To map the landscape of CAFs in BRCA-mutated and BRCA-WT tumors in the four different organs (Aim 1), we launched the assembly, together with our clinical collaborators at MSKCC (NY), of four cohorts of BRCA-mut and BRCA-WT patients. For each organ we aimed at identifying 50-80 cases for which resected tissue and patient data (clinical and demographic) exist, and samples could be used to prepare a tumor microarray (TMA). We have successfully assembled the PDAC TMA, we are at final stages of assembling the prostate TMA and are in the process of preparing the ovary and breast TMAs. We already analyzed an initial cohort of ovarian cancer samples (10 BRCA-mut and BRCA-WT patients), and have separately analyzed a cohort of 42 BRCA-mut and BRCA-WT PDAC patients. We have now assembled a MIBI panel imaging and analysis of 40 CAF, immune, and cancer markers. This panel will be used on all TMAs to define common and different markers across the different organs.
To study organ dependecies, we examined the stress response landscape in BRCA WT tumors in these four organs. Using a combination of experimental and computational methods, we found that stress responses vary within the TME and are especially active near cancer cells. Focusing on the non-immune stroma we found, across tumor types, that NRF2 and the oxidative stress response are distinctly activated in immune-regulatory CAFs and in a unique subset of cancer-associated pericytes (Lior et al, Cell Reports 2024).
We developed an experimental-mathematical approach to decompose the tumor microenvironment into circuits (Aim 2), and found a hierarchical network of interactions in breast cancer, with CAFs at the top secreting factors primarily to tumor-associated macrophages. We showed that this network is composed of repeating circuit motifs, studied the fibroblast-macrophage circuit in-vitro, and identifyed a lignad-receptor pair (RARRES2-CMKLR1) mediating this interaction. This study demonstrated that the complexity of the tumor microenvironment may be simplified by identifying small circuits, facilitating the development of strategies to modulate it (Mayer* and Milo* et al, Nature Communications 2023).
Based on our findings in PDAC we are combining small molecules targeting HSF1 (in CAFs) with PARP-inhibitors (targeting BRCA-mut cancer cells) in an injectable mouse model of PDAC to test the effect of this BRCA-specific composition targeting both the mutated cancer cells and the matching CAFs. We also engineered HSF1-Flox Col1A1 -CRE muce in which HSF1 is knocked-out in fibroblasts, to test the effect of HSF1 loss in the stroma in a complementary manner. This work is on going.