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2015 ; 527
(7579
): 525-530
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Epithelial-to-mesenchymal transition is dispensable for metastasis but induces
chemoresistance in pancreatic cancer
#MMPMID26560028
Zheng X
; Carstens JL
; Kim J
; Scheible M
; Kaye J
; Sugimoto H
; Wu CC
; LeBleu VS
; Kalluri R
Nature
2015[Nov]; 527
(7579
): 525-530
PMID26560028
show ga
Diagnosis of pancreatic ductal adenocarcinoma (PDAC) is associated with a dismal
prognosis despite current best therapies; therefore new treatment strategies are
urgently required. Numerous studies have suggested that epithelial-to-mesenchymal
transition (EMT) contributes to early-stage dissemination of cancer cells and is
pivotal for invasion and metastasis of PDAC. EMT is associated with phenotypic
conversion of epithelial cells into mesenchymal-like cells in cell culture
conditions, although such defined mesenchymal conversion (with spindle-shaped
morphology) of epithelial cells in vivo is rare, with quasi-mesenchymal
phenotypes occasionally observed in the tumour (partial EMT). Most studies
exploring the functional role of EMT in tumours have depended on
cell-culture-induced loss-of-function and gain-of-function experiments involving
EMT-inducing transcription factors such as Twist, Snail and Zeb1 (refs 2, 3,
7-10). Therefore, the functional contribution of EMT to invasion and metastasis
remains unclear, and genetically engineered mouse models to address a causal
connection are lacking. Here we functionally probe the role of EMT in PDAC by
generating mouse models of PDAC with deletion of Snail or Twist, two key
transcription factors responsible for EMT. EMT suppression in the primary tumour
does not alter the emergence of invasive PDAC, systemic dissemination or
metastasis. Suppression of EMT leads to an increase in cancer cell proliferation
with enhanced expression of nucleoside transporters in tumours, contributing to
enhanced sensitivity to gemcitabine treatment and increased overall survival of
mice. Collectively, our study suggests that Snail- or Twist-induced EMT is not
rate-limiting for invasion and metastasis, but highlights the importance of
combining EMT inhibition with chemotherapy for the treatment of pancreatic
cancer.