Pancreatic Ductal Adenocarcinoma Tumor Microenvironment Research Articles

Abstract B038: Tumor Derived Parathyroid Hormone Related Protein is an Orchestrator of Immunosuppression in Pancreatic Cancer

Abstract Pancreatic ductal adenocarcinoma (PDAC) has the lowest 5-year survival of common cancers, owing to a lack of early detection and ineffective therapies. Immune checkpoint inhibitors hold promise for PDAC patients, and while they represent the most ongoing clinical trials, they have had little success. Parathyroid Hormone Related Protein (PTHrP; encoded by PTHLH) defines the most aggressive squamous/basal/quasi-mesenchymal PDAC subtype. Our previous work revealed autocrine PTHrP signaling mediates tumor growth, epithelial-to-mesenchymal transition (EMT), and metastasis. However, PTHrP’s relationship with immune cells of the tumor microenvironment (TME) remains unknown. Investigation of tumors from KrasG12D; p53R172H; Pdx1-Cre; YFP (KPCY) and KPCY-Pthlh loxP/WT (KPCY-Pthlhhet) mice revealed less tumor associated neutrophils (TANs) and greater cytotoxic T cell infiltration, demonstrating the necessity of PTHrP for immune exclusion. Orthotopic implantation of Pthlh overexpressing KPCY cells (KPCY-PthlhOE) revealed a greater proportion of TANs than the control. A concomitant decrease in the number of effector T and natural killer cells in the KPCY-PthlhOE tumors was observed, showing PTHrP is sufficient to organize an immunosuppressive TME. Interestingly, recombinant human PTHrP was sufficient to induce TANs mobilization in vivo. To interrogate the mechanism of neutrophil trafficking into the TME, cytokine production was quantified in vitro. KPCY-PthlhOE exhibited a pronounced increase of Cxcl1 expression, a strong neutrophil chemokine, leading us to believe neutrophils migrate to the TME using a Cxcl1 gradient. Therefore, we hypothesized that PTHrP-mobilized neutrophils express the receptor for CXCL1; CXCR2. Indeed, recombinant PTHrP was sufficient to mobilize Cxcr2+ neutrophils in vivo. Furthermore, recombinant PTHrP was able to induce Cxcl1 production by KPCY tumor cells in vitro in a cAMP response element-binding protein(CREB)-dependent manner. These data describe a novel mechanism for the mobilization and infiltration of immune suppressive TANs into the TME, initiated by PTHrP. The PTHrP-dependent immunosuppressive TME excludes and inhibits effector immune cells. Further interrogation of PTHrP signaling during the genesis of the immune suppressive TME in PDAC may lead to the development of therapeutics to meet this unmet clinical need. Citation Format: Calvin Johnson, Jason Pitarresi. Tumor Derived Parathyroid Hormone Related Protein is an Orchestrator of Immunosuppression in Pancreatic Cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr B038.

Abstract A050: MDSC-derived transmembrane TNF is a central regulator of stromal inflammation and T-cell dysfunction in pancreatic cancer

Abstract INTRODUCTION: Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignancy characterized by stromal inflammation and T-cell dysfunction. Neutrophilic/granulocytic myeloid-derived suppressor cells (gMDSC) infiltrate early in PDAC development and contribute to a highly immunosuppressive tumor microenvironment (TME). We have previously shown that gMDSC-derived tumor necrosis factor (TNF) is a novel regulator of therapeutic resistance in the PDAC TME, and pharmacological targeting of transmembrane (tm)TNF-TNFR2 signaling can reprogram the TME to improve chemosensitivity. Here we dissect the functional consequences of gMDSC-derived tmTnf on cancer-associated fibroblast (CAF) skewness and CD8+ T-cell function. METHODS: To assess global effects of tmTNF in orthotopically and subcutaneously injected KPC models of PDAC, we compared T-cell/CAF phenotypes in littermate vs transgenic mice overexpressing exclusively tmTnf (tmTnfOE)—in which site-directed mutagenesis of TNF cleavage sites renders tmTNF uncleavable, resulting in systemically overexpressed tmTNF signaling. To investigate effects of gMDSC-derived tmTnf in vitro, J774M cells that phenocopy gMDSCs were engineered to overexpress exclusively tmTnf (J-tmTnfOE) or wild-type Tnf (J-TnfWT) following CRISPR/cas9 silencing of endogenous Tnf (J-TnfKO). These cells were co-cultured with dual reporter CAFs (Il6GFP=inflammatory iCAF; Acta2dsRed=myofibroblastic myCAF) and CD8+ T-cells followed by cell trace violet proliferation assay, flow cytometry phenotyping, and IFNγ ELISA. RESULTS: Compared to littermate controls, flank and orthotopic KPC tumor-bearing tmTnfOE mice displayed accelerated tumor kinetics and volume, respectively, as well as increase in stromal fibrosis and collagen deposition (Trichrome/Sirius Red). Flow cytometric phenotyping revealed increased proportion of iCAF (PDPN+Ly6C+) vs myCAF (PDPN+Ly6C-) in tmTNFOE vs littermate mice. Moreover, intratumoral gMDSCs isolated from tmTNFOE mice augmented CAF-Il6GFP:Acta2dsRed ratios ex vivo. CD8+ T-cell phenotyping revealed higher proportions of CD39+Ly108- dysfunctional and KLRG1+CD127- short-lived effector T-cells (SLEC), with concurrent reduction in CD127+KLRG1- memory progenitor effector T-cells (MPEC), in tmTnfOE compared with littermate tumors. Using confocal microscopy in vitro, we confirmed that transmembrane sequestration of Tnf was more pronounced in J-tmTNFOE vs J-TnfWT, with complete loss of subcellular Tnf in J-TnfKO cells. To define the precise contribution of gMDSC-tmTNF on CAF/T-cell skewness, co-culture of J-tmTnfOE with dual-reporter CAFs resulted in striking induction in CAF-Il6GFP compared with J-TnfKO-CAF co-cultures. Moreover, J-tmTnfOE significantly restrained CD8+ T-cell proliferation, MPEC differentiation, and IFN-γ release relative to J-TnfKO. CONCLUSIONS: gMDSC-tmTnf is a central regulator of inflammatory CAF polarization and CD8+ T-cell dysfunction in PDAC. Selective pharmacologic or genetic strategies to disrupt gMDSC-tmTNF derived signaling in the TME may improve chemoimmunotherapy sensitivity in PDAC. Citation Format: Andrew M Adams, Haleh Amirian, Christine I Rafie, Karthik Rajkumar, Erin Dickey, Harper M Marsh, Manan Patel, Siddharth Mehra, Nagaraj Nagathihalli, Nipun Merchant, Yoon S Yap, Luisa Cimmino, Erietta Stelekati, Anna Bianchi, Jashodeep Datta. MDSC-derived transmembrane TNF is a central regulator of stromal inflammation and T-cell dysfunction in pancreatic cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr A050.

