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<p>Oncogenic mutations in KRAS are present in approximately 95% of patients diagnosed with pancreatic ductal adenocarcinoma (<b>PDAC</b>) and are considered the initiating event during the development of pancreatic intraepithelial neoplasia (<b>PanIN</b>) precursor lesions. While it is well established that KRAS mutations can drive the initiation of pancreatic oncogenesis, the effects of oncogenic KRAS signaling on regulation of phosphatases during this process is not fully appreciated. Protein Phosphatase 2A (<b>PP2A</b>) has been implicated in suppressing KRAS-driven cellular transformation. However, low PP2A activity is observed in PDAC cells compared to non-transformed cells, suggesting that suppression of PP2A activity is an important step in the overall development of PDAC. In the current study, we demonstrate that KRASG12D induces the expression of both Cancerous Inhibitor of PP2A (<b>CIP2A</b>), an endogenous inhibitor of PP2A activity, and the PP2A target, c-MYC. Consistent with these findings, KRASG12D sequestered the specific PP2A subunit responsible for c-MYC degradation, B56a, away from the active PP2A holoenzyme in a CIP2A-dependent manner. During PDAC initiation <i>in vivo</i>, knockout of B56a promoted KRASG12D tumorigenesis by accelerating acinar-to-ductal metaplasia (<b>ADM</b>) and the formation of PanIN lesions. The process of ADM was attenuated <i>ex vivo</i> in response to pharmacological re-activation of PP2A utilizing direct small molecule activators of PP2A (<b>SMAP</b>s). Together, the results of this study suggest that suppression of PP2A-B56a through KRAS signaling can promote Myc-driven initiation of pancreatic tumorigenesis.</p>

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L’adénocarcinome canalaire du pancréas (PDAC) est un des cancers les plus agressifs avec un taux de survie à 5 ans de moins de 5 %. Une des raisons est l’absence de traitement thérapeutique efficace. Des efforts afin d’identifier de nouvelles cibles pour le traitement du PDAC sont donc nécessaires. Il a été démontré que la dénervation du pancréas régule la progression des PDAC dans des modèles murins. De plus, on a rapporté que les axones du système nerveux périphérique (SNP) innervent les tumeurs pancréatiques, mais l'identité précise des fibres infiltrant la tumeur est inconnue.Ici, nous avons caractérisé le remodelage des principales divisions du SNP, y compris les systèmes autonomes et sensoriels, dans des modèles murins qui récapitulent la maladie humaine. Nous avons aussi commencé à caractériser l'innervation des PDAC dans des échantillons humains. Nous avons observé une augmentation de la densité des fibres sympathiques positives pour la tyrosine hydroxylase (TH) dans les lésions pré-tumorales du pancréas, alors qu'une forte densité de fibres sensorielles positives pour le peptide lié au gène de la calcitonine (CGRP) a été observée dans les PDAC. Fait intéressant, alors que dans tissus normaux les axones sympathiques et sensoriels sont principalement associés aux vaisseaux sanguins, ils sont majoritairement isolés dans les lésions pré-tumorales et les PDAC. Ces données suggèrent que la plasticité axonale survient aux stades précoces du développement tumoral pour les fibres sympathiques et à un stade plus tardif pour les fibres sensorielles. Ce travail suggère de nouvelles cibles potentielles pour le traitement des PDAC. / Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with 5-year survival rate of less than 5%. One reason to explain this poor outcome is that there has been no effective therapeutic treatment for PDAC patients. Thus, efforts to identify novel targets for PDAC treatment are required. Denervation of the pancreas has been shown to regulate PDAC progression in murine models. In addition, axons of the peripheral nervous system (PNS) have been reported to innervate pancreatic tumors, but the precise identity of the tumor-infiltrating fibers is unknown. Here we characterized the remodeling of the main divisions of the PNS, including autonomic and sensory systems, in mouse models, which recapitulate the human disease. We also started to characterize the innervation of human PDAC samples. We observed an increased density of tyrosine hydroxylase (TH)-positive sympathetic fibers in pre-tumoral lesions of the pancreas, while a high density of calcitonin gene-related peptide (CGRP)-positive sensory fibers was seen within PDAC. Interestingly, whereas in the normal tissues TH+ and CGRP+ axons were mostly associated to blood vessels, they were mainly isolated in lesions and PDAC. These data suggest that axonal plasticity occurs at the early stage of tumor development for sympathetic fibers and at the late stage for sensory fibers. This work suggests potential novel targets for the treatment of PDAC.

