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Gastroenterology Research and Practice
Volume 2012 (2012), Article ID 781765, 10 pages
http://dx.doi.org/10.1155/2012/781765
Review Article

Desmoplasia in Pancreatic Cancer. Can We Fight It?

1Oncology Unit, Third Department of Medicine, Sotiria General Hospital, University of Athens, 10679 Athens, Greece
2Tufts University School of Medicine, Boston, MA 02111, USA

Received 25 May 2012; Accepted 17 September 2012

Academic Editor: Davor Stimac

Copyright © 2012 E. E. Merika et al. 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.

Abstract

The hallmark of pancreatic tumours, the desmoplastic reaction, provides a unique microenvironment that affects pancreatic tumour behaviour, its ability to grow and metastasize as well as resist the effects of chemotherapy. Complex molecular interactions and pathways give rise to the desmoplastic reaction. Breakdown or penetration of the desmoplastic reaction may hold the key to overcoming the limits of delivery of efficacious chemotherapy or the development of new targeted treatments. Herein we discuss such new developments to fight the desmoplastic reaction, including inhibitors of the epidermal growth factor, fibroblast growth factor, the hedgehog pathway, as well as new molecular targets like CD40 agonist and its effects on T cells, extracellular matrix modifying enzymes such as LOXL2 inhibitor and novel tumour penetrating peptides for delivery of drugs.