Pancreatic Metastasis Research Articles

Case of a Sister Mary Joseph’s Nodule in Pancreatic Adenocarcinoma: A Diagnostic Challenge

Background: Sister Mary Joseph (SMJ) nodule is a rare metastatic umbilical nodule with primary tumor genital or gastrointestinal sites. Pancreas is rare primary location for umbilical metastases. Pancreatic adenocarcinoma associated with SMJN usually arises from the body and tail of the pancreas. We report a case of SMJ nodule’s as a cutaneous manifestation of metastatic pancreatic head cancer. Case Report: A 59-year-old man, presented with epigastric, back pain and weight loss. On examination, an umbilical nodule was noted. Investigations confirmed a nodule of Sister Mary Joseph as a pancreatic head cancer metastasis. Conclusion: SMJN nodule remains as a rare tumor with metastatic origin of cancer most commonly digestive. Due the poor prognosis, early detection and systematic biopsy of any nodule or umbilical mass is indispensable.

Presumed radiological diagnosis of solid pseudopapillary tumors: do we really know what we are watching?

ObjectivesLittle is known about the clinicians’ ability to ascertain the identity of a pancreatic lesion as solid pseudopapillary tumors (SPT)preoperatively. We led this retrospective study to figure out the disease spectrum that mimic SPT, the key features of SPT and the accuracy of CT and MRI in characterizing them. MethodsRadiological and clinical database at a tertiary pancreatic disease center (Peking Union Medical College Hospital) was searched for patients who received CT or MRI with a presumed radiological diagnosis of SPT. Those patients’ clinical information and final pathological diagnosis were collected. ResultsDuring 2018.10–2021.12, 200 patients had a presumed radiological diagnosis of SPT, and 132 of them had unambiguous pathological diagnosis. SPT were confirmed in only 63.6% (84/132), while the others had a variety of neoplastic and nonneoplastic lesions, including pancreatic neuroendocrine tumors (n = 15), pseudocysts (n = 4), mucinous cystic neoplasms (n = 4), serous cystadenomas (n = 3), neural sheath tumors (n = 3), lymphoepithelial cysts (n = 2), and several very rare pathologies (n = 17). Of note, 11.4% (15/132) of those were benign or nonneoplastic lesions, while 6.8% (9/132) were neoplasms with highly aggressive nature, or pancreatic metastases, which require systematic evaluation and staging instead of upfront surgery. Retrospective radiological analysis based on key imaging features, clinical history and laboratory findings had an improved diagnostic accuracy of 78.5% with CT and 77.8% with MRI. ConclusionsThere is a broad disease spectrum mimicking SPT at CT and MRI. Key imaging features, clinical information and laboratory findings must be integrated to improve the diagnostic accuracy.

Uncooled TATO microwave system for liver ablation.

To evaluate the safety and efficacy of uncooled TATO microwave ablation (MWA) for primary and metastatic liver cancer. This was a retrospective study on percutaneous liver ablations performed with TATO MWA. Twenty-five ablations were performed; 11 (44%) were performed for hepatocellular carcinoma, 14 (56%) for colorectal carcinoma, gastric and pancreatic metastases. Adverse events were reported only in one(4%) ablation: an abscess that was observed in the ablated area and was resolved with a percutaneous drainage and antibiotic therapy. Local tumor control rate was 92% at the3-month follow-up. TATO MWA was safe and effective with high reproducibility in treating primary and secondary liver cancer with satisfactory technical and clinical outcomes.

Abstract B017: MICAL2 promotes pancreatic cancer growth and metastasis independent of MRTF-A signaling