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To optimize neoadjuvant radiochemotherapy of pancreatic ductal adenocarcinoma (PDAC), the value of new irradiation modalities such as proton therapy needs to be investigated in relevant preclinical models. We studied individual treatment responses to RCT using patient-derived PDAC organoids (PDO). Four PDO lines were treated with gemcitabine, 5-fluorouracile (5FU), photon and proton irradiation and combined RCT. Therapy response was subsequently measured via viability assays. In addition, treatment-naive PDOs were characterized via whole exome sequencing and tumorigenicity was investigated in NMRI Foxn1nu/nu mice. We found a mutational pattern containing common mutations associated with PDAC within the PDOs. Although we could unravel potential complications of the viability assay for PDOs in radiobiology, distinct synergistic effects of gemcitabine and 5FU with proton irradiation were observed in two PDO lines that may lead to further mechanistical studies. We could demonstrate that PDOs are a powerful tool for translational proton radiation research.

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Lokale Invasion und Ausbreitung von Tumorzellen entlang von Nerven und Gefäßen limitieren den Erfolg kurativer Therapien von Patienten mit Pankreaskarzinom (PDAC). Der axon guidance Faktor Slit2 und seine Robo-Rezeptoren steuern die Navigation von Nerven und Gefäßen sowie die Motilität von Epithelzellen. Sie stellen somit attraktive Regulatoren der klinisch bedeutsamen Ausbreitungswege des PDAC dar. Zielsetzung der vorgelegten Arbeit war die Charakterisierung der Expression von Slit2 im PDAC und seiner Funktion für Tumorwachstum und -ausbreitung. Quantitative Analysen belegten eine deutliche Reduktion der Slit2 mRNA Expression in humanen PDAC Proben im Vergleich zu gesundem Gewebe. Zudem korrelierten Slit2 mRNA-Werte unterhalb des Medians mit einer höheren Inzidenz lymphatischer Metastasierung und einem gesteigerten Prozentsatz befallener Lymphknoten. Die Slit2-Rezeptoren Robo1 und 4 wiesen hingegen vergleichbare Immunreaktivität im Tumor und gesundem Gewebe auf, wobei eine differentielle Lokalisation in Epithelien, Nerven und Gefäßen zu beobachten war. Die Re-Expression von Slit2 in Slit2-defizienten Zelllinien führte zu einer Hemmung der gerichteten Migration und Invasion. Der Robo1-Rezeptor knockdown hingegen stimulierte die Motilität von Tumorzellen mit endogener Slit2 Expression. Slit2-konditioniertes Medium aus Tumorzellen hemmte die Lamellipodienbildung und die Migration von Endothelzellen. In orthotopen humanen Xenograft-Modellen und einem murinen, syngenen Tumormodell reduzierte die Re-Expression von Slit2 in PDAC Zellen Tumorwachstum, Invasion, Metastasierung und Angiogenese. Zudem verminderte die Induktion von Slit2 in PDAC Zellen deren gerichtete Migration entlang aussprießender Neuriten in einem ex vivo Model. Die vorliegenden Daten weisen Slit2 die Funktion eines Tumorsuppressors im duktalen Pankreaskarzinom zu. Ein Verlust der Slit2-Robo Aktivität könnte somit Metastasierung und neuronale Invasion fördern und einen aggressiveren Phänotyp begünstigen. / Early dissemination of pancreatic ductal adenocarcinoma (PDAC) via vascular routes and neural invasion limits curative therapy, suggesting a central role for the interaction of tumor cells with blood vessels and nerves in the tumor stroma. Slit2 and its Robo receptors constitute a system of guidance cues that function in axon guidance, angiogenesis and epithelial morphogenesis, respectively. Here, we studied the expression of Slit2 in PDAC and its function for tumor growth and dissemination. Slit2 mRNA expression was reduced in specimens of human PDAC as compared to non-transformed pancreas and low Slit2 mRNA expression correlated with a higher incidence and a higher extent of lymphatic metastasis. In contrast, the Slit2 receptors Robo1 and Robo4 were uniformly present in clinical samples of PDAC and healthy pancreas and displayed differential localization on epithelial tumor cells, nerves and tumor vasculature. Stable or inducible re-expression of Slit2 in Slit2-deficient PDAC cell lines inhibited directed migration and invasion. Conversely, Robo1-knockdown stimulated the motility of PDAC cells with endogenous Slit2 expression. Tumor cell derived Slit2, furthermore, suppressed lamellipodia formation and migration of primary endothelial cells. In vivo studies in orthotopic human xenograft and mouse syngeneic pancreatic cancer models revealed that re-expression of Slit2 in PDAC cells inhibited tumor growth, invasion, metastasis and angiogenesis. In addition, induction of Slit2 in PDAC cells impaired the unidirectional migration along outgrowing neurites in ex vivo co-cultures of tumor cells and dorsal root ganglia. These data provide evidence for a functional role of Slit2 as a tumor suppressor in human PDAC. A loss of Slit2-Robo activity as observed in human PDAC samples, might consequently promote metastasis and neural invasion and favors a more aggressive phenotype.