Review
The Paradoxical Web of Pancreatic Cancer Tumor Microenvironment

https://doi.org/10.1016/j.ajpath.2018.09.009Get rights and content
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Pancreatic ductal adenocarcinoma (PDAC) is increasing in incidence and is projected to become the second leading cause of cancer death in the United States. Despite significant advances in understanding the disease, there has been minimal increase in PDAC patient survival. PDAC tumors are unique in the fact that there is significant desmoplasia. This generates a large stromal compartment composed of immune cells, inflammatory cells, growth factors, extracellular matrix, and fibroblasts, comprising the tumor microenvironment (TME), which may represent anywhere from 15% to 85% of the tumor. It has become evident that the TME, including both the stroma and extracellular component, plays an important role in tumor progression and chemoresistance of PDAC. This review will discuss the multiple components of the TME, their specific impact on tumorigenesis, and the multiple therapeutic targets.

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Pancreatic Cancer Theme Issue

Supported by National Cancer Institute/NIH grant NIH 5K12CA001727-20 (L.G.M.).

Disclosures: None declared.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

This article is a part of a review series on benign and neoplastic pancreatic lesions from their pathologic to molecular profiles and diagnoses.