Pancreatic cancer (PaC) is one of the most lethal tumors worldwide, difficult to diagnose, and with inadequate therapeutical chances. The most used therapy is gemcitabine, alone or in combination with nanoparticle albumin-bound paclitaxel (nab-paclitaxel), and the multidrug FOLFIRINOX. Unfortunately, PaC develops resistance early, thus reducing the already poor life expectancy of patients. The mechanisms responsible for drug resistance are not fully elucidated, and exosomes seem to be actively involved in this phenomenon, thanks to their ability to transfer molecules regulating this process from drug-resistant to drug-sensitive PaC cells. These extracellular vesicles are released by both normal and cancer cells and seem to be essential mediators of intercellular communications, especially in cancer, where they are secreted at very high numbers. This review illustrates the role of exosomes in PaC drug resistance. This manuscript first provides an overview of the pharmacological approaches used in PaC and, in the last part, focuses on the mechanisms exploited by the exosomes released by cancer cells to induce drug resistance.
胰腺癌是全球范围内致死率最高的恶性肿瘤之一，其诊断困难且治疗手段有限。目前主要采用吉西他滨单药治疗，或联合纳米白蛋白结合型紫杉醇及FOLFIRINOX多药方案。遗憾的是，胰腺癌极易早期产生耐药性，导致本已不佳的患者预后进一步恶化。耐药机制尚未完全阐明，而外泌体因其能将调控耐药过程的分子从耐药胰腺癌细胞传递至药物敏感细胞，被认为在该过程中发挥关键作用。这种细胞外囊泡可由正常细胞和癌细胞释放，作为细胞间通讯的重要介质，在癌症环境中分泌量尤为显著。本文系统综述了外泌体在胰腺癌耐药中的作用机制，首先概述胰腺癌的药物治疗现状，最后重点探讨癌细胞释放的外泌体诱导耐药的具体作用途径。
Exosomes: Emerging Modulators of Pancreatic Cancer Drug Resistance
肿瘤(癌症)患者之家