Abstract B045: Sensitizing the PDAC tumor microenvironment to immune checkpoint therapies: characterization of a PDAC 3D model to decipher immune infiltration

Abstract Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal solid tumor with an unfavorable prognosis, often resistant to conventional treatments due to its dense stroma rich in Cancer- Associated Fibroblasts (CAFs). Limited T cell infiltration and prevalence of immunosuppressive cells within the tumor hinder the efficacy of immune checkpoint inhibitors (ICIs). The objective of our project is to modify immune landscape of PDAC tumor microenvironment (TME) to induce ICIs sensitization. We thus develop novel therapeutic strategies combining an immunomodulatory cytokine Interleukine-15 (IL15), with conventional chemotherapies (Gemcitabine or Folfirinox). To accurately replicate the complex cancer-stroma interactions within the pancreatic tumor microenvironment, we constructed a three-dimensional in vitro heterospheroid model composed of xenograft-derived tumor cells from PDAC patients, both primary or immortalized CAFs, and peripheral blood mononuclear cells (PBMCs) from healthy donors. Human 3D models were first set up and characterized by cytometry, imaging mass spectrometry and immunohistochemistry. We showed that, CAFs produce components of the extracellular matrix, promote tumor cell growth, improve resistance to chemotherapy and are able to down-regulate immune cell infiltration and modulate the nature of infiltrated immune cells. Spatial analysis of spheroids using imaging mass cytometry show that CAF influences the distribution of immune cells in our models. Interestingly, Interleukine 15 treatment prompted robust infiltration of PBMCs into heterospheroids. Immunophenotyping experiments revealed a substantial shift in the nature of immune infiltration, marked by a pronounced increase in CD4+ and CD8+ T lymphocytes, gDelta T cell and NK cell populations. When combined with Gemcitabine and IL15, immune effector cell infiltration is remarkably increased, resulting in antitumoral effects and control of tumor cell growth. Moreover, therapeutic combinations induce activation of infiltrated immune effector cells with an increase of activation, degranulation and cytotoxic markers, such as IFNγ, CD107a, and Granzyme B respectively. Thus, the heterotypic spheroids described in our study are a suitable in vitro model to both characterize the influence of CAF on therapeutic effects and the mechanisms that drives immune suppressive microenvironment. Moving forward, the next steps will consist to conduct in vivo experiments using a syngeneic PDAC orthotopic model to assess whether this combined therapeutic approach sensitize the PDAC microenvironment to anti-PD1 therapies. Citation Format: Thomas Bessede, Clara Freixinos, Jennifer Barrat, Véronique Garambois, Nadia Vie, Henri-Alexandre Michaud, Julien Faget, Nathalie Bonnefoy, Céline Gongora, Bruno Robert, Laurent Gros, Christel Larbouret. Sensitizing the PDAC tumor microenvironment to immune checkpoint therapies: characterization of a PDAC 3D model to decipher immune infiltration [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr B045.

Abstract A060: Dysregulation of PTEN expression in a subset of Cancer Associated Fibroblasts by Tumor Secreted Factors in PDAC

Abstract Pancreatic Ductal Adenocarcinoma (PDAC) is a deadly malignancy. Cancer associated fibroblasts (CAFs) play a complex role in the PDAC tumor microenvironment (TME), with a subset contributing significantly to tumor progression. Phosphatase and tensin homolog (PTEN) is a tumor suppressor and its loss is associated with increased tumor aggressiveness. Our group previously demonstrated PTEN loss in SMA+ positive CAFS correlated with worsened outcomes in patients and in mouse PDAC models. Our group previously demonstrated the loss of PTEN in CAFS led to activation of Stat3, resulting in an immunosuppressive microenvironment (Lefler et al, 2022 PMID: 35803738). However, little is known of the signals produced by tumor cells or other cell types in the TME that trigger loss of PTEN in CAFs. This study aims to to elucidate the molecular mechanisms underlying PTEN loss in CAFs in PDAC. To address this gap, we employed single cell RNA sequencing of tumors from a mouse PDAC model and identified a (PDRGFRa+Lys6+Stat3+Pten-low) CAF subpopulation. Comparing normal pancreas epithelial cells to tumor cells in this data set, we identified the IL6 family of cytokines, (IL6; Oncostatin-M, OSM; and Leukemia Inhibitory Factor, LIF) and Transforming Growth Factor beta 1 (TGFb1) as potential ligands that regulated PTEN, while myeloid cells were a source of the IL6 family member Oncostatin M (OSM). Treatment of isolated CAFs with these factors revealed no significant difference in PTEN mRNA expression. Thus, we developed an in vitro reporter system in which a PTEN-GFP fusion protein is expressed in CAFs. Treating these CAFs with IL6, OSM and TGFb1 (but not LIF) led to a significant decrease in GFP fluorescence. Analysis of endogenous PTEN by western blot confirmed these results. We posited that expression of PTEN E3 ligases might be increased by treatment with these factors, leading to destruction of PTEN. In support of this hypothesis, the expression of E3 ligases WWP1 and WWP2 was increased by treatment with IL6 and OSM. Additionally, preliminary data has revealed that PTEN is oxidized in isolated CAFs, which causes loss of PTEN activity and potentially increased protein turnover. Current experiments are aimed at testing these potential mechanisms. To conclude, PTEN is dysregulated post-transcriptionally in CAFs. The mechanism of PTEN dysregulation could be via increased expression of E3 ligases that target PTEN and/or PTEN oxidation. Future efforts will be aimed at testing whether inhibition of these pathways can restore PTEN expression in mouse PDAC models. These pathways and interactions could be further exploited for therapeutic benefit in curbing PDAC progression. Citation Format: Ivo N. Woogeng, Lu Han, Samaneh Saberi, Cameron Bumbleburg, Joseph Beaudet, Sudarshana Sharma, Michael Ostrowski. Dysregulation of PTEN expression in a subset of Cancer Associated Fibroblasts by Tumor Secreted Factors in PDAC [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr A060.

