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World J Gastroenterol. May 14, 2021; 27(18): 2105-2121
Published online May 14, 2021. doi: 10.3748/wjg.v27.i18.2105
Stroma-targeting strategies in pancreatic cancer: Past lessons, challenges and prospects
Faran Polani, Patrick M Grierson, Kian-Huat Lim
Faran Polani, Patrick M Grierson, Kian-Huat Lim, Division of Oncology, Department of Internal Medicine, Barnes-Jewish Hospital and The Alvin J. Siteman Comprehensive Cancer Center, Washington University School of Medicine, Saint Louis, MO 63110, United States
Author contributions: Polani F, Grierson P and Lim KH contributed to the concepts, performed literature review, drafted the manuscript, and approved the final manuscript; Polani F and Lim KH drew the figure using BioRender.
Supported by National Institutes of Health/National Cancer Institute, No. 5R37CA219697-01 (to Lim KH); American Cancer Society, No. RSG-17-203-01-TBG (to Lim KH); and Alvin J. Siteman Cancer Center Siteman Investment Program (from Barnard Trust and The Foundation for Barnes-Jewish Hospital) (to Lim KH); and Emerson Collective Grant (to Grierson PM).
Conflict-of-interest statement: The authors have declared no conflict of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kian-Huat Lim, MD, PhD, Associate Professor, Division of Oncology, Department of Internal Medicine, Barnes-Jewish Hospital and The Alvin J. Siteman Comprehensive Cancer Center, Washington University School of Medicine, 660 South Euclid Avenue, Saint Louis, MO 63110, United States. klim@dom.wustl.edu
Received: January 8, 2021
Peer-review started: January 8, 2021
First decision: February 23, 2021
Revised: March 9, 2021
Accepted: April 21, 2021
Article in press: April 21, 2021
Published online: May 14, 2021
Core Tip

Core Tip: Stromal desmoplasia is not only a prominent histological hallmark of pancreatic cancer, but also a biological barrier to therapies. Various strategies aimed at targeting the stroma to improve therapeutic outcomes have been largely unsuccessful. Here we comprehensively reviewed the rationales and lessons learned from various stromal-targeting strategies and provide prospects on improving these approaches in future clinical trials.