A new study explains how pancreatic cancer becomes aggressive and spreads very early. Researchers found that the tumor can “reprogram” its surrounding environment, allowing cancer cells to invade nearby nerves and use them as pathways to spread through the body, a process known as perineural invasion.
The study shows that pancreatic tumors depend on support cells called stellate cells and a protein named periostin. Periostin reshapes the tissue around the tumor, creating a path that helps cancer cells reach nerves. At the same time, it forms a dense, fibrous shield around the tumor that makes it hard for chemotherapy and immunotherapy drugs to penetrate. This nerve invasion often happens before symptoms appear and is usually only detected after surgery.
These findings are important because pancreatic cancer has very high mortality, and periostin may be a new target for treatment. Blocking periostin or stopping stellate cells from supporting the tumor could slow or prevent early spread. Researchers are now exploring clinical trials to test whether existing periostin-blocking drugs, already studied in other cancers, could be used to stop pancreatic cancer from spreading before it advances.