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KMID : 0620920170490120001
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Experimental & Molecular Medicine
2017 Volume.49 No. 12 p.1 ~ p.1
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Complex roles of the stroma in the intrinsic resistance to gemcitabine in pancreatic cancer: where we are and where we are going
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Liang Chen
Shi Si
Meng Qing Cai
Liang Ding Kong
Ji Shun Rong
Zhang Bo
Qin Yi
Xu Jin
Ni Quan Xing
Yu Xian Jun
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Abstract
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Pancreatic ductal adenocarcinoma (PDAC) is among the most devastating human malignancies. The poor clinical outcome in PDAC is partly attributed to a growth-permissive tumor microenvironment. In the PDAC microenvironment, the stroma is characterized by the development of extensive fibrosis, with stromal components outnumbering pancreatic cancer cells. Each of the components within the stroma has a distinct role in conferring chemoresistance to PDAC, and intrinsic chemoresistance has further worsened this pessimistic prognosis. The nucleoside analog gemcitabine (GEM) is usually the recommended first-line chemotherapeutic agent for PDAC patients and is given alone or in combination with other agents. The mechanisms of intrinsic resistance to GEM are an active area of ongoing research. This review highlights the important role the complex structure of stroma in PDAC plays in the intrinsic resistance to GEM and discusses whether antistroma therapy improves the efficacy of GEM. The addition of antistroma therapy combined with GEM is expected to be a novel therapeutic strategy with significant survival benefits for PDAC patients.
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KEYWORD
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Cancer therapeutic resistance, Pancreatic cancer, Tumour heterogeneity
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