胰腺导管腺癌（PDAC）被认为是最致命的恶性肿瘤之一，其存活率极低，而且广泛存在化疗药物的耐药性。吉西他滨是治疗PDAC的主要药物之一，但由于肿瘤微环境（TME）与细胞内过程之间的相互作用，其疗效受到限制。在临床前模型中，吉西他滨的某些给药方案使TME发生改变，而不促进耐药性的产生。节奏化疗法是克服当前PDAC治疗中某些障碍的一种有前景的策略。本综述将重点讨论吉西他滨在治疗PDAC中的机制、联合疗法、吉西他滨与TME的相互作用以及吉西他滨在节奏化疗中的应用。版权所有© 2023 Elsevier B.V.出版。

Pancreatic ductal adenocarcinoma (PDAC) is considered one of the deadliest malignancies, with dismal survival rates and extremely prevalent chemoresistance. Gemcitabine is one of the primary treatments used in treating PDACs, but its benefits are limited due to chemoresistance, which could be attributed to interactions between the tumor microenvironment (TME) and intracellular processes. In preclinical models, certain schedules of administration of gemcitabine modulate the TME in a manner that does not promote resistance. Metronomic therapy constitutes a promising strategy to overcome some barriers associated with current PDAC treatments. This review will focus on gemcitabine's mechanism in treating PDAC, combination therapies, gemcitabine's interactions with the TME, and gemcitabine in metronomic therapies.Copyright © 2023. Published by Elsevier B.V.