Published online Mar 7, 2016. doi: 10.3748/wjg.v22.i9.2678
Peer-review started: September 29, 2015
First decision: November 13, 2015
Revised: December 19, 2015
Accepted: January 11, 2016
Article in press: January 11, 2016
Published online: March 7, 2016
Core tip: Pancreatic cancer (PC), the most aggressive type of common cancers, is characterized by a limited response to chemotherapeutics, which are often directed against the PC cells. One of the histological hallmarks of PC is the extensive desmoplastic stromal reaction that surrounds the PC cells. The PC stroma is not simply a bystander of the neoplastic process but plays an active part in disease progression and metastasis. The PC cells, cancer-associated fibroblasts, inflammatory cells, endothelial cells, and the extracellular matrix engage in a complex interplay, the modulation of which could hold potential for the future development of new PC therapies.