In spite of recent advances, pancreatic ductal adenocarcinoma (PDAC) is still extremely difficult to cure. Unfortunately, the benefits of chemotherapy for patients with advanced and metastatic cancer are not long-lasting. But whereas immunotherapy had made great strides in treating other solid tumors, including the discovery of cures when none existed just a decade ago, it has made very little progress with PDAC.

Numerous clinical trials with encouraging preclinical evidence have been unsuccessful, with the exception of a small subset of patients with carefully selected biomarkers. Researchers are working to nurture the hope that exists, though. Here,  they summarized the most current findings about the immunosuppressive tumor microenvironment (TME) in PDAC and lessons learned from clinical trials with checkpoint inhibitors, TME modifiers, cellular and vaccine therapies, oncolytic viruses, and other innovative approaches.

Then they went on to talk about what they hoped to see in terms of future advances in preclinical models of immunotherapy for PDAC, new strategies for altering the tumor microenvironment (TME) and the myeloid compartment, and emerging biomarkers for selecting patients who will likely respond to immunotherapy. They also talked about how they can enhance how success is measured in clinical trials by focusing on immunotherapy. Finally, they discussed the critical need to improve the design and implementation of innovative combination trials of experimental medications aimed at curing patients with PDAC.