When Samuel J. Klempner, M.D. received the $300,000 Ben Feinstein Memorial Research Scholar Award from the Gastric Cancer Foundation and the American Gastroenterology Association (AGA) in 2020, his goal was to probe causes and potential solutions to “peritoneal spread”—the migration of cancer cells into the lining of the abdomen. About 40% of patients experience this problem, which greatly lowers the odds of survival.
Klempner is excited about what he’s learned so far and enthusiastic about his research plan for the final year.
Klempner’s mission is to study the composition of the abdominal fluid in gastric cancer patients with peritoneal spread, which is called the ascites (uh-SY-tees), Specifically, he set out to characterize the immune components of ascites. Using ascites samples from 25 gastric cancer patients, his team analyzed single cell RNA sequencing data to determine what’s floating in the fluid—and to improve the understanding of how those components make defeating the cancer so difficult.
An early observation that the filtered ascites fluid helped tumor and immune cells survive led to an unanticipated direction toward studying the circulating factors in ascites. One area includes “exosomes” which are tiny vesicles that have been implicated in promoting tumor growth and driving resistance to some therapies, including immune therapies. The researchers found that exosomes are “very abundant” in ascites, Klempner said, and that they promote tumor cell invasion and blood vessel formation. “After exosomes are taken up by tumor cells, they give them information and growth signals to help them stay alive,” he said. “That’s probably one of the reasons ascites is difficult to treat.”
