Angiogenesis in pancreatic ductal adenocarcinoma: A controversial issue

Vito Longo, Oronzo Brunetti, Antonio Gnoni, Stefano Cascinu, Giampietro Gasparini, Vito Lorusso, Domenico Ribatti and Nicola Silvestris _

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Oncotarget. 2016; 7:58649-58658. https://doi.org/10.18632/oncotarget.10765

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Vito Longo1,*, Oronzo Brunetti2,*, Antonio Gnoni3, Stefano Cascinu4, Giampietro Gasparini5, Vito Lorusso2, Domenico Ribatti6,7 and Nicola Silvestris2

1 Department of Medical Oncology, Hospital of Taranto, Taranto, Italy

2 Medical Oncology Unit, Cancer Institute “Giovanni Paolo II”, Bari, Italy

3 Department of Medical Oncology, Hospital “Vito Fazi” of Lecce, Lecce, Italy

4 Medical Oncology Unit, University of Modena, Modena, Italy

5 Scientific Direction, Cancer Institute “Giovanni Paolo II”, Bari, Italy

6 Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy

7 National Cancer Institute “Giovanni Paolo II”, Bari, Italy

* These authors have contributed equally to this work

Correspondence to:

Nicola Silvestris, email:

Keywords: angiogenesis, pancreatic ductal adenocarcinoma, hypoxia, desmoplastic reaction

Received: May 27, 2016 Accepted: July 13, 2016 Published: July 21, 2016


Pancreatic ductal adenocarcinoma (PDAC) occurs in the majority of cases with early loco-regional spread and distant metastases at diagnosis, leading to dismal prognosis with a 5-year overall survival rate moderately over than 5%. This malignancy is largely resistant to chemotherapy and radiation, but the reasons of the refractoriness to the therapies is still unknown. Evidence is accumulating to indicate that the PDAC microenvironment and vascularity strongly contribute to the clinical features of this disease. In particular, PDAC is characterized by excessive dense extracellular matrix deposition associated to vasculature collapse and hypoxia with low drug delivery, explaining at least partly the low efficacy of antiangiogenic drugs in this cancer. Strategies aimed to modulate tumor stroma favoring vasculature perfusion and chemotherapeutics delivery are under investigation.

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