Abstract Introduction: Pancreatic ductal adenocarcinoma (PDAC) is a lethal cancer in large part due to its propensity for early metastasis. We used ChIP-seq to identify differentially tagged super-enhancer associated genes in PDAC and identified MICAL2 as a gene of interest. MICAL (molecule interacting with CasL) proteins are flavin monooyxgenases that induce actin depolymerization. MICAL2 canonically modulates nuclear actin to regulate SRF/MRTF-A (myocardin related transcription factor) mediated transcription to drive EMT (epithelial-mesenchymal transition) and fibrosis. In this study, we sought to determine the impact of MICAL2 on PDAC progression and its dependence on SRF/MRTF-A signaling. Methods: Studies were performed in human and murine PDAC models. MICAL2 and MRTF-A were knocked down with shRNA and gene expression quantitated with qPCR. In vitro cell viability was assessed by MTT colorimetric assay. Cell migration was tested with in vitro wound scratch assays. Cell cycle analysis was done with flow cytometry-based DNA content measurement. Subcutaneous, orthotopic, and intrasplenic injections of PDAC cells were performed to assess in vivo growth and metastasis. Protein expression was measured with Western blotting. Student’s t-test was used to confirm statistical significance of experimental results. Results: In human PDAC cell lines, MICAL2 knockdown decreased cell viability, reduced cell migration and wound healing, and induced cell cycle arrest at G0/G1. MICAL2 inhibition was associated with decreased p-AKT, c-Myc, and increased p27 by Western blot. Orthotopic and subcutaneous injections of KPC46 shMICAL2 cells were performed in syngeneic mice; orthotopic injections of shMICAL2 cells led to decreased tumor growth compared to control (0.26 gm vs. 1 gm, p = 0.008), not observed with shMRTF-A (1.032 gm vs. 1 gm, p = 0.95). Subcutaneous injections of MICAL2 knockdown cells led to no tumor growth; injections of MRTF-A knockdown cells again led to comparable tumor growth as control (3.02 gm vs. 1.72 gm, p = 0.24). GSEA (Gene Set Enrichment Analysis) of RNAseq data demonstrated a correlation between MICAL2 knockdown and downregulation of Hallmark EMT pathways. Intrasplenic injection studies in syngeneic mice revealed grossly decreased liver metastases after intrasplenic injection of shMRTF-A cells, with total abrogation of metastases after injection of shMICAL2 cells. Conclusions: MICAL2 promotes pancreatic cancer cell growth and metastasis. While MICAL2’s effect on metastasis appears largely dependent on SRF/MRTF-A, tumor growth appears to be MRTF-A independent, suggesting putative novel functions of MICAL2. Given its potentially targetable enzymatic domain and important role in promoting cell growth in vitro and tumor progression and metastasis in vivo, MICAL2 holds promise as a novel tractable therapeutic target in pancreatic cancer. Citation Format: Sohini Khan, Shweta Sharma, Divya Sood, Bharti Garg, Dawn Jaquish, Evangeline Mose, Edgar Esparza, Herve Tiriac, Andrew M. Lowy. MICAL2 promotes pancreatic cancer growth and metastasis independent of MRTF-A signaling [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer; 2022 Sep 13-16; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2022;82(22 Suppl):Abstract nr B017.

Abstract B023: RHAMMB promotes pancreatic cancer metastasis

Abstract Pancreatic cancer is a leading cause of cancer-related death. The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma (PDAC), and pancreatic neuroendocrine tumor (PNET) is the second common malignancy of pancreas. Pancreatic cancer patients are often diagnosed with metastatic diseases. The 5-year survival is lowest for pancreatic cancer among all cancers. There is an urgent need to understand the key regulators for pancreatic cancer metastasis and develop new therapeutic strategies. We found that Receptor for hyaluronan-mediated motility (RHAMM) is overexpressed in pancreatic cancer, but it is absent or limited in normal human tissues and not expressed in adult pancreas. RHAMM was initially identified as a protein that binds to hyaluronic acid (HA). RHAMM promotes HA-induced motility, modulates cytoskeletal organization, and activates extracellular-regulated kinase (Erk). RHAMM encodes 18 exons and alternative splicing yields different isoforms, RHAMMv1-4. We found that RHAMMB (known as RHAMMv3) is the most prominent alternative splicing isoform in PDAC and PNET, and high RHAMMB mRNA levels correlate with inferior survival of pancreatic cancer patients in TCGA cohort. We demonstrated that RHAMMB overexpression promotes metastasis of pancreatic cancer in mouse models and knockdown of RHAMM by shRNA suppresses migration and metastasis. Given RHAMM’s tumor-specific overexpression patten, we developed nanoparticles to target RHAMMB-overexpressing pancreatic cancer. We demonstrated that RHAMM-targeting nanoparticles loaded with multiple therapeutics can be used as a systemic therapy to suppress RHAMMB-overexpressing tumors in immunocompetent mice. Taken together, RHAMMB plays an important role for pancreatic cancer metastasis and serves as a therapeutic gateway for pancreatic cancer treatment. Citation Format: Xiang Chen, Tiantian Zhang, Seung Koo Lee, Dunrui Wang, Zhengming Chen, Ching-Hsuan Tung, Yao-Tseng Chen, Yi-Chieh Nancy Du. RHAMMB promotes pancreatic cancer metastasis [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer; 2022 Sep 13-16; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2022;82(22 Suppl):Abstract nr B023.

