CANCER-ASSOCIATED FIBROBLASTS MAINTAIN PANCREATIC CANCER CELL LIPID HOMEOSTASIS IN THE TUMOR MICROENVIRONMENT

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy whose abundant cancer-associated fibroblasts (CAFs) create a hallmark “desmoplasia” that severely limits oxygen and nutrient delivery. Here, we investigated the mechanisms by which PDAC cells maintain lipid homeostasis under these conditions. Exogenous unsaturated lipids, rather than de novo synthesis, sustain PDAC cell viability by relieving endoplasmic reticulum (ER) stress under nutrient scarcity. Furthermore, CAFs are less hypoxic than adjacent malignant cells in vivo, nominating them as a potential source of these obligatory species. CAF-conditioned medium promoted PDAC cell survival upon nutrient and oxygen deprivation, an effect reversed by delipidation. We determined that lysophosphatidylcholines (LPCs) are particularly enriched in CAF-conditioned medium and preferentially taken up by PDAC cells, where they are converted to phosphatidylcholine (PC) to sustain membrane integrity. Inhibiting LPC to PC conversion reversed the ability of exogenous unsaturated LPCs to sustain cancer cell survival and restrain ER stress. Collectively, these results reveal a critical lipid cross-feeding mechanism enabling PDAC cell survival and identify an innovative approach to targeting this metabolic dependency.