Cell Patient-derived Xenograft Research Articles

Abstract 1700: Clonal emergence of resistance to methotrexate in osteosarcoma barcoded PDX cells

Abstract Introduction: Osteosarcoma is known to have significant intratumoral heterogeneity with branched cancer evolution. We have studied the clonal emergence of resistance to targeted and cytotoxic chemotherapy in osteosarcoma barcoded cell lines derived from patient derived xenograft (PDX) models, in order to verify if short macroevolutionary jumps occur, as a consequence of chromosomal instability, leading to subclonal diversification after chemotherapy treatment. Methods: We have previously shown in our barcoded PDX models that, by applying selective pressure with methotrexate (MTX) IC95 treatment, a clonal subpopulations more resistant to MTX emerges. Preliminary data from Next-Gen sequencing of the genomic DNA extracted from the vehicles and selected clones have shown a wide variability of barcode abundance in the clones and the vehicles. Interestingly a reduced barcode abundance was observed in the clonal subpopulations as compared to the vehicles. Also, a wide range of clonal diversity was observed among the different clones and the vehicles, being high in the M17 PDX and its clones, and low in the OS252 PDX and its derived clones. Functional assays of MTX transport were performed by measuring the cellular uptake of [3H] MTX as previously described (Matherly L. Cancer Res. 1991) in both PDXs and derived clones. Our observations show that [3H] MTX uptake was affected differently in PDXs and derived clones, highlighting a wide variability in MTX transport, possibly due to different mutations in the reduced folate carrier (RFC) gene in different clones. In some of these clones, resistance to MTX might also be due to alterations in other genes involved in MTX cytotoxic activity (DHFR, FPGS, GGH). Results: By applying selective pressure with MTX to PDX derived cell lines we obtained clones whose genomic DNA has been studied with NGS technique. The results obtained by performing the functional assay of MTX transport on both PDXs and derived clones showed a wide variability in the MTX uptake, further supporting the initial hypothesis. Sequencing will allow us to study if there are mutations in the RFC gene and/or in other genes involved in MTX resistance in all the PDXs and derived clones. RNA sequencing (RNA-Seq) will suggest the pathway alterations that may be associated with the emergence of resistance. Conclusion - Barcoded PDX derived osteosarcoma cell lines have been created with resistant clones obtained after MTX treatment. Sequencing of the RFC gene and other genes involved in resistance to MTX, and RNA-Seq profiling will yield critical information on the clonality and mechanisms of resistance which will be presented. Acknowledgments: This work was funded by Swim Across America, the Foster Foundation, and the Barbara Epstein Foundation. Citation Format: Giuseppe Longo, Sylvester Jusu, Zhongting Zhang, Zhaohui Xu, Wendong Zhang, Michael Roth, Rui Yang, Douglas Harrison, Massimo Libra, Amer Najjar, Jonathan Gill, Richard Gorlick. Clonal emergence of resistance to methotrexate in osteosarcoma barcoded PDX cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1700.

Abstract 4567: Transcriptomic analysis of a 3D engineered cancer model recapitulating stage-dependent heterogeneity in colorectal PDX tumors

Abstract Colorectal cancer (CRC) is the third-most leading cause of cancer-related deaths in the United States. To advance the understanding of CRC tumor progression, models which mimic the tumor microenvironment (TME) and have translatable study outcomes are urgently needed. CRC patient-derived xenografts (PDXs) are promising tools for their ability to recapitulate tumor heterogeneity and key patient tumor characteristics, such as molecular characteristics. However, as in vivo models, CRC PDXs are costly and low-throughput, which leads to a need for equivalent in vitro models. To address this need, we previously established an in vitro model using a tissue engineering toolset with CRC PDX cells. However, it is unclear whether tissue engineering has the capacity to maintain patient- and/or cancer stage-specific tumor heterogeneity. To address this gap, we employed three PDX tumor lines, originated from stage II, III-B, and IV CRC tumors, in the formation of 3D engineered CRC PDX (3D-eCRC-PDX) tissues and performed an in-depth comparison between the 3D-eCRC-PDX tissues and the original CRC-PDX tumors. To form the tissues, CRC-PDX tumors were expanded in vivo and dissociated. The isolated cells were encapsulated within poly(ethylene glycol)-fibrinogen hydrogels and remained viable and proliferative post encapsulation over the course of 29 days in culture. To gain molecular insight into the maintenance of PDX line stage heterogeneity, we performed a transcriptomic analysis using RNA seq to determine the extent to which there were similarities and differences between the CRC-PDX tumors and the 3D-eCRC-PDX tissues. We observed the greatest correspondence in overlapping differentially expressed human genes, gene ontology, and Hallmark gene set enrichment between the 3D-eCRC-PDX tissues and CRC-PDX tumors in the stage II PDX line, while the least correspondence was observed in the stage IV PDX line. The Hallmark gene set enrichment from murine mapped RNA seq transcripts was PDX line-specific which suggested that the stromal component of the 3D-eCRC-PDX tissues was maintained in a PDX line-dependent manner. Consistent with our transcriptomic analysis, we observed that tumor cell subpopulations, including human proliferative (B2M+Ki67+) and CK20+ cells, remained constant for up to 15 days in culture even though the number of cells in the 3D-eCRC-PDX tissues from all three CRC stages increased over time. Yet, tumor cell subpopulation differences in the stage IV 3D-eCRC-PDX tissues were observed starting at 22 days in culture. Overall, our results demonstrate a strong correlation between our in vitro 3D-eCRC-PDX models and the originating in vivo CRC-PDX tumors, providing evidence that these engineered tissues may be capable of mimicking patient- and/or cancer stage-specific heterogeneity. Citation Format: Yuan Tian, Iman Hassani, Benjamin Anbiah, Bulbul Ahmed, William Van Der Pol, Elliot J. Lefkowitz, Peyton C. Kuhlers, Nicole L. Habbit, Martin J. Heslin, Elizabeth A. Lipke, Michael W. Greene. Transcriptomic analysis of a 3D engineered cancer model recapitulating stage-dependent heterogeneity in colorectal PDX tumors. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4567.