Abstract B021: The axon guidance receptor UNC5B is a driver of pancreatic cancer metastasis

Abstract Axon guidance pathways have often been linked to tumorigenesis by informatics analyses, but their roles in tumorigenesis are not well understood at a functional level. Here we show that axon guidance receptor UNC5B and its ligand, NTN1, promote the metastasis of pancreatic ductal adenocarcinomas (PDACs) by reducing anoikis and by promoting a mesenchymal phenotype. In vivo, removal of two floxed UNC5B alleles eliminated PDAC metastasis in the genetically engineered KPC mouse model, and also reduced metastasis by xenografted PDAC cell lines. PDAC metastasis also decreased upon treatment of animals with NP137, an antibody that targets NTN1. In vitro, deletion of UNC5B from pancreatic adenocarcinoma cell lines reduced invasiveness, and was sufficient to convert PDAC cell lines from an epithelial to a mesenchymal state. UNC5B also increased YAP1 expression but decreased anoikis; anoikis could then be restored by treatment with the YAP1 inhibitor CA3. Clinically, UNC5B expression associated with poor outcomes in patients with pancreatic adenocarcinomas. UNC5B and NTN1 expression increased upon truncation of the SWI/SNF component ARID1A, which is recurrently mutated in PDACs. Highly focal amplifications of UNC5B were also observed in some patient samples, and were mutually exclusive with mutations in ARID1A or ARID1B. NP137 is currently in clinical trials for various cancers, and may benefit pancreatic adenocarcinoma patients, particularly those with UNC5B amplifications or with ARID1A/ARID1B mutations. Citation Format: Chris Harris, Anthony Casabianca, Zach Sechrist, Cory Shields, Wade Narrow, Tracy Withers, Crissy Dudgeon, Mike O'Dell, Aram Hezel, Darren Carpizo. The axon guidance receptor UNC5B is a driver of pancreatic cancer metastasis [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer; 2022 Sep 13-16; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2022;82(22 Suppl):Abstract nr B021.

Abstract B020: Retinoic acid produced by hepatic stellate cells facilitates Netrin-1 mediated pancreatic cancer metastasis

Abstract A hallmark of pancreatic ductal adenocarcinoma (PDAC) is its proclivity for metastasis as evidenced by the fact that 85% are stage IV at diagnosis. This highlights the need to better understand the biology of metastatic PDAC and identify novel therapies for this patient population. Axon guidance genes have been shown to be involved in PDAC progression, but their role is unclear. We have investigated the role of the axon guidance molecule Netrin-1 and its receptors Unc5b and DCC in PDAC. We found that in both murine and human samples that NTN1 expression is increased in metastatic PDAC and the quasi-mesenchymal subtype. Murine and TCGA data indicate that Unc5b is the dominant NTN1 receptor and genetic knock-down (KD) or knock-out (KO) of either Netrin-1 or Unc5b decreases migration, invasion, and cell survival in vitro and hepatic metastatic growth in vivo. The mechanism of Netrin-1 upregulation in metastatic PDAC is unknown. We found that hepatic stellate cell (HSC) secreted retinoic acid upregulates NTN1 through both an RXR/RAR and Elf mediated mechanism. To determine if NTN1 is involved in the process of HSC activation we found that recombinant NTN1 added to HSCs in vitro induced activation. We examined the livers of mice harboring orthotopic PDAC tumors using murine pancreatic cancer lines that were either NTN1 wild type (WT) or KO, and found that the NTN-expressing lines increased HSC activation providing evidence that NTN1 is important for long distance intercellular communication between primary pancreatic tumors and the pre-metastatic liver. We detected NTN1 within extracellular vesicles, and mice pre-conditioned with EVs from NTN1 KO cells demonstrated a decreased metastatic burden as compared mice preconditioned with NTN1 WT cells. Treatment of several murine PDAC models (autochthonous and metastatic) with a monoclonal antibody to NTN1 led to decreased metastases and increased survival. These studies reveal that NTN1 is upregulated in metastatic PDAC mediated by a novel mechanism that involves EVs, HSC activation and RXR/RAR signaling. These studies provide pre-clinical evidence to support a human clinical trial of anti-NTN1 therapy in PDAC. Citation Format: Crissy Dudgeon, Anthony Casabianca, Chris Harris, Igor Astsaturov, Charline Ogier, Xiaoyang Su, Jason Pitarresi, Wade Narrow, Fady Soliman, Tracy Withers, Patrick Mehlen, Darren Carpizo. Retinoic acid produced by hepatic stellate cells facilitates Netrin-1 mediated pancreatic cancer metastasis [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer; 2022 Sep 13-16; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2022;82(22 Suppl):Abstract nr B020.