Abstract B046: Sensitizing the PDAC tumor microenvironment to immune checkpoint therapies: characterization of a PDAC 3D model to decipher immune infiltration

Abstract Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal solid tumor with an unfavorable prognosis, often resistant to conventional treatments due to its dense stroma rich in Cancer- Associated Fibroblasts (CAFs). Limited T cell infiltration and prevalence of immunosuppressive cells within the tumor hinder the efficacy of immune checkpoint inhibitors (ICIs). The objective of our project is to modify immune landscape of PDAC tumor microenvironment (TME) to induce ICIs sensitization. We thus develop novel therapeutic strategies combining an immunomodulatory cytokine Interleukine-15 (IL15), with conventional chemotherapies (Gemcitabine or Folfirinox). To accurately replicate the complex cancer-stroma interactions within the pancreatic tumor microenvironment, we constructed a three-dimensional in vitro heterospheroid model composed of xenograft-derived tumor cells from PDAC patients, both primary or immortalized CAFs, and peripheral blood mononuclear cells (PBMCs) from healthy donors. Human 3D models were first set up and characterized by cytometry, imaging mass spectrometry and immunohistochemistry. We showed that, CAFs produce components of the extracellular matrix, promote tumor cell growth, improve resistance to chemotherapy and are able to down-regulate immune cell infiltration and modulate the nature of infiltrated immune cells. Spatial analysis of spheroids using imaging mass cytometry show that CAF influences the distribution of immune cells in our models. Interestingly, Interleukine 15 treatment prompted robust infiltration of PBMCs into heterospheroids. Immunophenotyping experiments revealed a substantial shift in the nature of immune infiltration, marked by a pronounced increase in CD4+ and CD8+ T lymphocytes, gDelta T cell and NK cell populations. When combined with Gemcitabine and IL15, immune effector cell infiltration is remarkably increased, resulting in antitumoral effects and control of tumor cell growth. Moreover, therapeutic combinations induce activation of infiltrated immune effector cells with an increase of activation, degranulation and cytotoxic markers, such as IFNγ, CD107a, and Granzyme B respectively. Thus, the heterotypic spheroids described in our study are a suitable in vitro model to both characterize the influence of CAF on therapeutic effects and the mechanisms that drives immune suppressive microenvironment. Moving forward, the next steps will consist to conduct in vivo experiments using a syngeneic PDAC orthotopic model to assess whether this combined therapeutic approach sensitize the PDAC microenvironment to anti-PD1 therapies. Citation Format: Thomas Bessede, Clara Freixinos, Jennifer Barrat, Véronique Garambois, Nadia Vie, Henri-Alexandre Michaud, Julien Faget, Nathalie Bonnefoy, Céline Gongora, Bruno Robert, Laurent Gros, Christel Larbouret. Sensitizing the PDAC tumor microenvironment to immune checkpoint therapies: characterization of a PDAC 3D model to decipher immune infiltration [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr B046.

Abstract B074: Aberrant pericytes in PDAC: effects on endothelial-pericyte adhesion, vascular integrity, and tumor microenvironment

Abstract Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer death in men and women in the U.S., with a 5-year survival rate of 13%. Within the PDAC tumor microenvironment (TME), morphologically aberrant leaky vessels are responsible for hypoxia and impaired immune response, which likely reduces the efficacy of cancer therapies. We and others showed that pericyte (PC) coverage significantly correlates with vascular integrity, function, and intratumor hypoxia. Therefore, understanding the contribution of abnormal PC to the TME evolution is a critical step toward PDAC treatment options. Consequently, we hypothesize that correcting such undesirable phenotype via vascular normalization will enhance treatment efficacy. Our study revealed that tumor-associated pericytes across all PDAC tumor tissues exhibited ectopic alpha-smooth muscle actin (αSMA) cytoskeletal protein expression up to 10 times higher than normal pericytes, which was significantly correlated with vascular leakiness and hypoxia. Our previous publication showed that PDAC-derived extracellular vesicles are potent inducers of αSMA expression in pericytes characterized by biomechanical abnormalities. To evaluate the vascular functional defect, we performed a tube formation assay showing abnormal pericytes contribute to abnormal vasculatures in vitro. Our investigation aims to uncover the cause of the abnormal pericyte phenotype that disrupts the physical adhesion between pericytes and endothelial cells (EC), resulting in compromised vasculature. Our findings reveal consistently upregulated monocarboxylate transporters in vascular cells. To enhance EC-pericyte adhesion, we investigated lactate metabolic communication, which is tightly linked due to the proximity of ECs and pericytes. We have shown that in PDAC, MCT1 lactate exporters are upregulated in EC. Conversely, MCT12 lactate importers are highly expressed in pericytes. The high amount of lactate produced by ECs decreases the pH in the basement membrane. So, we knocked down MCT1 transporters in ECs to increase basement pH, leading to improved PC-EC attachment and pericyte homeostasis. Finally, we performed single-cell RNA sequencing to determine the pathological signature of tumor pericytes and identify potential target molecules for vascular normalization. In conclusion, our study indicates that tumor-associated pericytes undergo phenotype switching and disturbed metabolic communication under the influence of pancreatic cancer cells. These aberrant pericytes might contribute to non-optimal vascular integrity and function. Single-cell RNA sequencing helped understand the molecular signature of the PDAC pericyte, providing a powerful tool to develop novel targeting strategies for vascular normalization. Future work includes exploring the vascular normalization approach by suppressing pericyte phenotype switching to enhance vascular function and chemo- and immunotherapeutic efficacy. Citation Format: Vikneshwari Natarajan, Sangdeuk Ha, Jiha Kim. Aberrant pericytes in PDAC: effects on endothelial-pericyte adhesion, vascular integrity, and tumor microenvironment [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr B074.

