Interplay of tumor microenvironment cell types with parenchymal cells in pancreatic cancer development and therapeutic implications

Introduction: The process of "induction," namely, the formation of a tissue by the functional interaction between the epithelial layer and the stroma, is key for the development of many organs, in particular to the pancreas. Discussion: In diseases like pancreatic cancer, most studies performed to date, in the area of pancreatic cancer, have focused on studying epithelial cells and their contribution to this disease. Strikingly, until recently, the stroma that surrounds cancer cells in pancreatic tumors (desmoplastic reaction-tumor microenvironment) has remained an underrepresented area of research. However, several laboratories are increasingly posing questions as what is the role of this tumor microenvironment in the development and progression of this fatal disease. Therefore, in the current article, we define and describe the components of this desmoplastic reaction and the pancreatic tumor microenvironment and briefly review advances being made. More importantly, we highlight the urgent need of research in this field. Conclusion: We anticipate that, because of the paucity of knowledge on this subject, studies on the pancreatic tumor microenvironment will bring new concepts which will ultimately impact in designing new diagnosis and treatment for this disease. © 2009 Humana Press Inc.