Aggressive Subtype Of Breast Cancer Research Articles

FXR Agonism with Bile Acid Mimetic Reduces Pre-Clinical Triple-Negative Breast Cancer Burden.

Bariatric surgery is associated with improved outcomes for several cancers, including breast cancer (BC), although the mechanisms mediating this protection are unknown. We hypothesized that elevated bile acid pools detected after bariatric surgery may be factors that contribute to improved BC outcomes. Patients with greater expression of the bile acid receptor FXR displayed improved survival in specific aggressive BC subtypes. FXR is a nuclear hormone receptor activated by primary bile acids. Therefore, we posited that activating FXR using an established FDA-approved agonist would induce anticancer effects. Using in vivo and in vitro approaches, we determined the anti-tumor potential of bile acid receptor agonism. Indeed, FXR agonism by the bile acid mimetic known commercially as Ocaliva ("OCA"), or Obeticholic acid (INT-747), significantly reduced BC progression and overall tumor burden in a pre-clinical model. The transcriptomic analysis of tumors in mice subjected to OCA treatment revealed differential gene expression patterns compared to vehicle controls. Notably, there was a significant down-regulation of the oncogenic transcription factor MAX (MYC-associated factor X), which interacts with the oncogene MYC. Gene set enrichment analysis (GSEA) further demonstrated a statistically significant downregulation of the Hallmark MYC-related gene set (MYC Target V1) following OCA treatment. In human and murine BC analyses in vitro, agonism of FXR significantly and dose-dependently inhibited proliferation, migration, and viability. In contrast, the synthetic agonism of another common bile acid receptor, the G protein-coupled bile acid receptor TGR5 (GPBAR1) which is mainly activated by secondary bile acids, failed to significantly alter cancer cell dynamics. In conclusion, agonism of FXR by primary bile acid memetic OCA yields potent anti-tumor effects potentially through inhibition of proliferation and migration and reduced cell viability. These findings suggest that FXR is a tumor suppressor gene with a high potential for use in personalized therapeutic strategies for individuals with BC.

Targeting Interleukin-13 Receptor α2 and EphA2 in Aggressive Breast Cancer Subtypes with Special References to Chimeric Antigen Receptor T-Cell Therapy.

Breast cancer (BCA) remains the leading cause of cancer-related mortality among women worldwide. This review delves into the therapeutic challenges of BCA, emphasizing the roles of interleukin-13 receptor α2 (IL-13Rα2) and erythropoietin-producing hepatocellular receptor A2 (EphA2) in tumor progression and resistance. Highlighting their overexpression in BCA, particularly in aggressive subtypes, such as Her-2-enriched and triple-negative breast cancer (TNBC), we discuss the potential of these receptors as targets for chimeric antigen receptor T-cell (CAR-T) therapies. We examine the structural and functional roles of IL-13Rα2 and EphA2, their pathological significance in BCA, and the promising therapeutic avenues their targeting presents. With an in-depth analysis of current immunotherapeutic strategies, including the limitations of existing treatments and the potential of dual antigen-targeting CAR T-cell therapies, this review aims to summarize potential future novel, more effective therapeutic interventions for BCA. Through a thorough examination of preclinical and clinical studies, it underlines the urgent need for targeted therapies in combating the high mortality rates associated with Her-2-enriched and TNBC subtypes and discusses the potential role of IL-13Rα2 and EphA2 as promising candidates for the development of CAR T-cell therapies.

HSA-nanobinders crafted from bioresponsive prodrugs for combined cancer chemoimmunotherapy-an in vitro exploration.

Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer still lacking effective treatment options. Chemotherapy in combination with immunotherapy can restrict tumor progression and repolarize the tumor microenvironment towards an anti-tumor milieu, improving clinical outcome in TNBC patients. The chemotherapeutic drug paclitaxel has been shown to induce immunogenic cell death (ICD), whereas inhibitors of the indoleamine 2,3- dioxygenase 1 (IDO1) enzyme, whose expression is shared in immune regulatory and tumor cells, have been revealed to enhance the anti-tumor immune response. However, poor bioavailability and pharmacokinetics, off-target effects and hurdles in achieving therapeutic drug concentrations at the target tissue often limit the effectiveness of combination therapies. This work describes the development of novel biomimetic and carrier-free nanobinders (NBs) loaded with both paclitaxel and the IDO1 inhibitor NLG919 in the form of bioresponsive and biomimetic prodrugs. A fine tuning of the preparation conditions allowed to identify NB@5 as the most suitable nanoformulation in terms of reproducibility, stability and in vitro effectiveness. Our data show that NB@5 effectively binds to HSA in cell-free experiments, demonstrating its protective role in the controlled release of drugs and suggesting the potential to exploit the protein as the endogenous vehicle for targeted delivery to the tumor site. Our study successfully proves that the drugs encapsulated within the NBs are preferentially released under the altered redox conditions commonly found in the tumor microenvironment, thereby inducing cell death, promoting ICD, and inhibiting IDO1.

The Effect of Salvianolic Acid A on Tumor-Associated Macrophage Polarization and Its Mechanisms in the Tumor Microenvironment of Triple-Negative Breast Cancer.

Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer, with a high degree of malignancy and poor prognosis. Tumor-associated macrophages (TAMs) have been identified as significant contributors to the growth and metastasis of TNBC through the secretion of various growth factors and chemokines. Salvianolic acid A (SAA) has been shown to have anti-cancer activities. However, the potential activity of SAA on re-polarized TAMs remains unclear. As there is a correlation between the TAMs and TNBC, this study investigates the effect of SAA on TAMs in the TNBC microenvironment. For that purpose, M2 TAM polarization was induced by two kinds of TNBC-conditioned medium (TNBC-TCM) in the absence or presence of SAA. The gene and protein expression of TAM markers were analyzed by qPCR, FCM, IF, ELISA, and Western blot. The protein expression levels of ERK and p-ERK in M2-like TAMs were analyzed by Western blot. The migration and invasion properties of M2-like TAMs were analyzed by Transwell assays. Here, we demonstrated that SAA increased the expression levels of CD86, IL-1β, and iNOS in M2-like TAMs and, conversely, decreased the expression levels of Arg-1 and CD206. Moreover, SAA inhibited the migration and invasion properties of M2-like TAMs effectively and decreased the protein expression of TGF-β1 and p-ERK in a concentration-dependent manner, as well as TGF-β1 gene expression and secretion. Our current findings for the first time demonstrated that SAA inhibits macrophage polarization to M2-like TAMs by inhibiting the ERK pathway and promotes M2-like TAM re-polarization to the M1 TAMs, which may exert its anti-tumor effect by regulating M1/M2 TAM polarization. These findings highlight SAA as a potential regulator of M2 TAMs and the possibility of utilizing SAA to reprogram M2 TAMs offers promising insights for the clinical management of TNBC.

