The Janus-Faced Role of Cell-Mediated Immune Responses in Pancreatic Cancer

Elena Niccolai,1 Antonio Taddei,1,3 Federica Ricci,2 Maria Novella Ringressi,1,3 *Amedeo Amedei2

1. Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
2. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
3. Department of Biomedicine, Azienda Ospedaliera Universitaria Careggi (AOUC), Florence, Italy
*Correspondence to

Disclosure: The authors have declared no conflicts of interest.
Acknowledgements: This work was supported by grants from the regional contribution of ‘the Programma Attuativo Regionale (Toscana) cofinanziato dal FAS (adesso FSC) – PAR FAS 2007-2013,’ the Italian Ministry of University and Research, and the Foundation ‘Ente Cassa di Risparmio di Firenze’.
Received: 23.05.17 Accepted: 15.09.17
Citation: EMJ Oncol. 2017;5[1]:62-69.


Pancreatic cancer (PC) still represents an unresolved therapeutic challenge due to the associated poor prognosis and the lack of responsiveness to current treatments. Surgery, followed by adjuvant therapy, is the only potentially curative treatment for PC; however, only 20% of PC patients have a potential resectable disease at diagnosis and the overall 5-year survival rate does not exceed 20%. In this context, better, more effective strategies are needed. Immunotherapy is an interesting approach for cancer treatments, but increasing evidence testifies that the immune system plays contrasting roles in both tumour elimination and tumour progression. In particular, PC is considered relatively immune resistant due to the characteristic fibrosis, the presence of immunosuppressive cells, and the compact extracellular matrix that defines the tumour microenvironment and allows for the growth of cancer cells. Despite this, there is evidence that PC cells are able to induce an anti-tumour immune response that can impact the disease course. More recently, it has become clear that PC activates both the anti-cancer immune response and the immunosuppressive effects of the immune system; therefore, for the immune-therapeutic strategies to be effective, they should involve not only the stimulation of the immune system but also the control of the immunosuppressive milieu. In this review, we discuss the dual role of immune cells in the onset and progression of PC.

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