Authors have received support from the Avner Pancreatic Cancer Foundation.

All procedures were approved by the Animal Care and Ethics Committee of the University of New South Wales (17/109A). Female athymic Balb/c nude mice, aged 8-10 weeks weighing 16-19 g, were used for this protocol. Mice were housed in micro-isolator cages and fed commercially available pelleted food and water ad libitum.
1. Orthotopic pancreatic cancer implantation
<ol>
	<li>Prepare the cells for implantation. First, calculate the number of cells required for the procedure (1 x 10<sup...

<ol>
	<li>. SEER Cancer Statistics Review, 1975-2015, National Cancer Institute Available from: <a target="_blank" href="https://seer.cancer.gov/csr/1975_2015/">https://seer.cancer.gov/csr/1975_2015/</a> (2018)</li><li>Sugiura, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Margin+status,+recurrence+pattern,+and+prognosis+after+resection+of+pancreatic+cancer.">Margin status, recurrence pattern, and prognosis after resection of pancreatic cancer.</a> Surgery. 154 (5), 1078-1086 (2013).</li><li>Hishinuma, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Patterns+of+recurrence+after+curative+resection+of+pancreatic+cancer,+based+on+autopsy+findings.">Patterns of recurrence after curative resection of pancreatic cancer, based on autopsy findings.</a> Journal of Gastrointestinal Surgery. 10 (4), 511-518 (2006).</li><li>NCCN Clinical Practice Guidelines in Oncology - Pancreatic Adenocarcinoma (Version 3.2019). National Comprehensive Cancer Network Available from: <a target="_blank" href="https://www.nccn.org/professionals/physician_gls/pdf/pancreatic.pdf">https://www.nccn.org/professionals/physician_gls/pdf/pancreatic.pdf</a> (2019)</li><li>Breslin, T. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neoadjuvant+chemoradiotherapy+for+adenocarcinoma+of+the+pancreas:+treatment+variables+and+survival+duration.">Neoadjuvant chemoradiotherapy for adenocarcinoma of the pancreas: treatment variables and survival duration.</a> Annals of Surgical Oncology. 8 (2), 123-132 (2001).</li><li>Mokdad, A. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neoadjuvant+Therapy+Followed+by+Resection+Versus+Upfront+Resection+for+Resectable+Pancreatic+Cancer:+A+Propensity+Score+Matched+Analysis.">Neoadjuvant Therapy Followed by Resection Versus Upfront Resection for Resectable Pancreatic Cancer: A Propensity Score Matched Analysis.</a> Journal of Clinical Oncology. 35 (5), 515-522 (2017).</li><li>Tachezy, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sequential+neoadjuvant+chemoradiotherapy+(CRT)+followed+by+curative+surgery+vs.+primary+surgery+alone+for+resectable,+non-metastasized+pancreatic+adenocarcinoma:+NEOPA-+a+randomized+multicenter+phase+III+study+(NCT01900327,+DRKS00003893,+ISRCTN82191749).">Sequential neoadjuvant chemoradiotherapy (CRT) followed by curative surgery vs. primary surgery alone for resectable, non-metastasized pancreatic adenocarcinoma: NEOPA- a randomized multicenter phase III study (NCT01900327, DRKS00003893, ISRCTN82191749).</a> BMC Cancer. 14, 411 (2014).</li><li>Barbour, A. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+AGITG+GAP+Study:+A+Phase+II+Study+of+Perioperative+Gemcitabine+and+Nab-Paclitaxel+for+Resectable+Pancreas+Cancer.">The AGITG GAP Study: A Phase II Study of Perioperative Gemcitabine and Nab-Paclitaxel for Resectable Pancreas Cancer.</a> Annals of Surgical Oncology. , (2020).</li><li>Fu, X., Guadagni, F., Hoffman, R. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+metastatic+nude-mouse+model+of+human+pancreatic+cancer+constructed+orthotopically+with+histologically+intact+patient+specimens.">A metastatic nude-mouse model of human pancreatic cancer constructed orthotopically with histologically intact patient specimens.</a> Proceedings of the National Academy of Sciences of the United States of America. 89 (12), 5645-5649 (1992).</li><li>Marincola, F., Taylor-Edwards, C., Drucker, B., Holder, W. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Orthotopic+and+heterotopic+xenotransplantation+of+human+pancreatic+cancer+in+nude+mice.">Orthotopic and heterotopic xenotransplantation of human pancreatic cancer in nude mice.</a> Current Surgery. 44 (4), 294-297 (1987).</li><li>Vonlaufen, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pancreatic+stellate+cells:+partners+in+crime+with+pancreatic+cancer+cells.">Pancreatic stellate cells: partners in crime with pancreatic cancer cells.</a> Cancer Research. 68 (7), 2085-2093 (2008).</li><li>Xu, Z., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Role+of+pancreatic+stellate+cells+in+pancreatic+cancer+metastasis.">Role of pancreatic stellate cells in pancreatic cancer metastasis.</a> American Journal of Pathology. 177 (5), 2585-2596 (2010).</li><li>Tepel, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adjuvant+treatment+of+pancreatic+carcinoma+in+a+clinically+adapted+mouse+resection+model.">Adjuvant treatment of pancreatic carcinoma in a clinically adapted mouse resection model.