Journal
FRONTIERS IN PHARMACOLOGY
Volume 13, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fphar.2022.851512
Keywords
gemcitabine resistance; pancreatic cancer; c-Myc; PD-L1; artesunate
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Funding
- National Natural Science Foundation of China [82022074, 81874367]
- Guangdong Key Laboratory for Translational Cancer research of Chinese Medicine [2018B030322011]
- Natural Science Foundation for Distinguished Young Scholars of Guangdong Province, China [2017A030306033]
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Pancreatic cancer has a low overall survival rate and is often resistant to the first-line drug, Gemcitabine. This study found that c-Myc and PD-L1 were highly expressed in pancreatic tumors and dFdC-resistant cells. Moreover, the combination of dFdC and c-Myc inhibitors enhanced drug sensitivity, while overexpression of c-Myc reduced sensitivity. Additionally, ARTS was shown to reverse dFdC resistance in vitro and suppress pancreatic cancer in vivo.
Pancreatic cancer ranks fourth among cancer-related deaths, with a 5-years overall survival rate being below 10%. Gemcitabine (dFdC) has been considered the first-line drug for patients with pancreatic cancer. However, the clinical effectiveness is less than 20% due to drug resistance. Most importantly, overwhelming evidence suggested c-Myc and PD-L1 were generally highly expressed in pancreatic cancer patients. However, whether dFdC-resistant pancreatic cancer is associated with c-Myc and PD-L1 has not been elucidated. In our present study, we found that the expression of c-Myc and PD-L1 was markedly increased in pancreatic tumor tissues compared with adjacent tissues. Similarly, c-Myc and PD-L1 expression were also remarkably elevated in dFdC-resistant Panc-1 cells compared with parental cells. In addition, dFdC sensitivity was enhanced by the combination of dFdC and c-Myc inhibitors in Panc-1 cells. Interestingly, its sensitivity was reduced when c-Myc was overexpressed. Moreover, PD-L1 protein expression was dramatically down-regulated when treated with c-Myc inhibitors. Furthermore, artesunate (ARTS) screened from 18 compounds could reverse dFdC resistance in combination with dFdC in dFdC-resistant Panc-1 cells in vitro and suppressed DMBA-induced pancreatic cancer in vivo. In summary, our data revealed that the mechanism of dFdC resistance may be that c-Myc overexpression contributed to increased PD-L1 expression, and ARTS could overcome dFdC-resistant pancreatic cancer by inhibiting c-Myc and PD-L1. Our findings not only suggest c-Myc and PD-L1 as novel prognostic biomarkers in dFdC-resistant pancreatic cancer, but also provide ARTS as a promising candidate for overcoming dFdC resistance.
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