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      The integrin αvβ6 drives pancreatic cancer through diverse mechanisms and represents an effective target for therapy

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          Abstract

          Pancreatic ductal adenocarcinoma (PDAC) has a 5‐year survival rate of less than 4% and desperately needs novel effective therapeutics. Integrin αvβ6 has been linked with poor prognosis in cancer but its potential as a target in PDAC remains unclear. We report that transcriptional expression analysis revealed that high levels of β6 mRNA correlated strongly with significantly poorer survival ( n = 491 cases, p = 3.17 × 10 −8). In two separate cohorts, we showed that over 80% of PDACs expressed αvβ6 protein and that paired metastases retained αvβ6 expression. In vitro, integrin αvβ6 promoted PDAC cell growth, survival, migration, and invasion. Treatment of both αvβ6‐positive human PDAC xenografts and transgenic mice bearing αvβ6‐positive PDAC with the αvβ6 blocking antibody 264RAD, combined with gemcitabine, significantly reduced tumour growth ( p < 0.0001) and increased survival (log‐rank test, p < 0.05). Antibody therapy was associated with suppression of tumour cell activity (suppression of pErk growth signals, increased apoptosis seen as activated caspase‐3) and suppression of the pro‐tumourigenic microenvironment (suppression of TGFβ signalling, fewer αSMA‐positive myofibroblasts, decreased blood vessel density). These data show that αvβ6 promotes PDAC growth through both tumour cell and tumour microenvironment mechanisms and represents a valuable target for PDAC therapy. © 2019 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.

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          Most cited references20

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          Every step of the way: integrins in cancer progression and metastasis

          Cell adhesion to the extracellular matrix is fundamental to tissue integrity and human health. Integrins are the main cellular adhesion receptors that through multifaceted roles as signalling molecules, mechanotransducers and key components of the cell migration machinery are implicated in nearly every step of cancer progression from primary tumour development to metastasis. Altered integrin expression is frequently detected in tumours, where integrins have roles in supporting oncogenic growth factor receptor (GFR) signalling and GFR-dependent cancer cell migration and invasion. In addition, integrins determine colonization of metastatic sites and facilitate anchorage-independent survival of circulating tumour cells. Investigations describing integrin engagement with a growing number of versatile cell surface molecules, including channels, receptors and secreted proteins, continue to lead to the identification of novel tumour-promoting pathways. Integrin-mediated sensing, stiffening and remodelling of the tumour stroma are key steps in cancer progression supporting invasion, acquisition of cancer stem cell characteristics and drug resistance. Given the complexity of integrins and their adaptable and sometimes antagonistic roles in cancer cells and the tumour microenvironment, therapeutic targeting of these receptors has been a challenge. However, novel approaches to target integrins and antagonism of specific integrin subunits in stringently stratified patient cohorts are emerging as potential ways forward.
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            REporting recommendations for tumour MARKer prognostic studies (REMARK)

            Despite years of research and hundreds of reports on tumour markers in oncology, the number of markers that have emerged as clinically useful is pitifully small. Often initially reported studies of a marker show great promise, but subsequent studies on the same or related markers yield inconsistent conclusions or stand in direct contradiction to the promising results. It is imperative that we attempt to understand the reasons that multiple studies of the same marker lead to differing conclusions. A variety of methodological problems have been cited to explain these discrepancies. Unfortunately, many tumour marker studies have not been reported in a rigorous fashion, and published articles often lack sufficient information to allow adequate assessment of the quality of the study or the generalisability of the study results. The development of guidelines for the reporting of tumour marker studies was a major recommendation of the US National Cancer Institute and the European Organisation for Research and Treatment of Cancer (NCI-EORTC) First International Meeting on Cancer Diagnostics in 2000. Similar to the successful CONSORT initiative for randomised trials and the STARD statement for diagnostic studies, we suggest guidelines to provide relevant information about the study design, preplanned hypotheses, patient and specimen characteristics, assay methods, and statistical analysis methods. In addition, the guidelines suggest helpful presentations of data and important elements to include in discussions. The goal of these guidelines is to encourage transparent and complete reporting so that the relevant information will be available to others to help them to judge the usefulness of the data and understand the context in which the conclusions apply.
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              Cancer-associated stromal fibroblasts promote pancreatic tumor progression.