Abstract 6604: Spatial transcriptomics delineates tumor heterogeneity in NACT triple-negative breast cancer

Abstract BACKGROUND: Triple-Negative Breast Cancer (TNBC) is a highly aggressive subtype of breast cancer and only ~40% of TNBC patients achieve a pathological complete response (pCR) following neoadjuvant chemotherapy (NACT). Since molecular heterogeneity of TNBC may contribute to variable responses to NACT, we aimed to deconvolute TNBC’s histological and spatial transcriptomics (ST) patterns. METHODS: In total, 90 pre-treatment biopsies were collected from NACT-treated TNBC patients from archival samples and the ongoing FORCE (NCT03238144) clinical trial at Guy’s Hospital, London, UK. Of these, 38 achieved pCR (Responder), 46 had residual disease (Non-Responder) whilst 6 are currently undergoing NACT; 46 post-treatment surgical resections were collected from Non-Responders.Each sample was H&E stained, imaged, and annotated by a pathologist. A 6-digit classifier was designed to capture the histology of each region of interest (ROI), characterizing the tumour region, epithelial type and immune cell localization, population, distribution, and abundance.H&Es were used to guide ST profiling of serial sections which was performed on the GeoMx Digital Spatial Profiler. Tissues were stained with fluorescent antibodies against PanCK and CD45 to visualize the tissue, select ROIs and illuminate spatially resolved tumor and immune-enriched compartments, defined as PanCK+/CD45- and PanCK-/CD45+, respectively.Data analysis was performed in R 4.3.1 using the limma, dplyr, EdgeR, GeoMx Tools, GeoMx Workflows, RUV4, Spatial Experiment, SpatialDecon and GSVA packages, facilitating quality control, batch correction, differential and topographical gene expression, immune cell deconvolution and gene set enrichment analysis (GSEA), respectively. RESULTS: To date, we have performed ST profiling of 120 TNBC samples from 82 patients (46 Non-Responders; 36 Responders), totaling 3917 tumor or immune-cell enriched regions. Preliminary analyses revealed KEGG pathways involved in tissue adhesion are upregulated in tumor compartments of Non-Responders compared to Responders, whilst those involved in genomic integrity are suppressed. Unsupervised clustering of PanCK+CD45- regions in Non-Responders identified tumor clusters present in both pre- and post-NACT samples, suggesting potential chemo-resistant properties. Moreover, immune cell deconvolution of the PanCK-/CD45+ regions revealed spatially distinct patters of immune cell composition mapped to histological annotations identified by our ROI classifier. CONCLUSION: (S)Large scale ST of TNBC before and after NACT reveals novel patterns associated with response to treatment. We have designed a novel ROI classifier to spatially resolved transcriptomes of histological features, as such provide an in-depth characterization of the histo-genomics of TNBC. Citation Format: Isobelle Wall, Jelmar Quist, Sarah Pinder, KCL Cancer Biobank, Sheeba Irshad, Cheryl Gillet, Victoria Seewaldt, Kavitha Mukund, David Frankhouser, Shankar Subramaniam, Maddy Parsons, Anita Grigoriadis. Spatial transcriptomics delineates tumor heterogeneity in NACT triple-negative breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6604.

Abstract 1488: Spatial characterization of the tumor microenvironment of metastatic triple-negative breast cancer

Abstract Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer associated with high rates of recurrence and metastasis, which contribute to poor overall survival. The challenges in treating TNBC stem from its high intratumor heterogeneity and lack of expression of the estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 druggable targets. The tumor microenvironment (TME) plays a crucial role in disease progression. Within the TME, complex spatial interactions among tumor cells, immune cells, stroma, angiogenesis- and hypoxia-inducing factors collectively contribute to the advancement and spread of TNBC. In-depth understanding of the TME and interactions of the various components within can elucidate newer therapeutic targets, enhancing the prognosis of TNBC patients. Imaging mass cytometry (IMC) enables detailed analysis of cell-cell and cell-matrix interactions within the TME at the single-cell level. In this study, we aim to characterize the spatial relationships among various cell types within the TNBC TME using IMC, while also investigating differences in the TME of TNBC patients who developed distant metastasis (DM) compared to those who remained non-metastatic (NM). IMC was performed on formalin-fixed paraffin-embedded TNBC primary resection tissues (n= 16; DM= 7, NM= 9) from Stavanger University Hospital, Norway, using a panel of 25 metal-conjugated antibodies. Regions of interest were marked by the pathologist and the slides were laser ablated using Hyperion Imaging System. DeepCell was used to segment single cells based on surface markers. Mean intensity values of all markers for each cell were extracted and consolidated in R scripts for unsupervised clustering. Cell clusters were annotated based on phenotypic markers. Normalized expression of markers was compared for each cell type across DM and NM patients, including markers for cell proliferation, angiogenesis, hypoxia, and cell migration. Neighborhood analysis examined spatial associations between different cell types, highlighting differences in DM and NM patients. The IMC panel successfully provided spatial insights into the TME, including the characterization of tumor cells, immune cells (B cells, T cells, macrophages), endothelial cells, and proliferating cells. We identified 18 unique phenotypic cell clusters that were present at different frequencies in DM and NM patients. These clusters demonstrated different expression profiles of functional markers. t-SNE plots revealed distinct patterns of cell type distribution and unique protein expression profiles, highlighting significant differences between the two groups. Our data suggest a distinct spatial organization of the TME in TNBC patients who develop metastasis. This warrants further investigations to determine the role and interplay of TME features in predicting the risk of distant metastasis in TNBC. Citation Format: Mahak Bhargava, Jaspreet Kaur, Geetanjali Saini, Junjun Zheng, Yitian Xu, Shu-Hsia Chen, Ping-Ying Pan, Emma Rewcastle, Umay Kiraz, Emiel Adrianus Janssen, Ritu Aneja. Spatial characterization of the tumor microenvironment of metastatic triple-negative breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1488.