</a> Pancreatology. 6 (3), 240-247 (2006).</li><li>Torgenson, M. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Natural+history+of+pancreatic+cancer+recurrence+following+"curative"+resection+in+athymic+mice.">Natural history of pancreatic cancer recurrence following "curative" resection in athymic mice.</a> Journal Surgical Research. 149 (1), 57-61 (2008).</li><li>Metildi, C. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fluorescence-guided+surgery+allows+for+more+complete+resection+of+pancreatic+cancer,+resulting+in+longer+disease-free+survival+compared+with+standard+surgery+in+orthotopic+mouse+models.">Fluorescence-guided surgery allows for more complete resection of pancreatic cancer, resulting in longer disease-free survival compared with standard surgery in orthotopic mouse models.</a> Journal of the American College of Surgeons. 215 (1), 126-135 (2012).</li><li>Ni, X., Yang, J., Li, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Imaging-guided+curative+surgical+resection+of+pancreatic+cancer+in+a+xenograft+mouse+model.">Imaging-guided curative surgical resection of pancreatic cancer in a xenograft mouse model.</a> Cancer Letters. 324 (2), 179-185 (2012).</li><li>Hiroshima, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hand-held+high-resolution+fluorescence+imaging+system+for+fluorescence-guided+surgery+of+patient+and+cell-line+pancreatic+tumors+growing+orthotopically+in+nude+mice.">Hand-held high-resolution fluorescence imaging system for fluorescence-guided surgery of patient and cell-line pancreatic tumors growing orthotopically in nude mice.</a> Journal of Surgical Research. 187 (2), 510-517 (2014).</li><li>Hiroshima, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Metastatic+recurrence+in+a+pancreatic+cancer+patient+derived+orthotopic+xenograft+(PDOX)+nude+mouse+model+is+inhibited+by+neoadjuvant+chemotherapy+in+combination+with+fluorescence-guided+surgery+with+an+anti-CA+19-9-conjugated+fluorophore.">Metastatic recurrence in a pancreatic cancer patient derived orthotopic xenograft (PDOX) nude mouse model is inhibited by neoadjuvant chemotherapy in combination with fluorescence-guided surgery with an anti-CA 19-9-conjugated fluorophore.</a> PLoS One. 9 (12), 114310 (2014).</li><li>Hiroshima, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fluorescence-guided+surgery+in+combination+with+UVC+irradiation+cures+metastatic+human+pancreatic+cancer+in+orthotopic+mouse+models.">Fluorescence-guided surgery in combination with UVC irradiation cures metastatic human pancreatic cancer in orthotopic mouse models.</a> PLoS One. 9 (6), 99977 (2014).</li><li>Metildi, C. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ratiometric+activatable+cell-penetrating+peptides+label+pancreatic+cancer,+enabling+fluorescence-guided+surgery,+which+reduces+metastases+and+recurrence+in+orthotopic+mouse+models.">Ratiometric activatable cell-penetrating peptides label pancreatic cancer, enabling fluorescence-guided surgery, which reduces metastases and recurrence in orthotopic mouse models.</a> Annals of Surgical Oncology. 22 (6), 2082-2087 (2015).</li><li>Metildi, C. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fluorescence-guided+surgery+with+a+fluorophore-conjugated+antibody+to+carcinoembryonic+antigen+(CEA),+that+highlights+the+tumor,+improves+surgical+resection+and+increases+survival+in+orthotopic+mouse+models+of+human+pancreatic+cancer.">Fluorescence-guided surgery with a fluorophore-conjugated antibody to carcinoembryonic antigen (CEA), that highlights the tumor, improves surgical resection and increases survival in orthotopic mouse models of human pancreatic cancer.</a> Annals of Surgical Oncology. 21 (4), 1405-1411 (2014).</li><li>NCCN Guidelines: Pancreatic Adenocarcinoma. National Comprehensive Cancer Network Available from: <a target="_blank" href="https://www.nccn.org/professionals/physician_gls/pdf/pancreatic.pdf">https://www.nccn.org/professionals/physician_gls/pdf/pancreatic.pdf</a> (2019)</li><li>Maithel, S. K., Allen, P. 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H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Targeting+the+HGF/c-MET+pathway+in+advanced+pancreatic+cancer:+a+key+element+of+treatment+that+limits+primary+tumor+growth+and+eliminates+metastasis.">Targeting the HGF/c-MET pathway in advanced pancreatic cancer: a key element of treatment that limits primary tumor growth and eliminates metastasis.</a> British Journal of Cancer. , (2020).</li><li>Pothula, S. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Targeting+the+HGF/c-MET+pathway:+stromal+remodelling+in+pancreatic+cancer.">Targeting the HGF/c-MET pathway: stromal remodelling in pancreatic cancer.</a> Oncotarget. 8 (44), 76722-76739 (2017).</li><li>Pothula, S. 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The authors have nothing to disclose with respect to this project.

