title: Pancreatic cancer: The microenvironment needs attention too!
abstract: The abundant stromal/desmoplastic reaction, a characteristic feature of a majority of pancreatic adenocarcinomas (PDAC), has only recently been receiving some attention regarding its possible role in the pathobiology of pancreatic cancer. It is now well established that the cells predominantly responsible for producing the collagenous stroma are pancreatic stellate cells (PSCs). In addition to extracellular matrix proteins, the stroma also exhibits cellular elements including, immune cells, endothelial cells and neural cells. Evidence is accumulating to indicate the presence of significant interactions between PSCs and cancer cells as well as between PSCs and other cell types in the stroma. The majority of research reports to date, using in vitro and in vivo approaches, suggest that these interactions facilitate local growth as well as distant metastasis of pancreatic cancer, although a recent study using animals depleted of myofibroblasts has raised some questions regarding the central role of myofibroblasts in cancer progression. Nonetheless, novel therapeutic strategies have been assessed, mainly in the pre-clinical setting, in a bid to interrupt stromal-tumour interactions and inhibit disease progression. The next important challenge is for the translation of such pre-clinical strategies to the clinical situation so as to improve the outcome of patients with pancreatic cancer.
authors.affiliation: Pancreatic Research Group, South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia. Electronic address: m.apte@unsw.edu.au.
authors.forename: M V
authors.initials: MV
authors.lastname: Apte
authors.affiliation: Pancreatic Research Group, South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia.
authors.forename: Z
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Pancreatic Research Group, South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Pothula
authors.affiliation: Pancreatic Research Group, South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Medical Oncology, Prince of Wales Hospital, Sydney, and Faculty of Medicine, University of New South Wales, Sydney, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Goldstein
authors.affiliation: Pancreatic Research Group, South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia.
authors.forename: R C
authors.initials: RC
authors.lastname: Pirola
authors.affiliation: Pancreatic Research Group, South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia.
authors.forename: J S
authors.initials: JS
authors.lastname: Wilson
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology; D000818:Animals; D006801:Humans; D010190:Pancreatic Neoplasms / Q000473:pathology*; D059016:Tumor Microenvironment
keywords: Pancreatic cancer; Pancreatic ductal adenocarcinoma; Pancreatic fibrogenesis; Pancreatic stellate cells; Stromal–tumour interactions; Tumour microenvironment