Abstract 4668: In-vitro modeling of tumor-associated macrophages in glioblastoma

Abstract BACKGROUND: The Glioblastoma (GBM) tumor microenvironment (TME) is comprised of a plethora of cancerous and non-cancerous cells that contribute to GBM growth, invasion, and chemo- and radio-resistance. In-vitro models of GBM typically fail to incorporate multiple cell types. Some groups have addressed this problem by employing 3D bioprinting to incorporate macrophages, astrocytes, and other parenchymal cells in an extracellular matrix. However, these models also use serum-containing media, which has been shown to cause GBM brain-tumor initiating cells to lose their stem-like properties, and IL-4/13 polarized macrophages (M2), even though tumor-associated macrophages (TAMs) do not adhere to the traditional M2 phenotype. Taken together, these observations highlight a critical need to develop physiologically accurate in-vitro model systems for GBM. METHODS: THP-1 monocytes were transitioned from serum-containing RPMI 1640 to serum-free CTS™ AIM V™ SFM and TheraPEAKTM X-VIVOTM-15 Serum-free Hematopoietic Cell Medium. Monocytes were stimulated towards a macrophage-like state with PMA and polarized by co-culturing them with GBM patient-derived xenograft (PDX) lines, using transwell inserts. dPCR, a cytokine array, and a phagocytosis assay were used to characterize macrophages polarized by this method relative to classically polarized resting (M0), pro-inflammatory (M1), and anti-inflammatory (M2) macrophages. RESULTS: There was no significant difference in proliferation rates up to 48 hours for THP-1 monocytes grown in serum-free CTS AIM V or X-VIVO-15 media compared to serum-containing RPMI 1640. At 72 hours, both serum-free alternatives had slightly decreased proliferation relative to the serum-containing RPMI 1640; however, the X-VIVO-15 had higher proliferation relative to the CTS AIM V (p<0.0001). THP-1 macrophages polarized towards a tumor-supportive phenotype by the GBM PDX cell line, JX39P-RT, did not recapitulate the cytokine expression profile of any other polarization group. M2 macrophages had significantly higher phagocytic capacity (25%) of JX39P-RT relative to M0, M1, and TAMs (<15%, p<0.01). CONCLUSIONS: We have demonstrated a serum-free method by which we can polarize macrophages towards a GBM-supportive phenotype. This high-fidelity method of modeling TAMs in GBM will aid in the development of innate immunomodulatory therapeutics that may one day enter the clinic in hopes of improving GBM outcomes. Citation Format: Hasan Alrefai, Andee M. Beierle, Taylor L. Schanel, Lauren C. Nassour, Joshua C. Anderson, Patricia H. Hicks, Christopher D. Willey. In-vitro modeling of tumor-associated macrophages in glioblastoma. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4668.

Abstract 6166: TBL1, a multifunctional transcriptional regulator, is highly expressed in osteosarcoma and correlates with activated beta catenin

Abstract Background: Osteosarcoma (OS) is the most common primary bone cancer in children and adolescents. Two-thirds of OS patients are cured through chemotherapy and tumor resection. However, survival rates have plateaued over the past 30 years, especially for patients with relapsed and/or metastatic disease, with overall long-term outcomes of less than 30%. Transducin beta-like protein 1 (TBL1) protects beta-catenin from nuclear degradation and mediates Wnt targeted transcription by forming a TBL1-beta-catenin complex. Overexpression of TBL1 and nuclear beta-catenin are positively correlated to adverse clinicopathological features and poor prognosis for osteosarcoma patients. Functional experiments reveal that down-regulation of TBL1 and nuclear beta-catenin activity inhibit proliferation, migration, and invasion of osteosarcoma cells. The objective of this study was to determine TBL1 levels within a panel of OS patient-derived xenograft (PDX) tumors. Methods: TBL1 and beta-catenin protein levels were measured via western blot and immunohistochemistry in OS samples. We examined protein levels in OS PDX cell lines collected at distinct clinical stages of metastatic OS and OS primary tumor samples. TBL1, total beta-catenin, and activated beta-catenin levels were measured by immunohistochemical (IHC) staining in tissue microarray (TMA) derived from patient derived xenograft (PDX) tumor and clinical samples. Each tumor sample were formalin fixed, paraffin embedded, and spotted in triplicate on the TMA. Results: Beta-catenin and TBL1 protein were detected in OS samples, and we found higher TBL1 protein levels in cells derived from advanced disease stages. Assessment of TBL1 protein was expanded to OS tissue microarray where TBL1, total beta-catenin, and active beta-catenin were independently stained in a TMA. TBL1, total beta-catenin, and activated beta-catenin were present in 100% of OS PDX cores. Finally, a majority of OS cores were shown to have high expression for both TBL1 and active beta-catenin. Conclusion: Elevated TBL1 levels have been associated with metastatic disease and poor survival. We have measured TBL1 and activated beta-catenin protein levels in a variety of osteosarcoma samples and identified a large percentage of osteosarcoma that co-express both proteins. These results indicate that metastatic OS represents a TBL1 enriched patient population and is a candidate for therapeutics that target TBL1. Citation Format: Kimberly R. Holloway, Taku Yamamichi, Bikesh Nirala, Nino Rainusso, Jason T. Yustein, Stephen Horrigan. TBL1, a multifunctional transcriptional regulator, is highly expressed in osteosarcoma and correlates with activated beta catenin [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6166.

Abstract 2796: Tumor pharmacokinetics, pharmacodynamics and efficacy analysis of WEE1 inhibitor, zn-c3 in patient-derived xenograft models of glioblastoma

Abstract WEE1 kinase regulates G2/M checkpoint transition via phosphorylation of CDK1 and prevents entry into mitosis. WEE1 inhibition increases genomic instability due to G2/M checkpoint inactivation and can result in mitotic catastrophe as monotherapy or when combined with DNA damaging agents. In this study, we evaluated the efficacy as well as pharmacokinetic and pharmacodynamic properties of ZN-c3, a best-in-class WEE1 inhibitor, in orthotopic patient-derived xenograft (PDX) models of GBM. Mice with intracranial tumors were randomized to 80 mg/kg ZN-c3 PO QD x 2 weeks vs. placebo. ZN-c3 levels in plasma and contrast-enhancing tumor tissue were measured by liquid chromatography tandem mass spectrometry (LC-MS/MS). Unbound fractions were determined by equilibrium dialysis. Immunohistochemistry was performed to assess levels of pCDK1, phospho-Histone H3 (pHH3), and cleaved caspase 3 (CC3). The median unbound concentrations of ZN-c3 were 315 nmol/L and 15 nmol/kg in plasma and tumor tissue, respectively - higher than the biochemical IC50 of ZN-c3 for inhibition of WEE1 (3.8nM). An increase in pHH3(+) cells (0.40% vs. 6.57%, p=0.03) indicated drug-induced mitotic entry upon ZN-c3 treatment. ZN-c3 was potently cytotoxic across multiple patient-derived xenograft (PDX)-derived cell lines (IC50- 150-10000nM). Time and dose-escalation experiments exhibited target engagement at concentrations lower than IC50 values within one hour of treatment. Basal levels of WEE1 and pCDK1 were correlated with cell viability in response to ZN-c3 across multiple PDX cell lines. Overall, ZN-c3 is well tolerated, achieves pharmacologically-relevant unbound concentrations in GBM PDX models, and is associated with significant checkpoint modulation. Preclinical evaluation of ZN-c3 in combination with radiation therapy and DNA damage response pathway inhibitors is currently underway, which will support future combinatorial strategy for glioblastoma treatment. Citation Format: Shwetal Mehta, An-Chi Tien, Sonam Patel, Tigran Margaryan, Anilkumar Thaghalli Shivanna, Leonel Elena, Jennifer Molloy, William Knight, Ruiheng Hon, Mackenna Elliott, Mariya Stavnichuk, Zorana Opachich, Yu-Wei Chang, Chelsea Montgomery, Sarah Himes, Barbara Hopkins, Artak Tovmasyan, Nader Sanai. Tumor pharmacokinetics, pharmacodynamics and efficacy analysis of WEE1 inhibitor, zn-c3 in patient-derived xenograft models of glioblastoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2796.