Abstract B041: Fibroblast STAT3 Signaling in Pancreatic Cancer: Implications for Immunotherapy and Tumor Microenvironment Modulation

Abstract Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive cancer distinguished by a dense stromal microenvironment. The current investigation delves into the fibroblast-specific STAT3 signaling in the PDAC tumor microenvironment (TME) and its effects on immune cell infiltration and extracellular matrix (ECM) modulation. An association was identified between heightened levels of phosphorylated STAT3 (pSTAT3) in tumor-associated fibroblasts (CAFs) and a more unfavorable prognosis, particularly among male patients. Comparative analysis of gene expression patterns in normal fibroblasts and those deficient in STAT3, extracted from mouse models of pancreatic cancer, unveiled distinct gene expression profiles related to the inflammatory signaling pathway (IL6, ADM, CXCL11, CD80, VEGFA, TGFB1, STC1, STC2). Utilizing ChIP-Seq analysis with an anti-pSTAT3 antibody, it was confirmed that STAT3 binds to the regulatory regions of these genes, supporting its regulatory role in the inflammatory signaling pathway. Moreover, the absence of STAT3 in CAFs resulted in a decline in M2 macrophages and an upsurge in M1 macrophages within the TME, indicating a potential function of STAT3 in influencing macrophage polarization. Noteworthy observations also revealed that STAT3 signaling in CAFs impacts ECM remodeling, as illustrated by reduced collagen deposition. Furthermore, the deficiency of STAT3 in CAFs led to a notable reduction in the quantity of neutrophils within the TME in our mouse model. Additionally, a plausible involvement of STAT3 in neutrophil recruitment and activation through the CXCL1/CXCR2 axis was indicated. Alterations in the infiltration of neutrophils and macrophages due to the absence of STAT3 could profoundly influence the immune response against PDAC. The modified composition of ECM following STAT3 deletion might also impact the infiltration and functioning of immune cells. These outcomes underscore the significance of STAT3 signaling in CAFs as a promising therapeutic target in PDAC, offering potential for modulating the tumor microenvironment, augmenting anti-tumor immunity, and advancing patient outcomes. Citation Format: Samaneh Saberi, Cameron Bumbleburg, Caroline Everett, Julia E Lefler, Victoria Jordan, Lu Han, Sudarshana Sharma, Michael C. Ostrowski. Fibroblast STAT3 Signaling in Pancreatic Cancer: Implications for Immunotherapy and Tumor Microenvironment Modulation [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr B041.

Abstract B068: Human pancreatic cancer single cell atlas reveals association of CXCL10 positive fibroblasts and basal subtype tumor cells

Abstract Pancreatic ductal adenocarcinoma (PDAC) patients with tumors enriched for the basal-like molecular subtype exhibit severe resistance to standard of care treatments and have significantly worse overall survival, compared to patients with classical subtype enriched tumors. It is therefore important to develop resources that allow identification of novel targets in a statistically rigorous way to overcome therapeutic challenges. Here we compiled a single cell RNA sequencing (scRNAseq) atlas of the human pancreas with 229 individual patient samples, aggregated from raw data obtained from published studies. We mapped cell-type specific scRNAseq gene signatures in newly generated (n=12) and existing (n=13) spatial transcriptomics (ST) data from PDAC samples. Analysis of tumor cells from our scRNAseq atlas revealed nine transcriptionally distinct populations, two of which strongly align with a basal gene signature, correlating with worse overall survival in PDAC bulk RNAseq datasets. Deconvolution showed one of the basal populations identified to be the predominant tumor subtype in non- dissociated ST tissues and in vitro tumor cell and organoid PDAC lines. In bulk RNAseq datasets, we uncovered that myofibroblasts (myFb) expressing CXCL10 consistently correlated with both basal subtypes and were found near basal tumor cells using immunostaining. We also identified that besides immune cells, ductal cells also express CXCR3, the receptor for CXCL10, further suggesting a relationship between these cell types in PDAC tumor microenvironment (TME). Overall, we show that our newly built scRNAseq atlas, containing over 700,000 cells, integrated with ST data is a powerful resource, given that it corroborates numerous PDAC TME observations in the literature, with increased statistical power. Moreover, we uncovered a novel association between CXCL10+ myFb and basal tumor cells, underscoring the presence of unique spatial niches in PDAC that should be explored for the development of targeted therapies for this dismal disease. Citation Format: Ian M Loveless, Samantha B Kempt, Yuesong Wu, Daniel J Salas-Escabillas, Kailee Hartway, Madison George, Yetunde Makinwa, Thais Stockdale, Samuel D Zwernik, Kendyll Gartrelle, Rohit G Reddy, Daniel Long, Allison Wombell, Julie M Clark, Albert M Levin, David Kwon, Ling Huang, Ralph Francescone, Débora B Vendramini-Costa, Ben Stanger, Adam Alessio, Andrew M Waters, Yuehua Cui, Brian Theisen, Howard C Crawford, Nina G Steele. Human pancreatic cancer single cell atlas reveals association of CXCL10 positive fibroblasts and basal subtype tumor cells [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr B068.

