Late-stage pancreatic cancer harbors a fibrotic and immune-excluded tumor microenvironment that impedes immunotherapy success. A key to unlocking pancreatic cancer immunotherapy may be treating early-stage pancreatic cancer, when peripancreatic inflammation promoted by the microbiome potentiates oncogenic signaling and suppresses innate and adaptive immunity. Hence, understanding the role of microbiota in pancreatic cancer initiation, progression, and immunosuppression is crucial. We propose that not only are microbiota targets for immunomodulation in this disease, but also that microbiome profiling has a potential role in pancreatic cancer screening. Furthermore, combining microbiome profiling with liquid and tissue biopsy may validate the early pancreatic cancer treatment approach of microbiome modulation and immunotherapy.

晚期胰腺癌具有纤维化和免疫排斥的肿瘤微环境，阻碍了免疫治疗的成功。当微生物组促进的胰腺周围炎症增强致癌信号并抑制先天性和适应性免疫时，解锁胰腺癌免疫治疗的关键可能是治疗早期胰腺癌。因此，了解微生物群在胰腺癌的发生，发展和免疫抑制中的作用至关重要。我们提出，不仅是该疾病中免疫调节的微生物群靶标，而且微生物组图谱在胰腺癌筛查中也具有潜在作用。此外，结合微生物组分析与液体和组织活检可以验证微生物组调节和免疫治疗的早期胰腺癌治疗方法。