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Senescence-Induced Vascular Remodeling Creates Therapeutic Vulnerabilities in Pancreas Cancer.
Cell ( IF 45.5 ) Pub Date : 2020-03-31 , DOI: 10.1016/j.cell.2020.03.008
Marcus Ruscetti 1 , John P Morris 1 , Riccardo Mezzadra 1 , James Russell 2 , Josef Leibold 1 , Paul B Romesser 3 , Janelle Simon 1 , Amanda Kulick 4 , Yu-Jui Ho 1 , Myles Fennell 1 , Jinyang Li 5 , Robert J Norgard 5 , John E Wilkinson 6 , Direna Alonso-Curbelo 1 , Ramya Sridharan 7 , Daniel A Heller 7 , Elisa de Stanchina 4 , Ben Z Stanger 5 , Charles J Sherr 8 , Scott W Lowe 9
Affiliation  

KRAS mutant pancreatic ductal adenocarcinoma (PDAC) is characterized by a desmoplastic response that promotes hypovascularity, immunosuppression, and resistance to chemo- and immunotherapies. We show that a combination of MEK and CDK4/6 inhibitors that target KRAS-directed oncogenic signaling can suppress PDAC proliferation through induction of retinoblastoma (RB) protein-mediated senescence. In preclinical mouse models of PDAC, this senescence-inducing therapy produces a senescence-associated secretory phenotype (SASP) that includes pro-angiogenic factors that promote tumor vascularization, which in turn enhances drug delivery and efficacy of cytotoxic gemcitabine chemotherapy. In addition, SASP-mediated endothelial cell activation stimulates the accumulation of CD8+ T cells into otherwise immunologically "cold" tumors, sensitizing tumors to PD-1 checkpoint blockade. Therefore, in PDAC models, therapy-induced senescence can establish emergent susceptibilities to otherwise ineffective chemo- and immunotherapies through SASP-dependent effects on the tumor vasculature and immune system.

中文翻译:

衰老诱导的血管重塑在胰腺癌中造成治疗漏洞。

KRAS 突变胰腺导管腺癌 (PDAC) 的特点是促纤维增生反应,促进血管减少、免疫抑制和对化学和免疫治疗的抵抗。我们表明,靶向 KRAS 定向致癌信号的 MEK 和 CDK4/6 抑制剂的组合可以通过诱导视网膜母细胞瘤 (RB) 蛋白介导的衰老来抑制 PDAC 增殖。在 PDAC 的临床前小鼠模型中,这种诱导衰老的疗法产生了一种衰老相关的分泌表型 (SASP),其中包括促进肿瘤血管化的促血管生成因子,从而增强了药物递送和细胞毒性吉西他滨化疗的功效。此外,SASP 介导的内皮细胞活化会刺激 CD8+ T 细胞聚集到其他免疫学“冷”肿瘤中,使肿瘤对 PD-1 检查点阻断敏感。因此,在 PDAC 模型中,治疗诱导的衰老可以通过对肿瘤脉管系统和免疫系统的 SASP 依赖性影响,建立对其他无效的化学和免疫疗法的敏感性。
更新日期:2020-04-20
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