Abstract A035: 3D High-Density Collagen I Improves the Modeling of Aggressive Pancreatic Cancer

Abstract Background: Fibrillar collagen type I constitutes the majority of the extracellular matrix in pancreatic ductal adenocarcinoma (PDAC), yet most in vivo murine models involve the use of basement membrane extracts, which instead contain collagen type IV, as matrices to embed PDAC cells. Type I collagen in the PDAC tumor microenvironment has been associated with worse prognosis. Our hypothesis is that PDAC cells grown in 3D high-density collagen I (HDC) gels behave more aggressively compared to the same cells grown using conventional basement membrane matrix (BMM). Methods: The KPC1199 2D cell line was previously generated from a tumor-bearing male KPC mouse. KPC1199 cells were cultured in vitro in HDC or BMM for one week. Orthotopic tumors were established by embedding KPC1199 cells in HDC (N=10) or BMM (N=10) in the pancreatic tail of syngeneic C57BL/6J mice via laparotomy. Half of the tumors were collected five weeks after tumor implantation, and the other half utilized for a survival study. Collagen was imaged by second harmonic generation (SHG) microscopy. Results: In vitro imaging of single KPC1199 cells grown in HDC revealed an aggressive phenotype with clonal network-like structures compared to a spheroidal, non-aggressive phenotype for cells grown in BMM over the course of seven days. SHG imaging confirmed consistent formation and organization of collagen in HDC tumors but minimal to faint collagen formation in BMM tumors. Gross examination of HDC mice showed 60% with visible liver metastasis compared with none in the BMM mice. In the survival study, the entire HDC group died before the BMM group (p-value < 0.01). Conclusions: Our pilot study is the first, to our knowledge, to successfully generate orthotopic PDAC tumors using 3D high-density collagen I in a mouse model. KPC1199 cells embedded in HDC showed an aggressive phenotype in vitro, and resultant tumors demonstrated more robust collagen organization compared to the same cells grown in the BMM substrate. This aggressive phenotype translated to visible liver metastasis within five weeks in the HDC mice and prior to death from primary tumor burden. This is not typical for most KPC-derived cell lines but is typical for human PDAC patients. Our preliminary findings support the use of HDC as an alternative substrate for better modeling of this aggressive cancer. Citation Format: Kim Nguyen-Ta, Sural Ranamukhaarachchi, Jeffrey Turner, Utsav Joshi, Himangshu Sonowal, Jorge de la Torre Medina, Herve Tiriac, Stephanie Fraley, Rebekah White. 3D High-Density Collagen I Improves the Modeling of Aggressive Pancreatic Cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr A035.

Abstract A032: Cancer associated fibroblasts drive classical to basal change associated with increased T cell presence in pancreatic ductal adenocarcinoma

Abstract Introduction: A complex immunosuppressive tumor microenvironment (TME) is a distinctive feature of pancreatic ductal adenocarcinoma (PDAC). The TME consists of an admixture of cell types including epithelial, endothelial, immune cells of both myeloid and lymphoid origin, and cancer-associated fibroblasts (CAFs). The traditionally defined subtypes of PDAC tumor cells include classical, associated with the retention of epithelial markers and a better prognosis, and basal, which is characterized by a quasi-mesenchymal phenotype with poorer responses to chemotherapy and worse overall survival. Additionally, CAF subtypes are associated with specific roles within the TME. These include inflammatory (iCAF), with the capacity to secrete IL-6, myofibroblastic (myCAF), defined by high levels of alpha smooth muscle actin (αSMA) expression, and antigen presenting (apCAF), defined by expression of HLA-DR and antigen processing and presentation capacity. We hypothesized that interactions between CAFs and tumor cells altered tumor cell phenotype and could be delineated. Methods: Using multi-omics platforms, we evaluated the impact of CAF populations on tumor cell phenotype. Our approach integrated multiplex immunohistochemistry, imaging mass cytometry (IMC) and RNA-scope of patient tumor tissues with functional in vitro studies from matched patient-derived organoid (PDO) and CAF cocultures. The dynamic impact of CAFs on PDOs was examined using a combination of bulk RNA sequencing, multiparametric flow cytometry and secretome analysis, in addition to RT-qPCR and western blot comparing cocultures to matched PDO monocultures. Results: IMC of 15 patient tumors revealed distinct neighborhoods of CAFs and tumor cells. iCAFs were in close proximity to classical tumor cells, while myCAFs were in close proximity to basal tumor cells. Further, in our PDO-CAF co-cultures the PDOs underwent a shift from classical to basal subtype in 42% of co-cultures, a phenomenon also inferred in patient tissues by associating collagen content with classical or basal designation. We also captured a tumor cell population expressing both basal and classical markers that may represent a transition state. The shift from classical to basal tumor cell subtype was accompanied by enhanced epithelial-mesenchymal transition and a loss of IL-8 secretion. Interestingly, when we examined immune cell distribution within tumor tissues, T cells were both the most proximal and the most abundant immune cell type in relation to tumor cells. Moreover, the highest frequency of total and activated T cells was seen in close association with basal tumor cells. Conclusions: Our study underscores the importance of understanding the complex interplay between CAFs and tumor cells in PDAC. Further, we identify a relationship between T cells and tumor cell subtypes. By leveraging high-dimensional data and patient-derived models, we provide new insights into the spatial and functional dynamics of the PDAC TME, paving the way for novel therapeutic strategies to reprogram the TME and enhance patient survival. Citation Format: Jacquelyn W Zimmerman, Samantha Guinn, Mili Ramani, Brayan Perez, Joseph A Tandurella, Daniel J Zabransky, Jae W Lee, Emma Kartalia, Jignasha Patel, Sarah Shin, Alexei Hernandez, Courtney Cannon, Nicole Gross, Soren Charmsaz, Elana J Fertig, Richard A Burkhart, Won J Ho, Elizabeth M Jaffee. Cancer associated fibroblasts drive classical to basal change associated with increased T cell presence in pancreatic ductal adenocarcinoma [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr A032.

Abstract A045: Disrupting local immunosuppression through combination myCAF/myeloid targeting in pancreatic cancer