Abstract 599: Combination of CDK4/6 inhibitors with biguanides for treatment of triple negative breast cancer

Abstract Triple negative breast cancer (TNBC) is the most aggressive subtype of breast cancer (BC) and is associated with early relapse and high frequency of metastasis. This has been attributed in part to the lack of targeted therapies. TNBC occurs more frequently in younger women of African and Hispanic ancestry and with a higher risk of mortality than women of European ancestry. Emerging data shows activation of the AKT/mTOR pathway by insulin may occur in aggressive TNBC and inhibition of mTOR signaling by rapamycin, a potent mTOR inhibitor, induces cell cycle arrest and downregulation of cyclin D1 in TNBC cells. CDK4/6 inhibitors have demonstrated to be an effective therapeutic for estrogen receptor positive BC and although their use in TNBC patients remains uncertain their use in combination with other targeted therapies may be promising. We have developed a set of newly designed biguanides with potent anticancer action and safety doses in vivo that in combination with CDK4/6 inhibitors block TNBC cell growth in vitro and in vivo. Using TNBC cell proliferation in vitro assays, new biguanides show dose-dependent inhibition of cell proliferation (P<0.01). Further, combination of biguanides with ribocliclib, an orally bioavailable CDK4/6 inhibitor, produced additive and synergistic effects in TNBC cell lines in vitro (P<0.01). Biguanides are known to activate de LKB1-AMPK pathway. Western immunoblots showed our biguanide analogues also induce AMPK phosphorylation and significantly reduce phosphorylation of downstream mTOR signaling pathway components including S6 ribosomal protein and 4E-BP1, an effect that is potentiated by combination treatment with ribociblib. Further, cyclin D1 is known to be overexpressed in about 50% of BCs and binding to CDK 4/6 induces phosphorylation of Rb and cell cycle progression. Treatment with biguanides downregulated cyclin D1 expression in TNBC cells and combination treatment of ribociclib with biguanide JD006 was more effective at decreasing Rb phosphorylation than each drug alone. In addition, seahorse analysis evaluated mitochondrial respiratory function. Treatment with biguanides inhibited oxidative phosphorylation in a dose dependent manner, an important metabolic pathway that can drive drug resistance to therapy in cancer cells. In vivo, combination treatment of ribociclib with biguanide JD006 was more effective than each agent alone in stopping human TNBC xenograft progression in nude mouse models (P<0.05). Our preliminary data offer evidence that human TNBC are highly vulnerable to metabolic reprogramming by new biguanides. This work can yield insight on unanticipated mechanisms of biguanide action and rationale for new combination therapies with CDK 4/6 inhibitors as a new option for treatment of TNBC. Funding: CBCRP B27IB3869, JCCC Breast Cancer Award, Hickey Family Foundation, NCI U54 CA143930, Team Research Grant, UCLA TDG. Citation Format: Mario Morales Martinez, Eduardo Mauricio Gonzalez, Gang Deng, Gaoyuan Ma, Hyunsoo Kim, Linsey Stiles, Nalo Hamilton, Michael E. Jung, Richard J. Pietras, Diana C. Marquez-Garban. Combination of CDK4/6 inhibitors with biguanides for treatment of triple negative breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 599.

Abstract 5978: Therapeutic targeting of MELK using a drug repurposing approach to combat TNBC cells

Abstract Background: Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer linked to high chemo-resistant metastatic cases and limited therapeutic options due to the absence of conventional bioreceptors. Therefore, to treat TNBC, it is imperative to identify promising druggable biological targets. Experimental Procedures: An integrated bioinformatic analysis of microarray datasets was performed to identify significantly differentially expressed genes (DEGs) in TNBC. For selecting a potent therapeutic target, the function and significance of the upregulated DEGs in TNBC was investigated by an in silico study employing the UALCAN portal, String database, KM plotter, and Enrichr tools. This analysis included gene expression validation, insights into protein-protein interactions, survival analysis, and pathway mapping of the genes. To obtain potent drugs binding to the selected target MELK (maternal embryonic leucine zipper kinase), a drug repurposing approach was employed starting with virtual screening followed by molecular dynamic simulation (MDS) using GROMACS. Further, the anti-cancer activity of the top two drugs was validated by live-dead imaging, gene expression analyses, MTT-based cell viability and ROS detection assays. Results: Based on a stringent criterion for significant DEG identification (log2|FC|>1 & adjust P-value < 0.05), 25 overlapping upregulated genes were obtained from three selected datasets. Further, in silico analysis revealed that MELK is significantly upregulated across the four stages and subtypes of breast cancer, including TNBC. Higher MELK expression and its oncogenic interactions correlated with poor overall survival of TNBC patients. Evidence suggests that the existing inhibitor for MELK (OTSSP167) has shown poor specificity. Therefore, to block its activity, a library of 1293 FDA-approved drugs was screened against the kinase domain of MELK. MDS study and analysis using parameters like RMSD, RMSF and pair distance revealed that the top 10 drugs were strongly stabilized by H-bonds in the binding pocket of MELK, with minimal deviation and reduced fluctuations of MELK upon drug binding. Binding free energy calculation of drug-MELK interaction using the MM-PBSA method revealed that nine drugs possessed higher binding energy than the inhibitor. The top two drugs obtained from the study (originally kinase and reductase inhibitors respectively) were further validated for their in vitro anti-cancer efficacy in MDA-MB-231 and MDA-MB-468 cells. Treatment with these drugs exhibited (a) a dose-dependent decrease in proliferation, (b) significant cell death, (c) a marked increase in the cellular ROS levels, and (d) a decrease in the expression of MELK and its downstream targets in TNBC cell lines. Conclusion: The present study opens the avenue for using repurposed drugs as potential therapeutic molecules against MELK activity to combat TNBC progression. Citation Format: Arisha Arora, Shilpi Sarkar, Siddhartha S. Ghosh. Therapeutic targeting of MELK using a drug repurposing approach to combat TNBC cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5978.

