Pancreatic ductal adenocarcinoma (PDAC) is an incurable cancer resistant to traditional treatments, although a limited number of early-stage patients can undergo radical resection. Immunotherapies for the treatment of haematological malignancies as well as solid tumours have been substantially improved over the past decades, and impressive results have been obtained in recent preclinical and clinical trials. However, PDAC is likely the exception because of its unique tumour microenvironment (TME). In this review, we summarize the characteristics of the PDAC TME and focus on the network of various tumour-infiltrating immune cells, outlining the current advances in PDAC immunotherapy and addressing the effect of the PDAC TME on immunotherapy. This review further explores the combinations of different therapies used to enhance antitumour efficacy or reverse immunodeficiencies and describes optimizable immunotherapeutic strategies for PDAC. The concordant combination of various treatments, such as targeting cancer cells and the stroma, reversing suppressive immune reactions and enhancing antitumour reactivity, may be the most promising approach for the treatment of PDAC. Traditional treatments, especially chemotherapy, may also be optimized for individual patients to remodel the immunosuppressive microenvironment for enhanced therapy.

中文翻译：

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胰腺导管腺癌免疫治疗的最新进展和展望。

胰腺导管腺癌（PDAC）是对传统疗法有抗药性的不可治愈的癌症，尽管数量有限的早期患者可以进行根治性切除。在过去的几十年中，用于治疗血液系统恶性肿瘤以及实体瘤的免疫疗法已经得到了很大的改善，并且在最近的临床前和临床试验中已经获得了令人印象深刻的结果。然而，由于其独特的肿瘤微环境（TME），PDAC可能是例外。在这篇综述中，我们总结了PDAC TME的特征，并着重于各种肿瘤浸润免疫细胞的网络，概述了PDAC免疫疗法的最新进展，并探讨了PDAC TME对免疫疗法的影响。这篇综述进一步探讨了用于增强抗肿瘤功效或逆转免疫缺陷的不同疗法的组合，并描述了PDAC的最佳免疫疗法策略。多种治疗方法的一致组合，例如靶向癌细胞和间质，逆转抑制性免疫反应和增强抗肿瘤反应性，可能是治疗PDAC的最有前途的方法。传统疗法，尤其是化学疗法，也可以针对个别患者进行优化，以重塑免疫抑制性微环境以增强治疗效果。逆转抑制性免疫反应并增强抗肿瘤反应性，可能是治疗PDAC的最有前途的方法。传统疗法，尤其是化学疗法，也可以针对个别患者进行优化，以重塑免疫抑制性微环境以增强治疗效果。逆转抑制性免疫反应并增强抗肿瘤反应性，可能是治疗PDAC的最有前途的方法。传统疗法，尤其是化学疗法，也可以针对个别患者进行优化，以重塑免疫抑制性微环境以增强治疗效果。