Clear the suppressive neutrophils out of pancreatic tumours first
Pancreatic tumours are packed with a type of white blood cell that shuts down the immune attack. Blocking the signal that recruits them may open the tumour to immunotherapy.
CXCR2-dependent recruitment of granulocytic myeloid-derived suppressor cells is a dominant immunosuppressive mechanism in pancreatic and some head and neck cancers, and CXCR2 inhibition plus checkpoint blockade improved survival in genetically engineered mouse models. Human trials of CXCR1/2 inhibitors with chemotherapy or checkpoint blockade have been small and biomarker-light. The decisive step is patient selection by neutrophil infiltration measured on tissue, not by blood counts alone.
- Cold tumours and the immunosuppressive microenvironment · Most tumours keep the immune system out or asleep, so immunotherapy helps only a minority.
- No one can predict who responds to immunotherapy · Checkpoint drugs cure some patients and do nothing for most. We still cannot tell the two apart before treating.
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