Abstract 1191: Targeting the tumor extracellular matrix to enhance therapeutic interventions in glioblastoma

Abstract Brain cancers remain some of the most challenging tumors to treat. The goal of our research is to use a 3D in vitro model to acquire in-depth understanding on the unique environment of brain tumors in order to find new biomarkers of disease and develop more efficient therapeutic approaches. Brain extracellular matrix (ECM) plays a key role in glioblastoma invasion and therapeutic resistance. In particular, the aberrant biosynthesis of the main component of brain ECM, hyaluronic acid (HA), has been associated to pathological conditions. In this study, we investigate the influence of tumor extracellular microenvironment in glioblastoma progression. We focus here on the tumor-associated HA biosynthesis in response to biophysical alterations, such as hypoxia and stiffness, and after radio and chemotherapeutic interventions. The ability to manipulate tumor ECM can improve therapeutic outcomes and restrict glioblastoma growth and infiltration. We have established engineered brain tumor biomaterials based on functionalized gelatin hydrogels decorated with covalently bound HA. This biomaterial approach can monitor the response of patient-derived xenograft cell populations with different molecular signatures (1, 2) in combination with microfluidic devices. Here, we characterized tumor cell response to targeted inhibitors and ionizing radiation. We quantified HA molecular weight (MW) distribution of secreted HA, and the tumor cell response to inhibition of HA synthase 2 (HAS2) and hyaluronidase (Hyal). Analysis of HA biosynthesis suggests that GBM cells compensate for a lack of matrix-bound HA by producing soluble HA to stimulate invasion. Moreover, we revealed that different signaling pathways are altered in the tumor cells depending on the microenvironment as they respond to an EGFR and CD44 inhibitor. While the decrease in invasion and proliferation in gelatin-only matrices comes from the negative regulation of ERK pathway, HA plays a favorable role in the inhibition of EGFR, through STAT3 deactivation (3). The MW and abundance of HA are mediated by the activity of HA synthases and hyaluronidases. These enzymes vary in expression, rate, and MW of the HA produced. We have found a heterogeneous profile of MW distributions secreted by different tumor types when exposed to different targeted inhibitors. We have also shown an increase in HA secretion after exposure to radiation and inhibition of hyaluronidase, also associated to significant changes in cell proliferation. The oxidative stress induced by the hypoxic environment also induces the production of hyaluronic acid and significantly affects glycolysis and mitochondrial oxidative phosphorylation, that are further altered by the molecular weight of the HA present in the extracellular space. (1) Pedron S. Adv. Healthcare Mater. 2017; 6:1700529; (2) Pedron S. MRS Commun. 2017; 7:442-449; (3) Pedron S. Biomaterials 2019; 219:119371. Citation Format: Edward R. Neves, Joseph Mueller, Achal Anand, Kimberly A. Selting, Brendan A. Harley, Sara Pedron-Haba. Targeting the tumor extracellular matrix to enhance therapeutic interventions in glioblastoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1191.

Myosin Light-Chain Kinase Inhibition Potentiates the Antitumor Effects of Avapritinib in PDGFRA D842V-Mutant Gastrointestinal Stromal Tumor.

To create an in vivo model of PDGFRA D842V-mutant gastrointestinal stromal tumor (GIST) and identify the mechanism of tumor persistence following avapritinib therapy. We created a patient-derived xenograft (PDX) of PDGFRA D842V-mutant GIST and tested the effects of imatinib, avapritinib, and ML-7, an inhibitor of myosin light-chain kinase (MYLK). Bulk tumor RNA sequencing and oncogenic signaling were evaluated. Apoptosis, survival, and actin cytoskeleton were evaluated in GIST T1 cells and isolated PDX cells in vitro. Human GIST specimens were analyzed for MYLK expression. The PDX was minimally responsive to imatinib but sensitive to avapritinib. Avapritinib therapy increased tumor expression of genes related to the actin cytoskeleton, including MYLK. ML-7 induced apoptosis and disrupted actin filaments in short-term cultures of PDX cells and decreased survival in GIST T1 cells in combination with imatinib or avapritinib. Combined therapy with ML-7 improved the antitumor effects of low-dose avapritinib in vivo. Furthermore, MYLK was expressed in human GIST specimens. MYLK upregulation is a novel mechanism of tumor persistence after tyrosine kinase inhibition. Concomitant MYLK inhibition may enable the use of a lower dose of avapritinib, which is associated with dose-dependent cognitive side effects.

Identification of IRAK1BP1 as a candidate prognostic factor in lung adenocarcinoma.

Lung cancer is one of the major causes of cancer-related mortality worldwide. High-throughput RNA sequencing (RNA-seq) of surgically removed tumors has been used to identify new biomarkers of lung cancer; however, contamination by non-tumor cells in the tumor microenvironment significantly interferes with the search for novel biomarkers. Tumor organoids, as a pre-clinical cancer model, exhibit similar molecular characteristics with tumor samples while minimizing the interference from other cells. Here we analyzed six RNA-seq datasets collected from different organoid models, in which cells with oncogenic mutations were reprogrammed to mimic lung adenocarcinoma (LUAD) tumorigenesis. We uncovered 9 LUAD-specific biomarker genes by integrating transcriptomic data from multiple sources, and identified IRAK1BP1 as a novel predictor of LUAD disease outcome. Validation with RNA-seq and microarray data collected from multiple patient cohorts, as well as patient-derived xenograft (PDX) and lung cancer cell line models confirmed that IRAK1BP1 expression was significantly lower in tumor cells, and had no correlation with known markers oflung cancer prognosis. In addition, loss of IRAK1BP1 correlated with the group of LUAD patients with worse survival; and gene-set enrichment analysis using tumor and cell line data implicated that high IRAK1BP1 expression was associated with suppression of oncogenic pathways. In conclusion, we demonstrate that IRAK1BP1 is a promising biomarker of LUAD prognosis.

