Syngeneic Mice Research Articles

Abstract 7465: Leukemia inhibitory factor creates an immune suppressive tumor microenvironment and fosters tumor growth in KRAS-driven pancreatic ductal adenocarcinoma

Abstract Immune checkpoint blockade revolutionized cancer treatments by activating anti-tumor immunity. Pancreatic ductal adenocarcinoma (PDA) patients have not benefited from these advances due to an immune suppressive tumor microenvironment. Identifying PDA cell-encoded factors that drive immune evasion is necessary to unlock new immunologically active treatment options in PDA. We have recently demonstrated that the cytokine Leukemia inhibitory factor (LIF) is highly upregulated in PDA compared to the normal healthy pancreas. LIF is known for its immune suppressive qualities, but data on LIF in PDA is currently limited. We generated a conditional Lif flox (L) allele and crossed it into the well-established KrasLSL-G12D/+, Trp53flox/flox, Pdx1-Cre (KPC) mouse model. LKPC mice (n=29) had longer overall survival (69 days) than control KPC mice (n=29) (59 days), (p<0.05). LKPC mice harbored significantly smaller tumors with an average tumor weight of 0.6g compared to KPC control animals with an average tumor weight of 1.0g (p<0.005). Immunohistochemical evaluation of tumor proliferation measured by Ki-67 positivity in LKPC and KPC tumors at endpoint showed comparable results. Tumor-derived cell lines from KPC and LKPC mice showed no growth differences in vitro nor when reimplanted subcutaneously (sc) in immunodeficient mice. In contrast, we observed a significant decrease in tumor growth and weight in LKPC sc tumors (p<0.05) compared to the KPC sc tumors in syngeneic mice. LKPC sc tumors had significantly fewer neutrophils and more macrophages, particularly MHC II-high macrophages, known for their anti-tumor qualities when compared to KPC sc tumors using flow cytometry. A trend towards more CD8+ T-cells in sc LKPC tumors was also observed. Our genetically engineered mouse model confirmed this finding by immunohistochemical evaluation of tumors at endpoint, which demonstrated a significant increase of CD8+ T-cells in the LKPC animals compared to the KPC controls. In summary, we find that cancer-cell-expressed LIF augments tumor growth and shortens overall survival by changing the immune tumor microenvironment, nominating leukemia inhibitory factor depletion as a promising therapeutic immune target in KRAS-driven pancreatic cancer. Citation Format: Lisa Miller-Phillips, Imene Boukhalfa Hanafi, Alexis J. Combes, Shabana Bano, Lisiena Hysenaj, Jeroen P. Roose, Adam Olshen, Ashley Kiemen, Sarah Umetsu, Man-Tzu Wang, Eric A. Collisson. Leukemia inhibitory factor creates an immune suppressive tumor microenvironment and fosters tumor growth in KRAS-driven pancreatic ductal adenocarcinoma [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 7465.

Abstract 1940: Identifying resistant mechanisms to direct KRAS inhibitors in NSCLC

Abstract Mutations in the KRAS oncogenic driver gene are frequently found in malignancies such as pancreatic, colorectal, and lung cancers. The replacement of the amino acid glycine at position 12 (e.g., G12C, G12D, G12V) is a frequent mutation that traps the protein in an active state and promotes uncontrolled cell proliferation. KRAS was regarded as "undruggable" for many years due to insufficient drug-binding pockets on the protein's surface. Recent breakthroughs, however, have resulted in the development of covalent inhibitors capable of selectively targeting the KRAS G12C mutation, like Sotorasib (AMG510) and Adagrasib (MRTX849) which are approved by the FDA due to their encouraging effects in clinical trials. The identification of selective inhibitors of other oncogenic KRAS alleles, such as the noncovalent KRAS-G12D inhibitor, MRTX1133, and a pan-KRAS-inhibitor drug (BI2865) is also a promising next step in the treatment of KRAS-dependent malignancies. While these inhibitors have shown initial success, their use frequently leads to resistance, the mechanisms of which largely remain unknown. To fill this essential research gap, we are employing our pre-clinical syngeneic mouse models and KRAS mutant allele-specific cell lines to investigate the underlying molecular processes of acquired resistance to direct KRAS allele-specific inhibitors. Using these murine syngeneic cell lines and human NSCLC cell lines, we have generated a panel of cell lines with acquired resistance to these direct KRAS inhibitors. To elucidate the molecular underpinnings of acquired resistance to direct KRAS inhibitors, we performed proteomic profiling of the sensitive and resistant cells by RPPA analysis. Among the several proteins whose expressions were altered in the KRAS-inhibitor-resistant cells, we identified the YAP/TEAD1 pathway that was commonly upregulated in the cells resistant to MRTX849 (G12Ci) or MRTX1133 (G12Di). We also observed significant re-sensitization of the resistant cells to the specific KRAS inhibitors upon genetic or pharmacological inhibition of TEAD using siRNA or a TEAD-inhibitor, in vitro. Tumors from syngeneic mice that were implanted with KRAS inhibitor-resistant cells or their sensitive versions and treated with the specific KRAS inhibitors for 3-4 weeks, also exhibited increased nuclear YAP1 localization in the resistant tumors. We are currently performing in vitro and in vivo studies to understand the therapeutic efficacy of a TEAD inhibitor in combination with KRASi (MRTX849 or MRTX1133) to either reverse or prevent resistance to these direct KRAS inhibitors. We are also trying to identify alterations in the tumor immune microenvironment upon combination therapy targeting KRAS and TEAD. Successful completion of this research will help address the urgent need to understand ways to overcome resistance to KRAS inhibitors and increase their clinical efficacy. Citation Format: Samrat T. Kundu, David H. Peng, B. Leticia Rodriguez, Eileen L. McCarthy, Don L. Gibbons. Identifying resistant mechanisms to direct KRAS inhibitors in NSCLC [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 1940.

