ABSTRACT
Stroma cells contribute to the resistance of pancreatic cancer to chemotherapy by forming an insulating matrix around the tumor, squeezing the blood vessels and preventing chemotherapy drugs and immune cells from reaching it. The tumor microenvironment in pancreatic ductal adenocarcinoma (PDAC) is predominantly immunosuppressive and exerts potent restrains for antitumor immunity. Opportunities for precision medicine have been expanded to the field of immune-oncology. Integrating immunotherapy with precision medicine by leveraging molecular, genomic, cellular, clinical, behavioral, physiological, and environmental parameters to tailor immunotherapy options has generated enormous interests. In neoplastic PDAC cells, hyperactivated Focal adhesion kinase activity has been shown to orchestrate fibrotic and immunosuppressive tumor microenvironment. Emerging immunotherapeutics including immune checkpoint blockade antibodies and chimeric antigen receptor T cell therapies have led to durable response among responsive patients. However, challenges remain as only an objective response rate of 10–30% was observed among those receiving single agent immunotherapy.