Repurposing Verapamil to Enhance Killing of T-ALL Cells by the mTOR Inhibitor Everolimus.

New therapies are needed for patients with T-cell lymphoblastic leukemia (T-ALL) who do not respond to standard chemotherapy. Our previous studies showed that the mTORC1 inhibitor everolimus increases reactive oxygen species (ROS) levels, decreases the levels of NADPH and glucose-6-phosphate dehydrogenase (G6PD), the rate-limiting enzyme of the pentose phosphate pathway (PPP), and induces apoptosis in T-ALL cells. Studies in T-ALL-xenografted NOD/SCID mice demonstrated that everolimus improved their response to the glucocorticoid (GC) dexamethasone. Here we show that verapamil, a calcium antagonist used in the treatment of supraventricular tachyarrhythmias, enhanced the effects of everolimus on ROS and cell death in T-ALL cell lines. The death-enhancing effect was synergistic and was confirmed in assays on a panel of therapy-resistant patient-derived xenografts (PDX) and primary samples from T-ALL patients. The verapamil-everolimus combination produced a dramatic reduction in the levels of G6PD and induction of p38 MAPK phosphorylation. Studies of NOD/SCID mice inoculated with refractory T-ALL PDX cells demonstrated that the addition of verapamil to everolimus plus dexamethasone significantly reduced tumor growth in vivo. Taken together, our results provide a rationale for repurposing verapamil in association with mTORC inhibitors and GC to treat refractory T-ALL.

A new intronic quantitative PCR method led to the discovery of transformation from human ascites to murine malignancy in a mouse model.

To establish a fast and accurate detection method for interspecies contaminations in the patient-derived xenograft (PDX) models and cell lines, and to elucidate possible mechanisms if interspecies oncogenic transformation is detected. A fast and highly sensitive intronic qPCR method detecting Gapdh intronic genomic copies was developed to quantify if cells were human or murine or a mixture. By this method, we documented that murine stromal cells were abundant in the PDXs; we also authenticated our cell lines to be human or murine. In one mouse model, GA0825-PDX transformed murine stromal cells into a malignant tumorigenic murine P0825 cell line. We traced the timeline of this transformation and discovered three subpopulations descended from the same GA0825-PDX model: epithelium-like human H0825, fibroblast-like murine M0825, and main passaged murine P0825 displayed differences in tumorigenic capability in vivo. P0825 was the most aggressive and H0825 was weakly tumorigenic. Immunofluorescence (IF) staining revealed that P0825 cells highly expressed several oncogenic and cancer stem cell markers. Whole exosome sequencing (WES) analysis revealed that TP53 mutation in the human ascites IP116-generated GA0825-PDX may have played a role in the human-to-murine oncogenic transformation. This intronic qPCR is able to quantify human/mouse genomic copies with high sensitivity and within a time frame of a few hours. We are the first to use intronic genomic qPCR for authentication and quantification of biosamples. Human ascites transformed murine stroma into malignancy in a PDX model.

IMPDH inhibition activates TLR-VCAM1 pathway and suppresses the development of MLL-fusion leukemia.

Inosine monophosphate dehydrogenase (IMPDH) is a rate-limiting enzyme in de novo guanine nucleotide synthesis pathway. Although IMPDH inhibitors are widely used as effective immunosuppressants, their antitumor effects have not been proven in the clinical setting. Here, we found that acute myeloid leukemias (AMLs) with MLL-fusions are susceptible to IMPDH inhibitors invitro. We also showed that alternate-day administration of IMPDH inhibitors suppressed the development of MLL-AF9-driven AML invivo without having a devastating effect on immune function. Mechanistically, IMPDH inhibition induced overactivation of Toll-like receptor (TLR)-TRAF6-NF-κB signaling and upregulation of an adhesion molecule VCAM1, which contribute to the antileukemia effect of IMPDH inhibitors. Consequently, combined treatment with IMPDH inhibitors and the TLR1/2 agonist effectively inhibited the development of MLL-fusion AML. These findings provide a rational basis for clinical testing of IMPDH inhibitors against MLL-fusion AMLs and potentially other aggressive tumors with active TLR signaling.

Hyperactive CREB subpopulations increase during therapy in pediatric B-lineage acute lymphoblastic leukemia.

Persistence of residual disease in acute lymphoblastic leukemia (ALL) during the initial stages of chemotherapy is associated with inferior survival. To better understand clonal evolution and mechanisms of chemoresistance, we used multiparameter mass cytometry, at single-cell resolution, to functionally characterize pediatric B-ALL cells at disease presentation and those persisting during induction therapy. Analysis of ALL cells from presentation samples (n=42) showed that the most abundant phosphosignals were pCREB, pH2AX and pHH3 and we identified JAK-STAT and RAS pathway activation in five of six patients with JAK or RAS genetic aberrations. The clonal composition of ALL was heterogeneous and dynamic during treatment but all viable cell clusters showed pCREB activation. Levels of pCREB in ALL cells were increased or maintained during therapy and high dimensional analysis revealed a subpopulation of ALL cells at presentation that was positive for pCREB/pHH3/pS6 which increased during treatment in some patients, implicating this signaling node in conferring a survival advantage to multi-agent induction therapy. The small molecule CREB inhibitor, 666-15, was shown to reduce CREB transcriptional activity and induce apoptosis in ALL patient-derived xenograft cells of varying cytogenetic subtypes in vitro, both in the presence and absence of stromal support. Together, these data suggest that the cAMP signaling pathway may provide an opportunity for minimal residual disease-directed therapy for many patients at high risk of relapse.

