ADAM10 Proteases and Pancreatic CancerPage e8
EditorialPancreatic ductal adenocarcinoma (PDAC) is the 4 th leading cause of cancer-related deaths in the United States and is expected to rise to the second rank by 2020. 1 The survival rate of PDAC is estimated at less than 5% and the high mortality rate is attributed to the asymptomatic progression and aggressive nature of the tumor, which exhibit locally advanced or metastatic disease at the time of diagnosis. Majority of the pancreatic cancers are PDACs and are characterized by a fibrotic tumor stroma.The nucleoside analog Gemcitabine is the standard therapy used for treatment of PDAC but it shows only marginal therapeutic benefit.2,3 The limited accessibility of the drugs to the tumors is one of the major issues with PDAC, given the dense, highly fibrotic nature of the stroma. Tumor stroma comprises of Extracellular matrix (ECM) proteins, growth factors such as fibronectin and collagen, stromal fibroblasts, stellate cells, immune cells, and blood vessels. 4 The strong desmoplastic tumor stroma inhibits transvascular transport of drugs to the tumors, and therefore the tumors continue to grow and metastasize. Though the newly developed combinatorial therapies such as Nab-Paclitaxel (colloidal suspension of paclitaxel and human serum albumin) and FOLFIRINOX (combination of oxaliplatin, 5-FU, lucovorin and irinotecan) have shown significant improvement in survival in patients with metastatic cancer, they are associated with severe toxicity issues, and therefore additional strategies are being developed to effectively treat PDAC. 5,6 It is known that matrix-degrading enzymes affect cell adhesion and migration. Several transmembrane proteins that are involved in cell adhesion are cleaved by matrix degrading enzymes like matrix metalloproteinases, allowing detachment, migration and metastasis of cancer cells. Among the proteases, A Disintegrin And Metalloprotease (ADAM) family member ADAM10 has recently gained considerable attention for its role in tumor progression and metastasis. 7,8 The metalloprotease domain of ADAM10 is involved in proteolysis and ectodomain shedding of extracellular matrix-associated proteins whereas its disintegrin and cysteine rich domains are known to have adhesive activities.9 Proteins such as cadherins, CD44, Notch, Ephrin B1, amyloid precursor protein, and the chemokine CXCL16 are a few examples, whose ectodomain release contributes to migration and invasion of cancer cells. [10][11][12][13] Recent studies by others and us have shown that ADAM10 inhibition or down-regulation enhances the chemosensitivity of PDAC cells to gemcitabine and prevents their anchorage independent growth and migration. [13][14][15][16] PDACs over express ADAM10, and down-regulation of ADAM10 in PDAC cells have shown to significantly reduce the secreted levels of the soluble ectodomains of its substrates. We recently demonstrated that ADAM10 inhibition enhances cell-cell adhesion and formation of cadherin positive tight adherens junctions, indicating that activ...