Abstract 1217: Defining the anti-tumor activity and immune effects of the RASMULTI(ON) inhibitor RMC-7977 in preclinical models of NRAS-mutant melanoma

Abstract Introduction: Mutations in the small GTPase NRAS are the second most common oncogenic driver in cutaneous melanoma, being found in ~25% of cases. Targeted therapy strategies are currently lacking for NRAS-mutant melanoma. Here, we characterized the anti-tumor activity and immune effects of RMC-7977, a RASMULTI(ON) preclinical tool compound, representative of the investigational agent RMC-6236, in preclinical mouse and human models of NRAS-mutant melanoma. Methods: The in vitro potency of RMC-7977 was determined using mouse and human NRAS-mutant melanoma cell lines. Recovery of signaling was quantified by Western Blot and receptor tyrosine kinase (RTK) arrays. In vivo anti-tumor activity of RMC-7977 was determined in two syngeneic mouse melanoma models (SW1 NRASG13D and NRAS#5 NRASQ61R), and tumor immune infiltrate quantified using multiplexed IHC and flow cytometry. Mechanisms of resistance were defined using RNA-seq. Results: RMC-7977 had good activity in vitro against human cancer cell lines and in mouse models of NRAS-mutant melanoma. Time-course studies demonstrated RMC-7977 rapidly inhibited phospho-ERK signaling, which then began to recover after 8 hr of treatment. There was also evidence of adaptive receptor tyrosine kinase signaling by 48 hr. In syngeneic mouse models of NRAS-mutant melanoma, RMC-7977 led to a rapid inhibition of tumor growth, increased expression of tumor MHC class I and PD-L1 and an increase in CD4+ and CD8+ T cell infiltrate into tumors. Therapeutic escape was associated with decreased CD4+ and CD8+ T cell infiltration and increased numbers of immunosuppressive MDSCs. Cells collected from tumors resistant to RMC-7977 in vivo did not show any shift in sensitivity to the inhibitor when re-challenged in vitro, suggesting that the resistance observed in vivo resulted from mechanisms specific to the tumor microenvironment, for example adaptive RTK signaling or immune escape. RNA-seq and IHC analysis suggested that resistance was associated with decreased MHC expression and antigen presentation, as well as reduced co-stimulation of T cells. Combination studies of RMC-7977 with anti-PD-1 are ongoing to identify potential synergistic interactions in these preclinical models. Conclusion: RMC-7977 has anti-tumor activity in syngeneic mouse models of NRAS-mutant melanoma, associated with a robust immune response. Citation Format: Larissa A. Carvalho, Manali S. Phadke, Keiran S. M. Smalley. Defining the anti-tumor activity and immune effects of the RASMULTI(ON) inhibitor RMC-7977 in preclinical models of NRAS-mutant melanoma [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 1217.

Abstract 6857: Evolution of myeloid-mediated mechanisms of immunotherapy resistance at single-cell resolution with prostate cancer progression

Abstract Background: Patients with metastatic castration-resistant prostate cancer (mCRPC) are largely refractory to immune checkpoint inhibitors (ICIs). This resistance is, in part, attributed to the presence of immunosuppressive myeloid cells in tumors. However, attempts to target these cells broadly, such as CSF1R antagonism, have thus far failed clinically primarily due to their heterogeneous nature. Thus, we hypothesized that a more comprehensive understanding of immunosuppressive myeloid subsets and their molecular mechanisms at the single-cell level is critical to enhance the effectiveness of immunotherapy. Methods: We performed single-cell profiling of patient biopsies with either localized, metastatic hormone-sensitive prostate cancer, or mCRPC. We then reverse translated these findings in a syngeneic mouse model of CRPC, where we performed multi-omic single-cell assessment and conducted studies to assess tumor efficacy and gain mechanistic insights. Results: We identified a specific subset of tumor-associated macrophages with elevated hypoxia signatures, including higher SPP1 transcript levels (SPP1hi-TAMs). These macrophages become significantly more abundant as the disease advances, expressing elevated immunosuppressive molecular programs. Notably, CSF1R transcripts were significantly reduced in SPP1hi-TAMs, suggesting their potential role in the clinical ineffectiveness of CSF1R blockade. In a syngeneic mouse CRPC model, we identified an analogous macrophage subset through single-cell profiling and flow cytometry. These macrophages possess the ability to suppress T cell activity in co-culture. Consistent with these findings, adoptive transfer of Spp1hi-TAMs into CRPC promoted ICI resistance and worsened survival in vivo. Importantly, these macrophages proved resistant to anti-CSF1R treatment, underscoring the need to target their immunosuppressive signals as a potential therapeutic approach. Pathway analysis revealed enrichment of gene signatures associated with adenosine signaling in SPP1hi-TAMs both in patients and in mice, implicating this pathway as their immunosuppressive mechanism. Indeed, blocking adenosine signaling using antibodies or pharmacologic inhibitors resulted in a significant reduction in T cell suppression mediated by Spp1hi-TAMs in culture. Furthermore, pharmacologic blockade of adenosine receptors in vivo significantly decreased tumor growth and enhanced the responsiveness of tumor cells to ICI therapies. Conclusions: Our studies demonstrate that SPP1hi-TAMs become prevalent as the disease progresses. They are resistant to CSF1R blockade and play a key role in mediating immunotherapeutic resistance in vivo by activating adenosine signaling pathways. These findings highlight the potential of the associated signals as promising targets for therapeutic intervention. Citation Format: Aram Lyu, Zenghua Fan, Diamond Luong, Ali Setayesh, Alec Starzinski, Laura Valderrábano, Eliezer Van Allen, Lawrence Fong. Evolution of myeloid-mediated mechanisms of immunotherapy resistance at single-cell resolution with prostate 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 6857.