The IL7R-Antagonist OSE-127 Blocks Acute Lymphoblastic Leukemia Development Via a Dual Mode of Action

Acute lymphoblastic leukemia (ALL) may arise from precursor B or T cells (BCP- and T-ALL, respectively) and treatment is based on polychemotherapy. There is an urgent need for novel immunotherapy targets to reduce therapy toxicity and to target relapsed/refractory (r/r) disease, especially in T-ALL where immunotherapy approaches are scarce. The Interleukin-7-receptor (IL7R) has been shown to play a pivotal role in the development of both BCP-ALL and T-ALL (Geron et al. 2022; Silva et al. 2022). The IL7Rα-chain (CD127)-targeting antibody OSE-127 has a good safety profile in healthy volunteers (NCT03980080) and has entered phase 2 trials in Ulcerative Colitis (NCT04882007) and Sjögren's syndrome (NCT04605978). We previously reported high preclinical efficacy of OSE-127 in BCP-ALL patient derived xenograft (PDX) models of different cytogenetic backgrounds (Lenk and Baccelli et al. ASH, 2021). However, the preclinical efficacy of OSE-127 in T-ALL had not yet been investigated and the mechanism of action underlying its anti-leukemic efficacy remained unclear. First, we investigated the in vivo efficacy of OSE-127 treatment on BCP-ALL and T-ALL cells by conducting a preclinical phase 2-like PDX study. Two NSG mice per patient were injected with BCP-ALL (n=13) or T-ALL (n=9) PDX cells (including 7 r/r ALL samples), randomly assigned into treatment groups and OSE-127 therapy was initiated when 1% leukemic blasts were detected in the peripheral blood (PB). OSE-127 treated mice showed a reduction of PB blasts in 21/22 (95%) PDX samples in vivo when the corresponding control mice showed clinical signs of overt leukemia (Figure 1A). This translated into a 1.6-fold prolongation of median survival (MS) of OSE-127 treated PDX mice (P<0.0001, Figure 1B). Of note, blast reduction strongly correlated with CD127 expression levels in the samples (Pearson r=0.5372, P=0.0099). Next, we characterized the mode of action of OSE-127. As expected, OSE-127 blocked STAT5 phosphorylation in IL7-dependent ALL cell lines and PDX samples. As OSE-127 is not internalized by CD127 expressing cells (Belarif et al. 2018), we investigated whether OSE-127 might also exert immune-mediated effects. We found that OSE-127 did not promote antibody-dependent cellular cytotoxicity (ADCC), but efficiently induced macrophage-mediated antibody-dependent cellular phagocytosis (ADCP) in BCP- and T-ALL cell lines and PDX cells in vitro, in a manner dependent on CD127 expression levels (Pearson r=0.5000, P=0.0352, Figure 1C-D). In line with these observations, inactivating mutations of the Fc fraction of OSE-127 (OSE-127-LALAPG) prevented ADCP of ALL cells in vitro, while conserving its antagonistic properties on IL7R signaling. To further evaluate the contribution of ADCP to the anti-leukemic activity of OSE-127, we compared the in vivo efficacy of OSE-127 and OSE-127-LALAPG in ALL samples with dysfunctional IL7R signaling (e. g., DND41 cells showing constitutive pathway activation due to IL7Rα mutations or NALM6 cells being absent of P-STAT5 induction upon IL7 stimulation). In this context, OSE-127-LALAPG did not impact leukemic engraftment as compared to control treatment, while OSE-127 significantly reduced leukemic burden, thereby substantiating that ADCP contributes to the anti-leukemic efficacy of OSE-127 (Figure 1E). Finally, we conducted a phase2-like PDX overt leukemia study testing OSE-127 alone or in combination with Dexamethasone/Vincristine/PEG-Asparaginase chemotherapy employing PDX samples with high CD127 expression (6 BCP-ALL and 3 T-ALL-PDX samples with >50% CD127+ cells in flow cytometry analysis). OSE-127 alone significantly prolonged the survival of PDX mice in comparison to control treatment (MS 106d vs 79d, P=0.0071), which was comparable to the effect of chemotherapy (MS 106d vs 79d, P=0.0037). Importantly, the strongest effects were observed when combining OSE-127 with chemotherapy (MS 79d vs undefined, P=0.0003, Figure 1F). Overall, we propose OSE-127 as a novel potential immunotherapeutic agent for the treatment of BCP-ALL and T-ALL, particularly in r/r disease and in combination with chemotherapy. Due to its dual mode of action comprising ADCP induction and IL7R-pathway blockade, OSE-127 could be efficacious in CD127+ ALL with and without IL7R pathway alterations. L.L. and I.B. contributed equally to this work. N.P. and D.M.S. share senior authorship Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Spatially Confined T-Cell Mediated Anti-AML Tumor Immunity By Dual Recognition Antibodies (CD123/CD200)

Definitive cure of acute myeloid leukemia (AML) remains an unmet need. While recombinant antibody-based and CAR-T cell mediated immunotherapies bear great potential in targeting chemotherapy-resistant leukemic stem cells, these approaches are largely limited by the lack of specific targets uniquely expressed by leukemic cells. Here, we propose a combinatorial strategy using a two-target approach which may have improved on-target and reduced off-target effects. The well-known stem cell marker interleukin-3 receptor α (CD123) is expressed on most AML cells. CD200 recently emerged as a cell surface marker mediating immuno-evasion on high-risk AML cells. We engineered the "Prodrug-activating chain Exchange"(PACE) TriFAB system (Dickopf S et al. Biological Chemistry, 2022) to yield a combinatorial anti-AML directed T-cell response. PACE-TriFAB educts are complementary Knob-into-hole IgG derived prodrugs in which one half is exchanged by a dummy containing an interface destabilizing mutation in the CH3 domain. The CH2 domain of the main body is replaced by a CD3 FAB light or heavy chain, respectively. With the hinge region being replaced by a flexible linker and therefore lacking disulfide bonds, a chain exchange between two educts is enabled when in close proximity on the cell surface. This leads to an activated anti CD3 domain and a dummy-dummy by-product. To demonstrate the T-cell activating potential, we co-cultured fresh PBMCs from healthy donors together with the CD200+/CD123+ AML cell line Kasumi-1 and checked T-cell activation by flow cytometry (E:T ratio 5:1, prodrug conc. 20 nM, 24 h stimulation). We observed a marked increase in CD69, CD25 and CD137 expression on CD8+ cells in the case when the CD123 and CD200 prodrugs were applicated simultaneously together with target cells, but not when single prodrugs alone or without target cells were analyzed (Median fluorescence intensity for CD25, CD69 and CD137: No construct: 450, 8.900 & 2.100; prodrug CD200: 460, 8.700 & 2.100; prodrug CD123: 460, 9.600 & 2.000; both prodrugs: 6.500, 344.300 & 43.100; results confirmed in repeat experiments) For the evaluation of the specific cytotoxic effect of the construct we transduced Kasumi-1 cells with an mCherry lentiviral vector and imaged the cells co-cultured with PBMCs every 2 h over a time span of 60 h (E:T ratio 5:1, prodrug conc. 10 nM). Proliferation of the Kasumi-1-mCherry cells was observed when no prodrug or only a single prodrug was added. However, application of both prodrugs together led to a decrease in mCherry positive cell count (log2 fold changes to starting point: No PBMCs 1,2; no construct 0,9; prodrug CD200 0,9; prodrug CD123 0,4; both prodrugs -2,1; n=3). Not only could we show that this elimination of tumor cells was dose dependent but also it was constrained by the E:T ratio (pivot point from killing to proliferation at 0,1 nM and E:T of 1:2 n=3). Similar results were obtained using patient derived xenograft (PDX) AML cells. In contrast to Kasumi-1 AML cells, specific killing of patient-derived PDX cells could be documented with lower E:T ratios and lower prodrug concentrations (pivot point from killing to proliferation at 0,05 nM and E:T of 1:5) We also started to analyze the anti-leukemic effect in vivo. Luciferase-expressing CD200+/CD123+ AML PDX cells were injected into NSG mice. On day +15, PBMC from a healthy individual were transplanted, followed by additional applications of the antibodies on days +16, +18, +21, +23, +25 & +29. Tumor burden was analyzed by bioluminescence imaging (log10 fold change [P/sec] 2 weeks after PBMC injection: Control 1,9; treated -0,4; group size = 3). In conclusion the combination of anti CD200 and anti CD123 as prodrugs of an on-target activating trispecific T-cell engager kills AML cells in vitro and in vivo and has the potential to eliminate AML LSC while minimizing the risk for severe on-target off-leukemia toxicity. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Inhibition of PRMT5 Increases Sensitivity to BH3 Mimetics in Aggressive B Cell Malignancies

