Pancreatic Cancer Exploits Wound-Healing Mechanism to Evade Immune System

A recently published study from Mount Sinai’s Icahn School of Medicine has discovered a mechanism that pancreatic cancer cells use to evade the immune system. Senior study author and Professor of Genetic Engineering Brian D. Brown, PhD, explains that this immunity evasion ability has made pancreatic cancer among the hardest types of cancer to treat; it ranks as one of the most deadly cancers and the five-year survival rate is around 13%. 

His research team found that certain pancreatic cancer cells take advantage of the body’s natural wound-healing systems to shield themselves from the immune system, providing significant insight into why this cancer is so deadly, and opening the door to new avenues that could improve the efficacy of immunotherapy against pancreatic cancer. 

Fibrin is a protein that plays a key role in the clotting of blood and in wound healing by stopping blood flow. It forms a sort of adhesive mesh that gives platelets and other cells a base to clump onto and form clots to stop blood flow and boost healing. 

Small groups of pancreatic cancer cells can hijack this natural protein through genes that stabilize fibrin, and use it to develop an immune-protective environment where tumorous cells are shielded from the immune system. 

According to the research findings, disrupting the protection apparatus in preclinical models reduced tumor growth rates and increased immunotherapy response. Although the ability to activate fibrin stabilization genes and build protective environments was limited to just 5% of pancreatic cancer cells in lab models, their anti-immunity effect was significant enough to have a major impact on pancreatic cancer therapies. 

First study author and postdoctoral fellow Chiara Falcomatà says understanding how the protective environments develop could provide new avenues for targeting the cancer cell populations that can activate fibrin.  

The findings also suggest that the ability to activate PAI1 and PAI2, the genes that drive fibrin buildup, could also be responsible for an increased rate of blood-clotting complications in patients with pancreatic cancer. By suppressing immune activity and encouraging blood clotting, tumors may be elevating the risk of conditions like deep vein thrombosis in cancer patients. 

Researchers found that they could limit the immune suppression effect, reduce tumor growth, and improve anti-PD-1 immunotherapy efficacy by removing the genes that produce PAI1 and PAI2. 

They also triggered the same effects by blocking communication between fibrin and the macrophages that sustain the immuno-suppressive environment. Further research is needed to translate these findings into safe and effective treatments for pancreatic cancer patients. 

It would be interesting to get the views of researchers at companies like Calidi Biotherapeutics Inc. (NYSE American: CLDI) on whether interventions targeting fibrin could also be beneficial in other types of cancer. 

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