Prevention and reversion of pancreatic tumorigenesis through a differentiation-based mechanism

Abstract

Activating mutations in Kras are nearly ubiquitous in human pancreatic cancer and initiate precancerous pancreatic intraepithelial neoplasia (PanINs) when induced in adult murine acinar cells. PanINs normally take months to form, but can be rapidly induced by genetic deletion of acinar cell differentiation factors such as Ptf1a, suggesting that loss of mature cell identity is a rate-limiting step in pancreatic tumor initiation. Using a novel genetic mouse model that allows for independent control of oncogenic Kras and Ptf1a expression, we demonstrate that maintained activity of Ptf1a is sufficient to eliminate Kras-driven tumorigenesis, even in the presence of tumor-promoting inflammation. Furthermore, reintroduction of Ptf1a into established PanINs reverts their phenotype in vivo. Our results suggest that reactivation of an endogenous differentiation program can prevent and reverse oncogenesis in cells harboring tumor driving mutations, thus introducing a novel paradigm for solid tumor prevention and treatment.