Abstract

Abstract Despite decades of extensive basic and translational research improving our understanding of pancreatic ductal adenocarcinoma (PDAC), its complex biology remains a significant challenge and limits overcoming its dismal prognosis. Due to its resistance to conventional therapies and heterogeneous mutational landscape, molecular stratification and the development of targeted therapeutic options are essential for improving survival of PDAC patients. Previous work from our group investigated loss-of-function mouse models for the serine/threonine kinase ATM causing homologous recombination deficiency (HRD) in PDAC. Specifically, ATM loss caused certain oncogenic features in the arising tumors, including the acquisition of an invasive phenotype along with the emergence of a prominent desmoplastic reaction, but also sensitizes toward platinum-based therapies and PARP1 inhibition (Russell, Nat Commun; Perkhofer, Cancer Res; Gout, Gut). However, the mechanisms orchestrating these oncogenic features remain unclear. Here, we identified the histone-methyltransferase EZH2 as a direct ATM substrate to operate as an epithelial-mesenchymal gatekeeper. In detail, ATM-deficient tumors accumulated EZH2, suggesting that ATM status contributes to rewiring the epigenetic landscape of pancreatic tumors, subsequently supporting oncogenic features. To investigate whether and how EZH2 impacts ATM-deficient PDAC pathogenesis, we generated conditional double ATM and EZH2-knockout in the KrasG12D/+; Ptf1aCre/+ mice. Double-null mice showed extended mouse survival, reduced metastasis burden, and decreased undifferentiated malignant cell features. Interestingly, both in vivo and in vitro investigations revealed that ATM status significantly impacts EZH2 activity via a post-translational regulation axis. Specifically, the ATM kinase activity was critical to promote Culin1 E3-ubiquitin ligase recruitment and subsequent EZH2 ubiquitination and degradation. Finally, we demonstrated that a combinatorial therapy involving a potent EZH2 inhibitor promotes genomic instability and exacerbates the cytotoxic effects of PARP interference in ATM-deficient HRD PDAC. Overall, our study demonstrates that ATM deficiency significantly impacts EZH2 epigenetic functions and pinpoints the molecular stratification according to ATM status prior to pharmacological EZH2 interference in PDAC therapies as a valuable approach to target ATM-deficient HRD tumors. Citation Format: Elodie Roger, Anna Härle, Johann Gout, Lukas Perkhofer, Elisabeth Hessmann, Alexander Kleger. The EZH2 epigenetic factor orchestrates oncogenic properties in ATM-deficient pancreatic cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Pancreatic Cancer; 2023 Sep 27-30; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(2 Suppl):Abstract nr A077.

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