Texture and CT-features in differentiation of hypervascular pancreatic neuroendocrine tumors from renal cell carcinoma metastases: diagnostic model

Objective: to develop a diagnostic model that includes CT and radiomic features for the differential diagnosis of pancreatic neuroendocrine tumors (PNETs) G1 and G2 and pancreatic renal cell carcinoma (RCC) metastases.Material and Methods. 78 patients with 79 hypervascular PNETs and 17 patients with 24 pancreatic RCC metastases who underwent pancreatic resection and histological verification were selected in the study. All the patients underwent preoperative contrast enhanced CT (CECT). We assessed tumor attenuation, composition (cystic/solid), homogeneity (homogeneous/heterogeneous), calcification and presence of the main pancreatic duct (MPD) dilation. We calculated lesion-to-parenchyma contrast (LPC), relative tumor enhancement ratio (RTE) and extracted 52 texture features for arterial phase of CECT. Qualitative and texture features were compared between PNETs and pancreatic RCC metastasis. The selection of predictors for the logistic model was carried out in 2 successive stages: 1) selection of predictors based on one-factor logistic models, the selection criterion was p < 0.2; 2) selection of predictors using L2 regularization (LASSO regression after standardization of independent variables). The selected predictors were included in a logistic regression model without interactions, the coefficients of which were estimated using the maximum likelihood method with a penalty of 0.8.Results. There was no difference in composition, homogeneity (homogeneous/heterogeneous) and presence of the MPD dilation between groups. We did not find calcification in pancreatic RCC metastasis, in contrast to the PNETs (9% contained calcifications). After selection, the LCR, CONVENTIONAL_HUmin, GLCM_Correlation, NGLDM_Coarseness were included in the final diagnostic model, which showed a sensitivity and specificity of 95.8%; 62% in the prediction of pancreatic RCC metastases.Conclusion. The diagnostic model developed on the basis of texture and CT-features has high sensitivity (95.8%) with moderate specificity (62%), which allows it to be used in complex diagnostic cases to determine the patient's treatment tactics.

MACC1 promotes pancreatic cancer metastasis by interacting with the EMT regulator SNAI1

Metastasis is the dominant cause of cancer-related mortality. Metastasis-associated with colon cancer protein 1 (MACC1) has been proven to play a critical role in cancer metastasis. However, the prometastatic role of MACC1 in regulating the pancreatic cancer (PC) metastatic phenotype remains elusive. Here, we report that MACC1 is highly expressed in The Cancer Genome Atlas (TCGA) and tissue microarray (TMA) and identified as a good indicator for poor prognosis. Overexpression or knockdown of MACC1 in PC cells correspondingly promoted or inhibited pancreatic cancer cell migration and invasion in a MET proto-oncogene receptor tyrosine kinase (MET)-independent manner. Notably, knockdown of MACC1 in PC cells markedly decreased the liver metastatic lesions in a liver metastasis model. Mechanistically, MACC1 binds to the epithelial-mesenchymal transition (EMT) regulator snail family transcriptional repressor 1 (SNAI1) to drive EMT via upregulating the transcriptional activity of SNAI1, leading to the transactivation of fibronectin 1 (FN1) and the trans-repression of cadherin 1 (CDH1). Collectively, our results unveil a new mechanism by which MACC1 drives pancreatic cancer cell metastasis and suggest that the MACC1-SNAI1 complex-mediated mesenchymal transition may be a therapeutic target in pancreatic cancer.

