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Outline
Pancreatic cancer is one of the digestive system malignancies with the poorest prognosis, with a five-year survival rate of only approximately 13%, and even lower at 8.5% in the Chinese population. Due to difficulties in early diagnosis, most patients are already at an advanced stage at the time of diagnosis, with limited treatment options and a propensity for resistance to radiotherapy and chemotherapy. KRAS (kirsten rat sarcoma viral oncogene homolog) mutations occur in over 90% of pancreatic cancer cases. Mutant KRAS not only drives tumor proliferation but also remodels the immune microenvironment through various mechanisms, such as inducing infiltration of immunosuppressive cells and upregulating immune checkpoint molecules, thereby leading to immune evasion. In recent years, with the introduction of KRAS inhibitors into clinical practice, targeting KRAS has shown potential for remodeling the tumor immune microenvironment. This article systematically reviews the mechanisms by which KRAS mutations contribute to the formation of an immunosuppressive microenvironment in pancreatic cancer, the progress in the development of KRAS-targeted drugs, and the current status and challenges of their combination with immunotherapy, providing new insights for precision treatment of pancreatic cancer.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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