Abstract 1795: Tumor-targeting Salmonella A1-R selectively delivers recombinant methioninase and inhibits syngeneic-cancer mouse models

Abstract Background: Methionine addiction, termed the Hoffman effect, is a general hallmark of cancer. Methionine restriction (MR) using an MR diet or recombinant methioninase (rMETase) is effective for all types of cancer. However, methionine restriction also inhibits the activity of CD8-positive T-lymphocytes. Therefore, we hypothesized that methionine depletion in the tumor only may be more effective for cancer therapy. We previously developed Salmonella A1-R, which selectively targets and kills tumors. In the present study, we established rMETase-producing Salmonella A1-R, by transfer of the Pseudomonas putida methioninase gene, to target and inhibit syngeneic cancer mouse models. Methods: A plasmid containing the Pseudomonas putida methioninase gene was extracted from rMETase-producing E. coli and inserted into Salmonella A1-R using electroporation. The rMETase-producing Salmonella A1-R (A1-R-rMETase) infected several cancer cell lines in vitro, including HT29, PC-3, MDA-MB-435, and Lewis Lung Carcinoma (LLC). LLC was chosen for in vivo studies as it supported extensive growth of A1-R-rMETase. We determined 108 A1-R-rMETase was a safe dosage in C57BL/6 mice. LLC cells (106) were injected in male C57BL/6 mice aged 4-6 weeks subcutaneously. After tumor growth, 18 mice were divided into three groups of 6. One group was injected with phosphate-buffered saline (PBS) via the tail vein, twice per week as a control. Another group was injected with 108 Salmonella A1-R via the tail vein, twice per week. Another group was injected with 108 A1-R-rMETase via the tail vein, twice per week for two weeks. Tumor size was measured with calipers three times per week for 3 weeks. On day 22, tumor methionine level was measured using HPLC in the PBS control and the mice injected with A1-R-rMETase. Results: The mean LLC tumor size of each group on day 22 was as follows: The PBS control: 741.5 mm3; mice injected with A1-R: 566.3 mm3; and mice injected with A1-R-rMETase: 198.8 mm3. Turkey’s multiple comparisons test showed a significant difference between the PBS control and mice injected with A1-R-rMETase (p<0.0001) and between mice injected with A1-R and mice injected with A1-R-rMETase (p=0.0036). However, the PBS control and the mice injected with A1-R did not show a significant difference (p=0.1794). The mice injected with A1-R-rMETase showed a significantly lower mean methionine level than mice injected with PBS (5.9 nM/mg protein vs. 11.1 nM/mg protein, p=0.0095, Mann Whitney test). Conclusion: Tumor-targeting Salmonella A1-R modified to express the Pseudomonas putida methioninase gene (A1-R-rMETase), inhibited LLC tumor growth in a syngeneic mouse model and reduced the methionine level in the tumor. A1-R-rMETase combines the tumor targeting and killing capability of A1-R itself and restriction methionine selectively in tumors. Citation Format: Yutaro Kubota, Yusuke Aoki, Noriyuki Masaki, Koya Obara, Sei Morinaga, Kohei Mizuta, Motokazu Sato, Ming Zhao, Qinghong Han, Bouvet Michael, Takuya Tsunoda, Robert M. Hoffman. Tumor-targeting Salmonella A1-R selectively delivers recombinant methioninase and inhibits syngeneic-cancer mouse models [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 1795.

Abstract 4041: Translational assessment of triple combination with Tislelizumab (anti-PD-1), LBL-007 (anti-LAG-3) and < for Surzebiclimab (anti-TIM-3) highlights its strong anti-tumor activity and < for clinical potential in solid tumors such as HNSCC

Abstract Background: Therapeutics targeting PD-(L)1 have demonstrated impressive clinical activity in several type of cancers. However, only a small proportion of patients develop long-term response and resistance frequently occurs. LAG-3 and TIM-3 are inhibitory immune checkpoints frequently upregulated and co-expressed with PD-1 on tumor-infiltrating T cells, contributing to T cell dysfunction. Thus, we hypothesized that simultaneously targeting PD-1/LAG-3/TIM-3 would further restore T cell response and the triple combination of Tislelizumab (Tisle, anti-PD-1), LBL-007 (anti-LAG-3) and Surzebiclimab (Surze, anti-TIM-3) would provide greater clinical benefit.Methods: To evaluate the rationale and the anti-tumor activity of triple combination, LAG-3 and TIM-3 expression were analyzed in in vitro T cells, syngeneic mouse models and cancer patients with anti-PD-(L)1 therapy. The effects of dual blockade of PD-1/LAG-3, PD-1/TIM-3 and the triple blockade of PD-1/LAG-3/TIM-3 on T cell function were evaluated in in vitro activated PBMCs and the anti-tumor efficacy were evaluated in syngeneic mouse models. Relevant gene expression and immune signatures were ranked across 31 solid tumor types in TCGA.Results: Both LAG-3 and TIM-3 expression on T cells were upregulated by anti-PD-1 treatment in syngeneic mouse tumors, similar trend was observed in cancer patients with anti-PD-(L)1 therapy. Dual combination of Tisle/LBL-007 or Tisle/Surze enhanced IFNγ production in in vitro activated human T cells. The dual blockade of PD-1/LAG-3 or PD-1/TIM-3 significantly enhanced tumor growth inhibition compared with anti-PD-1 monotherapy in syngeneic mouse models. The triple combination of Tisle/LBL-007/Surze further enhanced IFNγ production in in vitro activated T cells. In a mouse MC38 colon carcinoma model, the triple blockade of PD-1/LAG-3/TIM-3 demonstrated enhanced anti-tumor activity compared with either dual combination, evidenced by trend of increased tumor growth inhibition and higher tumor-free incidence rate. Finally, the responsiveness of PD-1/LAG-3/TIM-3 triple combination was predicted using 5 signatures, including early effector T cell signature, inflamed signature, LAG-3, TIM-3 and PD-L1 expression. The in silico analyses indicated strong potential in clinical utility such as squamous cell carcinoma of the head and neck (HNSCC).Conclusions: The concurrent blockade of PD-1/LAG-3/TIM-3 represents a promising strategy to enhance T cell function and anti-tumor activity. The results demonstrated the therapeutic potential of the triple combination. A Ph2 study evaluating Tisle in combination with LBL-007 and/or Surze in first-line treatment of recurrent or metastatic HNSCC (NCT05909904) is recruiting. Citation Format: Hengrui Zhu, Jinhui Zhang, Han Yan, Xiao Ding, Juan Yang, Yu Jiang, Minjuan Deng, Haoxuan Song, Fangfang Ping, Fuyun Sun, Xiaoyu Li, Lijie Zhang, Bin Jiang, Weiwei Song, Zhirong Shen, Wei Jin, Jiyuan Zhang, Yun Zhang. Translational assessment of triple combination with Tislelizumab (anti-PD-1), LBL-007 (anti-LAG-3) and < for Surzebiclimab (anti-TIM-3) highlights its strong anti-tumor activity and < for clinical potential in solid tumors such as HNSCC [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 4041.

