Periostin: Cancer Spread & Pain Through Nerves
- A new Brazilian study has revealed the key role of the protein periostin and stellate pancreatic cells in allowing pancreatic cancer to infiltrate nerves and spread early,increasing the...
- The findings are published in the journal Molecular and Cellular Endocrinology.
- The most common type of pancreatic cancer is adenocarcinoma, which originates in the glandular tissue that produces pancreatic juice.
A new Brazilian study has revealed the key role of the protein periostin and stellate pancreatic cells in allowing pancreatic cancer to infiltrate nerves and spread early,increasing the risk of metastasis. The research demonstrates how the tumor reprograms part of the surrounding healthy tissue to acquire a high capacity for invasion.This mechanism is associated with the aggressiveness of the disease and the difficulty of treatment. It also points to possible targets for more precise therapies and personalized treatments.
The findings are published in the journal Molecular and Cellular Endocrinology.
The most common type of pancreatic cancer is adenocarcinoma, which originates in the glandular tissue that produces pancreatic juice. It accounts for 90% of diagnosed cases. Although it is not among the most frequent types of cancer, it is considered an aggressive and highly lethal tumor, with a mortality rate almost equivalent to its incidence rate. Globally, there are approximately 510,000 new cases and nearly the same number of deaths each year.
In Brazil, the National Cancer Institute (INCA) estimates that there are about 11,000 cases and 13,000 deaths every year.
“It’s an aggressive cancer that’s challenging to treat.Around 10% of patients have a chance of long-term survival, such as five years after diagnosis,” says Pedro Luiz Serrano Uson Junior, an oncologist and one of
This altered habitat generates a desmoplastic reaction: intense fibrosis around the tumor formed by cells and proteins that harden and inflame the tissue. This hinders the arrival of chemotherapy and immunotherapy drugs as they have more difficulty penetrating the hardened tissue. This creates a “microenvironment” that favors the survival and spread of the tumor.
“That’s why pancreatic cancer is still so difficult to treat,” says Uson.
The oncologist emphasizes that this ability to infiltrate is decisive for the poor prognosis of patients with pancreatic cancer: “Perineural invasion is a sign that cancer cells have gained mobility. They escape the tumor mass, travel through healthy tissue, and reach nerve and lymphatic bundles, which carry them to other regions of the body, facilitating the progress of metastases.”
He says that more than half of pancreatic cancer cases show perineural invasion in the early stages, which is only discovered during surgery.
“Unfortunately, we discover this perineural invasion after it’s already occurred. It’s only seen in the surgical specimen when it goes for biopsy,” Uson adds.
Promising target
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Given this complex scenario, the researchers say that periostin emerges as a promising therapeutic target. Blocking its action or eliminating the stellate cells that produce it may reduce perineural invasion and limit the tumor’s metastatic capacity.
“This work points to paths that may guide future approaches to treating pancreatic cancer,” says Nakaya.
Clinical trials on other tumors are already testing antibodies against periostin. According to Nakaya, this helps explore whether this pathway may also be relevant in the pancreas.
Uson points out that this strategy is part of the advance toward precision medicine.
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