Fig. 2

Vaccinations can inhibit the release of various pro-tumor cytokines. Programmed death-1 ligand (PD-L1) inhibits the antitumor effects of Dendritic cell (DC) immunization and regulates regulatory T cells (Treg) which as a result upregulate IL-10 and IL-2 as well as downregulate IFN-γ. 2) ARF6/AMAP1 signaling pathway is closely correlated with the intracellular recycling of PD-L1. Inhibition of ARF6/AMAP1 can reduce PD-L1 cell surface expression. 3) Tumor antigens in PC such as telomerase, enolase, WT1, and mesothelin can stimulate cancer-specific T-cell responses. For example, CD4+ and CD8+ T cells that specifically target mesothelin can be enhanced by vaccination. 4) Vaccines such as live attenuated bacteria expressing mesothelin (CRS-207) and GM-CSF transduced allogeneic whole tumor cell vaccine (GVAX) can improve the immune system in PC by stimulating anti-tumor T cell infiltration. (+) Promote (−) Inhibit