Abstract 6653: Oncolytic virotherapy induces a long-term immune antitumoral response leading to glioma eradication

Abstract Oncolytic herpes simplex viruses (oHSVs) have shown promise as effective treatments against various cancers. Our study evaluated the efficacy of R-115, an oHSV retargeted to human Her2 (hHer2), fully virulent in its target cells and expressing murine interleukin 12 (mIL12), in a high-grade, immunocompetent murine glioma model. This model is based on orthotopically transplant of cells derived from PDGFB-induced primary gliomas in syngeneic mice, engineered to express hHer2. Our experimental design compared the impact of R-115 on gliomas where all cells expressed hHer2 against a setup where only about 50% of cells expressed hHer2. The latter aimed to replicate the heterogeneity of patient’s high-grade gliomas, where not all cells express the target molecule. Strikingly, results in terms of overall survival and tumor eradication were similar in both setups, with about a quarter of animals showing complete glioma eradication. This suggests that mIL12-armed oHSV's impact is less about direct viral-induced cell death and more about the immune response elicited by the mIL12-expressing virus. This response effectively targets cells lacking the viral-targeted protein but likely sharing other neoantigens with hHer2-positive cells. Mice cured in both experimental setups were rechallenged with purely hHer2-negative cells. Almost all did not develop gliomas, indicating a strong immune response capable of rejecting the tumor. Plasma analysis revealed that R-115-treated mice from both setups were more immunoreactive against both hHer2-positive and negative cells compared to untreated mice. Further, co-culturing long-surviving mice's splenocytes with glioma cells showed increased cell division in CD8, CD4 and CD19 populations, and elevated IFN-γ, granzyme B, and TNF-α production. These findings underscore R-115's profound anti-cancer potential, especially its capacity to elicit an immune response effective against glioma cells, irrespective of their expression of the target molecule. This outcome, coupled with the results of the rechallenge experiments, is pivotal. It suggests that in a clinical context, an interleukin-12-expressing oHSV could effectively target not only residual cells post-surgical resection but also infiltrating cells that are distant from the site of virus administration. Encouraged by these promising findings, we are currently advancing our research with a novel oHSV that expresses mIL12 and targets EGFRvIII, a mutation found exclusively in tumor cells. This is aimed at enhancing the safety and translatability of this therapeutic approach. Citation Format: Francesca Piaggio, Francesco Alessandrini, Chiara Riviera, Irene Appolloni, Davide Ceresa, Daniela Marubbi, Tatiana Gianni, Gabriella Campadelli-Fiume, Paolo Malatesta. Oncolytic virotherapy induces a long-term immune antitumoral response leading to glioma eradication [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 6653.

Abstract 6596: BRMS1 downregulation alters the tumor microenvironment and induces immunotherapy resistance in lung adenocarcinoma

Abstract Background: Lung cancer is the leading cause of cancer-related deaths globally. During cancer progression, tumor cells interact with tumor-infiltrating immune cells (TIICs) creating an immunosuppressive microenvironment. Therefore, it is essential to delineate the communication dynamics between cancer cells and TIICs to identify novel pathways for therapeutic targeting. BRMS1 is a metastasis suppressor gene that is frequently downregulated in lung adenocarcinoma (LUAD). We, and others, have shown that loss of BRMS1 results in increased distant metastatic disease. Given the strong correlation between immune suppression, metastasis, and immunotherapy resistance we sought to elucidate if BRMS1 contributes to these processes. Specifically, we hypothesized that loss of BRMS1 in LUAD cells influences the immune cell composition, shaping an immunosuppressive microenvironment and decreasing tumor response to immunotherapy. Methods: To experimentally address our hypothesis, we generated KrasG12D P53fl/fl Brms1−/− mice inducing spontaneous tumors with Ad-Cre intratracheal inoculation. RNA-seq scRNA-seq on Brms1+/+ and Brms1−/− tumors, coupled with cell type annotations using mMCP-counter and DCATS were used to identify diverse TIIC subsets. To validate our observation, we performed immunofluorescence and flow cytometry to assess the number of TIICs. To explore the impact of Brms1 loss on the efficacy of anti-PD1 immunotherapy, a syngeneic CMT167 mouse model with BRMS1KD cells implanted in the flank was treated with an anti-PD1 antibody. Results: Differential gene expression analysis of RNA-seq data revealed a reduction in CCL9, CCL24, CLEC1B, PYCARD and other proinflammatory molecules in Brms1−/− tumors. Gene ontology and GSEA highlighted a diminished immune response signature in Brms1−/- tumors. In contrast, hallmark gene sets like IFNγ response, IL6 signaling, and inflammation are highly enriched in Brms1+/+ tumors. mMCP-counter suggested a decrease in CD8+ T cells in Brms1−/- tumors. Likewise, scRNA-seq data confirmed a significant decrease in cytotoxic CD8+ T cells in the Brms1−/− mice. Immunofluorescence and flow cytometric analysis showed a reduction in cytotoxic CD8+ T cells with low proliferative potential (Ki67+) in the Brms1−/− mice. Postmortem on our syngeneic mouse tumors after a 30-day anti-PD1 antibody treatment revealed a significantly larger mean tumor size in the BRMS1KD group compared to the WT group (942.4 mm³ vs. 184 mm³; p<0.023). Immunophenotyping on these tumors using flow cytometry also demonstrated reduced cytotoxic CD8+ T cells in the KD group post-treatment. Conclusion: Our data suggest that reduced BRMS1 expression in LUAD alters CD8+ T cell composition and primary tumor response to immunotherapy. Implications of our findings underscore the potential of BRMS1 as a therapeutic target in the context of immunotherapy-resistant LUAD. Citation Format: Manendra B. Lankadasari, Yuan Liu, Brooke Mastrogiacomo, Yingjie Zhu, Elizabeth G. Dunne, Cameron N. Fick, Choudhary Harsha, Jorge S. Reis-Filho, David R. Jones. BRMS1 downregulation alters the tumor microenvironment and induces immunotherapy resistance in lung adenocarcinoma [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 6596.

