ADAM12 is a circulating marker for stromal activation in pancreatic cancer and predicts response to chemotherapy

V. L. Veenstra, H. Damhofer, C. Waasdorp, L. B. van Rijssen, M. J. van de Vijver, F. Dijk, H. W. Wilmink, M. G. Besselink, O. R. Busch, D. K. Chang, P. J. Bailey, A. V. Biankin, H. M. Kocher, J. P. Medema, J. S. Li, R. Jiang, D. W. Pierce, H. W.M. van Laarhoven, M. F. Bijlsma*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Pancreatic ductal adenocarcinoma (PDAC) is characterized by abundant stroma that harbors tumor-promoting properties. No good biomarkers exist to monitor the effect of stromal targeting therapies or to predict response. We set out to identify such non-invasive markers for PDAC stroma and predict response to therapy. Gene expression datasets, co-culture experiments, xenografts, and patient samples were analyzed. Serum samples were measured from a cohort of 58 resected patients, and 87 metastatic or locally advanced PDAC patients. Baseline and follow-up levels were assessed in 372 additional metastatic PDAC patients who received nab-paclitaxel with gemcitabine (n = 184) or gemcitabine monotherapy (n = 188) in the phase III MPACT trial. Increased levels of ADAM12 were found in PDAC patients compared to healthy controls (p < 0.0001, n = 157 and n = 38). High levels of ADAM12 significantly associated with poor outcome in resected PDAC (HR 2.07, p = 0.04). In the MPACT trial survival was significantly longer for patients who received nab-paclitaxel and had undetectable ADAM12 levels before treatment (OS 12.3 m vs 7.9 m p = 0.0046). Consistently undetectable or decreased ADAM12 levels during treatment significantly associated with longer survival as well (OS 14.4 m and 11.2 m, respectively vs 8.3, p = 0.0054). We conclude that ADAM12 is a blood-borne proxy for stromal activation, the levels of which have prognostic significance and correlate with treatment benefit.

Original languageEnglish
Article number87
Issue number11
Publication statusPublished - 1 Nov 2018

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