Intra-tumoral Cell Neighborhoods Shape PDA Outcomes

Distinct intra-tumoral cell neighborhoods were identified in pancreatic ductal adenocarcinoma (PDA), with variations in immune and tumor cell subsets based on neighboring cells. Tumors from long-term survivors had a higher presence of stromal-associated macrophages, while short-term survivors had more immune-excluded tumor cells. Chemotherapy-treated tumors showed lower quantities of tumor-associated T cells and macrophages, but higher amounts of proliferating tumor cell subsets with immune-rich neighborhoods. Furthermore, a composite index incorporating lower levels of immune-excluded tumor cells and higher spatially distinct immune cell subsets was associated with improved survival in patients treated with neoadjuvant chemotherapy.