Abstract Klotho is a transmembranal protein, which can be cleaved, shed and act as a circulating hormone. Klotho deficient mice present a syndrome of early aging, while overexpression of klotho extends lifespan. Klotho is a potent inhibitor of the insulin growth factor (IGF)-1 and the basic fibroblast growth factor (FGF) pathways. Klotho is also an essential co-factor for the activity of FGF23 and thus serves as a major regulator of phosphate homeostasis. We have recently identified klotho as a tumor suppressor in breast cancer. As klotho is expressed in the normal pancreas and as the IGF-1 and FGF pathways are involved in pancreatic cancer development, we undertook to study the expression and activity of klotho in pancreatic cancer. Immunohistochemistry analysis revealed significantly reduced expression of klotho in pancreatic cancer compared to normal pancreas, and low levels of klotho mRNA were noted in the pancreatic cancer cells Panc1, Colo357 and MiaPaCa2 compared to normal pancreas cells. Further studies revealed that klotho silencing is mediated by epigenetic mechanisms. Overexpression of klotho or treatment with soluble klotho (8pM) reduced clonal growth of pancreatic cancer cell lines, and a synergistic effect was observed in combination with chemotherapeutic drugs. Daily injections of klotho (10μg/kg) inhibited tumor formation of Panc1 cells in athymic mice. Klotho inhibited activation of the IGF-1 pathway in pancreatic cancer cells. As klotho further enhanced growth inhibition by the IGF-1R inhibitor AG1024, modulation of additional signaling pathways by klotho was suspected. Indeed, klotho overexpression inhibited the bFGF pathway in these cells. The extracellular region of klotho is composed of two internal repeats, KL1 and KL2, and each of them can be cleaved and act separately. While both domains share homology to glycosidase, a structural model suggested that only KL1 retains enzymatic activity. While the KL2 domain did not show growth inhibitory activities, KL1 effectively slowed growth of pancreatic cancer cells, both in vitro and in vivo and was found to be a potent inhibitor of the IGF-1 and bFGF pathways. Importantly, KL1 did not promote FGF23 signaling and therefore, in contrary to the full-length protein, its administration to mice did not affect phosphate homeostasis. In conclusion, these studies indicate klotho as a potent tumor suppressor in pancreatic cancer and suggest, for the first time, that klotho growth inhibitory activities are mediated by the KL1 domain, possibly due to its putative enzymatic activities. As the KL1 domain is not involved in regulation of phosphate homeostasis, its administration may serve as a potential safe and effective novel strategy for the treatment of pancreatic cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2192. doi:10.1158/1538-7445.AM2011-2192