Background Angiogenesis is the most essential element of tumor growth and metastasis. A large number of new tumor blood vessels serve as a “transport channel” to provide abundant oxygen and nutrients for the rapid proliferation of cancer cells. Both new tumors, progressive tumors, and even residual cancer cells after intensive anti-cancer treatment depend on similar blood supply to continue their growth. On the other hand, the widespread neovascularization of the tumor or its periphery is also a key “gateway” for cancer cells to enter the bloodstream and metastasize, allowing free cancer cells to rapidly spread to distant areas with the systemic blood flow. Recent advances in anti-angiogenesis, which is an important part of the anti-cancer strategy, are emerging in the field of targeted therapy. The core mechanism of anti-angiogenesis is to destroy or inhibit local neovascularization, cut off oxygen and other nutrients for tumor cell growth, and disrupt the metastatic pathway of cancer cells, which is imaginatively called “tumor starvation therapy”. However, even though anti-angiogenic therapy has been effective in solid tumors such as liver cancer, kidney cancer and lung cancer, and many new drugs such as bevacizumab, sorafenib and sunitinib have been developed, it still has little effect in the treatment of pancreatic cancer and has not been confirmed by any phase III clinical trials. Previous studies have suggested that the “lack of vascularity” characteristic of pancreatic cancer, i.e. the lack of sufficient neovascularization in the tumor, may be an important reason for the poor anti-angiogenic efficacy. However, recently, Professor Yu Xian-F’s group at the Institute of Pancreatic Oncology, Fudan University found that pancreatic cancers with a high microvessel density (MVD) in the tumor may not benefit from anti-angiogenic therapy even though the blood supply is richer. More importantly, they found that in addition to microvessel density, microvessel intensity (MVI) also has an important impact on the efficacy of tumor metastasis and anti-angiogenic therapy. In contrast, tumors with poor vascular integrity and low microvessel density maintain a high frequency of tumor metastasis; only when microvessel density is high and vascular integrity is also poor is the likelihood of tumor metastasis greatest. The results illustrate a new view that the ideal anti-angiogenic therapy should reduce tumor microvessel density to reduce cancer cell feeding and metastatic pathways on the one hand, and improve vascular integrity to maintain the vascular wall barrier on the other hand, both of which can truly improve the efficacy of anti-angiogenic therapy. This study, published in the prestigious international journal PLOS One, is an important finding in the field of comprehensive treatment of pancreatic cancer. Professor Xian-Jun Yu from Cancer Hospital of Fudan University is the corresponding author of the paper. Professor Yu is mainly engaged in clinical and basic translational research on pancreatic cancer, focusing on exploring the key mechanisms of the malignant biology of pancreatic cancer, carrying out research on individualized and standardized treatment of pancreatic cancer, and applying it to clinical practice to make the treatment more rational and effective.