Pancreatic Ductal Adenocarcinoma: A Strong imbalance of Good and Bad immunological Cops in the Tumor Microenvironment

Abstract : Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive and lethal cancers with very few available treatments. For many decades, gemcitabine was the only treatment for patients with PDAC. A recent attempt to improve patient survival by combining this chemotherapy with FOLFIRINOX and nab-paclitaxel failed and instead resulted in increased toxicity. Novel therapies are urgently required to improve PDAC patient survival. New treatments in other cancers such as melanoma, non-small-cell lung cancer, and renal cancer have emerged, based on immunotherapy targeting the immune checkpoints cytotoxic T-lymphocyte-associated antigen 4 or programmed death 1 ligand. However, the first clinical trials using such immune checkpoint inhibitors in PDAC have had limited success. Resistance to immunotherapy in PDAC remains unclear but could be due to tissue components (cancer-associated fibroblasts, desmoplasia, hypoxia) and to the imbalance between immunosuppressive and effector immune populations in the tumor microenvironment. In this review, we analyzed the presence of ``good and bad immunological cops'' in PDAC and discussed the significance of changes in their balance.
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Etienne D. Foucher, Clement Ghigo, Salem Chouaib, Jerome Galon, Juan Iovanna, et al.. Pancreatic Ductal Adenocarcinoma: A Strong imbalance of Good and Bad immunological Cops in the Tumor Microenvironment. Frontiers in Immunology, Frontiers, 2018, 9, ⟨10.3389/fimmu.2018.01044⟩. ⟨hal-02143543⟩

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