A resectional orthotopic mouse model of pancreatic cancer is important because it allows for the testing of adjuvant and neoadjuvant treatments. This is particularly important in pancreatic cancer where surgery remains the most effective treatment but is associated with high risk of recurrence. This paper describes a method which will reliably produce a pancreatic cancer which is potentially curable with resection, replicating the clinical scenario where neoadjuvant/ adjuvant therapy is required.
<p class="jove_conte...

Pancreatic ductal adenocarcinoma (pancreatic cancer [PC]) is associated with a poor prognosis1. Surgical resection remains the only potentially curative treatment for PC and should be considered for patients presenting with early stage disease. Unfortunately, even with R0 resection (i.e., resection margins free of tumor), the recurrence rate (local or from undetected metastatic disease) is high2,3. Therefore, systemic adjuvant therapy is indicated in almost all patients who undergo resection4. Furthermore, while neoadjuvant therapy is now recommended only for borderline-resectable cancers, its indications are expanding such that its routine use is the focus of much clinical research5,6,7,8. In order to develop novel therapeutic approaches for PC involving resection, these approaches need to be first assessed in pre-clinical models that accurately recapitulate clinical settings.
Orthotopic mouse models of PC have been frequently used in the past to test drug treatments9,10. Many of these were produced by injection of cancer cells alone into mouse pancreas, resulting in tumors that lacked the prominent stroma that is characteristic of PC. More recently, co-injection orthotopic models, such as the one we first developed by injecting a mixture of human PC and human pancreatic stellate cells (PSCs, the primary producers of the collagenous stroma in PC), have come into regular use11,12. The tumors produced by such co-injection of cancer and stromal cells exhibit (i) both the cancer elements and the characteristic stromal (desmoplastic) component of PC, and (ii) enhanced cancer cell proliferation and metastasis11. Thus, this model closely resembles human PC. While a number of resectional models of orthotopic PC have been described13,14,15,16, none have reflected the clinical realities of pancreatic resection in humans as accurate as this model, and therefore have been suboptimal for testing adjuvant or neoadjuvant treatments.
The aims of the mouse model presented were to demonstrate how to: (i) successfully implant orthotopic pancreatic cancer while minimizing inadvertent peritoneal dissemination and (ii) subsequently completely resect the cancer. The paper highlight tips and potential pitfalls of this technique.

