Abstract 6629: Cancer-associated nerves regulate anti-tumor immunity in pancreatic cancer

Abstract Nerves serve an emerging component of the tumor microenvironment (TME), contributing to tumorigenesis and cancer progression. Neural invasion (NI) is a common feature of pancreatic ductal adenocarcinoma (PDAC), accounting for distant metastasis and local recurrence. However, the mechanism by which tumor associated nerves (TANs) regulate anti-tumor immunity remains largely elusive. Here, we investigated the association between TANs and immunosuppressive TME to develop more effective therapeutic strategies for PDAC. Using tumor samples of PDAC patients, we identified that the nerves invaded by cancer cells showed increased adrenergic activation accompanied with no parasympathetic or sensory innervation changes. Patients with severe NI were associated with increased catecholamine levels. Additionally, single-cell RNA-sequencing and spatial transcriptome analysis of tumors from patients with PDAC revealed that peri-neural niches of severe NI patients were characterized by decreased CD8+ T cells and increased activity of M2 polarization of tumor-associated macrophages (TAMs), and regulatory T (Treg) cells, which was validated by multiplexed immunofluorescence staining. We further identified that CD8+ T cells expressing β-adrenaline receptors (β-ARs) reduced proliferation and cytokine production when exposure to catecholamines in a dose-dependent manner or co-cultured with dorsal root ganglia pretreated with cancer cells. KrasLSL-G12D; p53LoxP; Pdx1-CreER (KPC) mice treated with catecholamines accelerated tumor progression by inhibiting T cell-mediated antitumor responses, which was abrogated by surgical sympathectomy of KPC mice. Especially, in an orthotopic PDAC model, nonselective β-blocker propranolol in combination with immune checkpoint blockade (ICB) significantly enhanced active CD8+ T cells with concurrent reduced tumor growth. We suggest a novel regulatory mechanism of inhibiting anti-tumor immunity that can promote cancer progression mediated by TANs invasion. These data establish a close connection between the nerves, cancer cells, and immune cells and provide the potential novel targets of therapeutic approaches in PDAC. Citation Format: Ruiyuan Xu, Jianlu Song, Yuan Chen, Xinpeng Yin, Chengcheng Wang, Yupei Zhao. Cancer-associated nerves regulate anti-tumor immunity in pancreatic cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6629.