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World J Clin Cases. Jul 6, 2021; 9(19): 4998-5006
Published online Jul 6, 2021. doi: 10.12998/wjcc.v9.i19.4998
Role of epithelial-mesenchymal transition in chemoresistance in pancreatic ductal adenocarcinoma
Xiu Hu, Wei Chen
Xiu Hu, Department of Pharmacy, Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou 310002, Zhejiang Province, China
Wei Chen, Cancer Institute of Integrated Traditional Chinese and Western Medicine, Key Laboratory of Cancer Prevention and Therapy Combining Traditional Chinese and Western Medicine of Zhejiang Province, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang Province, China
Author contributions: Chen W initiated the manuscript concept and approved the final version of the manuscript; Hu X drafted the review and wrote the manuscript.
Supported by Zhejiang Provincial Nature Science Foundation of China, No. LR20H160001; Key R&D projects of Zhejiang Province, No. 2020C03G5263593; Zhejiang Provincial Ten Thousand Plan for Young Top Talents (2018); Training Objects of Health Innovative Talents of Zhejiang Health (2018); Key Project Co-constructed by Zhejiang Province and Ministry, No. WKJ-ZJ-1916; Natural Science Foundation of China, No. 81972693, No. 81802383, No. 81972674, No. 81673809 and No. 31900543; Zhejiang Provincial Traditional Chinese Medicine Science and Technology Project, No. 2020ZZ004.
Conflict-of-interest statement: The authors declare that they have no conflict of interests for this article.
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: Wei Chen, PhD, Chief Doctor, Cancer Institute of Integrated Traditional Chinese and Western Medicine, Key laboratory of cancer prevention and therapy combining traditional Chinese and Western Medicine of Zhejiang Province, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, No. 234 Gucui Road, Hangzhou 310012, Zhejiang Province, China. wei_chen@zju.edu.cn
Received: January 28, 2021
Peer-review started: January 28, 2021
First decision: February 24, 2021
Revised: March 11, 2021
Accepted: May 15, 2021
Article in press: May 15, 2021
Published online: July 6, 2021
Abstract

Pancreatic cancer (PC) is the seventh leading cause of cancer death worldwide. The vast majority of patients who have PC develop metastases, resulting in poor treatment effects. Although great progress in therapeutic approaches has been achieved in recent decades, extensive drug resistance still persists, representing a major hurdle to effective anticancer therapy for pancreatic ductal adenocarcinoma (PDAC). Therefore, there is an urgent need to better understand the drug resistance mechanisms and develop novel treatment strategies to improve patient outcomes. Numerous studies suggest that chemoresistance is closely related to epithelial-mesenchymal transition (EMT) of PDAC cells. Thus, this article summarizes the impact of EMT on PDAC from the perspective of chemotherapy resistance and discusses the possible novel applications of EMT inhibition to develop more effective drugs against PDAC.

Keywords: Epithelial-mesenchymal transition, Drug resistance, Carcinoma, Pancreatic ductal, Transcription factors, MicroRNAs

Core Tip: This article reviews the role of epithelial-mesenchymal transition in the emergence of chemotherapy resistance in pancreatic ductal adenocarcinoma and summarizes the potential epithelial-mesenchymal transition targets to overcome chemoresistance.