Abstract Immunotherapy has revolutionized clinical care for many cancers, yet the approach has not been fully realized in immunologically cold tumors like Pancreatic Ductal Adenocarcinoma (PDAC). One striking hallmark of PDAC is local immunosuppression (LIS) which leads to cytotoxic T cell inactivation and exclusion. There is great need for an increased understanding of the cellular crosstalk within tumors and the identification of stromal and immune populations involved in shaping the tumor microenvironment (TME). Oncogenic KRAS activation in tumor cells promotes the invasion and proliferation of tumor-supporting stromal cells, while excluding cancer-targeted cytotoxic T cells. LIS is mediated by multiple subtypes of cancer-associated fibroblasts (CAFs) and myeloid cells resident within the tumor parenchyma. Multiple prior attempts to reverse LIS in PDAC by targeting individual stromal cell populations have been unsuccessful, alluding to the complexity of stromal crosstalk within the TME. The stromal diversity of PDAC complicates investigating paracrine cascades involving multiple cell types. To decipher diverse drug effects on altering the TME, we employ in vivo studies in mouse models recapitulating the human disease, as well as a novel tumor explant model that enables the short-term culture of intact human or murine PDAC. Importantly, PDAC explants maintain their histopathological architecture and cellular diversity over time. This medium-throughput platform allows for testing of multiple drugs and mechanistic hypotheses in the native PDAC TME. We show in preliminary data that Smoothened inhibition (SMOi) decreases proliferation and activity of myCAFs, but provokes the expansion of CD11b-positive myeloid cells in vivo. Thus, we hypothesize that LIS in PDAC is maintained by a delicate balance between myCAFs and myeloid cells, preventing effective T cell invasion. Single cell RNA-seq data comparing ctrl vs. SMOi-treated murine PDAC elucidates stromal subpopulations involved in the LIS phenotype and guides the identification of myeloid subtypes emerging after SMOi. Strikingly, we demonstrated that simultaneous SMOi and targeting myeloid cells via anti-Gr1 or CCR1 inhibition (CCR1i) significantly elevates cytotoxic T cell numbers up to 20x within the TME. We are currently investigating whether the activity of these T cells may be further potentiated through combination with immunomodulatory agents. By testing various treatment combination in the same TME, we will identify the best synergistic effects for future immunotherapy approaches in human PDAC. In summary, we are elucidating the complex mechanism behind LIS in PDAC by employing our novel explant culture system alongside in vivo studies. We aim to develop a translatable regimen to neutralize LIS, reactivating the cytotoxic T cells in the tumor periphery to invade, proliferate, and attack cancer cells. Citation Format: Marie C Hasselluhn, Lukas Vlahos, Dafydd Thomas, Quin T Waterbury, Alvaro Curiel Garcia, Amanda R Decker-Farrell, Tanner C Dalton, Stephen A Sastra, Carmine F Palermo, Timothy C Wang, Andrea Califano, Kenneth P Olive. Disrupting local immunosuppression through combination myCAF/myeloid targeting in pancreatic cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr A045.

Abstract A048: Paricalcitol improves survival in tumor-permissive cancer-associated fibroblast subtype of pancreatic cancers

Abstract INTRODUCTION: Pancreatic ductal adenocarcinoma (PDAC) remains a deadly disease with poor survival and limited therapy options. While traditional cytotoxic agents target cancer cells, there has been growing interest in tumor microenvironment (TME) modulation given that desmoplastic stroma and immune suppression are hallmarks of PDAC. Recently, vitamin D agonism has been identified as a potential treatment to normalize the PDAC TME. We have previously described tumor-intrinsic and cancer-associated fibroblast (CAF) subtypes of PDAC that independently predict survival, but whether these subtypes are associated with outcomes after TME modulation has not been studied. METHODS: We evaluated the association of treatment outcomes in a Phase 2 trial of neoadjuvant nab-paclitaxel (A), gemcitabine (G), cisplatin (C), and paricalcitol (P) (NCT03138720) and a Phase 2 trial of A+G+C+hydroxychloroquine (HCQ) (NCT04669197) in patients with non-metastatic PDAC. RNA-sequencing was performed on 28 pretreatment biopsy samples. PurIST and DeCAF were used to determine tumor-intrinsic and CAF subtypes, respectively. Clinical variables such as CA19-9 levels, resectability, and overall survival (OS) were examined. RESULTS: For tumor-intrinsic subtypes, 5 tumors (18%) were basal-like and 23 (82%) were classical. For CAF subtypes, 11 (39%) were tumor-permissive (perm)CAF and 17 (61%) were tumor-restraining (rest)CAF. Neither tumor-intrinsic or CAF subtypes were associated with CA19-9 normalization or resectability at time of diagnosis in either trial. OS was available for NCT03138720; patients with basal-like tumors receiving A+G+C+P had worse median survival of 12.3 months compared to 20.9 months for those with classical tumors, although this difference did not reach statistical significance (log-rank P = 0.065). In two independent cohorts of 925 and 129 patients, those with permCAF tumors had an increased hazard ratio of at least 1.5 (P < 0.001) compared to patients with restCAF tumors for OS. Compared to this historical data, we did not find a difference in OS between patients with permCAF tumors (19.5 months) compared to restCAF tumors (19.7 months, log-rank P = 0.56). CONCLUSION: In the study of A+G+C+P, there was a disparity in OS between patients with basal-like vs. classical tumors, in contrast to the interim results of the COMPASS and PASS-01 trials, where patients with basal-like tumors receiving A+G had similar OS compared to patients with classical tumors. Compared to prior analysis, there was no difference in OS for patients with permCAF tumors vs. those with restCAF tumors, which may suggest that either paricalcitol (or the cytotoxic combination) may be of benefit for patients with permCAF tumors and normalize the CAF landscape. Single-agent studies with paired pre- and post-treatment samples are needed to better understand how to best tailor therapy regiments for patients based on tumor subtypes. Citation Format: Jaewon J Lee, Priscilla S Chan, Changfei Luan, Elena V Kharitonova, Naim U Rashid, Xianlu L Peng, Erkut H Borazanci, Jen Jen Yeh. Paricalcitol improves survival in tumor-permissive cancer-associated fibroblast subtype of pancreatic cancers [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr A048.

