Hypoxia-driven oncometabolite L-2HG maintains stemness-differentiation balance and facilitates immune evasion in pancreatic cancer

Vineet K. Gupta, Nikita S. Sharma, Brittany Durden, Vanessa T. Garrido, Kousik Kesh, Dujon Edwards, Dezhen Wang, Ciara Myer, Beatriz Mateo-Victoriano, Sai Sundeep Kollala, Yuguang Ban, Zhen Gao, Sanjoy K. Bhattacharya, Ashok Saluja, Pankaj K. Singh, Sulagna Banerjee

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


In pancreatic cancer, the robust fibroinflammatory stroma contributes to immune suppression and renders tumors hypoxic, altering intratumoral metabolic pathways and leading to poor survival. One metabolic enzyme activated during hypoxia is lactate dehydrogenase A (LDHA). As a result of its promiscuous activity under hypoxia, LDHA produces L-2 hydroxyglutarate (L-2HG), an epigenetic modifier, that regulates the tumor transcriptome. However, the role of L-2HG in remodeling the pancreatic tumor microenvironment is not known. Here we used mass spectrometry to detect L-2HG in serum samples from patients with pancreatic cancer, comprising tumor cells as well as stromal cells. Both hypoxic pancreatic tumors as well as serum from patients with pancreatic cancer accumulated L-2HG as a result of promiscuous activity of LDHA. This abnormally accumulated L-2HG led to H3 hypermethylation and altered gene expression, which regulated a critical balance between stemness and differentiation in pancreatic tumors. Secreted L-2HG inhibited T-cell proliferation and migration, suppressing antitumor immunity. In a syngeneic orthotopic model of pancreatic cancer, inhibition of LDH with GSK2837808A decreased L-2HG, induced tumor regression, and sensitized tumors to anti-PD1 therapy. In conclusion, hypoxia-mediated promiscuous activity of LDH produces L-2HG in pancreatic tumor cells, regulating the stemness-differentiation balance and contributing to immune evasion. Targeting LDH can be developed as a potential therapy to sensitize pancreatic tumors to checkpoint inhibitor therapy.

Original languageEnglish (US)
Pages (from-to)4001-4013
Number of pages13
JournalCancer Research
Issue number15
StatePublished - Aug 1 2021

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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