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Cancers 2014, 6(4), 2137-2154;

Desmoplasia and Chemoresistance in Pancreatic Cancer

Division of Gastroenterology, Endocrinology and Metabolism, University Hospital, Philipps-Universitaet Marburg, Baldingerstrasse, Marburg 35043, Germany
Department of Medicine II (Department of Gastroenterology, Hepatology, and Infectious Diseases), University Medical Center Mannheim (UMM), Theodor-Kutzer-Ufer 1-3, Mannheim 68135, Germany
Lung Cancer, Genomics/Epigenomics Group, Division of Epigenomics and Cancer Risk Factors, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69121, Germany
Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 52 Huddinge, Sweden
Gastrocentrum, Karolinska University Hospital, Stockholm, Stockholm 141 86, Sweden
Author to whom correspondence should be addressed.
Received: 29 April 2014 / Revised: 8 September 2014 / Accepted: 24 September 2014 / Published: 21 October 2014
(This article belongs to the Special Issue Cancer Drug Resistance)
Full-Text   |   PDF [633 KB, uploaded 21 October 2014]   |  


Pancreatic ductal adenocarcinoma (PDAC) occurs mainly in people older than 50 years of age. Although great strides have been taken in treating PDAC over the past decades its incidence nearly equals its mortality rate and it was quoted as the 4th leading cause of cancer deaths in the U.S. in 2012. This review aims to focus on research models and scientific developments that help to explain the extraordinary resistance of PDAC towards current therapeutic regimens. Furthermore, it highlights the main features of drug resistance including mechanisms promoted by cancer cells or cancer stem cells (CSCs), as well as stromal cells, and the acellular components surrounding the tumor cells—known as peritumoral desmoplasia—that affects intra-tumoral drug delivery. Finally, therapeutic concepts and avenues for future research are suggested, based on the topics discussed. View Full-Text
Keywords: pancreatic cancer; desmoplasia; drug resistance; SFM-DR; CAM-DR; de novo resistance; cancer stem cells; matrix; future therapies pancreatic cancer; desmoplasia; drug resistance; SFM-DR; CAM-DR; de novo resistance; cancer stem cells; matrix; future therapies

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Schober, M.; Jesenofsky, R.; Faissner, R.; Weidenauer, C.; Hagmann, W.; Michl, P.; Heuchel, R.L.; Haas, S.L.; Löhr, J.-M. Desmoplasia and Chemoresistance in Pancreatic Cancer. Cancers 2014, 6, 2137-2154.

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