Pancreatic ductal
adenocarcinoma (PDAC), although tenth in
cancer incidence, holds the dubious distinction of being the fifth cause of
cancer deaths in the Western countries and possibly the deadliest
malignancy. Inoperable PDAC is characterized by late diagnosis, extensive
metastases, extremely poor response to
chemotherapy and, consequently, poor patients' prognosis-6.7% 5-year survival. PDAC reflects the failure of the medical profession to significantly prolong patients' lives and modest expectations for future cure. PDAC is characterized by extensive desmoplastic reaction, resulting in approximately 50% of
tumor's volume consisting of non-
tumor cells and extracellular matrix (ECM) stroma. These properties imply an important role for cell-ECM interaction, making cell-matrix adhesion molecules, such as
integrins, of special interest as possible candidate targets for future anti-PDAC
therapies. This review will attempt to overview the status of studies dealing with the involvement of
integrins in the unique aggressive character of PDAC, the current status of experimental
cancer therapies targeted at
integrins, and the possible application of these preliminary clinical experiments to future PDAC
therapy. I will also try to delineate the reasons for the failures of PDAC
therapies and make some modest suggestions that might improve the health scientific community approaches to this extremely difficult problem.