Unravelling the impact of exosomes in pancreatic cancer metastasis through a new organotypic-liver slide culture system

Unravelling the impact of exosomes in pancreatic cancer metastasis through a new organotypic-liver slide culture system

Whole-Body MRI Showing Unusual Pancreatic Metastasis from a Forearm Rhabdomyosarcoma without Lung Involvement.

Whole-Body MRI Showing Unusual Pancreatic Metastasis from a Forearm Rhabdomyosarcoma without Lung Involvement.

RGWAS: A Novel Genome-Wide Association Study to Link Genomics to Radiomics for Pancreatic Cancer

<h3>Purpose/Objective(s)</h3> Pancreatic cancer is a critical global health problem with the highest mortality rate among all major cancers. The 5-year survival rate remained at ∼10% despite decades of clinical and research efforts. Clearly, new and synergistic approaches are needed to battle this ferocious disease. In this study, a novel radiomics-based genome-wide association study (RGWAS) was conducted in a unique patient population, linking genomics to radiomics in pancreatic cancer. <h3>Materials/Methods</h3> A unique pancreatic cancer rapid autopsy dataset was included for the study, where comprehensive tissue samples were collected from tumors and normal organs within hours of patient death. On 28 patients, whole exome sequencing (WES) was conducted to identify significant somatic mutations with VarScan. Diagnostic dynamic contrast CT of abdomen was used to manually segment the primary tumor and metastatic lesions, from which ∼1000 radiomic features were extracted. Using LASSO, radiomic features most significantly associated with clinical endpoints such as overall survival and with interesting genetic variants (i.e., somatic SNVs) were identified. <h3>Results</h3> Based on WES, somatic mutations of KRAS, TP53, and CDKN2A occur at high rates in both primary and metastatic tumors. Interestingly, some highly occurring somatic mutations in the primary tumor, such as BRCA1 and MYC, were not top ranked in metastases. Instead, somatic mutations of IS2, the insulin receptor substrate 2, occur at a high rate in metastases. RGWAS found several significant peaks (P-value<10⁻⁵) for certain radiomic features, uncovering interesting correlations between genetic mutations and imaging phenotypes. Some of these radiomic features were consistently associated with genetic variants between primary and metastatic tumors. <h3>Conclusion</h3> A unique patient dataset with rapid autopsy tumor and normal tissue samples was analyzed using a novel integrative RGWAS approach. RGWAS linked relevant radiomic features to interesting oncogenes and clinical phenotypes. These findings provide promising genetic and radiomic feature candidates for follow-up work, and shed light on the mechanism of pancreatic cancer progression and metastasis.

Muc16 depletion diminishes KRAS-induced tumorigenesis and metastasis by altering tumor microenvironment factors in pancreatic ductal adenocarcinoma.

MUC16, membrane-bound mucin, plays an oncogenic role in pancreatic ductal adenocarcinoma (PDAC). However, the pathological role of MUC16 in the PDAC progression, tumor microenvironment, and metastasis in cooperation with KrasG12D and Trp53R172H mutations remains unknown. Deletion of Muc16 with activating mutations KrasG12D/+ and Trp53R172H/+ in mice significantly decreased progression and prolonged overall survival in KrasG12D/+; Trp53R172H/+; Pdx-1-Cre; Muc16-/- (KPCM) and KrasG12D/+; Pdx-1-Cre; Muc16-/- (KCM), as compared to KrasG12D/+; Trp53R172H/+; Pdx-1-Cre (KPC) and KrasG12D/+; Pdx-1-Cre (KC) mice, respectively. Muc16 knockout pancreatic tumor (KPCM) displays decreased tumor microenvironment factors and significantly reduced incidence of liver and lung metastasis compared to KPC. Furthermore, in silico data analysis showed a positive correlation of MUC16 with activated stroma and metastasis-associated genes. KPCM mouse syngeneic cells had significantly lower metastatic and endothelial cell binding abilities than KPC cells. Similarly, KPCM organoids significantly decreased the growth rate compared to KPC organoids. Interestingly, RNA-seq data revealed that the cytoskeletal proteins Actg2, Myh11, and Pdlim3 were downregulated in KPCM tumors. Further knockdown of these genes showed reduced metastatic potential. Overall, our results demonstrate that Muc16 alters the tumor microenvironment factors during pancreatic cancer progression and metastasis by changing the expression of Actg2, Myh11, and Pdlim3 genes.

