Regulation and modulation of antitumor immunity in pancreatic cancer

Nat Immunol. 2020 Oct;21(10):1152-1159. doi: 10.1038/s41590-020-0761-y. Epub 2020 Aug 17.

Abstract

Pancreatic ductal adenocarcinoma carries a dismal prognosis, and outcomes have improved little with modern therapeutics. Checkpoint-based immunotherapy has failed to elicit responses in the vast majority of patients with pancreatic cancer. Alongside tumor cell-intrinsic mechanisms associated with oncogenic KRAS-induced inflammation, the tolerogenic myeloid cell infiltrate has emerged as a critical impediment to adaptive antitumor immune responses. Furthermore, the discovery of an intratumoral microbiome and the elucidation of host-microbe interactions that curtail antitumor immunity also present opportunities for intervention. Here we review the mechanisms of immunotherapy resistance in pancreatic ductal adenocarcinoma and discuss strategies to directly augment T cell responses in parallel with myeloid cell- and microbiome-targeted approaches that may enable immune-mediated control of this malignancy.

Publication types

  • Review

MeSH terms

  • Adaptive Immunity
  • Animals
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Carcinoma, Ductal / immunology*
  • Carcinoma, Ductal / therapy
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use*
  • Immune Tolerance
  • Immunomodulation
  • Immunotherapy / methods*
  • Microbiota
  • Myeloid-Derived Suppressor Cells / immunology*
  • Pancreatic Neoplasms / immunology*
  • Pancreatic Neoplasms / therapy
  • T-Lymphocytes / immunology*
  • T-Lymphocytes / transplantation
  • Tumor Microenvironment

Substances

  • Antineoplastic Agents, Immunological
  • Immune Checkpoint Inhibitors