Abstract

Pancreatic ductal adenocarcinoma (PDAC) isone of the most common malignant tumors with poor prognosis due to extremelyhigh malignancy, low rate of eligibility for surgical resection andchemoradiation resistance. Increasing evidence indicate that the interactionbetween activated pancreatic stellate cells (PSCs) and PDAC cells plays animportant role in the development of PDAC. By producing high levels of cytokines,chemotactic factors, growth factors and excessive extracellular matrix (ECM),PSCs create desmoplasia and a hypoxic microenvironment that promote theinitiation, development, evasion of immune surveillance, invasion, metastasisand resistance to chemoradiation of PDAC. Therefore, targeting the interactionbetween PSCs and PDAC cells may represent a novel therapeutic approach toadvanced PDAC, especially therapies that target PSCs of the pancreatic tumormicroenvironment.