<table>
	<tbody>
		<tr>
			<td>Animals, Materials and Equipment for Implantation Procedure</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>AsPC-1 human pancreatic cancer cell line, luciferase tagged (luc+ gene from Promega PGL3 Basic plasmid)</td>
			<td>American Type Culture Collection, Manassas, VA, USA</td>
			<td></td>
			<td>supplied by Professor Takashi Murakami, Saitama Medical University, Saitama, Japan</td>
		</tr>
		<tr>
			<td>Autoclip wound clips, 9 mm</td>
			<td>Becton Dickson Pty Ltd, North Ryde, NSW, Australia</td>
			<td>500346</td>
			<td></td>
		</tr>
		<tr>
			<td>Basic Dressing Pack</td>
			<td>Multigate Medical Products Pty Ltd, Villawood, NSW, Australia</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Cancer associated human pancreatic stellate cells</td>
			<td>Pancreatic Research Group cell bank</td>
			<td></td>
			<td>In house cell bank</td>
		</tr>
		<tr>
			<td>Cryogenic tubes, 1.0 mL</td>
			<td>Thermo Fisher Scientific Australia Pty Ltd, Scoresby, VIC, Australia</td>
			<td>366656</td>
			<td></td>
		</tr>
		<tr>
			<td>Disposable stainless-steel scalpel blade with handle, size 15</td>
			<td>Livingstone International, Mascot, NSW,</td>
			<td>SCP15</td>
			<td></td>
		</tr>
		<tr>
			<td>Foetal bovine serum (FBS)</td>
			<td>Life Technologies Corporation, Tullamarine, VIC, Australia</td>
			<td>16000044</td>
			<td></td>
		</tr>
		<tr>
			<td>Gilles fine tooth forceps 12 cm</td>
			<td></td>
			<td></td>
			<td>Generic stainless steel microsurgical instrument set</td>
		</tr>
		<tr>
			<td>Heated mats to maintain body temperature during surgery and postoperative recovery</td>
			<td>Generic</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Homozygous athymic nude mice: Strain BALB/c-Fox1nu/Ausb, female</td>
			<td>Australian Bioresources, Moss Vale, NSW, Australia</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Iscove&#39;s modified Dulbecco&#39;s medium (IMDM) with 4mM L-glutamine and no phenol red</td>
			<td>Life Technologies Corporation, Tullamarine, VIC, Australia</td>
			<td>21056023</td>
			<td></td>
		</tr>
		<tr>
			<td>Jewellers forceps 11.5 cm</td>
			<td></td>
			<td></td>
			<td>Generic stainless steel microsurgical instrument set</td>
		</tr>
		<tr>
			<td>Micro needle holder (round handle) 15 cm straight</td>
			<td></td>
			<td></td>
			<td>Generic stainless steel microsurgical instrument set</td>
		</tr>
		<tr>
			<td>Micro scissors (round handle) 15 cm straight</td>
			<td></td>
			<td></td>
			<td>Generic stainless steel microsurgical instrument set</td>
		</tr>
		<tr>
			<td>Penicillin 10,000 U/mL, streptomycin 10,000 &#956;g/mL</td>
			<td>Life Technologies Corporation, Tullamarine, VIC, Australia</td>
			<td>15140122</td>
			<td></td>
		</tr>
		<tr>
			<td>Polyglycolic acid suture, size USP 5/0 on 13mm half-circle round-bodied needle</td>
			<td>Braun Australia Pty Ltd, Bella Vista, NSW, Australia</td>
			<td>C1049407</td>
			<td></td>
		</tr>
		<tr>
			<td>Portable weighing scale</td>
			<td>Precision balances, Bradford, MA, USA</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Reflex clip applier and clip remover</td>
