- Özdemir, Berna C;
- Pentcheva-Hoang, Tsvetelina;
- Carstens, Julienne L;
- Zheng, Xiaofeng;
- Wu, Chia-Chin;
- Simpson, Tyler R;
- Laklai, Hanane;
- Sugimoto, Hikaru;
- Kahlert, Christoph;
- Novitskiy, Sergey V;
- De Jesus-Acosta, Ana;
- Sharma, Padmanee;
- Heidari, Pedram;
- Mahmood, Umar;
- Chin, Lynda;
- Moses, Harold L;
- Weaver, Valerie M;
- Maitra, Anirban;
- Allison, James P;
- LeBleu, Valerie S;
- Kalluri, Raghu
Pancreatic ductal adenocarcinoma (PDAC) is associated with marked fibrosis and stromal myofibroblasts, but their functional contribution remains unknown. Transgenic mice with the ability to delete αSMA(+) myofibroblasts in pancreatic cancer were generated. Depletion starting at either noninvasive precursor (pancreatic intraepithelial neoplasia) or the PDAC stage led to invasive, undifferentiated tumors with enhanced hypoxia, epithelial-to-mesenchymal transition, and cancer stem cells, with diminished animal survival. In PDAC patients, fewer myofibroblasts in their tumors also correlated with reduced survival. Suppressed immune surveillance with increased CD4(+)Foxp3(+) Tregs was observed in myofibroblast-depleted mouse tumors. Although myofibroblast-depleted tumors did not respond to gemcitabine, anti-CTLA4 immunotherapy reversed disease acceleration and prolonged animal survival. This study underscores the need for caution in targeting carcinoma-associated fibroblasts in PDAC.