Dietary Fat Content Influences PanIN Progression and Pancreatic Cancer Development in Mice

Dietary macronutrient composition has emerged as a key modulator of pancreatic tumorigenesis, yet the impact of lipid-rich diets, particularly ketogenic diets (KD) on the earliest stages of pancreatic cancer development remains unclear. To investigate how dietary lipids shape the initiation and progression of Kras-driven neoplasia, we examined the effects of low-fat diet (LFD), high-fat diet (HFD), and KD in the Ptf1aCreERT2;KrasG12V (AcinarKrasG12V) mouse model. KD fed mice showed the shortest survival (median 26 days) compared with SD (87 days; p = 0.02) and LFD (57 days; p = 0.02), while HFD fed mice also exhibited reduced survival relative to SD (35 days; p = 0.05). KD feeding induced severe glucose intolerance and elevated circulating B-hydroxybutyrate levels. Histologically, KD fed AcinarKrasG12V mice developed invasive, sarcomatoid-like pancreatic ductal adenocarcinoma (PDAC), while HFD fed mice showed increased poorly differentiated PDAC; in both groups these aggressive tumors were associated with extensive fibrosis and increased stromal CD39 expression relative to tumor compartments. Proteomic analysis demonstrated activation of PI3K, Akt, mTOR and EGFR signaling in KD and HFD-fed AcinarKrasG12V mice. Serum cytokines/chemokines profiling revealed pro-inflammatory and pro-angiogenic milieu in KD-fed AcinarKrasG12V mice. Collectively, these results show that dietary lipid enrichment prior to oncogenic Kras activation may accelerate early pancreatic neoplasia and foster a microenvironment conducive to tumor progression. These findings underscore the need for careful consideration of KD use in individuals at elevated risk for pancreatic cancer.