			<td>World Precision Instruments, Sarasota, FL, USA</td>
			<td>500345</td>
			<td></td>
		</tr>
		<tr>
			<td>Roswell Park Memorial Institute (RPMI) 1640 with phenol red and 300 mg/L Lglutamine</td>
			<td>Life Technologies Corporation, Tullamarine, VIC, Australia</td>
			<td>11875085</td>
			<td></td>
		</tr>
		<tr>
			<td>Round bodied vessel dilator 15 cm, 0.1 mm tip</td>
			<td></td>
			<td></td>
			<td>Generic stainless steel microsurgical instrument set</td>
		</tr>
		<tr>
			<td>Trypsin 0.05%, EDTA 0.02%</td>
			<td>Life Technologies Corporation, Tullamarine, VIC, Australia</td>
			<td>25300054</td>
			<td>For pancreatic stellate cells</td>
		</tr>
		<tr>
			<td>Trypsin 0.25%, EDTA 0.02%</td>
			<td>Life Technologies Corporation, Tullamarine, VIC, Australia</td>
			<td>25200056</td>
			<td>For ASPC-1 cells</td>
		</tr>
		<tr>
			<td>U-100 insulin syringes, 0.5 mL with 29 G (0.33 mm) &#215; 13 mm needle</td>
			<td>Terumo Medical Corporation, Elkton, MD, USA</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Equipment for Resection Procedure</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Alm self-retaining retractor</td>
			<td></td>
			<td></td>
			<td>Generic stainless steel microsurgical instrument set</td>
		</tr>
		<tr>
			<td>Autoclip wound clips 9 mm</td>
			<td>Becton Dickson Pty Ltd, North Ryde, NSW</td>
			<td>500346</td>
			<td></td>
		</tr>
		<tr>
			<td>Basic Dressing Pack</td>
			<td>Multigate Medical Products Pty Ltd, Villawood, NSW, Australia</td>
			<td>08-559NP</td>
			<td></td>
		</tr>
		<tr>
			<td>Disposable stainless-steel scalpel blade with handle, size 15</td>
			<td>Livingstone International, Mascot, NSW,</td>
			<td>SCP15</td>
			<td></td>
		</tr>
		<tr>
			<td>Gilles fine tooth forceps 12 cm</td>
			<td></td>
			<td></td>
			<td>Generic stainless steel microsurgical instrument set</td>
		</tr>
		<tr>
			<td>Hand-held high temperature fine tip cautery</td>
			<td>Bovie Medical Corporation, Melville, NY, USA</td>
			<td>AA01</td>
			<td></td>
		</tr>
		<tr>
			<td>Heated mats to maintain body temperature during surgery and postoperative recovery</td>
			<td>Generic</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>IVIS Lumina II Bioluminescent Imaging Device</td>
			<td>Caliper Life Sciences, Hopkinton, MA, USA</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Jewellers forceps 11.5 cm</td>
			<td></td>
			<td></td>
			<td>Generic stainless steel microsurgical instrument set</td>
		</tr>
		<tr>
			<td>Micro needle holder (round handle) 15 cm straight</td>
			<td></td>
			<td></td>
			<td>Generic stainless steel microsurgical instrument set</td>
		</tr>
		<tr>
			<td>Micro scissors (round handle) 15 cm straight</td>
			<td></td>
			<td></td>
			<td>Generic stainless steel microsurgical instrument set</td>
		</tr>
		<tr>
			<td>Polyglycolic acid suture, size USP 5/0 on 13mm half-circle round-bodied needle</td>
			<td>Braun Australia Pty Ltd, Bella Vista, NSW, Australia</td>
			<td>C1049407</td>
			<td></td>
		</tr>
		<tr>
			<td>Portable weighing scale</td>
