Abstract

BackgroundThe majority of pancreatic ductal adenocarcinomas (PDAC) are diagnosed at the metastatic stage, and standard therapies have limited activity with a dismal 5-year survival rate of only 8%. The liver and lung are the most common sites of PDAC metastasis, and each have been differentially associated with prognoses and responses to systemic therapies. A deeper understanding of the molecular and cellular landscape within the tumor microenvironment (TME) metastasis at these different sites is critical to informing future therapeutic strategies against metastatic PDAC.ResultsBy leveraging combined mass cytometry, immunohistochemistry, and RNA sequencing, we identify key regulatory pathways that distinguish the liver and lung TMEs in a preclinical mouse model of metastatic PDAC. We demonstrate that the lung TME generally exhibits higher levels of immune infiltration, immune activation, and pro-immune signaling pathways, whereas multiple immune-suppressive pathways are emphasized in the liver TME. We then perform further validation of these preclinical findings in paired human lung and liver metastatic samples using immunohistochemistry from PDAC rapid autopsy specimens. Finally, in silico validation with transfer learning between our mouse model and TCGA datasets further demonstrates that many of the site-associated features are detectable even in the context of different primary tumors.ConclusionsDetermining the distinctive immune-suppressive features in multiple liver and lung TME datasets provides further insight into the tissue specificity of molecular and cellular pathways, suggesting a potential mechanism underlying the discordant clinical responses that are often observed in metastatic diseases.

Highlights

  • Pancreatic cancer, mostly comprised of pancreatic ductal adenocarcinoma (PDAC), is the third leading cause of death in the USA with over 45,000 deaths this year [1]

  • Over 70% of pancreatic ductal adenocarcinomas (PDAC) patients are diagnosed with metastatic disease at diagnosis, and the 5-year survival rate for these patients has only modestly risen to 10% [2]

  • Establishing models of hepatic and pulmonary metastatic pancreatic ductal adenocarcinoma To establish directly comparable lung and liver PDAC metastasis, we utilized a murine pancreatic adenocarcinoma cell line driven by Kras and Trp53 mutations (KPC) [12] injected into the two most common visceral sites of metastatic disease, liver, and lung

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Summary

Introduction

Pancreatic cancer, mostly comprised of pancreatic ductal adenocarcinoma (PDAC), is the third leading cause of death in the USA with over 45,000 deaths this year [1]. Multiple institutional reviews have observed that isolated pulmonary metastatic disease has significantly better prognosis than patients with liver metastases [4,5,6]. This clinical distinction is not unique to PDACs. Similar prognostic contrast has been noted for melanomas and lung cancers, and patients with liver metastases have poorer survival outcomes when treated with PD-1 immune checkpoint therapy when compared with patients who have disease involvement in other visceral sites including lung [7, 8]. The majority of pancreatic ductal adenocarcinomas (PDAC) are diagnosed at the metastatic stage, and standard therapies have limited activity with a dismal 5-year survival rate of only 8%. A deeper understanding of the molecular and cellular landscape within the tumor microenvironment (TME) metastasis at these different sites is critical to informing future therapeutic strategies against metastatic PDAC

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