{"entity":{"id":"paper-ho-pancreatic-tumour-microenvironment-review-nrco-2020","kind":"paper","name":"The tumour microenvironment in pancreatic cancer: clinical challenges and opportunities","aka":[],"tldr":"A review of every attempt to attack the tissue around pancreatic cancer, explaining why deconstructing the scar tissue and blocking single immune-suppressing pathways failed and what multi-target approaches are being tried instead.","summary":"Metastatic pancreatic ductal adenocarcinoma remains one of the most lethal solid tumours despite multi-agent chemotherapy. Efforts to exploit the tumour microenvironment by deconstructing the desmoplastic stroma and targeting immunosuppressive pathways have largely failed; evidence now shows the stroma is multi-faceted, illustrating the complexity of targeting isolated features. The review describes how the microenvironment has been targeted, notes clinical outcomes that unexpectedly contradicted preclinical observations, and considers multi-modal approaches and biologically integrated targets aimed at remodelling it.","asOf":"2026-09-24","links":[{"label":"Ho, Jaffee and Zheng, Nat Rev Clin Oncol 2020: the tumour microenvironment in pancreatic cancer","url":"https://doi.org/10.1038/s41571-020-0363-5"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/32398706/"}],"tags":[],"related":[],"cancers":["pancreatic"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["johns-hopkins"],"pathways":["tumor-microenvironment","caf-activation-desmoplasia","myeloid-suppression-axis"],"terms":["desmoplasia","cold-vs-hot"],"trials":[],"people":["elizabeth-jaffee","lei-zheng"],"bottlenecks":[],"keyPapers":[],"journals":["nature-reviews-clinical-oncology"],"dependsOn":[],"notes":[],"journal":"Nature Reviews Clinical Oncology","year":2020,"doi":"10.1038/s41571-020-0363-5","pmid":"32398706","authors":"Ho WJ, Jaffee EM, Zheng L.","paperType":"review","findings":["Stromal deconstruction and single-pathway immunosuppression blockade have largely failed clinically.","The stroma is multi-faceted; isolated targets contradict preclinical predictions."],"whatItMeans":"The reference for why pancreatic microenvironment trials read as a list of failures and what the field now means by remodelling rather than removing the stroma.","caveats":["Narrative review.","Published before the most recent stromal and vaccine readouts."],"changedPractice":false},"route":"/key-papers/paper-ho-pancreatic-tumour-microenvironment-review-nrco-2020/","neighbours":{"cancer":[{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"institution":[{"id":"johns-hopkins","kind":"institution","name":"Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center","route":"/institutions/johns-hopkins/"}],"pathway":[{"id":"caf-activation-desmoplasia","kind":"pathway","name":"Fibroblast activation, desmoplasia & matrix stiffness","route":"/pathways/caf-activation-desmoplasia/"},{"id":"myeloid-suppression-axis","kind":"pathway","name":"Myeloid suppression: TAMs, MDSCs & don't-eat-me signals","route":"/pathways/myeloid-suppression-axis/"},{"id":"tumor-microenvironment","kind":"pathway","name":"Tumour microenvironment (TME)","route":"/pathways/tumor-microenvironment/"}],"term":[{"id":"desmoplasia","kind":"term","name":"Desmoplasia (tumour stroma)","route":"/terms/desmoplasia/"},{"id":"cold-vs-hot","kind":"term","name":"Hot vs cold tumours","route":"/terms/cold-vs-hot/"}],"person":[{"id":"elizabeth-jaffee","kind":"person","name":"Elizabeth M. Jaffee","route":"/people/elizabeth-jaffee/"},{"id":"lei-zheng","kind":"person","name":"Lei Zheng","route":"/people/lei-zheng/"}],"journal":[{"id":"nature-reviews-clinical-oncology","kind":"journal","name":"Nature Reviews Clinical Oncology","route":"/journals/nature-reviews-clinical-oncology/"}]}}