			<td>Precision balances, Bradford, MA, USA</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Reflex wound clip applier and clip remover</td>
			<td>World Precision Instruments, Sarasota, FL, USA</td>
			<td>500345</td>
			<td></td>
		</tr>
		<tr>
			<td>Round bodied vessel dilator 15 cm, 0.1 mm tip</td>
			<td></td>
			<td></td>
			<td>Generic stainless steel microsurgical instrument set</td>
		</tr>
		<tr>
			<td>Titanium &#8220;Weck style&#8221; Ligaclip, small</td>
			<td>HZMIM, Hangzhou, China</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Titanium Ligaclip applier for open surgery, small</td>
			<td>HZMIM, Hangzhou, China</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Volatile anaesthetic machine, including vapouriser and induction chamber</td>
			<td>Generic</td>
			<td></td>
			<td>Generic vapouriser and induction chamber</td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Drugs for Procedures</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>70% w/w ethanol solution</td>
			<td>Sigma-Aldrich Pty Ltd, Castle Hill, NSW, Australia</td>
			<td></td>
			<td>Applied topically as surgical skin preparation</td>
		</tr>
		<tr>
			<td>Buprenorphine 0.3 mg/mL</td>
			<td>Troy Laboratories Pty Ltd, Glendenning, NSW, Australia</td>
			<td></td>
			<td>Dose: 0.05 mg/kg s.c.</td>
		</tr>
		<tr>
			<td>D-Luciferin (1 U/g)</td>
			<td>PerkinElmer, Inc., Waltham, MA, USA</td>
			<td>122799</td>
			<td>diluted in PBS to 15 mg/mL. Dose: 150 mg/kg i.p</td>
		</tr>
		<tr>
			<td>Enrofloxacin 50 mg/mL</td>
			<td>Troy Laboratories Pty Ltd, Glendenning, NSW, Australia</td>
			<td></td>
			<td>Dose: 5 mg/kg s.c.</td>
		</tr>
		<tr>
			<td>Flunixin 50 mg/mL</td>
			<td>Norbrook Laboratories Australia, Tullamarine, VIC, Australia</td>
			<td></td>
			<td>Dose: 2.5 mg/kg s.c.</td>
		</tr>
		<tr>
			<td>Isoflurane</td>
			<td>Zoetis Australia Pty Ltd., Rhodes, NSW, Australia</td>
			<td></td>
			<td>Dose (vapourised with oxygen): 4% induction, 3% maintenance</td>
		</tr>
		<tr>
			<td>Ketamine 100 mg/mL</td>
			<td>Maylab, Slacks Creek, QLD, Australia</td>
			<td></td>
			<td>Dose: 80 mg/kg i.p.</td>
		</tr>
		<tr>
			<td>Povidone-Iodine 10% w/v solution</td>
			<td>Perrigo Australia, Balcatta, WA, Australia</td>
			<td>RIO00802F</td>
			<td>Applied topically to the anterior abdomen as surgical skin preparation</td>
		</tr>
		<tr>
			<td>Refresh eye ointment (liquid paraffin 42.5% w/w, soft white paraffin 57.3% w/w)</td>
			<td>Allergan Australia Pty Ltd, Gordon, NSW, Australia</td>
			<td></td>
			<td>Applied to both eyes</td>
		</tr>
		<tr>
			<td>Sodium chloride 0.9% w/v</td>
			<td>Braun Australia Pty Ltd, Bella Vista, NSW, Australia</td>
			<td>9481P</td>
			<td>Dose: 900 &#956;L s.c.</td>
		</tr>
		<tr>
			<td>Water for injections BP</td>
			<td>Pfizer Australia, Sydney, NSW, Australia</td>
			<td></td>
			<td>For dilution of drugs</td>
		</tr>
		<tr>
			<td>Xylazine 20 mg/mL</td>
			<td>Troy Laboratories Pty Ltd, Glendenning, NSW, Australia</td>
			<td></td>
			<td>Dose: 10 mg/kg i.p.</td>
		</tr>
	</tbody>
</table>

