Published online Aug 7, 2018. doi: 10.3748/wjg.v24.i29.3222
Peer-review started: May 4, 2018
First decision: May 17, 2018
Revised: May 31, 2018
Accepted: June 27, 2018
Article in press: June 27, 2018
Published online: August 7, 2018
Core tip: Pancreatic cancer is one of the deadliest cancers due to its highly aggressive biology and resistance to broad range of therapeutics. Expression of ATP-binding cassette (ABC) transporters by cancer cells is one of the main mechanisms responsible for the lowered drug accumulation. However, the attempts made in multidrug resistance reversal by the inhibition of their activity have not provided satisfactory results in clinical trials. Nevertheless, current knowledge on the role played by ABC transporters in carcinogenesis beyond chemoresistance, could create the opportunity for the development of novel, direct targeted therapeutic strategies. Additionally, the association between ABC transporters expression and pancreatic ductal adenocarcinoma patients’ prognosis and response to applied therapies confirms their pharmacological potential.