for clinicians and scientists to understand tumor immunology, identify novel biomarkers, and optimize the position of immunotherapy in therapeutic sequence, in order to improve pancreatic cancer clinical trial outcomes. Our collaborative efforts in targeting pancreatic TME will be the mainstay of achieving better clinical prognosis among pancreatic cancer patients. Ultimately, pancreatic cancer will be a treatable medical condition instead of a death sentence for a patient.
Insights
Pancreatic cancer
Area of Science:
- Oncology
- Immunology
- Cancer Biology
Background:
- Pancreatic cancer has a low survival rate (<5%) and is often diagnosed late.
- Limited effective treatments exist for advanced pancreatic cancer.
- Pancreatic tumors are resistant to therapy and create an immunosuppressive tumor microenvironment (TME).
Purpose of the Study:
- To review the unique properties of the pancreatic tumor microenvironment (TME).
- To explore strategies for overcoming TME-mediated resistance to immunotherapy.
- To discuss combination therapies for advanced pancreatic cancer.
Main Methods:
- Summarized evidence on pancreatic cancer TME properties.
- Reviewed strategies to overcome TME resistance.
- Examined combination therapies targeting TME barriers.
Main Results:
- Pancreatic TME properties contribute to immunotherapy resistance.
- Combination therapies can enhance T cell priming and reduce immunosuppression.
- Breaking down the desmoplastic barrier improves lymphocyte infiltration.
Conclusions:
- Understanding pancreatic tumor immunology is crucial for improving clinical trial outcomes.
- Targeting the pancreatic TME is key to better patient prognosis.
- Future efforts aim to make pancreatic cancer a treatable condition.
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