Abstract Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal disease with limited treatment options. PDAC patients are commonly treated with chemotherapeutic drugs to induce DNA damage in rapidly dividing tumor cells, however tumors frequently develop resistance to chemotherapies, underscoring the need for more effective therapeutic strategies. The DNA damage response (DDR) is required for detecting and repairing chemotherapy-induced DNA damage, and DDR alterations have been shown to contribute to chemoresistance. Another key factor driving chemoresistance in PDAC is the dense stroma, which is composed of a variety of non-tumor cell types including cancer associated fibroblasts (CAFs). We have recently identified a novel CAF-induced resistance mechanism involving NDRG1 (N-myc downstream regulated gene 1), a protein that plays a role in stress responses. CAF-induced signaling cascade results in the phosphorylation of NDRG1 and NDRG1-dependent DNA repair and protection from chemotherapies in pancreatic cancer cells. Specifically, inhibition of SGK1-mediated phosphorylation of NDRG1 and NDRG1 knockout both resulted in increased chemotherapy-induced DNA damage assessed via comet assay, and decreased replication fork speed and recovery after fork stalling assessed via DNA fiber spreading assay. To gain insight into the molecular mechanism of NDRG1-mediated DNA repair and replication, we performed a BioID screen to identify binding partners of NDRG1 and we have identified meiotic recombination 11 (MRE11), a nuclease involved in critical DNA repair pathways, as a novel binding partner of NDRG1. We have found that the interaction between MRE11 and NDRG1 is enriched during late S/early G2 cell cycle phases and under hydroxyurea-induced replication stress. Furthermore, we have found that the interaction is weakened when SGK1-mediated phosphorylation is inhibited. Interestingly, using the fork protection fiber spreading assay, we have found that blocking SGK1-mediated NDRG1 phosphorylation and blocking MRE11 exonuclease activity using mirin both result in increased protection of nascent DNA at stalled forks. However, in NDRG1 knockout cells, treatment with mirin leads to decreased protection of nascent DNA, suggesting that NDRG1 and MRE11 may be acting in the same pathway and that NDRG1 is required for MRE11’s activity at stalled forks. In summary, our work has uncovered a novel protein interaction that may play a key role in pancreatic cancer chemoresistance due to its role in the processing of stalled replication forks. Citation Format: Hanna M Doh, Nina Kozlova, Taru Muranen. Elucidating the mechanistic role of the MRE11-NDRG1 interaction in DNA repair and chemoresistance [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: DNA Damage Repair: From Basic Science to Future Clinical Application; 2024 Jan 9-11; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2024;84(1 Suppl):Abstract nr PR008.