Int J Biol Sci 2021; 17(10):2666-2682. doi:10.7150/ijbs.59117 This issue


Microorganisms in chemotherapy for pancreatic cancer: An overview of current research and future directions

Si-Yuan Lu1,2,3,4*, Jie Hua1,2,3,4*, Jin Xu1,2,3,4*, Miao-Yan Wei1,2,3,4, Chen Liang1,2,3,4, Qing-Cai Meng1,2,3,4, Jiang Liu1,2,3,4, Bo Zhang1,2,3,4, Wei Wang1,2,3,4, Xian-Jun Yu1,2,3,4✉, Si Shi1,2,3,4✉

1. Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
3. Shanghai Pancreatic Cancer Institute, Shanghai, China.
4. Pancreatic Cancer Institute, Fudan University, Shanghai, China.
*These authors contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution License ( See for full terms and conditions.
Lu SY, Hua J, Xu J, Wei MY, Liang C, Meng QC, Liu J, Zhang B, Wang W, Yu XJ, Shi S. Microorganisms in chemotherapy for pancreatic cancer: An overview of current research and future directions. Int J Biol Sci 2021; 17(10):2666-2682. doi:10.7150/ijbs.59117. Available from

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Graphic abstract

Pancreatic cancer is a malignant tumor of the digestive system with a very high mortality rate. While gemcitabine-based chemotherapy is the predominant treatment for terminal pancreatic cancer, its therapeutic effect is not satisfactory. Recently, many studies have found that microorganisms not only play a consequential role in the occurrence and progression of pancreatic cancer but also modulate the effect of chemotherapy to some extent. Moreover, microorganisms may become an important biomarker for predicting pancreatic carcinogenesis and detecting the prognosis of pancreatic cancer. However, the existing experimental literature is not sufficient or convincing. Therefore, further exploration and experiments are imperative to understanding the mechanism underlying the interaction between microorganisms and pancreatic cancer. In this review, we primarily summarize and discuss the influences of oncolytic viruses and bacteria on pancreatic cancer chemotherapy because these are the two types of microorganisms that are most often studied. We focus on some potential methods specific to these two types of microorganisms that can be used to improve the efficacy of chemotherapy in pancreatic cancer therapy.

Keywords: Pancreatic cancer, Oncolytic viruses, Bacteria, Mycoplasma, Chemotherapy