Abstract 694: PAWI-2 overcomes tumor stemness and drug resistance in pancreatic cancer stem cells

Abstract

Abstract Today, pancreatic cancer (PC) remains a major health problem in the US and soon will be the second most common cause of mortality due to cancer. However, most of the front-line PC chemotherapies cause serious side effects and a majority of patients with PC are often resistant to clinical therapies. The fact that cancer stem cells (CSCs) become enriched after anti-cancer therapy implicates CSCs as key contributors to tumor dormancy, metastasis, and relapse in PC. Given the important role of human pancreatic cancer stem cells (hPCSCs) in PC, development of a novel treatment strategy that targets hPCSCs or their extrinsic and intrinsic regulators could be of great clinical utility to treat PC. Herein, we used a highly validated hPCSCs model (FGβ3 cells) to test a novel compound (PAWI-2) to target CSCs. In this hPCSC model, integrin αvβ3 expression was shown to be a marker/functional contributor to CSC progression and drug resistance attributed to its ability to trigger anchorage-independent cell survival and tumor metastasis. Specifically, integrin αvβ3 recruits KRAS and RalB to tumor cell plasma membranes to activate NF-κB signaling that triggers dysregulated KRAS-RalB-NF-κB pathways. This was shown to be a pharmacological target to reverse CSC-like properties or re-sensitize drug resistance (e.g., EGFR inhibitors, erlotinib) of established FGβ3 tumors. Compared to parental FG cells, PAWI-2 showed greater potency to inhibit cell viability and self-renewal capacity of FGβ3 cells. PAWI-2 inhibited dysregulated integrin β3-KRAS-RalB-NF-κB signaling independent of KRAS and Ral. This is clinically relevant because >90% of KRAS is activated by mutations in PC and RAS or Ral inhibitors have not proven effective clinically. PAWI-2 targeted downstream of KRAS signaling and was negatively regulated by other feedback mechanisms. This was further shown by genetic knockdown of key regulator and co-treatment of specific inhibitors. PAWI-2 overcomes erlotinib resistance in FGβ3 cells with greater potency than bortezomib. In the proposed mechanism of PAWI-2 action, key regulators link the inhibition of KRAS signaling and cell cycle arrest (G2/M). The great utility and pharmacological potency of PAWI-2 in FGβ3 cells (that possess stem-like properties) compared to FG cells provide a basis for further development. PAWI-2 as an efficient therapeutic to reverse tumor stemness and resensitize CSC tumors to drug inhibition. This work was supported by Inception Award from California Institute for Regenerative Medicine (CIRM) (DISC1-10583; J.R. Cashman) and by funds from the Human BioMolecular Research Institute. Citation Format: Jiongjia Cheng, John Cashman, Jorge Gomez-Galeno. PAWI-2 overcomes tumor stemness and drug resistance in pancreatic cancer stem cells [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 694.