Introduction: Protein Arginine Methyltransferase 5 (PRMT5) is a type II methyltransferase that catalyzes symmetric dimethylation of arginine. PRMT5 is highly expressed in several types of aggressive B cell malignancies, and increased PRMT5 expression has been associated with poor disease prognosis. Several small molecule inhibitors targeting PRMT5 have been developed and showed promising anti-tumor effect in pre-clinical studies including in mantle cell lymphoma (MCL) and diffuse large B cell lymphoma (DLBCL). JNJ-64619178, a potent and specific PRMT5 inhibitor, exhibited broad antiproliferative activity in cancer cell lines from multiple cancer types and cell lines derived xenograft mouse model (Brehmer et al., 2021). In a phase 1 clinical trial of JNJ-64619178 (NCT03573310), patients with advanced solid tumors and non-Hodgkin lymphoma demonstrated manageable toxicity and preliminary evidence of antitumor activity at selected dose levels (Villar et al., 2020). In addition, in patients with lower-risk myelodysplastic syndromes, JNJ-64619178 had manageable hematologic toxicity at the selected expansion dose, but did not have significant clinical activity (Haque et al., 2021). Inhibition of PRMT5 alone could induce cell cycle arrest instead of apoptosis depending on the types of cancer (Zhu et al., 2019), therefore we hypothesized that the combination of PRMT5i and pro-apoptotic BH3 mimetics therapies could be synergistic in aggressive B cell malignancies. Methods: We used dynamic BH3 profiling (DBP) to measure the net pro-apoptotic signaling induced by ex vivo drug treatments (as per Montero et al., 2015). Other standard techniques included shRNA mediated gene knockdown, Western blot, cell viability assays including PI/Annexin V and CellTiter-Glo, and reactive oxygen species (ROS) measurement by flow cytometry with dihydroethidium (DHE) staining. The DLBCL cell lines (HBL1, TMD8, RI-1, OCI-Ly1, Karpas 422, SUDHL4, Toledo), double hit lymphoma (DHL) patient-derived xenograft (PDX) cell lines (DW19), mantle cell lymphoma (MCL) cell lines (Mino, Jeko-1), T cell acute leukemia (T-ALL) cell line (Jurkat) and Burkitt lymphoma (BL) cell line (Raji) were used to investigate the in vitro anti-cancer activity of JNJ-64619178 (Janssen Pharmaceuticals) and BH3 mimetics (venetoclax [BCL2i], S63845 [MCL-1i] and A1331852 [BCL-xLi], Selleckchem). SynergyFinder was used to calculate drug synergism. Results: In all 7 DLBCL cell lines and the DHL-PDX cell line, we found synergistic induction of apoptosis with JNJ-64619178 plus venetoclax (synergy score, 2.82~51.42). The lowest level of synergy was observed in OCI-Ly1 cells, which are intrinsically highly sensitive to venetoclax monotherapy. The combination of JNJ-64619178 with S63845 synergistically induced apoptosis in 5 out of 7 cell lines (synergy score, -1.91~35.64). While the combination of JNJ-64619178 with A1331852 synergistically induced apoptosis in all 7 cell lines (synergy score 1.88~46.73), 4 of them had weak synergy score (1.88~9.4). To confirm the effects we observed with pharmacologic inhibition of PRMT5, we performed shRNA mediated knockdown of PRMT5, which similarly revealed increased sensitivity to venetoclax. In MCL cell lines, combining JNJ-64619178 with venetoclax or A1331852 was more synergistic in inducing cell death than combining with S63845. The T-ALL Jurkat cell line was resistant to JNJ-64619178 and single BH3 mimetic-induced apoptosis. Combining JNJ-64619178 with A1331852 but not venetoclax or S63845 strongly induced apoptosis. The Burkitt cell line Raji was resistant to JNJ-64619178, venetoclax and A1331852, but was sensitive to S63845. The addition of JNJ-64619178 and a single BH3 mimetic in these Raji cells had only a minor synergistic effect. The synergy scores are summarized in Figure 1. Using DBP, JNJ-64619178 was found to increase overall apoptotic priming of DLBCL and MCL cell lines (> 15% increase in cytochrome c loss). By measuring ROS levels, we found increased ROS production (> 2-fold increase in median fluorescent intensity) in response to JNJ-64619178 before the onset of apoptosis, suggesting a possible mechanism by which JNJ-64619178 increases apoptotic priming. Conclusions: The combination of a PRMT5 inhibitor with BH3 mimetics, especially venetoclax, is worthy of further exploration as a potential therapeutic strategy for DLBCL and MCL. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

IKZF1 Deletions Induce Resistance to AraC in BCP-ALL Reversible By CDK8/19 Inhibition

