Modulating p38MAPK recalibrates sensitivity of drug-resistant pancreatic adenoductal carcinoma cells toward chemotherapy and correlate with improved outcome in PDAC patients: Experimental and metadata evidence

Pancreatic cancer is one of the deadliest cancers and has very limited therapeutic options and a dismal prognosis. Among various signaling pathways which are activated during tumor development, hyperactivation of Mitogen-Activated Protein Kinase (MAPK) is responsible for high grade angiogenesis, polarization of Tumor Associated Macrophages, unfolded protein responses and exhaustion of T cells, which together contributes towards this therapeutic resistance. We therefore believe that MAPK targeting is expected to enhance sensitivity of highly resistant PDAC cells toward various cancer directed interventions. In this context, we investigated the impact of modulating p38MAPK on the sensitivity of pancreatic cancer cells towards gemcitabine. Supporting our hypothesis, our results convincely, demonstrated that indeed, p38 inhibition sensitizes both KRAS positive Panc-1 and MiaPaCa2 pancreatic carcinoma cells towards gemcitabine induced death. Interestingly p38MAPK targeting significantly reduced the cell viability, clonogenic potential of these cells and enhanced the early apoptosis. Our in-silico studies, supporting our in vitro data, potentially correlated that that high expression of p38α MAPK14 in PDAC patients is associated with poor prognosis and disease free survival. Deep miming of in silico data further demonstrated that MAPK14, in association with, hypoxia inducible factor-1 alpha and vascular endothelial growth factor signaling pathways promote angiogenic programming of PDAC which render these tumors refractory for cancer directed interventions. Based on our preliminary data, we believe that p38 MAPK based approach is potential approach for changing the faith of PDAC patients toward chemo and immunotherapy and believed to improve PDAC burden effectively in the host.