KRAS Inhibition Activates an Actionable CD24 "Don't Eat Me" Signal in Pancreatic Cancer.

Yongkun Wei, Minghui Liu, Er-Yen Yen, Jun Yao, Zhenzhen Xun, Phuoc T Nguyen, Xiaofei Wang, Zecheng Yang, Abdelrahman Yousef, Dean Pan, Yanqing Jin, Ching-Fei Li, Madelaine S Theardy, Jangho Park, Yiming Cai, Mitsunobu Takeda, Matthew Vasquez, Elizabeth M Park, David H Peng, Yong Zhou, Hong Zhao, Timothy P Heffernan, Andrea Viale, Huamin Wang, Stephanie S Watowich, Han Liang, Dan Zhao, Ronald A DePinho, Wantong Yao, Haoqiang Ying
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Abstract

KRAS G12C inhibitors (G12Ci) have produced encouraging, albeit modest and transient, clinical benefit in pancreatic ductal adenocarcinoma (PDAC). Identifying and targeting resistance mechanisms to G12Ci treatment is therefore crucial. To better understand the function of KRAS G12C and possible G12Ci bypass mechanisms, we developed an autochthonous KRAS G12C - driven PDAC model. Compared to the classical KRAS G12D PDAC model, the G12C model exhibits slower tumor growth, yet similar histopathological and molecular features. Aligned with clinical experience, G12Ci treatment of KRAS G12C tumors produced modest impact despite stimulating a 'hot' tumor immune microenvironment. Immunoprofiling revealed that CD24, a 'don't eat me' signal, is significantly upregulated on cancer cells upon G12Ci treatment. Blocking CD24 enhanced macrophage phagocytosis of cancer cells and significantly sensitized tumors to G12Ci treatment. Similar findings were observed in KRAS G12D -driven PDAC. Together, this study reveals common and distinct oncogenic KRAS allele-specific biology and identifies a clinically actionable adaptive mechanism that may improve the efficacy of oncogenic KRAS inhibitor therapy in PDAC.

Significance: Generation of an autochthonous KRAS G12C -driven pancreatic cancer model enabled elucidation of specific effects of KRAS G12C during tumor development, revealing CD24 as an actionable adaptive mechanism in cancer cells induced upon KRAS G12C inhibition.

KRAS抑制激活了癌症胰腺中可操作的CD24“不要吃我”信号。
KRAS G12C抑制剂(G12Ci)在胰腺导管腺癌(PDAC)中产生了令人鼓舞的、尽管适度且短暂的临床益处。因此,识别和靶向G12Ci治疗的耐药性机制至关重要。为了更好地了解KRAS G12C等位基因的肿瘤生物学和可能的旁路机制,我们开发了一种新的本地KRAS G12C-驱动的PDAC模型。与经典的KRAS G12D PDAC模型相比,G12C模型表现出较慢的肿瘤生长,但具有相似的组织病理学和分子特征。根据临床经验,G12Ci治疗KRAS G12C肿瘤产生了适度的影响,尽管刺激了“热”肿瘤免疫微环境。免疫分析显示,在G12Ci治疗后,癌症细胞的CD24(一种“do-not-eat-me”信号)显著上调。阻断CD24增强了癌症细胞的巨噬细胞吞噬作用,并使肿瘤对G12Ci治疗显著敏感。在KRAS G12D驱动的PDAC中也观察到了类似的发现。我们的研究揭示了常见和独特的致癌KRAS等位基因特异性生物学,并确定了一种临床可行的适应性机制,该机制可能提高PDAC中致癌KRAS抑制剂治疗的疗效。意义:缺乏可靠的临床前模型限制了对PDAC中KRAS G12C抑制剂耐药性机制的探索。我们生成了一个本地KRAS G12C驱动的PDAC模型,该模型揭示了PDAC发育过程中KRAS G12C的等位基因特异性生物学。我们确定CD24是在KRAS G12C抑制诱导的癌症细胞中可操作的适应性机制,并且在临床前模型中阻断CD24使PDAC对KRAS抑制剂敏感。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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