Fig. 7

Future integrated therapeutic strategies for PDAC. The future goal of PDAC treatment is more precise. On the basis of traditional therapies such as surgery plus chemoradiotherapy, we design targeted drugs according to the changes of specific genes, the activation of tumor-promoting signaling pathways, the abnormal metabolic process, and the microbiota. Further, through in-depth exploration of the microenvironment of primary and metastatic lesions, we can find the commonness of the immune characteristics of a class of patients, and add drugs targeting TIME on the basis of immune subtypes, including CAF reprogramming, ECM normalization, restoration of myeloid cell function, ICIs, adoptive T cell therapy, and vascular normalization. This integrated strategy can meet the final requirement of precision treatment, that is, every patient should be treated as an exception