Abstract 1423: Harnessing the gut microbiome to modulate immune checkpoint blockade response in triple-negative breast cancer

Abstract Triple-negative breast cancer (TNBC) is one of the most aggressive subtypes of breast cancer. The discovery that this subtype has the highest levels of tumor-infiltrating immune cells and programmed death ligand 1 (PD-L1) expression in the tumor microenvironment (TME) has propelled the use of anti-PD-1 immune checkpoint blockade (ICB) therapy, in combination with chemotherapy, as a treatment for TNBC patients. This has advantageously impacted TNBC patient outcomes such as survival, yet there remains a need to improve patient response to ICB therapies. The gut microbiome, in particular, increased abundance of Akkermansia muciniphila was associated with ICB therapy response in other cancer types. A. muciniphila can degrade mucins and produce short-chain fatty acid (SCFA) metabolites. Therefore, we investigated the interplay between A. muciniphila, SCFAs, and ICB therapy efficacy in TNBC models. As diet is the main modifier of the gut microbiome, we first investigated diet-gut microbiome interactions on ICB efficacy. Using the EO771 syngeneic murine model of TNBC, female C57BL/6 tumor-bearing mice consuming a low-fat control, or high-fat Western, or Mediterranean diet, were treated with 3 doses of 200µg of IgG or anti-PD-L1 antibodies and tumor progression was monitored. To assess changes in tumoral immune cell populations, end-of-study tumor tissue was used for immunohistochemistry (IHC). To evaluate modulation on the gut microbiome, metagenomic sequencing was performed on DNA isolated from fecal samples collected at the end-of-study, and targeted SCFA metabolomic analysis was performed on plasma collected at the study endpoint. Results show mice consuming a Mediterranean diet treated with anti-PD-L1 had significant increases in the abundance of gut A. muciniphila and plasma SCFAs, as well as significantly reduced primary tumor volume and increased immune cell activity within the TME. To then investigate if direct supplementation of A. muciniphila or SCFAs could enhance ICB efficacy, EO771 tumor-bearing mice were treated with 3 doses of 200µg of IgG, anti-PD-L1 or anti-PD-1 antibodies with a subset of mice stratified to also receive A. muciniphila or exogenoussupplementation of SCFAs. Tumor progression was measured and changes in tumoral immune cell populations were assessed with end-of-study tumor tissue prepared for flow cytometry and IHC. Results show mice supplemented with A. muciniphila and treated with anti-PD-L1 therapy demonstrated response to treatment, with a significant reduction in tumor volume as well as increased levels of immune cell populations in the TME. Mice supplemented with SCFAs and treated with a combination of anti-PD-1 and chemotherapy demonstrated enhanced response to treatment, with a significant reduction in tumor volume. In conclusion, data from our lab suggest that increased levels of gut A. muciniphila and SCFAs drive ICB efficacy in TNBC. Citation Format: Kenysha YJ. Clear, Adam S. Wilson, Elizabeth R. Stirling, Yu-Ting Tsai, Valerie Payne, David R. Soto-Pantoja, Katherine L. Cook. Harnessing the gut microbiome to modulate immune checkpoint blockade response in triple-negative breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1423.

Abstract 573: SLC22A17 as a promising target for triple-negative breast cancer

Abstract Introduction: Triple-negative breast cancer (TNBC) represents a highly aggressive subtype of breast cancer, accounting for approximately 15% of all cases of invasive breast cancer globally. The absence of a well-defined cell membrane receptor has significantly limited the therapeutic options available for treating this malignancy. Consequently, there is a compelling need to explore novel receptors that could potentially revolutionize the treatment strategies employed for TNBC. Recent scientific research has unveiled SLC22A17, a cell surface receptor known for its involvement in iron transport, as a substantial contributor to the development of various cancer types. Thus, the primary objective of this study is to comprehensively evaluate the significance of SLC22A17 and its potential as a therapeutic target in TNBC. Experimental Procedures: In this study, we meticulously examined the expression patterns of SLC22A17 across distinct subtypes of breast cancer utilizing immunohistochemistry. Computational tools were employed to delve into the role of SLC22A17 within TNBC datasets. To assess the impact of SLC22A17 on TNBC, we employed various methods, including siRNA-mediated silencing, to investigate its role in cell proliferation, apoptosis, epithelial-mesenchymal transition (EMT), and migration. Additionally, we conducted western blot analyses to assess the expression levels of SLC22A17 and cellular signaling molecules, such as Akt/mTOR and JAK/STAT, within the context of TNBC cells. Results: Our analysis revealed a significant upregulation of SLC22A17 in both TNBC tissues and cell lines, establishing a direct correlation with patient survival outcomes. Silencing the expression of SLC22A17 resulted in reduced cell proliferation, migration, EMT, increased apoptosis, and enhanced autophagy. These effects were accompanied by the inhibition of Akt/mTOR and STAT3 signaling pathways. Moreover, we observed the involvement of the inflammatory cytokine TNF-α, which induced the expression of SLC22A17 in TNBC cell lines and governed various hallmark features of TNBC. Notably, the suppression of SLC22A17 mitigated these processes. Conclusion: In conclusion, this investigation suggests the pivotal role played by SLC22A17 in TNBC and posits its potential as a novel and promising therapeutic target for the management of this formidable disease. Citation Format: Ajaikumar B. Kunnumakkara, Krishan Kumar Thakur. SLC22A17 as a promising target for triple-negative breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 573.

