Updates in Immunotherapy for Pancreatic Cancer

被引:0
|
作者
Chick, Robert Connor [1 ]
Pawlik, Timothy M. [1 ]
机构
[1] Ohio State Univ, Dept Surg, Wexner Med Ctr, Columbus, OH 43210 USA
关键词
pancreatic cancer; immunotherapy; personalized; tumor microenvironment; immune checkpoint inhibitor; cancer vaccine; T-CELLS; TUMOR MICROENVIRONMENT; CHECKPOINT INHIBITORS; STROMAL INFLAMMATION; NEOADJUVANT THERAPY; OPEN-LABEL; COMBINATION; TRIAL; PEMBROLIZUMAB; FOLFIRINOX;
D O I
10.3390/jcm13216419
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with limited effective therapeutic options. Due to a variety of cancer cell-intrinsic factors, including KRAS mutations, chemokine production, and other mechanisms that elicit a dysregulated host immune response, PDAC is often characterized by poor immune infiltration and an immune-privileged fibrotic stroma. As understanding of the tumor microenvironment (TME) evolves, novel therapies are being developed to target immunosuppressive mechanisms. Immune checkpoint inhibitors have limited efficacy when used alone or with radiation. Combinations of immune therapies, along with chemotherapy or chemoradiation, have demonstrated promise in preclinical and early clinical trials. Despite dismal response rates for immunotherapy for metastatic PDAC, response rates with neoadjuvant immunotherapy are somewhat encouraging, suggesting that incorporation of immunotherapy in the treatment of PDAC should be earlier in the disease course. Precision therapy for PDAC may be informed by advances in transcriptomic sequencing that can identify immunophenotypes, allowing for more appropriate treatment selection for each individual patient. Personalized and antigen-specific therapies are an increasing topic of interest, including adjuvant immunotherapy using personalized mRNA vaccines to prevent recurrence. Further development of personalized immune therapies will need to balance precision with generalizability and cost.
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页数:18
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