Cholesterol-sharing mechanism points to potential new target for pancreatic cancer treatment
· Medical Xpressedited by Sadie Harley, reviewed by Robert Egan
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Fox Chase Cancer Center researchers identified a potential therapeutic target for pancreatic cancer after showing that tumor growth can be slowed and immune suppression can be reduced in preclinical trials by blocking a particular protein, called anoctamin 6 (ANO6).
The study, published in Nature Cancer, found that ANO6 helps pancreatic cancer cells obtain nutrients from surrounding cells while suppressing the immune system's ability to fight tumors. ANO6 enables cancer-associated fibroblasts (CAFs)—cells that make up much of the dense tissue surrounding pancreatic tumors—to transfer cholesterol and other lipids to cancer cells.
"These findings help explain how pancreatic cancer cells obtain essential nutrients despite the unusual structure of the pancreatic tumor microenvironment," said Igor Astsaturov, M.D., Ph.D., a professor at Fox Chase and co-senior author of the study. "Cancer-associated fibroblasts are not passive bystanders. They actively support tumor growth by transferring lipids to cancer cells."
CAFs help feed pancreatic cancer cells
Pancreatic ductal adenocarcinoma (PDAC), the most common type of pancreatic cancer, is surrounded by dense connective tissue and has relatively few functional blood vessels as these collapse due to the expansion of CAFs and their self-generated collagenous fibers acting as a functional unit. How cancer cells obtain nutrients such as cholesterol in this environment has remained unclear.
"We found that CAFs can act as a source of these nutrients," said Edna Cukierman, Ph.D., professor and co-leader of the Cancer Signaling and Microenvironment Program at Fox Chase and co-senior author of the study.
"Using laboratory and animal models, we discovered that CAF units acquire cholesterol from the bloodstream and transfer it to nearby pancreatic cancer cells through a process called trogocytosis."
The study showed that during trogocytosis, cancer cells take small pieces of the CAF cell membranes, allowing them to acquire cholesterol and other lipids needed for survival and growth. The process depends on ANO6, which helps prepare the CAF membrane for transfer.
When researchers reduced or eliminated ANO6 in CAFs, the cells were less able to support pancreatic cancer cell survival. In mouse models, tumors supported by ANO6-positive CAFs grew substantially faster than those without functional ANO6.
ANO6 also suppresses cancer-fighting T cells
The study also showed that the same process can interfere with the immune response.
"With Serge Fuchs, professor at the University of Pennsylvania and co-author on the paper, we were surprised to find that the same cellular mechanism can benefit the tumor in two ways—by supplying cancer cells with lipids while also weakening cancer-fighting T cells," said Astsaturov. "Targeting ANO6 could potentially disrupt both of these tumor-supporting functions at the same time."
CAFs form direct contacts with cytotoxic T lymphocytes (CTLs), immune cells that can recognize and kill cancer cells. During these interactions, the T cells can acquire CAF membrane material, including cholesterol. Excess cholesterol in the tumor environment can contribute to T-cell exhaustion, making the immune cells less effective.
In mouse models, blocking ANO6 reduced cholesterol accumulation in tumor-infiltrating T cells and improved markers of T-cell activity. Laboratory experiments also showed that T cells exposed to CAFs with reduced ANO6 had greater cancer-killing activity.
Blocking ANO6 reduced tumor growth
The researchers tested whether disrupting ANO6 could slow pancreatic cancer growth.
In mouse models, treatment with niclosamide or clofazimine—drugs that inhibited ANO6-dependent activity in the study—significantly reduced tumor weight. Niclosamide also reduced the delivery of cholesterol to pancreatic cancer cells.
The researchers noted that trogocytosis is one of several ways pancreatic cancer cells may obtain lipids, and that further research is needed to determine whether selectively targeting ANO6 could be an effective treatment strategy. The ANO6-targeting drugs used in the study may also be deployed to treat other recalcitrant cancers beyond pancreatic adenocarcinoma.
"We believe our findings identify ANO6 as a potential therapeutic target that could simultaneously disrupt the nutrient supply supporting pancreatic cancer cells and reduce the immune-suppressive effects of the tumor microenvironment," said Astsaturov.
"Excitingly, reducing ANO6 expression also disrupted the stromal synapse-mimicry circuit we previously identified, which coordinates tumor nutritional support, CAF-unit metabolism, and immune suppression. These findings position ANO6 as the missing mechanistic link that unifies nearly a decade of discoveries by our team," said Cukierman.
Publication details
ANO6-mediated trogocytosis of cancer-associated fibroblasts promotes pancreatic cancer cell growth and immune suppression, Nature Cancer (2026). DOI: 10.1038/s43018-026-01265-5
Journal information: Nature Cancer
Key medical concepts
Pancreatic Ductal AdenocarcinomaCancer-Associated FibroblastsTrogocytosisCholesterol
Clinical categories
Oncology Provided by Temple University Who's behind this story?
Sadie Harley
BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →
Robert Egan
Bachelor's in mathematical biology, Master's in creative writing. Well-traveled with unique perspectives on science and language. Full profile →
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