Abstract B051: Influence of MUC16 on the immune tumor microenvironment of PDAC

Abstract Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease. In most cases, PDAC initiation results from oncogenic KRAS mutations, that act in part by directly increasing levels of a glycoprotein called Mucin-16 (MUC16). MUC16 is virtually absent in the normal pancreas, expressed on tumor cells in >65% of PDAC and is a marker of poor prognosis. The cell autonomous roles of MUC16 involve signaling through the ErbB-1/2/3 axes, and eliciting downstream AKT and GSK-3β activation to promote cell proliferation and survival. PDAC has a very interesting “immune cold” tumor microenvironment (TME) that is devoid of anti-tumor T cells and is instead flush with pro-tumor myeloid cells like macrophages. However, the role of MUC16 in influencing immune cells, particularly macrophages has not been investigated. Methods: We use immunohistochemistry to check for macrophage populations in spontaneous and orthotopic models of PDAC, KPC (LSL-Kras G12D/+ ; LSL-Trp53 R172H/+ ; Pdx-1- Cre) and a derived KPC-MUC16 knockout (KPC-M16KO). Orthotopic implantation with KPC and KPC-M16- cells was done to assess survival. In vitro cytokine screening from M16+/- cells was done to understand cytokine players in MUC16-mediated immunosuppression. Clodronate liposomes (CL) and neutral control liposomes (NL) were used to deplete macrophages in orthotopically implanted KPC and KPC-M16- tumor-bearing mice, and flow cytometry was conducted to profile macrophages and T cells in the pancreas and spleens at the experimental endpoint. Results: We show that KPC-M16KO tumors have decreased M2-like macrophages, and a modest increase in M1-like macrophages, leading to a high M1/M2 ratio suggesting reduced immune suppressed cells in the KPC-M16KO models. KPC-M16KO tumor-bearing mice showed longer survival compared to the KPC group. In addition, we detect low levels of CCL2 and Serpin-E1 in cell lines and tumor tissues from KPC-M16KO models suggesting that they could serve as potential regulators of macrophage infiltration and M2-like polarization downstream of MUC16. Siglec-E (murine homolog of human Siglec-7/9) was also downregulated in KPC-M16KO tumors, suggesting MUC16-Siglec mediated immunosuppression as another mechanism. CL administration (versus NL) resulted in significant macrophage depletion in the spleens of mice with KPC and KPC-M16KO tumors, however, such depletion was not robust in the pancreas. Immune profiling studies showed a high M1/M2 ratio in the spleen and pancreas of mice treated with CL, suggesting a tumor cell-macrophage crosstalk, that could mediate M2-like macrophage states in a macrophage-rich TME. Mice treated with CL have smaller tumors, and KPC-M16KO+CL group had the smallest tumors, indicative that dual disruption of MUC16 and macrophages lowers tumor burden. Conclusions: These results suggest that MUC16 plays a crucial role in modulating the tumor immune microenvironment by increasing the accumulation of immunosuppressive macrophages in PDAC. Citation Format: Christabelle Rajesh, Satish Sagar, Prakash Radhakrishnan. Influence of MUC16 on the immune tumor microenvironment of PDAC [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr B051.

A 3D Bio-Printed-Based Model for Pancreatic Ductal Adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is a disease with a very poor prognosis, characterized by incidence rates very close to death rates. Despite the efforts of the scientific community, preclinical models that faithfully recreate the PDAC tumor microenvironment remain limited. Currently, the use of 3D bio-printing is an emerging and promising method for the development of cancer tumor models with reproducible heterogeneity and a precisely controlled structure. This study presents the development of a model using the extrusion 3D bio-printing technique. Initially, a model combining pancreatic cancer cells (Panc-1) and cancer-associated fibroblasts (CAFs) encapsulated in a sodium alginate and gelatin-based hydrogel to mimic the metastatic stage of PDAC was developed and comprehensively characterized. Subsequently, efforts were made to vascularize this model. This study demonstrates that the resulting tumors can maintain viability and proliferate, with cells self-organizing into aggregates with a heterogeneous composition. The utilization of 3D bio-printing in creating this tumor model opens avenues for reproducing tumor complexity in the future, offering a versatile platform for improving anti-cancer therapy models.

The pro-inflammatory cytokines IL-1β and IL-6 promote upregulation of the ST6GAL1 sialyltransferase in pancreatic cancer cells

The ST6GAL1 sialyltransferase is overexpressed in multiple cancers including pancreatic ductal adenocarcinoma (PDAC). ST6GAL1 adds an α2-6-linked sialic acid to N-glycosylated membrane receptors, which consequently modulates receptor structure and function. While many studies have investigated the effects of ST6GAL1 on cell phenotype, there is a dearth of knowledge regarding mechanisms that regulate ST6GAL1 expression. In the current study, we evaluated the regulation of ST6GAL1 by two pro-inflammatory cytokines, IL-1β and IL-6, that are abundant within the PDAC tumor microenvironment. Cytokine activity was monitored using the Suit-2 PDAC cell line and two Suit-2-derived metastatic subclones, S2-013 and S2-LM7AA. For all three cell models, treatment with IL-1β or IL-6 increased the expression of ST6GAL1 protein and mRNA. Specifically, IL-1β and IL-6 induced expression of the ST6GAL1 YZ mRNA isoform, which is driven by the P3 promoter. The ST6GAL1 H and X isoforms were not detected. Promoter reporter assays confirmed that IL-1β and IL-6 activated transcription from the P3 promoter. We then examined downstream signaling mechanisms. IL-1β is known to signal through the NFκB transcription factor, whereas IL-6 signals through the STAT3 transcription factor. CUT&RUN experiments revealed that IL-1β promoted the binding of NFκB to the ST6GAL1 P3 promoter, and IL-6 induced the binding of STAT3 to the P3 promoter. Finally, we determined that inhibitors of NFκB and STAT3 blocked the upregulation of ST6GAL1 stimulated by IL-1β and IL-6, respectively. Together, these results highlight a novel molecular pathway by which cytokines within the tumor microenvironment stimulate the upregulation of ST6GAL1 in PDAC cells.

Nanoparticle delivery of innate immune agonists combined with senescence-inducing agents promotes T cell control of pancreatic cancer.

Pancreatic ductal adenocarcinoma (PDAC) has quickly risen to become the third leading cause of cancer-related death in the United States. This is in part because of its fibrotic tumor microenvironment (TME) that contributes to poor vascularization and immune infiltration and subsequent chemo- and immunotherapy failure. Here, we investigated an immunotherapy approach combining delivery of stimulator of interferon genes (STING) and Toll-like receptor 4 (TLR4) innate immune agonists by lipid-based nanoparticle (NP) coencapsulation with senescence-inducing RAS-targeted therapies, which can remodel the immune suppressive PDAC TME through the senescence-associated secretory phenotype. Treatment of transplanted and autochthonous PDAC mouse models with these regimens led to enhanced uptake of NPs by multiple cell types in the PDAC TME, induction of type I interferon and other proinflammatory signaling pathways, increased antigen presentation by tumor cells and antigen-presenting cells, and subsequent activation of both innate and adaptive immune responses. This two-pronged approach produced potent T cell-driven and type I interferon-mediated tumor regression and long-term survival in preclinical PDAC models dependent on both tumor and host STING activation. STING and TLR4-mediated type I interferon signaling was also associated with enhanced natural killer and CD8+ T cell immunity in human PDAC samples. Thus, combining localized immune agonist delivery with systemic tumor-targeted therapy can orchestrate a coordinated type I interferon-driven innate and adaptive immune response with durable antitumor efficacy against PDAC.

