REVIEW article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1519277
This article is part of the Research TopicExploring Microbial Interactions in Pancreatic Ductal Adenocarcinoma MicroenvironmentView all 4 articles
A Double-Edged Sword Against PDAC "Sword Of Damocles": Potential Roles and Applications of The Human Microbiota in PDAC Diagnosis and Treatment
Provisionally accepted
Maria Sindaco1,2
Leonardo Mercanti1,2
VALENTINA PUCA1,3
Mariangela Mazzone1,2
Maria Carmela Di Marcantonio1,2Raffaella Muraro1,2Michele Fiordaliso1,4
Gabriella Mincione1,2*- 1University of Studies G. d'Annunzio Chieti and Pescara, Chieti, Italy
- 2Department of Innovative Technologies in Medicine and Dentistry, University of Studies G. d'Annunzio Chieti and Pescara, Chieti, Italy
- 3Department of Pharmacy, University of Studies G. d'Annunzio Chieti and Pescara, Chieti, Italy
- 4Department of Medicine and Aging Sciences,, Chieti, Italy
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Pancreatic Ductal Adenocarcinoma (PDAC) is currently a major oncological threat given the very low 5-year survival rates of 8-9%.. The tumor itself is intertwined with its surrounding tissue in a peculiar tumoral microenvironment (TME) which contributes to resistance against the host immune system and traditional clinical treatments, such as chemotherapy. One of the components of TME is the microbiota, which mainly includes the bacterial species identified in the tumor tissue at various stages.Current literature highlights an active role of the microbiota in tumorigenesis, progression, metastasis, and chemotherapy response in PDAC patients. This review gathered the most recent findings about microbial composition in PDAC patients, along with the effects of intra and extra-tumoral (GI and oral) microbial species on the TME and immune system, their role in tumor progression and immuno-modulation. This paper provides an insight on the potential use of microbes as diagnostic and prognostic markers, and as an additional therapeutic strategy.The study of microbiota offer new ways to slow down carcinogenesis, modulate the immune response, and even serve as an early diagnostic tool in the absence of specific serum markers. In the current review we will offer an inquiry on these potential roles.We sorted out the most recent literature with a comprehensive and critical approach, sourcing papers from PubMed. We exclusively opted for papers that were published in the last 5 years on journals with IF≥4, with a focus on the impact of intra-tumoral microbiome on the natural history of PDAC, from pre-tumoral lesions to metastasis.
Keywords: microbiota, PDAC, TME, IPMN, Immunotherapy, FMT, Bacteriotherapy, viral vectors
Received: 29 Oct 2024; Accepted: 30 May 2025.
Copyright: © 2025 Sindaco, Mercanti, PUCA, Mazzone, Di Marcantonio, Muraro, Fiordaliso and Mincione. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Gabriella Mincione, University of Studies G. d'Annunzio Chieti and Pescara, Chieti, Italy
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