American Association for Cancer Research
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Supplementary Figures S1-S6 from Warfarin Blocks Gas6-Mediated Axl Activation Required for Pancreatic Cancer Epithelial Plasticity and Metastasis

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journal contribution
posted on 2023-03-30, 23:05 authored by Amanda Kirane, Kathleen F. Ludwig, Noah Sorrelle, Gry Haaland, Tone Sandal, Renate Ranaweera, Jason E. Toombs, Miao Wang, Sean P. Dineen, David Micklem, Michael T. Dellinger, James B. Lorens, Rolf A. Brekken

Supplementary Figures S1-S6. Axl is required for the growth of Mia PaCa-2 tumors (S1); Characterization of 10C9 (S2); Warfarin inhibits autocrine activation of Axl in pancreatic tumor cells (S3); In vivo warfarin effects (S4); Maintenance of mesenchymal phenotype is Axl dependent and inhibited by warfarin (S5); Acquisition of Axl expression sensitizes Capan-EMT cells to warfarin (S6).



Repurposing “old” drugs can facilitate rapid clinical translation but necessitates novel mechanistic insight. Warfarin, a vitamin K “antagonist” used clinically for the prevention of thrombosis for more than 50 years, has been shown to have anticancer effects. We hypothesized that the molecular mechanism underlying its antitumor activity is unrelated to its effect on coagulation, but is due to inhibition of the Axl receptor tyrosine kinase on tumor cells. Activation of Axl by its ligand Gas6, a vitamin K-dependent protein, is inhibited at doses of warfarin that do not affect coagulation. Here, we show that inhibiting Gas6-dependent Axl activation with low-dose warfarin, or with other tumor-specific Axl-targeting agents, blocks the progression and spread of pancreatic cancer. Warfarin also inhibited Axl-dependent tumor cell migration, invasiveness, and proliferation while increasing apoptosis and sensitivity to chemotherapy. We conclude that Gas6-induced Axl signaling is a critical driver of pancreatic cancer progression and its inhibition with low-dose warfarin or other Axl-targeting agents may improve outcome in patients with Axl-expressing tumors. Cancer Res; 75(18); 3699–705. ©2015 AACR.