Induction of ADAM10 by Radiation Therapy Drives Fibrosis, Resistance, and Epithelial-to-Mesenchyal Transition in Pancreatic Cancer

Cancer Res. 2021 Jun 15;81(12):3255-3269. doi: 10.1158/0008-5472.CAN-20-3892. Epub 2021 Feb 1.


Stromal fibrosis activates prosurvival and proepithelial-to-mesenchymal transition (EMT) pathways in pancreatic ductal adenocarcinoma (PDAC). In patient tumors treated with neoadjuvant stereotactic body radiation therapy (SBRT), we found upregulation of fibrosis, extracellular matrix (ECM), and EMT gene signatures, which can drive therapeutic resistance and tumor invasion. Molecular, functional, and translational analysis identified two cell-surface proteins, a disintegrin and metalloprotease 10 (ADAM10) and ephrinB2, as drivers of fibrosis and tumor progression after radiation therapy (RT). RT resulted in increased ADAM10 expression in tumor cells, leading to cleavage of ephrinB2, which was also detected in plasma. Pharmacologic or genetic targeting of ADAM10 decreased RT-induced fibrosis and tissue tension, tumor cell migration, and invasion, sensitizing orthotopic tumors to radiation killing and prolonging mouse survival. Inhibition of ADAM10 and genetic ablation of ephrinB2 in fibroblasts reduced the metastatic potential of tumor cells after RT. Stimulation of tumor cells with ephrinB2 FC protein reversed the reduction in tumor cell invasion with ADAM10 ablation. These findings represent a model of PDAC adaptation that explains resistance and metastasis after RT and identifies a targetable pathway to enhance RT efficacy. SIGNIFICANCE: Targeting a previously unidentified adaptive resistance mechanism to radiation therapy in PDAC tumors in combination with radiation therapy could increase survival of the 40% of PDAC patients with locally advanced disease.See related commentary by Garcia Garcia et al., p. 3158 GRAPHICAL ABSTRACT:

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • ADAM10 Protein / antagonists & inhibitors
  • ADAM10 Protein / genetics
  • ADAM10 Protein / metabolism*
  • Amyloid Precursor Protein Secretases / antagonists & inhibitors
  • Amyloid Precursor Protein Secretases / genetics
  • Amyloid Precursor Protein Secretases / metabolism*
  • Animals
  • Antifibrotic Agents / therapeutic use
  • Apoptosis
  • Carcinoma, Pancreatic Ductal / pathology
  • Carcinoma, Pancreatic Ductal / radiotherapy*
  • Cell Movement
  • Cell Proliferation
  • Ephrin-B2 / blood
  • Epithelial-Mesenchymal Transition*
  • Female
  • Fibrosis / drug therapy
  • Fibrosis / etiology
  • Fibrosis / metabolism
  • Fibrosis / pathology*
  • Gamma Rays / adverse effects*
  • Humans
  • Membrane Proteins / antagonists & inhibitors
  • Membrane Proteins / genetics
  • Membrane Proteins / metabolism*
  • Mice
  • Mice, Inbred C57BL
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / radiotherapy*
  • Prognosis
  • Radiation Injuries / drug therapy
  • Radiation Injuries / etiology
  • Radiation Injuries / metabolism
  • Radiation Injuries / pathology*
  • Survival Rate
  • Tumor Cells, Cultured
  • Xenograft Model Antitumor Assays


  • Antifibrotic Agents
  • EFNB2 protein, human
  • Ephrin-B2
  • Membrane Proteins
  • Amyloid Precursor Protein Secretases
  • ADAM10 Protein
  • ADAM10 protein, human