an orthotopic resectional mouse model of pancreatic cancer

There is a lack of satisfactory animal models to study adjuvant and/or neoadjuvant therapy in patients being considered for surgery of pancreatic cancer (PC). To address this deficiency, we describe a mouse model involving orthotopic implantation of PC followed by distal pancreatectomy and splenectomy. The model has been demonstrated to be safe and suitably flexible for the study of various therapeutic approaches in adjuvant and neo adjuvant settings.
In this model, a pancreatic tumor is first generated by implanting a mixture of human pancreatic cancer cells (luciferase-tagged AsPC-1) and human cancer associated pancreatic stellate cells into the distal pancreas of Balb/c athymic nude mice. After three weeks, the cancer is resected by re-laparotomy, distal pancreatectomy and splenectomy. In this model, bioluminescence imaging can be used to follow the progress of cancer development and effects of resection/treatments. Following resection, adjuvant therapy can be given. Alternatively, neoadjuvant treatment can be given prior to resection.
Representative data from 45 mice are presented. All mice underwent successful distal pancreatectomy/splenectomy with no issues of hemostasis. A macroscopic proximal pancreatic margin greater than 5 mm was achieved in 43 (96%) mice. The technical success rate of pancreatic resection was 100%, with 0% early mortality and morbidity. None of the animals died during the week after resection.
In summary, we describe a robust and reproducible technique for a surgical resection model of pancreatic cancer in mice which mimics the clinical scenario. The model may be useful for the testing of both adjuvant and neoadjuvant treatments.

Fifty-nine consecutive mice underwent implantation surgery. Gross leakage occurred in eight (14%) mice. The degree of leakage at the time of injection is estimated as described above in the protocol section. After three weeks to allow these implanted tumors to grow, pre-resection bioluminescence imaging was performed to exclude mice with gross metastatic disease prior to resection. Forty-five (76%) mice underwent surgical resection.
All 45 (100%) mice underwent successful distal pancreatectomy...

Watch this Scientific Journal Video about An Orthotopic Resectional Mouse Model of Pancreatic Cancer at JoVE.com

An Orthotopic Resectional Mouse Model of Pancreatic Cancer

In the clinical context, patients with localized pancreatic cancer will undergo pancreatectomy followed by adjuvant treatment. This protocol reported here aims to establish a safe and effective method of modelling this clinical scenario in nude mice, through orthotopic implantation of pancreatic cancer followed by distal pancreatectomy and splenectomy.

There is a lack of satisfactory animal models to study adjuvant and/or neoadjuvant therapy in patients being considered for surgery of pancreatic cancer ...

