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Enzymatic Targeting of the Stroma Ablates Physical Barriers to Treatment of Pancreatic Ductal Adenocarcinoma

机译:基质的酶靶向消除物理障碍,以治疗胰腺导管腺癌。

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摘要

Pancreatic ductal adenocarcinomas (PDAs) are characterized by a robust fibroinflammatory response. We show here that this desmoplastic reaction generates inordinately high interstitial fluid pressures (IFPs), exceeding those previously measured or theorized for solid tumors, and induces vascular collapse, while presenting substantial barriers to perfusion, diffusion, and convection of small molecule therapeutics. We identify hyaluronan, or hyaluronic acid (HA), as the primary matrix determinant of these barriers and show that systemic administration of an enzymatic agent can ablate stromal HA from autochthonous murine PDA, normalize IFP, and re-expand the microvasculature. In combination with the standard chemotherapeutic, gemcitabine, the treatment permanently remodels the tumor microenvironment and consistently achieves objective tumor responses, resulting in a near doubling of overall survival.
机译:胰腺导管腺癌(PDA)的特征是强烈的纤维炎症反应。我们在这里显示,这种增塑反应会产生非常高的组织液压力(IFPs),超过了先前针对实体瘤进行测量或理论计算的间质液压力,并诱发了血管萎缩,同时对小分子疗法的灌注,扩散和对流提供了实质性障碍。我们确定透明质酸或透明质酸(HA),作为这些障碍的主要基质决定因素,并表明全身给药的酶促剂可以消融来自自体鼠PDA的基质HA,使IFP正常化,并重新扩展微脉管系统。与标准的化疗药物吉西他滨联合使用,该治疗可永久性地重塑肿瘤的微环境,并始终如一地实现客观的肿瘤反应,从而使总体生存率几乎翻倍。

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