The therapeutic advantage of anlotinib for pancreatic cancer may lie in its effect on targeting the tumor microenvironment: 1Pancreatic stellate cells (PSCs), a major component of the tumor microenvironment (TME) of pancreatic cancer, expel a large number of extracellular matrix components, such as laminin, collagen, and fibronectin (24), inhibit the absorption of chemotherapeutic drugs and trigger drug resistance (25). This evidence concerns the gene FN1 and familial pancreatic carcinoma.