Immunotherapy in pancreatic cancer: New hope or mission impossible?

Pancreatic cancer (PC), one of the most lethal diseases, remains a challenging problem. Novel cancer therapy targeting the immune system has been explored. Although immunotherapy has yielded a favorable response in pre-clinical models, no significant improvement has been confirmed in clinical trials for PC. This may be partly attributable to the unique immunosuppressive tumor microenvironment of PC. Studies focusing on combination therapy showed the ability to break the immunosuppressive tumor microenvironment and enhance the immune response, which can translate to clinical benefits. Moreover, the application of sequencing techniques and neo-antigen vaccines has achieved promising results in clinical trials, which promote the development of personalized immunotherapy. However, lack of effective biomarkers is another challenge for the realization of personalized immune medicine. Biomarkers are urgently needed to identify subgroup of patients who would benefit from immunotherapy. In this review, we discuss advances in immunotherapy for pancreatic cancer, as well as the challenges and prospects for personalized immune medicine. •Immunotherapy has promising effects in cancer while no significant improvement has been confirmed in pancreatic cancer.•Different kinds of immunotherapies for pancreatic cancer and their merits and demerits were discussed.•The combination therapies showed their ability to break the unique immunosuppressive tumor microenvironment.•Personalized immunotherapy has achieved promising results in clinical trials for pancreatic cancer.•Challenges and hopes are coexisting in the study of immunotherapy for pancreatic cancer.