Sung-Hoon Moon, MD, PhD, Associate Professor, Department of Internal Medicine, University of Hallym College of Medicine, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170-gil, Dongan-gu, Anyang 14068, South Korea. endomoon@hallym.or.kr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 6, 2021; 9(13): 2969-2982 Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.2969
Immunotherapy for pancreatic cancer
Jai Hoon Yoon, Ye-Ji Jung, Sung-Hoon Moon
Jai Hoon Yoon, Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, South Korea
Ye-Ji Jung, Department of Internal Medicine, Hallym University, Anyang 14068, South Korea
Sung-Hoon Moon, Department of Internal Medicine, University of Hallym College of Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, South Korea
Author contributions: Yoon JH performed the drafting of the writing and performed data analysis and prepared tables; Jung YJ performed collection and analysis of data; Moon SH performed the majority of the writing, prepared the figures and tables.
Conflict-of-interest statement: The authors have no potential conflicts of interest. The authors alone are responsible for the content and writing of the paper.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sung-Hoon Moon, MD, PhD, Associate Professor, Department of Internal Medicine, University of Hallym College of Medicine, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170-gil, Dongan-gu, Anyang 14068, South Korea. endomoon@hallym.or.kr
Received: January 4, 2021 Peer-review started: January 4, 2021 First decision: January 23, 2021 Revised: February 3, 2021 Accepted: March 9, 2021 Article in press: March 9, 2021 Published online: May 6, 2021
Abstract
Pancreatic cancer, a highly lethal cancer, has the lowest 5-year survival rate for several reasons, including its tendency for the late diagnosis, a lack of serologic markers for screening, aggressive local invasion, its early metastatic dissemination, and its resistance to chemotherapy/radiotherapy. Pancreatic cancer evades immunologic elimination by a variety of mechanisms, including induction of an immunosuppressive microenvironment. Cancer-associated fibroblasts interact with inhibitory immune cells, such as tumor-associated macrophages and regulatory T cells, to form an inflammatory shell-like desmoplastic stroma around tumor cells. Immunotherapy has the potential to mobilize the immune system to eliminate cancer cells. Nevertheless, although immunotherapy has shown brilliant results across a wide range of malignancies, only anti-programmed cell death 1 antibodies have been approved for use in patients with pancreatic cancer who test positive for microsatellite instability or mismatch repair deficiency. Some patients treated with immunotherapy who show progression based on conventional response criteria may prove to have a durable response later. Continuation of immune-based treatment beyond disease progression can be chosen if the patient is clinically stable. Immunotherapeutic approaches for pancreatic cancer treatment deserve further exploration, given the plethora of combination trials with other immunotherapeutic agents, targeted therapy, stroma-modulating agents, chemotherapy, and multi-way combination therapies.
Core Tip: This review article addressed the role of immune cells in the development of pancreatic cancer, the tumor microenvironment, the cancer immunity cycle, the mechanisms and efficacies of immunotherapeutic drugs in pancreatic cancer, and the response criteria for use in trials aimed at testing immunotherapeutics. The strength of this article includes 2 characteristic tables for basic mechanisms and clinical outcomes related with pancreatic cancer immunotherapy.
