Figure 1. Our current understanding of the contribution of IL-6 family cytokines to PanIN and PDAC development.

Pre-invasive PanIN lesions develop from normal ductal epithelia, through PanIN stages 1A, 1B, 2, and 3, to stage 4 invasive and/or metastatic PDAC. This process is associated with acinar-to-ductal metaplasia (ADM) early in disease, combined with an accumulation of oncogenic mutations (most common mutations are indicated). A number of cells within the tumour microenvironment have been shown to secrete IL-6 family cytokines, which in turn results in the activation of a pro-tumorigenic signalling cascade. A better understanding of the relationship between each of these cells within the tumour microenvironment may reveal new therapeutic opportunities to manage cancer progression.