- Lytle, Nikki K;
- Ferguson, L Paige;
- Rajbhandari, Nirakar;
- Gilroy, Kathryn;
- Fox, Raymond G;
- Deshpande, Anagha;
- Schürch, Christian M;
- Hamilton, Michael;
- Robertson, Neil;
- Lin, Wei;
- Noel, Pawan;
- Wartenberg, Martin;
- Zlobec, Inti;
- Eichmann, Micha;
- Galván, José A;
- Karamitopoulou, Eva;
- Gilderman, Tami;
- Esparza, Lourdes Adriana;
- Shima, Yutaka;
- Spahn, Philipp;
- French, Randall;
- Lewis, Nathan E;
- Fisch, Kathleen M;
- Sasik, Roman;
- Rosenthal, Sara Brin;
- Kritzik, Marcie;
- Von Hoff, Daniel;
- Han, Haiyong;
- Ideker, Trey;
- Deshpande, Aniruddha J;
- Lowy, Andrew M;
- Adams, Peter D;
- Reya, Tannishtha
Drug resistance and relapse remain key challenges in pancreatic cancer. Here, we have used RNA sequencing (RNA-seq), chromatin immunoprecipitation (ChIP)-seq, and genome-wide CRISPR analysis to map the molecular dependencies of pancreatic cancer stem cells, highly therapy-resistant cells that preferentially drive tumorigenesis and progression. This integrated genomic approach revealed an unexpected utilization of immuno-regulatory signals by pancreatic cancer epithelial cells. In particular, the nuclear hormone receptor retinoic-acid-receptor-related orphan receptor gamma (RORγ), known to drive inflammation and T cell differentiation, was upregulated during pancreatic cancer progression, and its genetic or pharmacologic inhibition led to a striking defect in pancreatic cancer growth and a marked improvement in survival. Further, a large-scale retrospective analysis in patients revealed that RORγ expression may predict pancreatic cancer aggressiveness, as it positively correlated with advanced disease and metastasis. Collectively, these data identify an orthogonal co-option of immuno-regulatory signals by pancreatic cancer stem cells, suggesting that autoimmune drugs should be evaluated as novel treatment strategies for pancreatic cancer patients.