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Review
. 2022 Sep 15;14(18):4479.
doi: 10.3390/cancers14184479.

The Role of the Microbiome in Pancreatic Cancer

Koji Miyabayashi  1 , Hideaki Ijichi  1 , Mitsuhiro Fujishiro  1
Affiliations
Review

The Role of the Microbiome in Pancreatic Cancer

Koji Miyabayashi et al. Cancers (Basel). .

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal malignancies, with little improvement in outcomes in recent decades, although the molecular and phenotypic characterization of PDAC has contributed to advances in tailored therapies. PDAC is characterized by dense stroma surrounding tumor cells, which limits the efficacy of treatment due to the creation of a physical barrier and immunosuppressive environment. Emerging evidence regarding the microbiome in PDAC implies its potential role in the initiation and progression of PDAC. However, the underlying mechanisms of how the microbiome affects the local tumor microenvironment (TME) as well as the systemic immune system have not been elucidated in PDAC. In addition, therapeutic strategies based on the microbiome have not been established. In this review, we summarize the current evidence regarding the role of the microbiome in the development of PDAC and discuss a possible role for the microbiome in the early detection of PDAC in relation to premalignant pancreatic diseases, such as chronic pancreatitis and intraductal papillary mucinous neoplasm (IPMN). In addition, we discuss the potential role of the microbiome in the treatment of PDAC, especially in immunotherapy, although the biomarkers used to predict the efficacy of immunotherapy in PDAC are still unknown. A comprehensive understanding of tumor-associated immune responses, including those involving the microbiome, holds promise for new treatments in PDAC.

Keywords: chronic pancreatitis (CP); immune checkpoint blockade (ICB); intraductal papillary mucinous neoplasm (IPMN); microbiome; pancreatic ductal adenocarcinoma (PDAC); tumor microenvironment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Specific microbiota associated with PDAC.
Figure 2
Figure 2
Specific microbiota and associated metabolic and biochemical pathways.
Figure 3
Figure 3
Diagram showing the association and potential roles of microbiomes with pancreatic precursors and PDAC. The microbiome may be a biomarker used to detect PDAC at an early stage and plays a pro-tumorigenic role via inflammation and immunomodulation. Microbiome-targeted therapies could be new therapeutic strategies in PDAC.
See this image and copyright information in PMC

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