Abstract 6546: Spatial immunology landscapes that correlate with survival in triple negative breast cancer

Abstract Triple negative breast cancer (TNBC) is an aggressive subtype of breast cancer characterized by negative immunohistochemistry staining for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Treatment options for TNBCs are limited due to lack of tumor-specific targeted therapies, resulting in poor prognosis and patient survival. This is exacerbated by lack of prognostic markers of response. While current studies suggest tumor immune interactions are important, current immune activity quantifications, such as scores quantifying abundance of tumor-infiltrating lymphocytes (TILs), are not sufficient to define tumor immune status. We used imaging mass cytometry (IMC) to measure 33 markers on primary tumors of 100 patients undergone chemotherapy with long-term follow-up to explore the tumor immune microenvironment of TNBCs. Concordant with previous studies, a higher ratio of T-cells was associated with response to chemotherapy and longer overall survival (adjusted p-value<0.05). Moreover, using Kmeans clustering we identified 13 distinct cellular neighborhoods, reflective of the heterogenous nature of TNBCs. Among others, we identified a neighborhood, characterized by low CD14+ expression, low cytokeratin, high vimentin expression and high CD45RO, that contributes highest impact on correlation with overall survival (adjusted p-value<0.01). These results suggest an important role for memory T cells in the stroma. Thus, resolving spatial organization of the tissue is important to understanding patient response to therapy in TNBCs. Citation Format: Ali Foroughi pour, Jan Martinek, Te-Chia Wu, Santhosh Sivajothi, Zichao Liu, Jie Zhou, David Rimm, Paul Robson, Katherine Bates, Karolina Palucka, Jeffrey H. Chuang. Spatial immunology landscapes that correlate with survival in triple negative breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6546.

Abstract 2939: Harnessing in vivo CRISPR screen to uncover metabolic dependencies during cancer progression

Abstract Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer, with the worst prognosis and limited treatment options. TNBC cells undergo metabolic reprogramming in response to nutrient limitations and changes in the tumor microenvironment throughout cancer progression. In the early stages, tumor cells are found to prioritize nutrient uptake and biosynthesis, but as they grow, intensified competition for nutrients fosters the emergence of subpopulations of cancer cells that excel in utilizing specific nutrients. The substantial metabolic pathways and genes that regulate each phase of cancer progression remain poorly understood. To address this, we have developed a stable integration, site-specific, and inducible CRISPR-Cas9 system that allows for temporal control of genetic perturbation. We conducted an unbiased in vivo loss-of-function CRISPR screen aimed at identifying metabolic vulnerabilities at different phases of cancer progression of TNBC. The inducible CRISPR system was activated only at the desired study period of each phase, thus capable of uncovering metabolic dependencies for TNBC proliferation at each distinct phase of cancer progression. As many large-scale CRISPR screens have previously been performed to identify gene dependencies for cancer progression in vitro, our CRISPR screen could address the shortcomings of in vitro screens by identifying novel essential metabolic genes that are significantly important for cancer growth in vivo. Preliminary data from our CRISPR screen revealed different pathways to be significantly important for tumor growth and proliferation at different phases of TNBC progression. For example, we find that ferroptosis is altered during the early lag phase of TNBC cancer progression, whereas, at the later stage of cancer progression, metastatic tumors upregulate serine metabolism, suggesting that secondary tumors could have distinct metabolism from the primary sites. Altogether, the findings from this study could provide valuable insights into stepwise metabolic dependencies arising from microenvironmental limitations and identify potential therapeutic targets at each phase of cancer progression. Moreover, our CRISPR-Cas9 model holds promise for dissecting the complex mechanisms of other cancer progressions. Citation Format: Seow Qi Ng, Zhengwei Wu, Jessica A. Lidster, Wai Leong Tam. Harnessing in vivo CRISPR screen to uncover metabolic dependencies during cancer progression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2939.

Abstract 4385: ZCCHC3 and Efp are prognostic factors for triple-negative breast cancer and potentially modulate cell division-related pathway

Abstract Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer with poor prognosis and limited therapeutic strategies, lacking expression of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. We previously demonstrated that estrogen responsive finger protein (Efp)/TRIM25 functions as a ubiquitin ligase that degrades cell cycle checkpoint 14-3-3 sigma and promotes cell growth of ER-positive breast cancer [Urano et al., Nature 417:871-875, 2002]. In TNBC cells, we further showed that Efp regulates cell cycle-related gene expression and promotes cell proliferation [Sato et al., Biochem Biophys Res Commun 624:81-88, 2022]. Efp also exerts a distinct function to activate cellular RNA sensors such as RIG-I (retinoic acid inducible gene I), which plays a role in the innate immunity [Gack et al., Nature 446:916-920, 2007]. Another immune-related gene zinc finger CCHC domain-containing protein 3 (ZCCHC3) was recently suggested as Efp interactor, although its pathological relevance in breast cancer remains elusive. We here aimed to clarify the role of ZCCHC3 in TNBC. Immunohistochemical analysis of TNBC tissues from over 100 Japanese patients showed that a positive ZCCHC3 immunoreactivity (IR) was significantly associated with shorter disease-free survival (DFS) and positively correlated with Efp IR. Notably, patients with both ZCCHC3 and Efp IR positivity showed much shorter DFS than those with ZCCHC3 positivity alone. Functional analysis of ZCCHC3 by siRNA silencing demonstrated that ZCCHC3 promotes the proliferation, migration, and cell cycle progression of MDA-MB-231 TNBC cells. We established long-term culturable TNBC patient-derived cells (TNBC-PDC) using spheroid culture technique and revealed that the spheroid growth was suppressed by ZCCHC3-specific siRNA treatment. Moreover, ZCCHC3-specific siRNA injection suppressed in vivo tumor growth of MDA-MB-231 cells inoculated in immunodeficient mice. RNA sequencing analysis of ZCCHC3-silenced TNBC cells showed that cell division-related pathway was enriched among downregulated genes, including non-structural maintenance of chromosomes condensin I complex subunit H (NCAPH). NCAPH silencing inhibited the proliferation of TNBC-PDCs and MDA-MB-231 cells. Overall, ZCCHC3 and Efp are potential poor prognostic factors and can be applied to alternative therapeutic options for TNBC. Citation Format: Akihiro Fujimoto, Kazuhiro Ikeda, Toshihiko Takeiwa, Keiichi Kinowaki, Takuya Ogura, Hidetaka Kawabata, Akihiko Osaki, Kuniko Horie, Satoshi Inoue. ZCCHC3 and Efp are prognostic factors for triple-negative breast cancer and potentially modulate cell division-related pathway [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4385.

