1. Image-based detection and targeting of therapy resistance in pancreatic adenocarcinoma.
- Author
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Fox RG, Lytle NK, Jaquish DV, Park FD, Ito T, Bajaj J, Koechlein CS, Zimdahl B, Yano M, Kopp J, Kritzik M, Sicklick J, Sander M, Grandgenett PM, Hollingsworth MA, Shibata S, Pizzo D, Valasek M, Sasik R, Scadeng M, Okano H, Kim Y, MacLeod AR, Lowy AM, and Reya T
- Subjects
- Animals, Carcinoma in Situ genetics, Carcinoma in Situ pathology, Carcinoma, Pancreatic Ductal genetics, Carcinoma, Pancreatic Ductal metabolism, Carcinoma, Pancreatic Ductal pathology, Cell Transformation, Neoplastic genetics, Disease Models, Animal, Disease Progression, Drug Resistance, Neoplasm genetics, Female, Gene Deletion, Genes, Reporter genetics, Humans, Male, Mice, Models, Genetic, Neoplastic Cells, Circulating metabolism, Nerve Tissue Proteins deficiency, Nerve Tissue Proteins metabolism, Oligonucleotides, Antisense administration & dosage, Oligonucleotides, Antisense genetics, Oligonucleotides, Antisense pharmacokinetics, Oligonucleotides, Antisense therapeutic use, Pancreatic Neoplasms genetics, Pancreatic Neoplasms metabolism, Pancreatic Neoplasms pathology, RNA-Binding Proteins metabolism, Signal Transduction drug effects, Survival Rate, Xenograft Model Antitumor Assays, Carcinoma, Pancreatic Ductal drug therapy, Drug Resistance, Neoplasm drug effects, Molecular Imaging, Nerve Tissue Proteins genetics, Pancreatic Neoplasms drug therapy, RNA-Binding Proteins genetics
- Abstract
Pancreatic intraepithelial neoplasia is a pre-malignant lesion that can progress to pancreatic ductal adenocarcinoma, a highly lethal malignancy marked by its late stage at clinical presentation and profound drug resistance. The genomic alterations that commonly occur in pancreatic cancer include activation of KRAS2 and inactivation of p53 and SMAD4 (refs 2-4). So far, however, it has been challenging to target these pathways therapeutically; thus the search for other key mediators of pancreatic cancer growth remains an important endeavour. Here we show that the stem cell determinant Musashi (Msi) is a critical element of pancreatic cancer progression both in genetic models and in patient-derived xenografts. Specifically, we developed Msi reporter mice that allowed image-based tracking of stem cell signals within cancers, revealing that Msi expression rises as pancreatic intraepithelial neoplasia progresses to adenocarcinoma, and that Msi-expressing cells are key drivers of pancreatic cancer: they preferentially harbour the capacity to propagate adenocarcinoma, are enriched in circulating tumour cells, and are markedly drug resistant. This population could be effectively targeted by deletion of either Msi1 or Msi2, which led to a striking defect in the progression of pancreatic intraepithelial neoplasia to adenocarcinoma and an improvement in overall survival. Msi inhibition also blocked the growth of primary patient-derived tumours, suggesting that this signal is required for human disease. To define the translational potential of this work we developed antisense oligonucleotides against Msi; these showed reliable tumour penetration, uptake and target inhibition, and effectively blocked pancreatic cancer growth. Collectively, these studies highlight Msi reporters as a unique tool to identify therapy resistance, and define Msi signalling as a central regulator of pancreatic cancer.
- Published
- 2016
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