Microbiome in pancreatic ductal adenocarcinoma: emerging mechanisms and clinical implications

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies due to the lack of effective early diagnostic tools and the high resistance to conventional therapies, resulting in poor prognosis and limited survival benefits for most patients. Emerging evidence suggests a significant association between the microbiome and the development of pancreatic cancer, with microbial dysbiosis potentially influencing tumorigenic pathways, immune regulation, and metabolic reprogramming, thereby contributing to disease progression. Moreover, the microbiome and its related metabolites have demonstrated promising potential as noninvasive diagnostic biomarkers and therapeutic targets, offering new opportunities for early detection and personalized intervention. This review highlights the current insights into the roles of gut and oral microbiota in PDAC pathogenesis and explores novel perspectives for developing early detection strategies, preventive measures, and alternative treatment approaches.