Abstract 4612: Inhibition of BCL2 and XPO1 demonstrates synergistic effects in triple-negative breast cancer cell lines

Abstract Background: Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer, accounting for about 15-20% of all breast cancers. Characterized by a lack of estrogen and progesterone receptors and non-amplified HER2, treatment options are limited compared to other breast cancer subtypes. The aim of this study was to evaluate eltanexor (Elta), an XPO1 inhibitor, in combination with venetoclax (Ven), a Bcl-2 inhibitor to promote apoptosis in TNBC models. Methods: CellTiter-Glo Cell Viability Assay was utilized to determine cell viability in 6 TNBC cell lines after 72-hour exposure to no drug, Elta, Ven or the combination. Synergy scores were determined using the Bliss model in SynergyFinder+, scores 10 or above indicating synergy. Apoptosis (by Annexin V) was assessed after 24- and 48-hour exposure to drug via flow cytometry. Immunoblots were used to assess the mechanism of action in cell lines treated for 24 hours. Results: CellTiter Glo displayed greater anti-proliferative activity in combination versus single agent exposure. Synergy was observed in CAL-120, BT-20, and MDA-MB-468 cell lines, with synergy score values ranging from -13.22 - 25.07. Additive effects were observed in other cell lines. An increase in apoptosis was observed in CAL-51 and MDA-MB-231 cells after 24- and 48-hour treatment that was greater with the combination. CAL-51 cells exposed to single agent Ven or Elta [0.5 µM] for 24 hours had significantly less apoptosis than those exposed to the combo (p = <0.0001). After a 48-hour exposure, CAL-51 cells exposed to single agent Ven had less apoptosis than in combination with Elta [0.1 µM] (p = 0.0431) or Elta [0.5 µM] (p = 0.0036 µM]. Additionally, single agent Elta [0.5 µM] resulted in less apoptosis than the combination (p = 0.0067). Similar results were observed in MDA-MB-231 cells. We observed an increase in apoptotic markers with the combination in all cell lines treated. In all cell lines, DNA-damage marker pH2Ax increased with Ven and the combination. In the CAL-51 cells, p53 increased following Elta or combination exposure. In the MDA-MB-231 cells, a decrease in the anti-apoptotic protein MCL1 was observed with Elta or combination. Conclusion: The combination of Elta and Ven resulted in increased apoptosis and antiproliferative activity in TNBC cell lines. Combined, the two drugs synergistically functioned to increase DNA damage and promote apoptotic cell death. This work supports the continued evaluation of Elta and Ven in TNBC. Citation Format: Marilyn Marie Jackson, Stephen G. Smoots, Adrian T. Dominguez, Evan Dus, Stacey Bagby, Cameron Binns, Todd M. Pitts, Jennifer R. Diamond. Inhibition of BCL2 and XPO1 demonstrates synergistic effects in triple-negative breast cancer cell lines [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4612.

Abstract 504: Anticancer effects of kaempferol through cell cycle arrest and the inhibition of proliferation in genetically distinct triple-negative breast cancer cells

Abstract Triple-negative breast cancer (TNBC) is one of the most known aggressive subtypes of breast cancer, affecting 1 in 3 newly diagnosed cancers in women. TNBC affects African-American women disproportionally in comparison to Caucasian women. Due to the lack of estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptors (HER-2), it poses direct challenges to the efficacy of standard hormonal therapies. The current TNBC treatments present higher toxicity and multiple side effects. An alternative would be using natural compounds that have emerged as potential anticancer agents. Kaempferol is a major flavonoid aglycone found in many fruits, vegetables, and herbs, including grapes, tomatoes, broccoli, tea, and ginkgo biloba leaves. In this study, we investigated the differential effect of kaempferol on cell toxicity, cell growth, and underlying mechanisms in inducing cell cycle arrest in genetically different TNBC cells from Caucasian (MDA-MB-231) and African American (MDA-MB- 468) women. Kaempferol significantly inhibited cell growth in both the cell lines with a more profound effect against MDA-MB-231 (IC50: 43.86 µM) compared to MDA-MB-468 cells (IC50: 53.47 µM). Also, kaempferol treatment induced cell cycle arrest at S-phase in both cancer cell subtypes. The MDA-MB-231 cells showed a kaempferol effect at lower concentrations (6.25µM and 12.5µM), while MDA-MB-468 cells showed the same effect at higher concentrations (25µM and 50µM). Kaempferol also modulated CDK gene expression associated with cell cycle progression in breast cancer cells. The inhibition at S-phase is important in cancer treatment because it targets the highly proliferative nature of cancer cells characterized by uncontrolled cell division. This study indicates that, by inducing cell cycle arrest at the S-phase, kaempferol may interfere with cancer cell growth and proliferation by inhibiting DNA replication, offering potential therapeutic benefits. This approach could reduce side effects and increase treatment efficacy, providing hope for more effective interventions in the fight against TNBC. Citation Format: Sukhmandeep Kaur, Patricia Mendonca, Karam F. A. Soliman. Anticancer effects of kaempferol through cell cycle arrest and the inhibition of proliferation in genetically distinct triple-negative breast cancer cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 504.

Abstract 435: A key regulatory role of the translation initiation factor DAP5 in the metabolic reprogramming of metastatic breast cancer

Abstract Triple negative breast cancer (TNBC) is one of the most aggressive subtypes of breast cancer, accounting for 10-15% of all breast cancers in women. The frequency of metastasis in TNBC is disproportionally high compared to other subtypes of breast cancer and is the primary cause of patient mortality. At the cellular level, TNBC's aggressive nature demands rapid adaptation of the tumor cells to navigate cellular stressors for survival and metastatic transformation. These survival adaptations include a cancer cell’s ability to reprogram its metabolism and regulate mRNA translation control, coordinating alternative pathways to retain a selective proteome and metabolites that will aid in survival, proliferation, and migration. Advanced cancers, including TNBC, are generally highly glycolytic, and have lower rates of mitochondrial respiration (OXPHOS), a phenomenon known as the Warburg effect. This metabolic shift prioritizes the generation of essential metabolic intermediates, to facilitate the production of cellular biomass and fuel proliferation. Another notable alternative pathway is mediated by the ubiquitously expressed translation initiation factor, Death Associated Protein 5 (DAP5). DAP5 is a homolog of eIF4G and mediates translation independently of the canonical mTORC1/eIF4E pathway. Our findings suggest that this alternative translation initiation plays a crucial role in regulating the metabolic reprogramming of metastatic breast cancer. This non-canonical pathway via DAP5 facilitates the selective translation of 20-30% cap-dependent mRNAs, many of which are essential in cancer cell survival, migration, and metabolism. Importantly, it has recently been shown that DAP5 is critical for breast cancer metastasis but not in primary tumor development. Furthermore, TNBC patient data shows that elevated levels of DAP5 mRNA are correlated with poor survival and metastasis. Our data, using the highly metastatic TNBC cell line, MDA-MB-231, demonstrated that silencing DAP5 significantly reduced glycolytic rate and glycolytic capacity. Consistent with these findings, translatome profiling, showed that DAP5 silencing reduced numerous metabolic targets including glycolytic enzymes and metabolite transporters. Calcium (Ca2+) signaling, which has an important role in cancer progression, migration, and cellular bioenergetics is also affected by DAP5 in TNBC cells. Collectively, our findings indicate that breast cancer cells utilize the translation initiation factor DAP5 to selectively translate mRNAs that support metabolic reprogramming and cell migration, suggesting that DAP5 has a key regulatory role in the cancer’s transformation. Citation Format: Erna Mitaishvili, Guilherme Henrique Souza Bomfim, Anna Zou, Moira Sauane, Rodrigo Lacruz, Columba de la Parra. A key regulatory role of the translation initiation factor DAP5 in the metabolic reprogramming of metastatic breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 435.