Background Deletions and mutations affecting lymphoid transcription factor IKZF1 occur in about 10-15% of pediatric patients and up to 50% of adults with B cell precursor acute lymphoblastic leukemia (BCP-ALL) and predict a poor outcome. We have shown previously that loss of IKZF1 function compromises the therapeutic efficacy of glucocorticoids (GCs). Here, we investigated whether loss of IKZF1 function also affects therapy response to other chemotherapeutic agents used in the treatment of ALL. Aim To develop tailored treatment protocols for IKZF1 deficient leukemia Results We used CRISPR-Cas9 to target the IKZF1 locus in SEM pro-B ALL cells and evaluated the response to standard chemotherapy used in the treatment of ALL. We observed that IKZF1-/- SEM cells show a markedly reduced response to the pyrimidine analogue cytarabine (AraC) relative to IKZF1 wild type cells, with an 8-fold increase in IC50. The same drug resistance profile was observed upon shRNA-mediated knockdown of IKZF1 as well as in B-cells isolated from 8 to 14 weeks-old Ikzf1+/- mice. Using ex vivo cultures of patient derived xenografts (PDX), we observed that IKZF1 deficient leukemic cells were significantly more resistant to AraC relative to cells wild type for IKZF1 (3-fold increase in area under the curve (AUC) (Figure A). In addition, we targeted the IKZF1 protein for proteasomal degradation using the thalomide Iberdomide in PDX cells wildtype for IKZF1, showing that this drug-induced IKZF1 loss leads to AraC resistance in 7 out of 8 PDX samples. To provide in-patient evidence for AraC resistance, we compared the reduction in tumor load between patients with leukemias wildtype for IKZF1 with those carrying IKZF1 deficiencies after treatment with an AraC containing treatment block (cumulative dose of 1200 mg/m2 AraC, 6-mercaptopurine 60 mg/m2/day p.o., for 28 days and 2 doses of 1000 mg/m2 cyclophosphamide). In the Dutch ALL10/11 protocol, this treatment block is flanked by minimal residual disease (MRD) measurements. We selected all patients with a high tumor load (MRD of 10-2) before the start of the AraC containing block and calculated the reduction in leukemia burden by comparing MRD levels before and after treatment with the AraC containing interval. This showed that the response to AraC treatment was attenuated in patients with IKZF1 deleted ALL (n=25) compared to patients WT for IKZF1 (n=35) (**p=0.0065). Because IKZF1 deficient cells did not show resistance to other compounds used in this treatment block, we attribute the reduced treatment response to increased AraC resistance. To further confirm the involvement of IKZF1 loss in AraC resistance, we performed a single mouse trial in which we compared AraC treatment response in mice transplanted with IKZF1 wildtype leukemias (n=5) with IKZF1 deficient leukemias (n=7), confirming that the latter respond more poorly to treatment. To study whether resistance in response to IKZF1 loss can be reversed and obtain more insights into the biology behind the observed AraC resistance, we performed CRISPR/Cas9 screens to identify drug targets that can restore response to AraC therapy. Briefly, IKZF1 deficient cells were transduced with a library of gRNAs targeting subset of genes (kinases and genes involved in cellular metabolism). Transduced cells were treated with a sublethal dose of AraC and the relative abundance of each gRNA before and after treatment was calculated. In addition to known modifiers of the AraC therapy response such as deoxycytidine kinase, we also identified novel targets that may be targeted to sensitize cells to cytarabine treatment. Guide RNAs targeting the mediator kinases CDK8/19 were selectively and strongly depleted during treatment, suggesting that these proteins modify response to cytarabine treatment. Indeed, small-molecule inhibitors targeting CDK8/19 kinase activity synergized with cytarabine induced killing of leukemic cells (Figure B). Conclusion Together, our results demonstrate that loss of IKZF1 function confers resistance to AraC in BCP-ALL. Moreover, this resistance can be overcome by use of small molecule inhibitors such as those targeting CDK8/19. We expect that these studies will aid in the rational design of combination therapies that will further improve treatment response in these high-risk leukemias. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

BCL-XL Blockage with A1155463 Significantly Increases Efficacy of Venetoclax in Mantle Cell Lymphoma in Vitro and In Vivo

Mantle cell lymphoma (MCL) is a rare chronically relapsing subtype of aggressive B-cell non-Hodgkin lymphoma characterized by the canonical chromosomal translocation t (11;14) and other molecular cytogenetic aberrations including overexpression of BCL2 protein. Venetoclax (VEN), a BCL2 inhibitor, has demonstrated activity in MCL both as a monotherapy and in combination with other targeted agents. Treatment with single agent venetoclax is, however, hampered by frequent development of drug resistance caused in large part by adaptive upregulation of other anti-apoptotic BCL2 family members. Immunodeficient NOD-SCID-gamma mice were xenografted subcutaneously with MCL cell lines and PDX cells established from patients with relapsed and refractory MCL. The therapy was given for two weeks. VEN was administered by oral gavage (100 mg/kg/d), A1155463 was administered intraperitoneally (10 mg/kg/d). Western blotting was implemented to evaluate expression levels of BCL2 proteins, immunoprecipitation was used to analyze the levels of BIM bound to BCL2 and BCL-XL before and after exposure to VEN. CRISPR-Cas9 was employed to derive clones with BCL-XL knock-out. Blood cell counts in mice on A1155463 +/- VEN therapy were analyzed using the Mindray BC-5300 Auto Hematology Analyzer. In this study, we analyzed molecular mechanisms of in vivo acquired resistance to VEN using a panel of several murine cell line-based xenografts (CDX) and patient-derived xenografts (PDX) of MCL. First, the mice xenotransplanted with VEN-sensitive MCL cells were subject to monotherapy with VEN until development of resistant tumors (VEN-R). Western blot analysis of VEN-R tumors revealed upregulation of BCL-XL in majority of VEN-R tumors compared to controls. Other changes included upregulation of MCL1 and downregulation of BIM proteins in several models. Immunoprecipitation experiments confirmed that BCL-XL indeed serves as a buffer for BIM released from BCL2 after exposure to VEN thereby blocking VEN-triggered apoptosis. Importantly, we demonstrated that the upregulation of BCL-XL caused not only VEN resistance, but also led to BCL-XL-specific pro-apoptotic priming of VEN-R lymphoma cells. In vitro, the combination of VEN and A1155463, a specific BCL-XL inhibitor, induced cytotoxic synergy on a panel of MCL cell lines and primary cells. CRISPR-Cas9-mediated BCL-XL knock-out resulted in marked sensitization to VEN-induced apoptosis in MCL cell lines. In vivo, pharmacological blockage of BCL-XL strongly increased sensitivity to VEN. Despite that A1155463 exerted limited anti-lymphoma activity as monotherapy on tested CDX and PDX models, its combination with VEN was synthetically lethal and exerted significantly enhanced anti-lymphoma activity. The efficacy of the VEN and A1155463 combination was highly effective even in mice bearing VEN-R tumors (tumors with acquired VEN resistance, Figure 1). It has been published that mechanisms responsible for BCL-XL upregulation include activation of NFkappaB signaling via CD40 and hypoxia. Upregulation of BCL-XL induced by these factors in turn caused VEN resistance in vivo. Indeed, we confirmed that upregulation of BCL-XL was observed already after engraftment of VEN-sensitive MCL cells in immunodeficient mice. MCL cells isolated ex vivo from the established CDX tumors were significantly more sensitive to BCL-XL inhibition compared to the corresponding in vitro growing cell lines. Our results thus confirmed increased BCL-XL dependence of MCL cells in vivo compared to in vitro. We suggest that these microenvironmental factors were also critical for the selection of VEN-resistant clones during the therapy with VEN. Historically, experimental therapy of patients with chronic lymphocytic leukemia with navitoclax, a combined inhibitor of BCL2 and BCL-XL, was rater disappointing. The plausible reasons included both low efficacy of navitoclax due to insufficient BCL2 inhibition, and a dose-limiting thrombocytopenia. We demonstrated that the thrombocytopenia associated with continued therapy with A1155463 could be managed by 4 days on / 3 days off treatment strategy, which cannot be applied in case of fixed dual BCL2/BCL-XL inhibitors like navitoclax, or AZD4320. In summary, the combined inhibition of BCL2 and BCL-XL with VEN and A1155463 is a highly effective experimental treatment strategy for R/R MCL with a potential translation to the clinical grounds. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Multiparametric Magnetic Resonance Imaging and Metabolic Characterization of Patient-Derived Xenograft Models of Clear Cell Renal Cell Carcinoma.