This protocol describes a robust and reproducible surgical resection model of pancreatic cancer in mice, which may be used for testing adjuvant and neoadjuvant therapy. This technique combines a co-infection orthotopic model, which is effective at recapitulating human pancreatic cancer with a safe and effective pancreatic resection technique. While an immunodeficient model is described in this protocol, an alternative immunocompetent model, using KPC tumor cells implanted into C57 black six mice may be performed.This alternative would be useful for testing immune therapies. To begin, place the anesthetized mouse on a sterile field in a supine position and apply povidone iodine, followed by 70%ethanol for skin preparation. Dissect the skin by making a longitudinal incision on the left cranial quadrant of the abdomen and incise the muscular layers between forceps.After mounting the syringe with the cell suspension on the injection device, place the purse string swab over the laparotomy incision and exteriorize the spleen and pancreatic tail through the swab's opening. Tighten the purse strings swab gently and expose the pancreatic tail for injection, making sure that the gauze contacts the pancreas circumferentially, but does not constrict it. Grasp the tail of the pancreas, using forceps and gently place lateral tension on it.Puncture the pancreas with the needle, bevel up and advance it while the needle tip is lifted slightly upward until the bevel has completely entered the peritoneum. Inject the parenchyma of the pancreas with the cell suspension in a slow and controlled fashion. After injection, hold the needle in place for a few seconds before withdrawing to minimize leakage.Use a povidone iodine soaked swab to carefully dab the site to absorb any inadvertently leaked cell suspension. Replace the spleen and pancreas back to its orthotopic position and close the abdominal wall with 5-0 polyglycolic acid suture. Close the skin with clips.Make a longitudinal incision in the skin of the left cranial quadrant of the abdomen. Preferably through the previous incision site. Bluntly dissect the skin off the underlying, muscular abdominal wall and place an all self retaining retractor to hold the wound open.Incise the muscular layer between forceps, just to one side of the suture line of the previous operation. And then extend the incision to excise the entire previous suture line. Exteriorize the spleen and pancreas by retracting it cranially.In this case, some adhesions were found attached to the inferior aspect of the tumor. This was divided by cautery. The colon may be found attached to the caudal aspect of the pancreas by filmy adhesions.If this is found, bluntly dissect the colon off. Expose the segment of pancreas for ligation by carefully passing a pair of forceps dorsal to the splenic vessels at the body of the pancreas. Ligate the pancreas proximal to the tumor with a titanium legation clip and then transect the pancreas distal to this with cautery.Alternatively, ligate the pancreas in continuity with 5-0 polyglycolic acid suture before transection, in order to control the pancreatic stump. Carefully retract the pancreas caudally and cauterize the gastro splenic vessels between the cranial pole of the spleen and the stomach. Keeping in mind that the vessels are small and may easily bleed if avulse or inadequately cauterized.Such vessels may retract into the abdominal cavity and cause bleeding, which may be difficult to control. Remove the specimen and examine the surgical site to confirm hemostasis. Close the abdominal wall with a 5-0 polyglycolic acid suture in a continuous fashion and close the skin with clips.Out of 59 consecutive mice who underwent implantation surgery, gross leakage occurred in eight mice. After three weeks of tumor growth, the pre-resection bioluminescence imaging allowed the exclusion of mice with gross metastatic disease from surgical resection. This left 45 mice that proceeded to pancreatectomy.The procedure was successfully carried out in 100%of mice. A macroscopic proximal pancreatic margin, greater than five millimeters was achieved in 43 of these mice. At the time of resection, local metastasis was found in nine out of 45 mice.In addition to metastasis to the suture line, isolated metastatic nodules on the greater curve of the stomach were observed in three mice and a subcapsular nodule on the liver in one mouse. Local extra pancreatic invasion occurred in six mice with direct invasion into the suture line in five mice and into the liver in one mouse. One week post-resection, 32 mice had a maximum radiance ratio of less than 10, indicating minimal or no residual disease.The mean surgery time from induction of anesthesia to closure was 22 minutes. The key step in the resection procedure is recognizing the bloodless embryological plane dorsal to the splenic vessels and pancreas. Dissecting this plane frees up a segment of the pancreas for subsequent ligation.After resection, the mice may be treated with adjuvant therapies. Progression of disease may then be assessed, using bioluminescence imaging in combination with necropsy findings and animal survival, depending on the local animal ethics protocols.

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Research

JoVE Journal

Cancer Research

9.6K Görüntüleme.  University of New South Wales. This protocol describes a robust and reproducible surgical resection model of pancreatic cancer in mice, which may be used for testing adjuvant and neoadjuvant therapy. This technique combines a co-infection orthotopic model, which is effective at recapitulating human pancreatic cancer with a safe and effective pancreatic resection technique. While an immunodeficient model is described in this protocol, an alternative immunocompetent model, using KPC tumor cells implanted into C57 black six m...