胰腺导管腺癌（PDAC）是最致命的实体恶性肿瘤之一，其特点是侵袭性和转移潜力，5年生存率仅为8-11%。尽管 PDAC 治疗和管理取得了显着进步，但治疗替代方案仍然有限。主要原因之一是个体内和个体间肿瘤的高度异质性，这种异质性是通过转录因子和表观遗传调节因子的复杂网络建立和维持的。表观遗传药物在 PDAC 中显示出有希望的临床前结果，目前正在临床试验中评估其使癌细胞对细胞毒性药物敏感和抵消 PDAC 肿瘤微环境的免疫抑制特征的能力。在这篇综述中，我们讨论了表观遗传治疗策略的现状，以克服分子和细胞 PDAC 异质性，以改善治疗反应。版权所有 © 2024。由 Elsevier Inc. 出版。

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal solid malignancies, characterized by its aggressiveness and metastatic potential, with a 5-year survival rate of only 8-11%. Despite significant improvements in PDAC treatment and management, therapeutic alternatives are still limited. One of the main reasons is its high degree of intra- and inter-individual tumor heterogeneity which is established and maintained through a complex network of transcription factors and epigenetic regulators. Epigenetic drugs, have shown promising preclinical results in PDAC and are currently being evaluated in clinical trials both for their ability to sensitize cancer cells to cytotoxic drugs and to counteract the immunosuppressive characteristic of PDAC tumor microenvironment. In this review, we discuss the current status of epigenetic treatment strategies to overcome molecular and cellular PDAC heterogeneity in order to improve response to therapy.Copyright © 2024. Published by Elsevier Inc.