Patient-derived xenografts (PDX) are high-fidelity cancer models typically credentialled by genomics, transcriptomics and proteomics. Characterization of metabolic reprogramming, a hallmark of cancer, is less frequent. Dysregulated metabolism is a key feature of clear cell renal cell carcinoma (ccRCC) and authentic preclinical models are needed to evaluate novel imaging and therapeutic approaches targeting metabolism. We characterized 5 PDX from high-grade or metastatic ccRCC by multiparametric magnetic resonance imaging (MRI) and steady state metabolic profiling and flux analysis. Similar to MRI of clinical ccRCC, T2-weighted images of orthotopic tumors of most PDX were homogeneous. The increased hyperintense (cystic) areas observed in one PDX mimicked the cystic phenotype typical of some RCC. The negligible hypointense (necrotic) areas of PDX grown under the highly vascularized renal capsule are beneficial for preclinical studies. Mean apparent diffusion coefficient (ADC) values were equivalent to those of ccRCC in human patients. Hyperpolarized (HP) [1-13C]pyruvate MRI of PDX showed high glycolytic activity typical of high-grade primary and metastatic ccRCC with considerable intra- and inter-tumoral variability, as has been observed in clinical HP MRI of ccRCC. Comparison of steady state metabolite concentrations and metabolic flux in [U-13C]glucose-labeled tumors highlighted the distinctive phenotypes of two PDX with elevated levels of numerous metabolites and increased fractional enrichment of lactate and/or glutamate, capturing the metabolic heterogeneity of glycolysis and the TCA cycle in clinical ccRCC. Culturing PDX cells and reimplanting to generate xenografts (XEN), or passaging PDX in vivo, altered some imaging and metabolic characteristics while transcription remained like that of the original PDX. These findings show that PDX are realistic models of ccRCC for imaging and metabolic studies but that the plasticity of metabolism must be considered when manipulating PDX for preclinical studies.

Oncolytic Urabe mumps virus: A promising virotherapy for triple-negative breast cancer

Historically, the clinical utility of oncolytic virotherapy as a treatment for a wide range of cancer types was first demonstrated by three pilot human clinical trials conducted in Japan in the 1970s and 1980s using a wild-type Urabe mumps virus (MuV) clinical isolate. Using a sample of the actual original oncolytic Urabe MuV clinical trial virus stock (MuV-U-Japan) used in these Japanese clinical trials, we found that MuV-U-Japan consisted of a wide variety of very closely related Urabe MuVs that differed by an average of only three amino acids. Two MuV-U-Japan isolates, MuV-UA and MuV-UC, potently killed a panel of established human breast cancer cell lines invitro, significantly extended survival of nude mice with human triple-negative breast cancer (TNBC) MDA-MB-231 tumor xenografts invivo, and demonstrated significant killing activity against breast cancer patient-derived xenograft (PDX) cell lines grown as 3D organoids, including PDXs from patients resistant to anthracycline- and taxane-based chemotherapy. We also report success in developing a large-scale MuV-U production and purification process suitable for supporting Investigational New Drug applications for clinical trials. This study demonstrates the suitability of the MuV-UC virus for translation to modern clinical trials for treating patients with TNBC.

IMMU-07. HUMANIZED BI-SPECIFIC ANTIBODY SHOWS POTENT ACTIVITY IN PATIENT-DERIVED XENOGRAFT MODELS OF GLIOBLASTOMA

Abstract BACKGROUND Advancements in bioengineering have allowed bispecific Abs to develop with therapeutic applications in immuno-oncology. Here we describe a fully humanized bispecific t cell engager (BiTE) that binds the GBM-associated antigen interleukin 13 receptor alpha 2 (IL13Rα2) and the T Cell receptor CD3 epsilon (CD3ε) to elicit an anti-tumor immune response in patient-derived models of GBM. METHODS In vitro, BiTE-mediated activation of T Cells was assessed via flow cytometry as measurements of T cell activation markers CD25 and CD69 and cytokines IFNγ and TNFα. BiTE-directed T cell-mediated cytotoxicity was assessed in GBM 6 and GBM12patient-derived xenograft lines. In vivo, GBM6 patient-derived xenograft cells were intracranially implanted in NSG-MHC I/II DKO mice, reconstituted with HLA-matched donor peripheral blood lymphocytes (PBMC), and subsequently treated with 2.5 mg/kg BiTE via i.p. injection x 4 days/week of therapeutic BiTE for three weeks. Animals were followed for survival, and the brains of long-term survivors were analyzed for residual disease and T cell infiltration. RESULTS In vitro, BiTE potently activated T cells as determined by a high expression of CD25 and CD69 and the production of TNFα and IFNγ. BiTE also directed T cell-mediated cytotoxicity against GBM cells in a dose-dependent manner, with significant activity still seen in the low nanogram range. In vivo, BiTE significantly extended the survival of tumor-bearing animals in GBM6patient-derived xenograft models. Histological analysis of long-term surviving mice shows complete absence of tumor and robust presence of CD8+ T cells localized to the original site of tumor implantation. CONCLUSIONS Our data demonstrate the efficacy of humanized BiTE in patient-derived GBM models, and our results support the investigation of this novel therapeutic in a clinical trial setting.FUNDING: R01 NS122395-01 and R01 NS095642-01