GJB3 promotes pancreatic cancer liver metastasis by enhancing the polarization and survival of neutrophil.

Connexins are membrane expressed proteins, which could assemble into hexamers to transfer metabolites and secondary messengers. However, its roles in pancreatic cancer metastasis remains unknown. In this study, by comparing the gene expression patterns in primary pancreatic cancer patients primary and liver metastasis specimens, we found that Gap Junction Protein Beta 3 (GJB3) significantly increased in Pancreatic ductal adenocarcinoma (PDAC) liver metastasis. Animal experiments verified that GJB3 depletion suppressed the hepatic metastasis of PDAC cancer cells. Further, GJB3 over expression increased the neutrophil infiltration. Mechanistic study revealed that GJB3 form channels between PDAC tumor cells and accumulated neutrophil, which transfer cyclic adenosine monophosphate (cAMP) from cancer to neutrophil cells, which supports the survival and polarization. Taken together, our data suggesting that GJB3 could act as a potential therapeutic target of PDAC liver metastasis.

Targeting breast and pancreatic cancer metastasis using a dual-cadherin antibody

The successful application of antibody-based therapeutics in either primary or metastatic cancer depends upon the selection of rare cell surface epitopes that distinguish cancer cells from surrounding normal epithelial cells. By contrast, as circulating tumor cells (CTCs) transit through the bloodstream, they are surrounded by hematopoietic cells with dramatically distinct cell surface proteins, greatly expanding the number of targetable epitopes. Here, we show that an antibody (23C6) against cadherin proteins effectively suppresses blood-borne metastasis in mouse isogenic and xenograft models of triple negative breast and pancreatic cancers. The 23C6 antibody is remarkable in that it recognizes both the epithelial E-cadherin (CDH1) and mesenchymal OB-cadherin (CDH11), thus overcoming considerable heterogeneity across tumor cells. Despite its efficacy against single cells in circulation, the antibody does not suppress primary tumor formation, nor does it elicit detectable toxicity in normal epithelial organs, where cadherins may be engaged within intercellular junctions and hence inaccessible for antibody binding. Antibody-mediated suppression of metastasis is comparable in matched immunocompetent and immunodeficient mouse models. Together, these studies raise the possibility of antibody targeting CTCs within the vasculature, thereby suppressing blood-borne metastasis.

Literature review of imaging, pathological diagnosis, and outcomes of metachronous lung and pancreatic metastasis of cecal cancer

BackgroundPancreatic metastasis from colorectal cancer is extremely rare. Here, we report a case of colorectal cancer with lung and pancreatic metastasis and analyze the histopathology, immunohistochemistry, and next-generation sequencing (NGS) to generate a differential diagnosis and treatment of metastatic colon cancer.Case presentationAC1A 78-year-old man was admitted because of a recently elevated carcinoembryonic antigen. This patient had undergone laparoscopic right hemicolectomy for cecal cancer IIA (T3N0M0) 5 years before admission, and thoracoscopic left upper lung wedge resection for primary colon cancer lung metastasis 2 years before admission. At that time, the patient was thought to have pancreatic metastasis from colon cancer. He underwent laparoscopic distal pancreatectomy (combined with splenectomy). Postoperative pathology revealed colon cancer metastasis. We performed NGS on tumor samples at three loci and found colon cancer's most common oncogenic driver genes (KRAS, APC, and TP53). One month after surgery, the patient was given capecitabine for six cycles of chemotherapy. At present, no high adverse reactions have been reported.DiscussionFor patients with pancreatic space-occupying, such as a previous history of colorectal cancer, and recent carcinoembryonic antigen elevation, we should highly suspect pancreatic metastatic colorectal cancer. NGS is an essential auxiliary for identifying metastatic tumors. Surgery combined with postoperative chemotherapy is an effective treatment.