Abstract 5645: HuR regulates aerobic glycolysis in triple negative breast cancer (TNBC)

Abstract Introduction: The RNA-binding protein Human Antigen R (HuR/ELAVL1) is ubiquitously expressed and exerts post-transcriptional regulation on mRNAs characterized by U/AU-rich sequences in their 3' UTR. Elevated cytoplasmic expression of HuR has been associated with various malignancies, influencing key cellular processes such as proliferation, apoptosis, angiogenesis, and metastasis. The involvement of HuR influences prognostic outcomes and hence is a potential biomarker and therapeutic target in cancer research. The present study investigates the oncogenic role of HuR in TNBCs, an aggressive subtype of breast cancer. Methods: Immunohistochemistry was performed on TNBC patient tumor tissue (n=40) to asses the expressions of HuR and MMP9. Human TNBC cell lines MDA-MB-231 and MDA-MB-468 were used for in vitro studies after confirming cytoplasmic HuR accumulation in these cells via Immunofluorescence. The RNA binding activity of HuR was disrupted using CMLD2, a specific inhibitor of HuR, and subsequent physiological changes were assessed through functional assays. An exploratory investigation of HuR-moderated metabolic changes was performed employing NANOSTRING nCounter XT gene expression assay using metabolic pathways panel. Investigation and/or validation of molecular changes were done via immunoblotting. Results: Meta-analysis using Liu-2014 TNBC dataset correlated high HuR protein expression with reduced patient survival (p=0.028). HuR (77%) and MMP9(55%) were found to be overexpressed in TNBC tissues. Inhibiting HuR with CMLD2 resulted in the downregulation of the protein and its downstream targets CDK2, MMP9, and β catenin. HuR inhibition compromised proliferation, migration, Matrigel invasion and EMT (downregulated E-Cadherin, N-Cadherin, and Vimentin) in TNBC cell lines. Further, HuR inhibition resulted in decreased clonogenicity in 2D and 3D TNBC cultures. Transcriptomics studies showed that HuR inhibition in MDA-MB-231 altered the profile of glycolytic genes in addition to other pathways such as cell cycle and DNA damage repair. In accordance, the expression of glycolytic proteins was reduced upon CMLD2 treatment. Similar results were obtained on HuR knockdown by siRNA suggesting that HuR-mediated effects on TNBC progression might be in part through its modulation of aerobic glycolysis. Conclusion: Overall, our results demonstrate HuR as a positive regulator of aerobic glycolysis in TNBCs and the ability of CMLD2 to inhibit HuR provides a rationale to consider it as a potential anticancer agent for TNBCs. Citation Format: Arundhathi Dev J R, Ajay Gogia, Sandeep R. Mathur, S.V.S. Deo, Chandra Prakash Prasad. HuR regulates aerobic glycolysis in triple negative breast cancer (TNBC) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5645.

Abstract 7595: PRMT5 inhibitor synergizes with PARP inhibitors in triple-negative breast cancer cells

Abstract Background: Treating triple-negative breast cancer (TNBC) patients, an aggressive subtype of breast cancer, is an ongoing clinical challenge. Small-molecule inhibitors targeting the poly ADP-ribose polymerase (PARP) DNA repair enzymes, have been approved for treating only a subset of TNBC patients with a specific genetic landscape (BRCA1 mutation). However, TNBC patients with wildtype BRCA1 (BRCA1WT) are still lacking targeted therapy and chemotherapy remains their main treatment strategy. High expression of protein arginine methyltransferase 5 (PRMT5) is linked to poor prognosis in breast cancer and PRMT5 alone or via its interacting proteins plays an oncogenic role in breast cancer. Recent evidence suggests that PRMT5 is a key player in regulating the repair of DNA double strand breaks (DSBs) either through homologous recombination (HR) or non-homologous end joining (NHEJ) depending on the PRMT5 expression level within the cell. This dependency of cancer cells on PRMT5 expression levels in deciding the repair pathway of choice can be exploited for developing therapies. We hypothesize that in BRCA1 wildtype TNBC cells, inhibiting PRMT5 activity will force the cells to rely on NHEJ rather than HR to repair DNA DSBs, and introducing PARP inhibitors in this setting will inactivate NHEJ as well, causing synthetic lethality and cell death. In this study, we evaluated the pre-clinical benefit of combining PARP inhibitors with a PRMT5 inhibitor in TNBC cells. Methods: Human TNBC cell lines with wildtype BRCA1 (MDA-MB-468, HCC1806) and mutant BRCA1 (MDA-MB-436, SUM149-PT) were treated with varying doses of two PARP inhibitors (Olaparib, Talazoparib) and a PRMT5 inhibitor (GSK3326595) as single agents or in combination. MTT-based cell viability assay was used to determine cytotoxicity of the treatments. mRNA expression was determined by RT-qPCR after drug treatment. Results and Conclusion: We report that PRMT5 inhibition synergizes with both Olaparib and Talazoparib, to potentiate cell death in two BRCA1WT but not in BRCA1mut TNBC cell lines. Furthermore, we show that inhibiting PRMT5 in BRCA1WT cells upregulates the mRNA expression of RAD50, a DNA damage sensing gene in the HR pathway. Our ongoing study is to delineate the molecular mechanism of action for the observed synergy and whether PRMT5 inhibition can overcome resistance to PARP inhibitors. Through this study, we will identify a novel treatment strategy for the majority of TNBC patients (BRCA1WT) who currently lack targeted therapies. Citation Format: Samyuktha Suresh, Lisa A. McPherson, James M. Ford. PRMT5 inhibitor synergizes with PARP inhibitors in triple-negative breast cancer cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7595.

