Impact of microbiota-immunity axis in pancreatic cancer management

Abstract

The microbiota impact on human diseases is well-known, and a growing body of literature is providing evidence about the complex interplay between microbiota-immune system-human physiology/pathology, including cancers. Together with the defined risk factors (e.g., smoke habits, diet, diabetes, and obesity), the oral, gut, biliary, and intrapancreatic microbiota contribute to pancreatic cancer development through different pathways including the interaction with the immune system. Unfortunately, a great majority of the pancreatic cancer patients received a diagnosis in advanced stages not amenable to be radically treated and potentially cured. Given the poor pancreatic cancer prognosis, complete knowledge of these complicated relationships could help researchers better understand the disease pathogenesis and thus provide early potential non-invasive biomarkers, new therapeutic targets, and tools for risk stratification that might result in greater therapeutic possibilities and eventually in a better and longer patient survival.

Keywords: Gastrointestinal tumors; Hepatopancreatobiliary tumors; Pancreatic cancer; Gut microbiota; Dysbiosis; Cancer development; Carcinogenesis

Core Tip: Despite improvements in traditional patient treatment, pancreatic cancer remains a tumor with an increasing incidence and a poor prognosis, often diagnosed in late stages. The oral, gut, biliary, and intrapancreatic microbiota might contribute to pancreatic cancer through different pathways including a complex interplay with the immune system. Comprehending these complicated relationships could help researchers better understand the pathogenesis of pancreatic cancer, thus providing new promising options for early diagnosis, therapeutic targets, and risk stratification hoping that could translate into better and longer patient survival.