Multimodal Treatment Eliminates Cancer Stem Cells and Leads to Long-Term Survival in Primary Human Pancreatic Cancer Tissue Xenografts

Patrick C. Hermann, Sara M. Trabulo, Bruno Sainz, Anamaria Balic, Elena Garcia, Stephan A. Hahn, Mallaredy Vandana, Sanjeeb K. Sahoo, Patrizia Tunici, Annette Bakker, Manuel Hidalgo, Christopher Heeschen

Research output: Contribution to journalArticle

Abstract

Purpose:In spite of intense research efforts, pancreatic ductal adenocarcinoma remains one of the most deadly malignancies in the world. We and others have previously identified a subpopulation of pancreatic cancer stem cells within the tumor as a critical therapeutic target and additionally shown that the tumor stroma represents not only a restrictive barrier for successful drug delivery, but also serves as a paracrine niche for cancer stem cells. Therefore, we embarked on a large-scale investigation on the effects of combining chemotherapy, hedgehog pathway inhibition, and mTOR inhibition in a preclinical mouse model of pancreatic cancer.Experimental Design:Prospective and randomized testing in a set of almost 200 subcutaneous and orthotopic implanted whole-tissue primary human tumor xenografts.Results:The combined targeting of highly chemoresistant cancer stem cells as well as their more differentiated progenies, together with abrogation of the tumor microenvironment by targeting the stroma and enhancing tissue penetration of the chemotherapeutic agent translated into significantly prolonged survival in preclinical models of human pancreatic cancer. Most pronounced therapeutic effects were observed in gemcitabine-resistant patient-derived tumors. Intriguingly, the proposed triple therapy approach could be further enhanced by using a PEGylated formulation of gemcitabine, which significantly increased its bioavailability and tissue penetration, resulting in a further improved overall outcome.Conclusions:This multimodal therapeutic strategy should be further explored in the clinical setting as its success may eventually improve the poor prognosis of patients with pancreatic ductal adenocarcinoma.

Original languageEnglish (US)
Article numbere66371
JournalPLoS One
Volume8
Issue number6
DOIs
StatePublished - Jun 18 2013
Externally publishedYes

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pancreatic neoplasms
Combined Modality Therapy
Oncology
Neoplastic Stem Cells
Stem cells
Pancreatic Neoplasms
Heterografts
stem cells
Tumors
gemcitabine
Tissue
neoplasms
Survival
therapeutics
Neoplasms
adenocarcinoma
Adenocarcinoma
Tumor Microenvironment
Chemotherapy
Hedgehogs

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Hermann, P. C., Trabulo, S. M., Sainz, B., Balic, A., Garcia, E., Hahn, S. A., ... Heeschen, C. (2013). Multimodal Treatment Eliminates Cancer Stem Cells and Leads to Long-Term Survival in Primary Human Pancreatic Cancer Tissue Xenografts. PLoS One, 8(6), [e66371]. https://doi.org/10.1371/journal.pone.0066371

Multimodal Treatment Eliminates Cancer Stem Cells and Leads to Long-Term Survival in Primary Human Pancreatic Cancer Tissue Xenografts. / Hermann, Patrick C.; Trabulo, Sara M.; Sainz, Bruno; Balic, Anamaria; Garcia, Elena; Hahn, Stephan A.; Vandana, Mallaredy; Sahoo, Sanjeeb K.; Tunici, Patrizia; Bakker, Annette; Hidalgo, Manuel; Heeschen, Christopher.

In: PLoS One, Vol. 8, No. 6, e66371, 18.06.2013.

Research output: Contribution to journalArticle

Hermann, PC, Trabulo, SM, Sainz, B, Balic, A, Garcia, E, Hahn, SA, Vandana, M, Sahoo, SK, Tunici, P, Bakker, A, Hidalgo, M & Heeschen, C 2013, 'Multimodal Treatment Eliminates Cancer Stem Cells and Leads to Long-Term Survival in Primary Human Pancreatic Cancer Tissue Xenografts', PLoS One, vol. 8, no. 6, e66371. https://doi.org/10.1371/journal.pone.0066371
Hermann, Patrick C. ; Trabulo, Sara M. ; Sainz, Bruno ; Balic, Anamaria ; Garcia, Elena ; Hahn, Stephan A. ; Vandana, Mallaredy ; Sahoo, Sanjeeb K. ; Tunici, Patrizia ; Bakker, Annette ; Hidalgo, Manuel ; Heeschen, Christopher. / Multimodal Treatment Eliminates Cancer Stem Cells and Leads to Long-Term Survival in Primary Human Pancreatic Cancer Tissue Xenografts. In: PLoS One. 2013 ; Vol. 8, No. 6.
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