Stromal uncertainties in pancreatic cancer

Despite the clear rationale for using hedgehog inhibitors in pancreatic cancer-they deplete the stroma to improve chemotherapy delivery-clinical results have been disappointing. New data suggest that the large amounts of stroma surrounding some pancreatic cancers might actually have protective properties.^1,2

The findings could explain the negative clinical data for some hedgehog inhibitors in pancreatic cancer, but it remains to be seen whether the cautionary tale applies to other classes of stroma-depleting therapies. In addition, the data provide a rationale to retry two other classes of cancer drugs in pancreatic cancer-angiogenesis inhibitors and immune checkpoint inhibitors (see Box 1, "Revisiting the pancreas")...