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Phosphodiesterase type 5 inhibitors enhance chemotherapy in preclinical models of esophageal adenocarcinoma by targeting cancer-associated fibroblasts

Benjamin P. Sharpe Orcid Logo, Annette Hayden, Antigoni Manousopoulou, Andrew Cowie, Robert C. Walker Orcid Logo, Jack Harrington, Angel Izadi, Stella P. Breininger Orcid Logo, Jane Gibson, Oliver Pickering, Eleanor Jaynes, Ewan Kyle Orcid Logo, John H. Saunders Orcid Logo, Simon L. Parsons, Alison A. Ritchie Orcid Logo, Philip A. Clarke, Pamela Collier, Nigel P. Mongan, David O. Bates, Kiren Yacqub-Usman, Spiros D. Garbis, Zoë Walters, Matthew Rose-Zerilli, Anna M. Grabowska Orcid Logo, Timothy J. Underwood Orcid Logo

Cell Reports Medicine, Volume: 3, Issue: 6, Start page: 100541

Swansea University Author: Angel Izadi

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Abstract

The chemotherapy resistance of esophageal adenocarcinomas (EACs) is underpinned by cancer cell extrinsic mechanisms of the tumor microenvironment (TME). We demonstrate that, by targeting the tumor-promoting functions of the predominant TME cell type, cancer-associated fibroblasts (CAFs) with phospho...

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Published in: Cell Reports Medicine
ISSN: 2666-3791 2666-3791
Published: Elsevier BV 2022
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa60404
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Abstract: The chemotherapy resistance of esophageal adenocarcinomas (EACs) is underpinned by cancer cell extrinsic mechanisms of the tumor microenvironment (TME). We demonstrate that, by targeting the tumor-promoting functions of the predominant TME cell type, cancer-associated fibroblasts (CAFs) with phosphodiesterase type 5 inhibitors (PDE5i), we can enhance the efficacy of standard-of-care chemotherapy. In ex vivo conditions, PDE5i prevent the transdifferentiation of normal fibroblasts to CAF and abolish the tumor-promoting function of established EAC CAFs. Using shotgun proteomics and single-cell RNA-seq, we reveal PDE5i-specific regulation of pathways related to fibroblast activation and tumor promotion. Finally, we confirm the efficacy of PDE5i in combination with chemotherapy in close-to-patient and in vivo PDX-based model systems. These findings demonstrate that CAFs drive chemotherapy resistance in EACs and can be targeted by repurposing PDE5i, a safe and well-tolerated class of drug administered to millions of patients world-wide to treat erectile dysfunction. [Abstract copyright: Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.]
Keywords: esophageal adenocarcinoma; cancer-associated fibroblasts; phosphodiesterase type 5 inhibitors; chemotherapy; preclinical models
College: Faculty of Medicine, Health and Life Sciences
Funders: Medical Research Council UK Clinician Scientist Fellowship to T.J.U. ‘‘Exploring stromal-epithelial interactions in oesophageal cancer’’ G1002565 IDN0. 99762; Cancer Research UK & Royal College of Surgeons of England Advanced Clinician Scientist Fellowship to T.J.U. ‘‘Cellular interplay in oesophageal cancer.’’ A23924.
Issue: 6
Start Page: 100541