The advent of immunotherapy and targeted therapies has dramatically changed the outcomes of patients affected by many malignancies. Pancreatic cancer (PC) remains one the few tumors that is not treated with new generation therapies, as chemotherapy still represents the only effective therapeutic strategy in advanced-stage disease. Agents aiming to reactivate the host immune system against cancer cells, such as those targeting immune checkpoints, failed to demonstrate significant activity, despite the success of these treatments in other tumors. In many cases, the proportion of patients who derived benefits in early-phase trials was too small and unpredictable to justify larger studies. The population of PC patients with high microsatellite instability/mismatch repair deficiency is currently the only population that may benefit from immunotherapy; nevertheless, the prevalence of these alterations is too low to determine a real change in the treatment scenario of this tumor. The reasons for the unsuccess of immunotherapy may lie in the extremely peculiar tumor microenvironment, including distinctive immune composition and cross talk between different cells. These unique features may also explain why the biomarkers commonly used to predict immunotherapy efficacy in other tumors seem to be useless in PC. In the current paper, we provide a comprehensive and up-to-date review of immunotherapy in PC, from the analysis of the tumor immune microenvironment to immune biomarkers and treatment outcomes, with the aim to highlight that simply transferring the knowledge acquired on immunotherapy in other tumors might not be a successful strategy in patients affected by PC.

Immunotherapy in Pancreatic Cancer: Why Do We Keep Failing? A Focus on Tumour Immune Microenvironment, Predictive Biomarkers and Treatment Outcomes / Alessandro Di Federico, Mirta Mosca, Rachele Pagani, Riccardo Carloni, Giorgio Frega, Andrea De Giglio, Alessandro Rizzo, Dalia Ricci, Simona Tavolari, Mariacristina Di Marco, Andrea Palloni, Giovanni Brandi.. - In: CANCERS. - ISSN 2072-6694. - ELETTRONICO. - 14:10(2022), pp. 2429.1-2429.14. [10.3390/cancers14102429]

Immunotherapy in Pancreatic Cancer: Why Do We Keep Failing? A Focus on Tumour Immune Microenvironment, Predictive Biomarkers and Treatment Outcomes

Alessandro Di Federico
;
Mirta Mosca;Rachele Pagani;Riccardo Carloni;Giorgio Frega;Andrea De Giglio;Alessandro Rizzo;Dalia Ricci;Simona Tavolari;Mariacristina Di Marco
Membro del Collaboration Group
;
Andrea Palloni;Giovanni Brandi.
2022

Abstract

The advent of immunotherapy and targeted therapies has dramatically changed the outcomes of patients affected by many malignancies. Pancreatic cancer (PC) remains one the few tumors that is not treated with new generation therapies, as chemotherapy still represents the only effective therapeutic strategy in advanced-stage disease. Agents aiming to reactivate the host immune system against cancer cells, such as those targeting immune checkpoints, failed to demonstrate significant activity, despite the success of these treatments in other tumors. In many cases, the proportion of patients who derived benefits in early-phase trials was too small and unpredictable to justify larger studies. The population of PC patients with high microsatellite instability/mismatch repair deficiency is currently the only population that may benefit from immunotherapy; nevertheless, the prevalence of these alterations is too low to determine a real change in the treatment scenario of this tumor. The reasons for the unsuccess of immunotherapy may lie in the extremely peculiar tumor microenvironment, including distinctive immune composition and cross talk between different cells. These unique features may also explain why the biomarkers commonly used to predict immunotherapy efficacy in other tumors seem to be useless in PC. In the current paper, we provide a comprehensive and up-to-date review of immunotherapy in PC, from the analysis of the tumor immune microenvironment to immune biomarkers and treatment outcomes, with the aim to highlight that simply transferring the knowledge acquired on immunotherapy in other tumors might not be a successful strategy in patients affected by PC.
2022
Immunotherapy in Pancreatic Cancer: Why Do We Keep Failing? A Focus on Tumour Immune Microenvironment, Predictive Biomarkers and Treatment Outcomes / Alessandro Di Federico, Mirta Mosca, Rachele Pagani, Riccardo Carloni, Giorgio Frega, Andrea De Giglio, Alessandro Rizzo, Dalia Ricci, Simona Tavolari, Mariacristina Di Marco, Andrea Palloni, Giovanni Brandi.. - In: CANCERS. - ISSN 2072-6694. - ELETTRONICO. - 14:10(2022), pp. 2429.1-2429.14. [10.3390/cancers14102429]
Alessandro Di Federico, Mirta Mosca, Rachele Pagani, Riccardo Carloni, Giorgio Frega, Andrea De Giglio, Alessandro Rizzo, Dalia Ricci, Simona Tavolari, Mariacristina Di Marco, Andrea Palloni, Giovanni Brandi.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/919710
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