title: Pancreatic cancer and its stroma: a conspiracy theory.
abstract: Pancreatic cancer is characterised by a prominent desmoplastic/stromal reaction that has received little attention until recent times. Given that treatments focusing on pancreatic cancer cells alone have failed to significantly improve patient outcome over many decades, research efforts have now moved to understanding the pathophysiology of the stromal reaction and its role in cancer progression. In this regard, our Group was the first to identify the cells (pancreatic stellate cells, PSCs) that produced the collagenous stroma of pancreatic cancer and to demonstrate that these cells interacted closely with cancer cells to facilitate local tumour growth and distant metastasis. Evidence is accumulating to indicate that stromal PSCs may also mediate angiogenesis, immune evasion and the well known resistance of pancreatic cancer to chemotherapy and radiotherapy. This review will summarise current knowledge regarding the critical role of pancreatic stellate cells and the stroma in pancreatic cancer biology and the therapeutic approaches being developed to target the stroma in a bid to improve the outcome of this devastating disease.
authors.affiliation: Zhihong Xu, Srinivasa P Pothula, Jeremy S Wilson, Minoti V Apte, Pancreatic Research Group, South Western Sydney Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2170, Australia.
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Zhihong Xu, Srinivasa P Pothula, Jeremy S Wilson, Minoti V Apte, Pancreatic Research Group, South Western Sydney Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2170, Australia.
authors.forename: Srinivasa P
authors.initials: SP
authors.lastname: Pothula
authors.affiliation: Zhihong Xu, Srinivasa P Pothula, Jeremy S Wilson, Minoti V Apte, Pancreatic Research Group, South Western Sydney Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2170, Australia.
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Wilson
authors.affiliation: Zhihong Xu, Srinivasa P Pothula, Jeremy S Wilson, Minoti V Apte, Pancreatic Research Group, South Western Sydney Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2170, Australia.
authors.forename: Minoti V
authors.initials: MV
authors.lastname: Apte
mesh_terms: D000818:Animals; D014408:Biomarkers, Tumor / Q000378:metabolism; D002450:Cell Communication; D002471:Cell Transformation, Neoplastic / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D005109:Extracellular Matrix / Q000378:metabolism; D006801:Humans; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D014411:Neoplastic Stem Cells / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D009389:Neovascularization, Pathologic; D010190:Pancreatic Neoplasms / Q000098:blood supply / Q000276:immunology / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D058954:Pancreatic Stellate Cells / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D011379:Prognosis; D015398:Signal Transduction; D017154:Stromal Cells / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D019139:Tumor Escape; D059016:Tumor Microenvironment
chemical_list: D014408:Biomarkers, Tumor
keywords: Metastasis; Pancreatic cancer; Pancreatic stellate cells; Stromal reaction; Tumour-stroma interactions