Abstract 3385: Modeling evolutionary fitness in resistant cancers based on a common adaptability trait

Abstract Cancer is composed of a major subpopulation of proliferative cells and a minor subpopulation of highly adaptable cells. Although it is evident that cancer is an evolution like process driven by rare adaptable cancer cells that persist under various selection pressures, most of our knowledge about cancer comes from studying proliferative cancer cells. To overcome the hurdle in modeling adaptable cancer cell state that defeats all currently offered therapies, we are exploiting a linkage that exists between different adaptability substates such as metabolic, regulatory, and structural substates. Our studies, thus far carried out with aggressive triple-negative breast cancer and melanoma cell lines, suggest that it is feasible to apply severe metabolic challenges as realistic selection pressures/bottlenecks for modeling highly abnormal and highly adaptable cancer cells that drive cancer evolution and therapy resistance. The most significant aspect of our approach is an ability to model rare resistant cells (approximately 0.01% of cells) that survive in reversible quiescence under selection pressures. Monitoring of cells under microscope for several weeks under a severe and prolonged metabolic challenge, for example, a lack of glutamine in culture medium, revealed perhaps most interesting and cancer-relevant cells that survive in quiescence for weeks and then advance to generate therapy-resistant cells. Such microscopic monitoring revealed a significant heterogeneity among surviving cells. As examples, 1) surviving cells differ in the depth of quiescence, some cells trying to proliferate sooner than others; 2) as cells progress from quiescence to proliferation, their fate is far from certain: cells may progress to yield few cells, tiny colony, or large colony and then stop proliferating and in most instances die (abortive attempts at evolution). Of significance, the cell lines derived inflammatory breast cancer (IBC), an aggressive subtype of breast cancer, possessed a higher evolutionary fitness than non-IBC cell lines. This approach also eliminates 99.99% of cells that proliferate in cell culture but would not survive selection pressures in the body. The adaptable cells that survived the bottleneck and then proliferated indefinitely were highly resistant and metastatic. Molecular analyses of adaptable cells, including gene expression microarrays, CGH microarrays, and whole genome sequencing revealed mechanisms for their plasticity (exemplified by markers of high EMT), and for generating cellular diversity by altering epigenome (exemplified by low TET2) and by structural modifications in transcriptome (exemplified by high FTO). We conclude that the phenotype-based approach described here is good at modeling deep intrinsic resistance and may be useful in developing strategies for improving outcomes in resistant cancers. Supported by a State of Texas Grant for Rare and Aggressive Cancers. Citation Format: Balraj Singh, Vanessa N. Sarli, Anthony Lucci. Modeling evolutionary fitness in resistant cancers based on a common adaptability trait [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3385.

Abstract 2100: Novel LIPA targeted therapy for treating inflammatory breast cancer

Abstract Background: Inflammatory breast cancer (IBC) is a rare but incredibly aggressive subtype of breast cancer (BC). IBC accounts for 2-4% of all occurrences of breast cancer and results in 7-10% of breast cancer-related deaths. IBC is only partially treatable with current therapies such as chemotherapy, surgery, and radiotherapy. Identification of novel therapeutic targets is urgently required. The main organelle for the synthesis, folding, and modification of proteins is called the endoplasmic reticulum (ER). Since elevated basal ER stress (ERS) is usually found in many cancers including IBC, our hypothesis was that the high basal ERS in IBC constitutes a serious vulnerability that can be targeted. Recently, we developed a small molecule ERX41 that promotes ER stress by blocking Lysosomal acid lipase A (LIPA) function in ER of cancer cells. The goal of the project is to test the utility of ERX-41 in treating IBC. Methods: To study the effect of ERX-41, we have used three well-established IBC model cells. We evaluated the efficacy of ERX-41 as a novel therapeutic for treating IBC using cell viability assays. The long-term effects of ERX-41 on IBC cell survival were evaluated using colony formation assays. Annexin V assays were used to measure apoptosis. Reporter assays, splicing assays, RT-qPCR, and Western blotting were used in mechanistic investigations. The effectiveness of ERX-41 was examined in vivo using KPL4 cell-based xenografts. Results: ERX-41 significantly decreased the viability of all three IBC model cells (SUM149, SUM190PT, and KPL4), with an IC50 of about 125 nM in MTT assay. Additionally, ERX-41 treatment significantly decreased IBC cells capacity to form colonies and promoted apoptosis. Specificity of the ERX41 mediated actions were confirmed using LIPA KO cells. Using RTqPCR based splicing assays, we demonstrated increased splicing of XBP1 as early as 6 hours after ERX41 treatment. Western analyses showed robust induction of stress markers (CHOP, PERK, ATF4) in IBC cells upon treatment with ERX-41. In KPL4 xenograft studies, ERX-41 showed significant reduction in the tumor volume. IHC analyses confirmed decreased proliferation marker and increased ER stress markers. Conclusions: Collectively, our results suggest that ERX-41 is a novel therapeutic agent that targets the LIPA with a unique mechanism of action and implicate ERX-41 binding to LIPA induces ER stress and promotes apoptosis of IBC cells. Citation Format: Zenaida Fuentes, Rahul Gopalam, Bianca A. Romo, Khaled Mohamed Nassar, Xue Yang, Behnam Ebrahimi, Paulina Ramirez, Chia-Yuan Chen, Scott Elmore, Harika Nagandla, Uday Pratap, Christoforos Thomas, Suryavathi Viswanadhapalli, Jung-Mo Ahn, Ganesh Raj, Ratna K. Vadlamudi. Novel LIPA targeted therapy for treating inflammatory breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2100.