title: Angiogenesis in pancreatic ductal adenocarcinoma: A controversial issue.
abstract: Pancreatic ductal adenocarcinoma (PDAC) occurs in the majority of cases with early loco-regional spread and distant metastases at diagnosis, leading to dismal prognosis with a 5-year overall survival rate moderately over than 5%. This malignancy is largely resistant to chemotherapy and radiation, but the reasons of the refractoriness to the therapies is still unknown. Evidence is accumulating to indicate that the PDAC microenvironment and vascularity strongly contribute to the clinical features of this disease. In particular, PDAC is characterized by excessive dense extracellular matrix deposition associated to vasculature collapse and hypoxia with low drug delivery, explaining at least partly the low efficacy of antiangiogenic drugs in this cancer. Strategies aimed to modulate tumor stroma favoring vasculature perfusion and chemotherapeutics delivery are under investigation.
authors.affiliation: Department of Medical Oncology, Hospital of Taranto, Taranto, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Longo
authors.affiliation: Medical Oncology Unit, Cancer Institute "Giovanni Paolo II", Bari, Italy.
authors.forename: Oronzo
authors.initials: O
authors.lastname: Brunetti
authors.affiliation: Department of Medical Oncology, Hospital "Vito Fazi" of Lecce, Lecce, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gnoni
authors.affiliation: Medical Oncology Unit, University of Modena, Modena, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
authors.affiliation: Scientific Direction, Cancer Institute "Giovanni Paolo II", Bari, Italy.
authors.forename: Giampietro
authors.initials: G
authors.lastname: Gasparini
authors.affiliation: Medical Oncology Unit, Cancer Institute "Giovanni Paolo II", Bari, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Lorusso
authors.affiliation: Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy.|National Cancer Institute "Giovanni Paolo II", Bari, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Ribatti
authors.affiliation: Medical Oncology Unit, Cancer Institute "Giovanni Paolo II", Bari, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Silvestris
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000818:Animals; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000473:pathology*; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D016503:Drug Delivery Systems; D005109:Extracellular Matrix / Q000378:metabolism; D006801:Humans; D000860:Hypoxia; D007249:Inflammation; D051379:Mice; D009389:Neovascularization, Pathologic; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology*; D010477:Perfusion; D011379:Prognosis; D059016:Tumor Microenvironment
chemical_list: D020533:Angiogenesis Inhibitors
keywords: angiogenesis; desmoplastic reaction; hypoxia; pancreatic ductal adenocarcinoma