The emerging standard-of-care for patients with inoperable pancreatic cancer is a combination of cytotoxic drugs gemcitabine and Abraxane, however patient response remains moderate.
Pancreatic cancer development and metastasis occur in complex settings with reciprocal feedback from micro-environmental cues influencing both disease progression and drug response. Recent studies assessing long-term, chronic targeting of the host tissue tension have yielded conflicting data on the utility of stromal targeting in limiting the progression of pancreatic cancer.
Here, we used intravital imaging to assess how transient manipulation of the tumour tissue, or ‘priming’, using the pharmaceutical Rho-kinase inhibitor Fasudil affects response to chemotherapy. Intravital FRET imaging of a CDK1 biosensor to monitor cytotoxic drugs efficacy revealed that priming improves pancreatic cancer response to gemcitabine/Abraxane at both primary and secondary sites.
Transient priming also impaired extravasation efficiency and fibrotic niche remodelling within the liver, two important features of cancer spread. Last, we demonstrate a graded response to priming in stratified patient-derived settings, highlighting that tailored fine-tuned tissue manipulation prior to chemotherapy may offer new opportunities in both primary and metastatic targeting of pancreatic cancer.