Desmoplastic Reaction in Pancreatic Ductal Adenocarcinoma

Ughur Aghamaliyev*, Yegana Hajiyeva and Felix Rückert

Desmoplastic Reaction in Pancreatic Ductal Adenocarcinoma

Despite significant effort and research funds, Pancreatic Ductal Adenocarcinoma remains one of the deadliest diseases. This cancer is characterized by a distinct desmoplastic reaction that constitutes 80% of the tumor volume. Accumulating evidences suggests that the stromal compartment in which the cancer cells are embedded contributes to many clinical characteristics of pancreatic cancer.

The stromal compartment is comprised of abundant extracellular matrix, fibroblasts, stellate cells, immune cells, nerve cells, growth factors and cytokines. To date, desmoplastic reaction components have been shown not only to contribute to the growth and metastasis of pancreatic cancer but also to chemotherapy resistance.

Therefore, further assessment of stroma-targeted therapies and their translation into clinical
situation may open a new era in pancreatic cancer management. Pancreatic Ductal Adenocarcinoma is the fourth leading cause of cancer related death in the USA and Europe.

Despite substantial progress of understanding the molecular biology of PDAC, the prognosis remains still poor with a combined overall 5-year-survival rate of less than 7%.

This high death rate is due to late diagnosis with no effective screening tools for detection of early tumors and the lack of curative treatment methods. Accumulating
evidence suggests that the aggressive phenotype of PDAC is not only due to epithelial cancer
cells, but also to the stromal compartment in which cancer cells are embedded.

The ECM itself is composed of structural proteins, enzymes and proteins involved in cell communication.

Pancreas Open J. 2016; 1(2): 22-29. doi: 10.17140/POJ-1-107