Abstract 4078: WTX-712, a conditionally active IL-21 INDUKINETM molecule, induces a strong anti-tumor phenotype through a differentiated mechanism

Abstract Despite great strides seen recently in the development of immunotherapies such as immune checkpoint inhibitors (ICI), many patients do not respond or acquire resistance, highlighting a need for alternative immunotherapies. As potent immunomodulators, cytokines have been explored as treatments for cancer, but their use has been limited due to toxicity and poor pharmacokinetics (PK). One of these key cytokines, interleukin 21 (IL-21), is a pluripotent cytokine that activates anti-tumor T cell responses, induces B cell activation, and promotes generation and maintenance of germinal centers and tertiary lymphoid structures. IL-21 acts on a broader range of cells and does not induce vascular leak syndrome compared to IL-2, another common-gamma chain family member. Half-life extended IL-21 (IL-21-HLE) drives robust anti-tumor activity in several syngeneic tumor mouse models. Of particular interest, IL-21-HLE showed superior anti-tumor activity compared to IL-2-HLE in the EMT-6 and Renca models, both of which are highly resistant to anti-PD-1/PD-L1 treatment. Although IL-21-HLE and IL-2-HLE induced a similar frequency of tumor infiltrating CD8+ T cells, IL-21-HLE treatment led to higher polyfunctionality in CD8+ T cells than IL-2-HLE treatment. Of note, IL-21-HLE induced greater amounts of effector cytokines, Granzyme B and perforin, than IL-2-HLE. Transcriptomic analysis revealed that IL-21 drives upregulation of a type I IFN signature in the tumor promoting an anti-tumorigenic microenvironment. Clinical activity of IL-21 has been hampered by poor PK and adverse events at dose levels associated with signs of efficacy. To overcome these limitations Werewolf Therapeutics has developed WTX-712, an IL-21 INDUKINETM molecule, which contains wild-type human IL-21, an inactivation domain, and a half-life extension domain tethered together by protease sensitive linkers. In preclinical studies with mouse syngeneic tumor models, WTX-712 is inactive in the periphery, and wild-type IL-21 is selectively released within the tumor, resulting in anti-tumor efficacy with an expanded therapeutic window compared to IL-21-HLE. Anti-tumor efficacy was linked to expansion and activation of tumor infiltrating CD8 T cells with increased polyfunctionality. We will show additional mechanistic data evaluating the effect of WTX-712 dosing on immune populations, including tumor spatial profiling using different models. Citation Format: Jenna M. Sullivan, Pamela A. Aderhold, Heather R. Brodkin, Celesztina Nagy-Domonkos, Kyriakos Economides, Daniel J. Hicklin, Nesreen Ismail, Yuka Lewis, Cynthia Seidel-Dugan, William M. Winston, Andres Salmeron. WTX-712, a conditionally active IL-21 INDUKINETM molecule, induces a strong anti-tumor phenotype through a differentiated mechanism [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 4078.

Abstract 489: Unlocking immune resistance and metastasis of PDAC via dual acting circularized nanodisc

Abstract Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive and deadliest forms of cancer. While major progress in immunotherapy has been made in recent years, it remains poorly effective in this malignancy. Two key players stand behind immune resistance of PDAC and inadequate efficacy of immunotherapy to suppress its metastasis. First, the immune-resistant pancreatic cancer stem cells (CSCs) evade immune surveillance acting as a source for tumor relapse and metastasis. This immune resistance stems from low immunogenicity of PDAC cells as well as the inaccessible CSCs that reside deep in the tumor core. Second, pancreatic cancer associated fibroblasts (CAFs) fuel metastasis of PDAC cells by suppressing their immune recognition and establishing pre-metastatic niche at distant organs to help their colonization. Our hypothesis is to overcome immune resistance of PDAC and inhibit early steps of its metastasis via simultaneous immunogenic eradication of immune resistant CSCs and switching immunosuppressive and pro-metastatic CAFs into quiescent ones. Therefore, we engineered ultrasmall circularized nanodiscs (cND) that encapsulate oncolytic peptide LTX-315 and fibroblast remodeling Notch signaling inhibitor. The engineered oncolytic LTX-315 loaded cND successfully induced immunogenic cell death (ICD) of both bulk PANC1 and pancreatic CSCs. Compared to non-treated and free LTX-315 treated cells, LTX-315 cND resulted in enhanced release of DAMPs including ATP and HMGB-1 as well as surface translocation of calreticulin. The ultrasmall size (9 nm) of cND enabled its deep tumor penetration to eradicate resistant CSCs, as revealed using 3D PDAC heterospheroids. In parallel, the Notch blocking cND promoted quiescence of the activated pancreatic stellate cells as denoted by downregulation of SMA, FAP and collagen. In KPC syngeneic PDAC mouse model, the dual oncolytic/Notch blocking cND combined with aPD-L1 therapy significantly suppressed tumor growth and prevented its metastasis to liver compared to vehicle-treated mice. Immunophenotyping study showed marked reduction in the abundance of CSCs and CAFs in the tumor treated with the cNDs. Moreover, the tumor infiltration of CD86+ MHCII+ dendritic cells and cytotoxic CD8+ T cells was enhanced after treatment with the cND. Overall, our dual strategy of targeting pancreatic CSCs and CAFs via oncolytic/Notch blocking cND boosted the anti-tumor and anti-metastatic efficacy of aPD-L1 therapy to eliminate primary PDAC tumor and suppress its metastasis. Citation Format: Ahmed Elzoghby, Hagar Emam, Seungbin Yim, Cuiyan Xin, Mahmoud Nasr. Unlocking immune resistance and metastasis of PDAC via dual acting circularized nanodisc [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 489.