A Low Level of CircPVRL3 Promotes Pancreatic Cancer Proliferation and Metastasis Through miR-194-5p/SOCS2 Axis

INTRODUCTION: The circular RNAs play essential roles for different types of cancer via sponging miRNAs. In the present study, we investigated that a low level of circPVRL3 promotes the processes of proliferation and metastasis in pancreatic ductal adenocarcinoma (PDAC) through miR-194-5p/SOCS2 axis. METHODS: Tumor samples from 56 cases PDAC patients were observed. A total of 22 (39.3%) cases were positive (high expression), and 34 (60.7%) were negative. The mechanism of proliferation and metastasis carried by miR-194-5p in PDAC cells was observed. Upstream gene circPVRL3 and downstream target gene SOCS2 of miR-194-5p were investigated by bioinformatic methods and mRNA-seq evaluation. Nude mice underwent subcutaneously injected PDAC cells and were treated with/without miR-194-5p agomir/antagomir to observe tumor weight and size. RESULTS: Tissue microarray test showed that the expression of miR-194-5p was higher in PDAC tissue than in tumor-adjacent tissue, and miR-194-5p expression was positively correlated with age (p = 0.028) and neuroinvasion (p = 0.021). CircPVRL3, SOCS2, and miR-194-5p were confirmed that constituted competing endogenous RNAs. Overexpression of miR-194-5p targeted SOCS2 promoted the progression of PDAC via regulating cell cycle and migration. Knockdown expression of circPVRL3 showed the same effects on PDAC cells. Animal experiments showed overexpression of miR-194-5p has a proliferation-promoted effect on tumor weight and size (Figure).FigureCONCLUSION: The present study revealed that low expression of circPVRL3 contributes to reducing the expression of SOCS2 through releasing for miR-194-5p in excess, which promoted proliferation and metastasis of PDAC. The unexpected result was that this phenomenon might be through phosphorylation of AKT that would be further studied.

Calcium Channel α2δ1 is Essential for Pancreatic Tumor-Initiating Cells through Sequential Phosphorylation of PKM2

Tumor-initiating cells (TICs) drive pancreatic cancer tumorigenesis, therapeutic resistance, and metastasis. However, TICs are highly plastic and heterogenous, which impede the robust identification and targeted therapy of such a population. The aim of this study is to identify the surface marker and therapeutic target for pancreatic TICs. We isolated voltage-gated calcium channel α2δ1 subunit (isoform 5)-positive subpopulation from pancreatic cancer cell lines and freshly resected primary tissues by fluorescence-activated cell sorting and evaluated their TIC properties by spheroid formation and tumorigenic assays. Coimmunoprecipitation was used to identify the direct substrate of CaMKⅡδ. We demonstrate that the voltage-gated calcium channel α2δ1 subunit (isoform 5) marks a subpopulation of pancreatic TICs with the highest TIC frequency among the known pancreatic TIC markers tested. Furthermore, α2δ1 is functionally sufficient and indispensable to promote TIC properties by mediating Ca2+ influx, which activates CaMKⅡδ to directly phosphorylate PKM2 at T454 that results in subsequent phosphorylation at Y105 to translocate into nucleus, enhancing the stem-like properties. Interestingly, blocking α2δ1 with its specific antibody has remarkably therapeutic effects on pancreatic cancer xenografts by reducing TICs. α2δ1 promotes pancreatic TIC properties through sequential phosphorylation of PKM2 mediated by CaMKⅡδ, and targeting α2δ1 provides a therapeutic strategy against TICs for pancreatic cancer.

Inhibition of Mitochondrial Redox Signaling with MitoQ Prevents Metastasis of Human Pancreatic Cancer in Mice.