Precision Targeting Strategies in Pancreatic Cancer: The Role of Tumor Microenvironment.

Pancreatic cancer demonstrates an ever-increasing incidence over the last years and represents one of the top causes of cancer-associated mortality. Cells of the tumor microenvironment (TME) interact with cancer cells in pancreatic ductal adenocarcinoma (PDAC) tumors to preserve cancer cells' metabolism, inhibit drug delivery, enhance immune suppression mechanisms and finally develop resistance to chemotherapy and immunotherapy. New strategies target TME genetic alterations and specific pathways in cell populations of the TME. Complex molecular interactions develop between PDAC cells and TME cell populations including cancer-associated fibroblasts, myeloid-derived suppressor cells, pancreatic stellate cells, tumor-associated macrophages, tumor-associated neutrophils, and regulatory T cells. In the present review, we aim to fully explore the molecular landscape of the pancreatic cancer TME cell populations and discuss current TME targeting strategies to provide thoughts for further research and preclinical testing.

Inhibition of SUMOylation Induces Adaptive Antitumor Immunity against Pancreatic Cancer through Multiple Effects on the Tumor Microenvironment.

Improvement of outcome in patients with pancreatic ductal adenocarcinoma (PDAC) requires exploration of novel therapeutic targets. Thus far, most studies of PDAC therapies, including those inhibiting small ubiquitin-like modifications (SUMOylation), have focused on PDAC epithelial cell biology, yet SUMOylation occurs in a variety of cell types. The mechanisms by which SUMOylation impacts PDAC in the context of its tumor microenvironment are poorly understood. We used clinically relevant orthotopic PDAC mouse models to investigate the effect of SUMOylation inhibition using a specific, clinical-stage compound, TAK-981. In contrast to its inhibition of PDAC cell proliferation in vitro, the survival benefit conferred by TAK-981 in vivo is dependent on the presence of T cells, suggesting that induction of adaptive antitumor immunity is an important antitumor effect of SUMOylation inhibition in vivo. To understand how this adaptive antitumor immunity is promoted, we investigated how SUMOylation inhibition in vivo alters major cell types/subtypes and their communications in the PDAC tumor microenvironment by performing transcriptomic analyses at single-cell resolution, which allowed mapping of cells in our orthotopic mouse model to cells in human PDAC tumors based on gene expression profiles. Findings are further validated by flow cytometry, immunofluorescence, IHC, western blots, and qPCR. The single-cell transcriptome dataset provided here suggests several combination strategies to augment adaptive immune responses that are necessary for durable disease control in patients with PDAC.

Enhancing Neoadjuvant Virotherapy's Effectiveness by Targeting Stroma to Improve Resectability in Pancreatic Cancer.

About one-fourth of patients with pancreatic ductal adenocarcinoma (PDAC) are categorized as borderline resectable (BR) or locally advanced (LA). Chemotherapy and radiation therapy have not yielded the anticipated outcomes in curing patients with BR/LA PDAC. The surgical resection of these tumors presents challenges owing to the unpredictability of the resection margin, involvement of vasculature with the tumor, the likelihood of occult metastasis, a higher ratio of positive lymph nodes, and the relatively larger size of tumor nodules. Oncolytic virotherapy has shown promising activity in preclinical PDAC models. Unfortunately, the desmoplastic stroma within the PDAC tumor microenvironment establishes a barrier, hindering the infiltration of oncolytic viruses and various therapeutic drugs-such as antibodies, adoptive cell therapy agents, and chemotherapeutic agents-in reaching the tumor site. Recently, a growing emphasis has been placed on targeting major acellular components of tumor stroma, such as hyaluronic acid and collagen, to enhance drug penetration. Oncolytic viruses can be engineered to express proteolytic enzymes that cleave hyaluronic acid and collagen into smaller polypeptides, thereby softening the desmoplastic stroma, ultimately leading to increased viral distribution along with increased oncolysis and subsequent tumor size regression. This approach may offer new possibilities to improve the resectability of patients diagnosed with BR and LA PDAC.

Theranostic nanoparticles for detection and treatment of pancreatic cancer.

Pancreatic ductal adenocarcinoma (PDAC) is one of the most recalcitrant cancers due to its late diagnosis, poor therapeutic response, and highly heterogeneous microenvironment. Nanotechnology has the potential to overcome some of the challenges to improve diagnostics and tumor-specific drug delivery but they have not been plausibly viable in clinical settings. The review focuses on active targeting strategies to enhance pancreatic tumor-specific uptake for nanoparticles. Additionally, this review highlights using actively targeted liposomes, micelles, gold nanoparticles, silica nanoparticles, and iron oxide nanoparticles to improve pancreatic tumor targeting. Active targeting of nanoparticles toward either differentially expressed receptors or PDAC tumor microenvironment (TME) using peptides, antibodies, small molecules, polysaccharides, and hormones has been presented. We focus on microenvironment-based hallmarks of PDAC and the potential for actively targeted nanoparticles to overcome the challenges presented in PDAC. It describes the use of nanoparticles as contrast agents for improved diagnosis and the delivery of chemotherapeutic agents that target various aspects within the TME of PDAC. Additionally, we review emerging nano-contrast agents detected using imaging-based technologies and the role of nanoparticles in energy-based treatments of PDAC. This article is categorized under: Implantable Materials and Surgical Technologies > Nanoscale Tools and Techniques in Surgery Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease Diagnostic Tools > In Vivo Nanodiagnostics and Imaging.