Abstract 2459: ADT-030 is a novel dual-acting RAS/β-catenin inhibitor that potentiates antitumor immunity

Abstract ADT-030 is a novel indene identified from a screening campaign and chemically optimized for drug-like properties that acts as a dual inhibitor of RAS and β-catenin signaling. Here we demonstrate that ADT-030 binds RAS with high affinity and inhibits MAPK/AKT signaling with high potency and selectivity in KRAS mutant cells to inhibit proliferation and induce apoptosis. ADT-030 also inhibits phosphodiesterase 10A (PDE10) that is overexpressed in cancer cells to selectively activate cyclic guanosine monophosphate (cGMP)/protein kinase G (PKG) signaling, which induces phosphorylation and degradation of the oncogenic pool of β-catenin. ADT-030 exhibited cytotoxicity to a variety of murine cancer cell lines in vitro, and inhibited tumor growth in syngeneic immunocompetent mice when orally administered. The antitumor activity of ADT-030 was diminished in mice that were immunodeficient or depleted of CD8+ T cells, indicating a critical role of the host immune system. In a metastatic breast tumor mouse model (4T1), ADT-030 not only delayed the growth of the primary tumor but also reduced tumor colonization in the lungs, leading to increased survival. CyTOF and scRNAseq analyses provided a plethora of information revealing the impact of ADT-030 on the immune milieu in the tumor microenvironment. Notably, ADT-030 selectively induced apoptosis of myeloid-derived suppressor cells (MDSCs) while CD8+ T cells were not affected. Consequently, ADT-030 treatment resulted in a marked reduction of MDSCs, which was accompanied by increased tumor infiltration of effector CD8+ T cells. ADT-030 treatment of cancer cells led to immunogenic cell death and enhanced dendritic cell activation. Furthermore, the ability of ADT-030 to augment the antitumor activity of immune checkpoint blockade therapy underlines its potential as a desirable immune-potentiating agent to improve the outcome of cancer immunotherapy. ADT-030 represents a development candidate ready for IND-enabling safety assessment. Citation Format: Md Yeashin Gazi, Ogacheko Okoko, Xin Wang, Caitlin Brandle, Xi Chen, Khalda Fadlalla, Adam Keeton, Yulia Maxuitenko, Catherine Hedrick, Huidong Shi, Gary Piazza, Gang Zhou. ADT-030 is a novel dual-acting RAS/β-catenin inhibitor that potentiates antitumor immunity [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 2459.

Abstract 4059: Vitokine-2: A TIL-targeting tumor activable engineered IL-2 for cancer treatment

Abstract Background: Interleukin-2 is the first approved immune-oncology (IO) drug to treat multiple metastatic cancers with durable and curative antitumor effects. Yet, its application is restricted due to severe toxicity, short half-life, and a small fraction of response rate. To reduce toxicity and improve efficacy, we developed Vitokine-2, a tumor infiltrating lymphocyte (TIL)-targeting, tumor activable, and precision engineered IL-2 that remains inert systemically but activated in the tumor microenvironment (TME). Methods: Through protein and structure-guided precision engineering, the biological activity of IL-2 was optimized, concealed, guided to exhausted TILs, and activated at TME. The biological activity was determined by measuring proliferation (Ki67) of CD8+ T and NK cells using human peripheral blood mononuclear cells (PBMCs). Pharmacokinetics (PK), pharmacodynamics (PD), and anti-tumor efficacy were evaluated in mice, encompassing healthy and multiple syngeneic tumor mouse models. Results: Vitokine-2 was inactive in stimulating CD8+T and NK cell proliferation in vitro. Yet, its biological activity was fully restored following the cleavage and release of the concealing domain. Vitokine-2 displayed a significantly prolonged in vivo pharmacokinetic profile due to half-life extension, concealing and reduction of target sink. Administration of Vitokine-2 in mice resulted in minimal or no detectable activation, proliferation, and expansion of cytotoxic CD8+T and NK cells in the systemic circulation. However, marked CD8+ T cell proliferation and expansion with enhanced expression of granzyme B, a cytotoxic functional biomarker, was observed within the TME. The effect was specific to cytotoxic lymphocytes but not regulatory T cells. Corroborating with the expansion and enhanced functionality of CD8+ T cells in TME, robust antitumor efficacy was observed with Vitokine-2 but not with the non-activable IL-2 counterpart. Furthermore, dose-dependent tumor killing efficacy and complete eradication of tumors were demonstrated in multiple syngeneic tumor models. Vitokine-2 was found to be safe and well tolerated with minimal interferon gamma release and body weight loss even at much higher doses. Conclusion: Vitokine-2 is a TIL-targeting, tumor activable and precision engineered IL-2. It demonstrated robust anti-tumor efficacy with minimal systemic toxicity. It is safe, well tolerated, and permits high dose administration, yielding a widened therapeutic window. Vitokine-2 presents a paradigm-shifting, potentially a first-in-class, highly safe and efficacious IO therapy with an immense potential to address both IO-responsive and unresponsive patient population. Citation Format: Sreerupa V. Challa, Yao-Te Hsieh, Karen Gelinas, Andrea Umana, Wei-chun Weng, Toska Berisha, Cameron Stephens, Yuesheng Li, Jing Xu. Vitokine-2: A TIL-targeting tumor activable engineered IL-2 for cancer treatment [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 4059.

Abstract 5314: Improved breast cancer tumor control with addition of CD40 agonist and Flt3 ligand to pegylated liposomal doxorubicin is only partially mediated by CD8 T cells