Simple SummaryIf improvements of diagnostic techniques and methodologies allow to increasingly detect cancers at the premetastatic stage, metastases still account for about 90% of cancer patient deaths in the clinics. Indeed, there is currently no specific treatment capable of blocking or even delaying the metastatic process. In this context, we previously showed that mitochondria are metabolic sensors initiating the metastatic process. Here, focusing on pancreatic cancer, with which about one-third of patients are diagnosed before the onset of metastases, we report that MitoQ, a mitochondria-targeted antioxidant, interrupts prometastatic redox signaling from mitochondria to the cell body. At doses compatible with the treatment of humans, we found that MitoQ represses pancreatic cancer cell migration, invasion and clonogenicity. It reduced the metastatic homing of human pancreatic cancer cells in mice by about 50%. If applied to patients, metastasis prevention with MitoQ could increase the chances of curing cancer with conventional treatments.At diagnosis, about 35% of pancreatic cancers are at the locally invasive yet premetastatic stage. Surgical resection is not a treatment option, leaving patients with a largely incurable disease that often evolves to the polymetastatic stage despite chemotherapeutic interventions. In this preclinical study, we hypothesized that pancreatic cancer metastasis can be prevented by inhibiting mitochondrial redox signaling with MitoQ, a mitochondria-targeted antioxidant. Using four different cancer cell lines, we report that, at clinically relevant concentrations (100–500 nM), MitoQ selectively repressed mesenchymal pancreatic cancer cell respiration, which involved the inhibition of the expression of PGC-1α, NRF1 and a reduced expression of electron-transfer-chain complexes I to III. MitoQ consequently decreased the mitochondrial membrane potential and mitochondrial superoxide production by these cells. Phenotypically, MitoQ further inhibited pancreatic cancer cell migration, invasion, clonogenicity and the expression of stem cell markers. It reduced by ~50% the metastatic homing of human MIA PaCa-2 cells in the lungs of mice. We further show that combination treatments with chemotherapy are conceivable. Collectively, this study indicates that the inhibition of mitochondrial redox signaling is a possible therapeutic option to inhibit the metastatic progression of pancreatic cancer.

Exosomal miR-485-3p derived from pancreatic ductal epithelial cells inhibits pancreatic cancer metastasis through targeting PAK1.

Cell competition is an important feature in pancreatic cancer (PC) progression, but the underlying mechanism remains elusive. This study aims to explore the role of exosomes derived from normal pancreatic ductal epithelial cells involved in PC progression. PC cells and pancreatic stellate cells (PSCs) were treated with exosomes isolated from pancreatic ductal epithelial cells. Cell proliferation was assessed by CCK8 assays. Cell migration and invasion were assessed by Transwell assays. PC and matched adjacent non-tumor tissue specimens were obtained from 46 patients pathologically diagnosed with PC at Peking University First Hospital from 2013 to 2017. Tissue miR-485-3p and p21-activated kinase-1 (PAK1) expression was examined by real-time polymerase chain reaction (RT-PCR), and the relationship of the two was analyzed using Pearman's product-moment correlation. The clinical significance of miR-485-3p was analyzed using the Chi-square test, Wilcoxon rank-sum test, and Fisher exact probability, respectively. The binding of miR-485-3p to PAK1 5'-untranslated region (5'-UTR) was examined by luciferase assay. PC cells were xenografted into nude mice as a PC metastasis model. Exosomes from pancreatic ductal epithelial cells suppressed PC cell migration and invasion as well as the secretion and migration of PSCs. MiR-485-3p was enriched in the exosomes of pancreatic ductal epithelial cells but deficient in those of PC cells and PSCs, in accordance with the lower level in PSCs and PC cells than that in pancreatic ductal cells. And the mature miR-485-3p could be delivered into these cells by the exosomes secreted by normal pancreatic duct cells, to inhibit PC cell migration and invasion. Clinical data analysis showed that miR-485-3p was significantly decreased in PC tissues (P < 0.05) and was negatively associated with lymphovascular invasion (P = 0.044). As a direct target of miR-485-3p, PAK1 was found to exert an inhibitory effect on PC cells, and there was a significantly negative correlation between the expression levels of miR-485-3p and PAK1 (r = -0.6525, P < 0.0001) in PC tissues. Moreover, miR-485-3p could suppress PC metastasis in vivo by targeting p21-activated kinase-1. Exosomal miR-485-3p delivered by normal pancreatic ductal epithelial cells into PC cells inhibits PC metastasis by directly targeting PAK1. The restoration of miR-485-3p by exosomes or some other vehicle might be a novel approach for PC treatment.