Resumen
Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive and deadliest cancer worldwide, with an overall survival (OS) rate, all stages combined, of still <10% at 5 years. For most patients with unresectable or recurrent PDAC, few therapeutic options are available with limited efficacy (median OS = 12 months). Moreover, immune checkpoint inhibitors that have been tested so far in PDAC failed to improve patient survival. This resistance of PDAC to therapies is, in part, related to the dense tumor stroma, which creates a mechanical barrier around the tumor cells and generates high interstitial pressure, preventing appropriate vascularization and thus limiting exposure to treatments. In that PDAC tumoral microenvironment, the inflammatory cell infiltrates are unbalanced toward an immunosuppressive over pro-inflammatory phenotype. Therefore, there is an urgent need to better define the composition of PDAC stroma and key immune players in order to identify new therapeutic targets and strategies.