title: CTGF antagonism with mAb FG-3019 enhances chemotherapy response without increasing drug delivery in murine ductal pancreas cancer.
abstract: Pancreatic ductal adenocarcinoma (PDA) is characterized by abundant desmoplasia and poor tissue perfusion. These features are proposed to limit the access of therapies to neoplastic cells and blunt treatment efficacy. Indeed, several agents that target the PDA tumor microenvironment promote concomitant chemotherapy delivery and increased antineoplastic response in murine models of PDA. Prior studies could not determine whether chemotherapy delivery or microenvironment modulation per se were the dominant features in treatment response, and such information could guide the optimal translation of these preclinical findings to patients. To distinguish between these possibilities, we used a chemical inhibitor of cytidine deaminase to stabilize and thereby artificially elevate gemcitabine levels in murine PDA tumors without disrupting the tumor microenvironment. Additionally, we used the FG-3019 monoclonal antibody (mAb) that is directed against the pleiotropic matricellular signaling protein connective tissue growth factor (CTGF/CCN2). Inhibition of cytidine deaminase raised the levels of activated gemcitabine within PDA tumors without stimulating neoplastic cell killing or decreasing the growth of tumors, whereas FG-3019 increased PDA cell killing and led to a dramatic tumor response without altering gemcitabine delivery. The response to FG-3019 correlated with the decreased expression of a previously described promoter of PDA chemotherapy resistance, the X-linked inhibitor of apoptosis protein. Therefore, alterations in survival cues following targeting of tumor microenvironmental factors may play an important role in treatment responses in animal models, and by extension in PDA patients.
authors.affiliation: Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, United Kingdom.
authors.forename: Albrecht
authors.initials: A
authors.lastname: Neesse
authors.forename: Kristopher K
authors.initials: KK
authors.lastname: Frese
authors.forename: Tashinga E
authors.initials: TE
authors.lastname: Bapiro
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Mark D
authors.initials: MD
authors.lastname: Sternlicht
authors.forename: Todd W
authors.initials: TW
authors.lastname: Seeley
authors.forename: Christian
authors.initials: C
authors.lastname: Pilarsky
authors.forename: Duncan I
authors.initials: DI
authors.lastname: Jodrell
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Spong
authors.forename: David A
authors.initials: DA
authors.lastname: Tuveson
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000276:immunology*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017209:Apoptosis; D021441:Carcinoma, Pancreatic Ductal / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D055513:Connective Tissue Growth Factor / Q000037:antagonists & inhibitors* / Q000276:immunology / Q000378:metabolism; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000556:secondary; D051379:Mice; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D016019:Survival Analysis; D051636:X-Linked Inhibitor of Apoptosis Protein / Q000378:metabolism; D000093542:Gemcitabine
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; C526318:CCN2 protein, mouse; D051636:X-Linked Inhibitor of Apoptosis Protein; D003841:Deoxycytidine; D055513:Connective Tissue Growth Factor; C560078:pamrevlumab; D000093542:Gemcitabine
keywords: chemoresistance; genetically engineered mouse models; pancreatic tumor stroma