Abstract Background: There is a need for improved immunotherapy strategies beyond current FDA approved treatments for triple negative breast cancer. Defective antigen presentation has been shown to play a contributory role in deficient anti-tumor immunity in breast cancers. Flt3 ligand (Flt3L) is a growth factor that increases differentiation into DC1 dendritic cells. CD40 agonist (CD40a) activates all 3 classes of antigen presenting cells - DCs, B cells, and macrophages. Synergy with chemotherapy and CD40a has been seen in other cancers but not explored in breast cancers. Methods: C57BL/6 mice (aged 6-8 weeks) were injected with 150,000 E0771 breast cancer cells within the mammary fat pad. Tumors were allowed to grow to a volume of ~50 mm3 before randomization into treatment groups. Mice were treated with triplet therapy of pegylated liposomal doxorubicin (PLD) via tail vein followed by Flt3L intraperitoneal (IP) daily for 5 days and CD40a IP 1 week later as well as monotherapy and doublet therapy controls. Tumor growth and survival were monitored throughout the experiment. Tumors were harvested for single cell RNA sequencing (scRNAseq) and immunohistochemistry. To further study subset specific effects on efficacy of the immunotherapy, CD8 and CD4 T-cells were systemically depleted with anti-CD8 and anti-CD4 antibodies administered IP every 4 days starting 2 days before PLD treatment. Results: Triplet therapy led to improved tumor control compared to no treatment, monotherapy, and doublet controls (p<0.0001). Increased tumor infiltration with CD8 T cells was observed with triplet therapy via immunohistochemistry. scRNAseq showed increased cDC1 subset with Flt3L treatment. Contrastingly, CD40a decreased DC subsets likely due to activation and emigration out of the tumor, remodeled macrophage populations, and decreased T regulatory cells. CD8 depletion led to faster tumor growth whereas CD4 depletion reduced tumor growth. Triplet therapy maintained efficacy over PLD with both CD8 and CD4 depletion but showed reduced magnitude of benefit with CD8 T cell depletion suggesting a partial CD8 mediated process. CD4 T cell depletion did not hinder triplet therapy efficacy compared to PLD but depletion further enhanced tumor control in combination with triplet therapy, with 20% (2/10) of animals achieving complete regression. Conclusion: Triplet therapy with PLD, Flt3L, and CD40a improved tumor control and survival in syngeneic E0771 breast cancer mouse model. Added benefit of immunotherapy to PLD is partially CD8 T cell mediated. CD4 depletion further enhances tumor control in combination with triplet therapy. Experiments to explore the interactive effect of triplet therapy with other pertinent immune subsets are ongoing. A clinical trial with this combination in metastatic triple negative breast cancer patients is open and recruiting (NCT05029999). Citation Format: Preteesh L. Mylabathula, Shruthi Nooka, Anas Alkhani, James Zhu, Ashley Vu, Riyasat Ali, Varshini Ramasamy Balasubramanian, Isaac Chan, Sangeetha M. Reddy. Improved breast cancer tumor control with addition of CD40 agonist and Flt3 ligand to pegylated liposomal doxorubicin is only partially mediated by CD8 T 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 5314.

Abstract 7534: Tobemstomig, a novel bispecific checkpoint inhibitory antibody to preferentially block PD-1 and LAG-3 on CD8 TILs over Tregs

Abstract Checkpoint inhibitors targeting PD-1 have shown unprecedented clinical efficacy in several cancer indications and therefore have, revolutionized the standard of care. However, despite this advancement, only ~20-30% of the patients derive durable benefit from such a treatment. One of the suggested reasons for this limited success is the expression/activation of compensatory inhibitory pathways such as LAG-3 on tumor-reactive T cells. Therefore, it is envisioned that simultaneous antagonism of PD-1 and LAG-3 receptors would overcome this adaptive resistance mechanism and allow a more profound reinvigoration of tumor-reactive T cells. LAG-3 is constitutively expressed by regulatory T cells (on Tregs) and it has been reported that its blockade increases Treg suppressive function which could potentially off-sets the benefit of blocking LAG-3 on tumor-reactive CD8 T cells.We therefore developed a 1+1 PD1-LAG3 bispecific antibody, Tobemstomig, with a unique PD-1 binder recognizing a glycoepitope and more than 20 fold higher affinity than the LAG-3 binder which recognizes a novel and differentiated binding epitope (E3). This difference in affinities allows for an avidity driven selectivity gain to PD-1 and LAG-3 double positive T cells over and the following advantages over monospecific and other bispecific aPD-1/-L1 and aLAG-3 antibodies:1.improved targeting to tumor-reactive T cells rather than Tregs due to the selectivity gain and different expression patterns of PD-1 and LAG-3 on these two T cell types, 2.reduced internalization, 3.resistance to drug-shaving by macrophages due to Fc -silencing via P329G LALA,4.increased in vitro T cell effector functions even in the presence of Tregs, 5.in-vivo targeting and expansion of CD8 TILs, including stem-like T cells, and increase in T cell effector functions and6.superior in vivo tumor control/eradication compared to combination of monospecific anti-PD1 and anti-LAG3 antibodies,in several mouse models including Panc02 in syngeneic huPD-1xhuLAG3 dtg mice and BXPC3, WSU, OCI-Ly18 and BC004 in humanized mice Tobemstomig has completed dose escalation and is currently tested in a composite proof of concept Ph2 trial in several solid tumor indications. Citation Format: Laura Codarri-Deak, Patrick Aaron Weber, Valeria Nicolini, Christian Klein, Pablo Umana, Stefan Seeber, Mario Perro, Stephane Leclair. Tobemstomig, a novel bispecific checkpoint inhibitory antibody to preferentially block PD-1 and LAG-3 on CD8 TILs over Tregs [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 7534.

Abstract 5935: Non-allosteric inhibition of enolase 1 sensitizes triple-negative breast cancer for checkpoint inhibitors

Abstract Background: Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer that commonly returns and spreads. Currently, very few options are available for TNBC treatment. Cancer cells exploit glycolytic machinery for the Warburg effect and aerobic glycolysis. Enolase 1 (ENO1) is the glycolytic enzyme expressed in most tissues, and many cancer cells have higher expression. Apart from the glycolytic role in the cytosol, ENO1 also plays different roles in cancer cells, including as a surface receptor. Method: non-allosteric chemical inhibition was developed and tested in vitro for its efficacy and target validation. Subsequently, in vivo examinations were conducted on emerging small molecules in syngeneic and patient-derived murine models of breast cancer to unveil their anti-tumor efficacy. Results: Our non-allosteric small molecule inhibitor, SU212, binds to ENO1 and restricts its movement within cells. SU212 treatment leads to the accumulation of ENO1 in the nucleus where it restrains the activity of c-Myc. The treatment causes the production of truncated ENO1 called myc promoter-binding protein 1 (MBP-1), which limits the activity of c-Myc. Stand-alone treatment of SU212 restrains the tumor progression and metastasis in orthotopic syngeneic and PDX mouse models. Combining SU212 and Anti-PD1 significantly inhibits tumor growth and metastasis in mouse models. C-Myc is linked to protein transcription that aids immune resistance and tumor evasion of immune surveillance. Suppression of c-Myc activity via SU212 treatment sensitizes the TNBC tumors for anti-PD1 therapy. Conclusions: This study provides compelling preclinical data for further development of SU0212 as an immune therapy sensitizer for the treatment of TNBC. Citation Format: Dhanir Tailor, Fernando Jose Garcia-Marques, Abel Bermudez, Wenqi Li, Arpit Dheeraj, Sharon J. Pitteri, Sanjay V. Malhotra. Non-allosteric inhibition of enolase 1 sensitizes triple-negative breast cancer for checkpoint inhibitors [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 5935.

