Abstract

Chemoresistance in pancreatic ductal adenocarcinoma (PDAC) frequently contributes to failure of systemic therapy. While the radiosensitizing properties of 5-fluorouracil (FU) are well known, it is unknown whether ionizing radiation (IR) sensitizes towards FU cytotoxicity. Here, we hypothesize that upregulation of thymidine phosphorylase (TP) by IR reverses FU chemoresistance in PDAC cells. The FU resistant variant of the human PDAC cell line AsPC-1 (FU-R) was used to determine the sensitizing effects of IR. Proliferation rates of FU sensitive parental (FU-S) and FU-R cells were determined by WST-1 assays after low (0.05 Gy) and intermediate dose (2.0 Gy) IR followed by FU treatment. TP protein expression in PDAC cells before and after IR was assessed by Western blot. To analyze the specificity of the FU sensitizing effect, TP was ablated by siRNA. FU-R cells showed a 2.7-fold increase of the half maximal inhibitory concentration, compared to FU-S parental cells. Further, FU-R cells showed a concomitant IR resistance towards both doses applied. When challenging both cell lines with FU after IR, FU-R cells had lower proliferation rates than FU-S cells, suggesting a reversal of chemoresistance by IR. This FU sensitizing effect was abolished when TP was blocked by anti-TP siRNA before IR. An increase of TP protein expression was seen after both IR doses. Our results suggest a TP dependent reversal of FU-chemoresistance in PDAC cells that is triggered by IR. Thus, induction of TP expression by low dose IR may be a therapeutic approach to potentially overcome FU chemoresistance in PDAC.

Highlights

  • Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer-related deaths in western countries (Siegel et al 2020)

  • Chemoresistance is a major obstacle to systemic therapy of PDAC with overall response rates to modern FU based regimens found to be about 35% (Adamska et al 2018; Tong et al 2018)

  • Following ionizing radiation (IR), we noted an increase in 5-FU sensitivity of the FU resistant (FU-R) PDAC cells

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Summary

Introduction

Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer-related deaths in western countries (Siegel et al 2020). Up to 20 percent of PDAC patients present with resectable disease, yet their prognosis remains poor (van Roessel et al 2020). Overall survival is widely known to be worse in non-curative PDAC patients despite treatment with modern chemo- and immunotherapeutic. Radiation and Environmental Biophysics agents (Conroy et al 2018). Resistance towards cytotoxic agents, ionizing radiation (IR), or both, confers biological aggressiveness and accounts for poor therapeutic response. Innate or acquired resistance of cancer cells diminishes the effectiveness of most chemotherapeutic agents. To overcome therapeutic resistance towards FU, the mechanisms of FU activation and development of resistance need to be addressed

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