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Fibroblast activation protein augments progression and metastasis of pancreatic ductal adenocarcinoma
Albert Lo, Chung-Pin Li, Elizabeth L. Buza, Rachel Blomberg, Priya Govindaraju, Diana Avery, James Monslow, Michael Hsiao, Ellen Puré
Albert Lo, Chung-Pin Li, Elizabeth L. Buza, Rachel Blomberg, Priya Govindaraju, Diana Avery, James Monslow, Michael Hsiao, Ellen Puré
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Research Article Oncology

Fibroblast activation protein augments progression and metastasis of pancreatic ductal adenocarcinoma

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Abstract

Pancreatic ductal adenocarcinomas (PDAs) are desmoplastic and can undergo epithelial-to-mesenchymal transition to confer metastasis and chemoresistance. Studies have demonstrated that phenotypically and functionally distinct stromal cell populations exist in PDAs. Fibroblast activation protein–expressing (FAP-expressing) cells act to enhance PDA progression, while α–smooth muscle actin myofibroblasts can restrain PDA. Thus, identification of precise molecular targets that mediate the protumorigenic activity of FAP+ cells will guide development of therapy for PDA. Herein, we demonstrate that FAP overexpression in the tumor microenvironment correlates with poor overall and disease-free survival of PDA patients. Genetic deletion of FAP delayed onset of primary tumor and prolonged survival of mice in the KPC mouse model of PDA. While genetic deletion of FAP did not affect primary tumor weight in advanced disease, FAP deficiency increased tumor necrosis and impeded metastasis to multiple organs. Lineage-tracing studies unexpectedly showed that FAP is not only expressed by stromal cells, but can also be detected in a subset of CD90+ mesenchymal PDA cells, representing up to 20% of total intratumoral FAP+ cells. These data suggest that FAP may regulate PDA progression and metastasis in cell-autonomous and/or non-cell-autonomous fashions. Together, these data support pursuing FAP as a therapeutic target in PDA.

Authors

Albert Lo, Chung-Pin Li, Elizabeth L. Buza, Rachel Blomberg, Priya Govindaraju, Diana Avery, James Monslow, Michael Hsiao, Ellen Puré

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Figure 5

Targeting FAP alters internal tumor architecture associated with necrotic cell death.

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Targeting FAP alters internal tumor architecture associated with necroti...
(A) Representative ultrasound images of the pancreatic tumors. The dashed line shows the border of pancreatic tumors. Within the tumor, the hypoechoic (darker) area is indicative of tumor necrosis, whereas hyperechoic (brighter) regions represent heterogeneous tumor structure, including stroma and vessels. Extensive tumor necrosis and a small cyst within the tumor are denoted using an asterisk and a number sign, respectively. (B) Tumors were harvested at the endpoint and stained with H&E (FH-KPC, n = 29; FKO-KPC, n = 23). Scale bar: 0.5 cm. The degree of necrosis within each tumor was assessed by a board-certified pathologist (ELB). χ2 test shows a statistically significant correlation between tumor necrosis and FAP deletion.

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