Pancreatic ductal adenocarcinoma (PDAC) accounts for up to 95% of all pancreatic cancer cases and is the seventh-leading cause of cancer death. Poor prognosis is a result of late presentation, a lack of screening tests and the fact some patients develop resistance to chemotherapy and radiotherapy. Novel therapies like immunotherapeutics have been of recent interest in pancreatic cancer. However, this field remains in its infancy with much to unravel. Immunotherapy and other targeted therapies have yet to yield significant progress in treating PDAC, primarily due to our limited understanding of the disease immune mechanisms and its intricate interactions with the tumour microenvironment (TME). In this review we provide an overview of current novel immunotherapies which have been studied in the field of pancreatic cancer. We discuss their mechanisms, evidence available in pancreatic cancer as well as the limitations of such therapies. We showcase the potential role of combining novel therapies in PDAC, postulate their potential clinical implications and the hurdles associated with their use in PDAC. Therapies discussed with include programmed death checkpoint inhibitors, Cytotoxic T-lymphocyte-associated protein 4, Chimeric Antigen Receptor-T cell therapy, oncolytic viral therapy and vaccine therapies including KRAS vaccines, Telomerase vaccines, Gastrin Vaccines, Survivin-targeting vaccines, Heat-shock protein (HSP) peptide complex-based vaccines, MUC-1 targeting vaccines, Listeria based vaccines and Dendritic cell-based vaccines.
胰腺导管腺癌（PDAC）占所有胰腺癌病例的95%，是癌症死亡的第七大原因。其预后不良源于疾病发现较晚、缺乏筛查手段，以及部分患者对化疗和放疗产生耐药性。近年来，免疫疗法等新型治疗手段在胰腺癌领域受到关注，但该领域仍处于起步阶段，尚有许多问题亟待阐明。由于对疾病免疫机制及其与肿瘤微环境（TME）复杂相互作用的认知有限，免疫疗法及其他靶向治疗在PDAC治疗中尚未取得显著进展。本文综述了当前胰腺癌领域已研究的新型免疫疗法，探讨其作用机制、在胰腺癌中的现有证据及治疗局限性，并展望联合疗法在PDAC中的潜在作用，推测其可能的临床意义及在PDAC应用中面临的挑战。讨论的疗法包括程序性死亡检查点抑制剂、细胞毒性T淋巴细胞相关蛋白4抑制剂、嵌合抗原受体T细胞疗法、溶瘤病毒疗法以及各类疫苗疗法，如KRAS疫苗、端粒酶疫苗、胃泌素疫苗、靶向生存素的疫苗、基于热休克蛋白肽复合物的疫苗、靶向MUC-1的疫苗、基于李斯特菌的疫苗和树突状细胞疫苗。
Advances in Immunotherapeutics in Pancreatic Ductal Adenocarcinoma
肿瘤(癌症)患者之家