              Pancreatic adenocarcinoma is characterized by a dense background of tumor associated stroma originating from abundant pancreatic stellate cells. The aim of this study was to determine the effect of human pancreatic stellate cells (HPSC) on pancreatic tumor progression. HPSCs were isolated from resected pancreatic adenocarcinoma samples and immortalized with telomerase and SV40 large T antigen. Effects of HPSC conditioned medium (HPSC-CM) on in vitro proliferation, migration, invasion, soft-agar colony formation, and survival in the presence of gemcitabine or radiation therapy were measured in two pancreatic cancer cell lines. The effects of HPSCs on tumors were examined in an orthotopic murine model of pancreatic cancer by co-injecting them with cancer cells and analyzing growth and metastasis. HPSC-CM dose-dependently increased BxPC3 and Panc1 tumor cell proliferation, migration, invasion, and colony formation. Furthermore, gemcitabine and radiation therapy were less effective in tumor cells treated with HPSC-CM. HPSC-CM activated the mitogen-activated protein kinase and Akt pathways in tumor cells. Co-injection of tumor cells with HPSCs in an orthotopic model resulted in increased primary tumor incidence, size, and metastasis, which corresponded with the proportion of HPSCs. HPSCs produce soluble factors that stimulate signaling pathways related to proliferation and survival of pancreatic cancer cells, and the presence of HPSCs in tumors increases the growth and metastasis of these cells. These data indicate that stellate cells have an important role in supporting and promoting pancreatic cancer. Identification of HPSC-derived factors may lead to novel stroma-targeted therapies for pancreatic cancer.
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                Author and article information

                Contributors
                j.f.marshall@qmul.ac.uk
                Journal
                J Pathol
                J. Pathol
                10.1002/(ISSN)1096-9896
                PATH
                The Journal of Pathology
                John Wiley & Sons, Ltd (Chichester, UK )
                0022-3417
                1096-9896
                30 July 2019
                November 2019
                : 249
                : 3 ( doiID: 10.1002/path.v249.3 )
                : 332-342
                Affiliations
                [ 1 ] Centre for Tumour Biology, Barts Cancer Institute, CRUK Centre of Excellence Queen Mary University of London, John Vane Science Centre London UK
                [ 2 ] Cancer Research UK Beatson Institute Glasgow UK
                [ 3 ] Institute of Cancer Research London UK
                [ 4 ] Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine Queen Mary University of London London UK
                [ 5 ] Academic Unit of Surgery, School of Medicine, College of Medical, Veterinary and Life Sciences University of Glasgow, Glasgow Royal Infirmary Glasgow UK
                [ 6 ] West of Scotland Pancreatic Unit Glasgow Royal Infirmary Glasgow UK
                [ 7 ] Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences University of Glasgow Glasgow UK
                [ 8 ] ARC‐NET Research Centre for Applied Research on Cancer University of Verona Verona Italy
                [ 9 ] Centre for Molecular Oncology, Barts Cancer Institute, CRUK Centre of Excellence Queen Mary University of London, John Vane Science Centre London UK
                [ 10 ] Division of Cancer Research, University of Dundee, James Arrott Drive Ninewells Hospital and Medical School Dundee UK
                [ 11 ] Bioscience, Oncology R&D, AstraZeneca Cambridge UK
                Author notes
                [*] [* ] Correspondence to: JF Marshall, Centre for Tumour Biology, Barts Cancer Institute – CRUK Centre of Excellence, Queen Mary University of London, John Vane Science Centre, Charterhouse Square, London, EC1M 6BQ, UK. E‐mail: j.f.marshall@ 123456qmul.ac.uk

                [†]

                These authors contributed equally to this work

                Author information
                https://orcid.org/0000-0003-1678-739X
                https://orcid.org/0000-0001-6771-1905
                https://orcid.org/0000-0002-0494-2295
                Article
                PATH5320
                10.1002/path.5320
                6852434
                31259422
                1f89e77f-e36f-4c1f-8732-0b6a4802d8c6
                © 2019 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 January 2019
                : 22 May 2019
                : 21 June 2019
                Page count
                Figures: 6, Tables: 1, Pages: 11, Words: 6083
                Funding
                Funded by: Howard Kerr PhD Fellowships
                Funded by: Pancreatic Cancer Research Fund , open-funder-registry 10.13039/100011704;
                Funded by: Wellcome Trust Research
                Funded by: Training Fellowship
                Funded by: CRUK Core Facilities at Barts Cancer Institute, London
                Award ID: C16420/A18066
                Funded by: CRUK Histology services at The Beatson Institute, Glasgow
                Categories
                Original Paper
                Original Papers
                Custom metadata
                2.0
                November 2019
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.1 mode:remove_FC converted:13.11.2019

                Pathology
                pdac,integrin,264rad,αvβ6,pancreas,cancer,transgenic,mouse model
                Pathology
                pdac, integrin, 264rad, αvβ6, pancreas, cancer, transgenic, mouse model

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