Abstract 3085: Cholesterol sulfotransferase SULT2B1b suppresses prostate tumor growth and regulates cholesterol metabolism in prostate cancer cells

Abstract Prostate cancer (PrCa) ranks as the second leading cause of cancer death in males in the United States. The 5-year survival rate drops drastically from 100% in patients with early-stage confined PrCa to 30% in those with advanced metastatic PrCa. Patients with advanced PrCa face limited long-term treatment options, often developing resistance to androgen-deprivation therapy and chemotherapy. Identifying and targeting pivotal molecules or pathways in advanced PrCa can substantially enhance patient survival. Our previous findings unveiled an inverse relationship between cholesterol sulfotransferase SULT2B1b and the severity of human PrCa. The highest levels of SULT2B1b were observed in the epithelium of normal prostates, with a progressive decrease as cancer advanced. The lowest levels were found in the most advanced metastatic samples. This study aims to determine whether SULT2B1b performs any active and critical functions in PrCa progression and assess whether it regulates cholesterol metabolism in PrCa cells. We generated SULT2B1b knockout (KO) clones from mouse PrCa cell line MyC-CaP and established inducible SULT2B1b overexpression lines from androgen receptor (AR)+ LNCaP and AR- PC3 human PrCa cells. These modified mouse and human cells were implanted into syngeneic FVB mice and immunodeficient NRG mice, respectively. MyC-CaP KO cells formed significantly larger tumors compared to parental cells, accompanied by reduced survival rates. In contrast, both LNCaP and PC3 tumors with induced SULT2B1b exhibited smaller sizes compared to control tumors, leading to improved survival rates. To investigate the impact of SULT2B1b on cholesterol metabolism and the underlying mechanisms behind SULT2B1b-regulated tumor growth, we examined genes related to lipoprotein signaling and cholesterol metabolism in MyC-CaP SULT2B1b KO cells using PCR arrays and qRT-PCR. Genes responsible for cholesterol uptake and synthesis (e.g. Ldlr, Cyp51, Sorl1, Pcsk9 and Insig1) were among the top upregulated genes, while genes controlling cholesterol efflux (e.g. Abca1) and esterification (e.g. Soat1 and Soat2) were downregulated in KO cells. Consistent with these gene expression patterns, intracellular cholesterol levels significantly increased in KO cells. Interestingly, although SULT2B1b did not affect cell proliferation under normal conditions, KO cells exhibited faster growth than parental cells when cultured in lipid-depleted or charcoal-stripped media, possibly due to altered intracellular cholesterol levels. In summary, these findings align with the expression pattern of SULT2B1b in human PrCa, demonstrating that SULT2B1b inhibits tumor growth, whereas its removal promotes tumor growth. This suggests SULT2B1b may serve as a critical tumor suppressor in PrCa. Its modulation of tumor growth may occur through the regulation of cholesterol metabolism. Citation Format: Jiang Yang, Dilinaer Wusiman, Timothy L. Ratliff. Cholesterol sulfotransferase SULT2B1b suppresses prostate tumor growth and regulates cholesterol metabolism in prostate 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 3085.

Abstract 2921: Extended treatment with IAP inhibitor xevinapant post radiotherapy improves therapeutic efficacy and promotes antitumor immunity in preclinical models

Abstract Background: Xevinapant is a first-in-class, oral IAP (inhibitor of apoptosis protein) inhibitor designed to restore cancer cell sensitivity to apoptosis induced by radiotherapy (RT) and chemotherapy. In a randomized phase 2 study of patients with unresected locally advanced squamous cell carcinoma of the head and neck, xevinapant + chemoradiotherapy (CRT) significantly improved locoregional control at 18 months, 3-year progression-free survival and nearly doubled 5-year overall survival vs. placebo + CRT (53% vs. 28%). Two phase 3 trials, in which patients receive 6 cycles of xevinapant or placebo monotherapy (3 cycles in combination with standard-of-care (C)RT followed by 3 cycles of monotherapy), are ongoing. Based on the roles of IAPs in apoptosis and tumor immunity, continual dosing of xevinapant post RT may deliver additional therapeutic benefit through modulation of multiple tumor microenvironment (TME) compartments. Methods: The impact on antitumor efficacy of xevinapant dosing duration was evaluated in A1419 (head and neck), LLC (lung) and MC38 (colorectal) syngeneic tumor-bearing mice treated with vehicle control, RT alone (3.6Gy, QD, 5 days), or RT + xevinapant (100 mg/kg, QD, 1, 2, or 4 weeks). To assess treatment-mediated TME modulation in MC38 tumors, RNAseq and FACS-based immune profiling was performed, followed by functional validation with ex vivo ELISpot assays, in vitro immunogenic cell death assays, T cell activation assays, and macrophage polarization and viability assays. To evaluate the effect of xevinapant on RT-induced cancer associated fibroblast (CAF) activation and CAF-modulated immune phenotype, activation assay and cytokine profiling was performed. Results: In the tumor models tested, RT in combination with extended xevinapant dosing markedly improved efficacy and prolonged survival compared to treatment arms of RT with shorter xevinapant dosing durations, RT alone, and vehicle control. RNAseq and FACS analyses suggested a TME with enhanced antitumor immunity, while ELISpot and in vitro T cell assays confirmed that extended xevinapant dosing promoted antigen-specific T cell response and T cell activation. Furthermore, macrophage polarization and viability assays suggested that xevinapant reduced the viability of M2 macrophages which may have contributed to the increased M1:M2 macrophage ratio and the improved antitumor immune response observed in vivo. In addition, via the suppression of RT-mediated CAF activation, xevinapant may promote M1 polarization of macrophages and recruitment of T cells by upregulating GM-CSF and CXCL10 in CAFs. Conclusions: Extended dosing of xevinapant post concurrent RT improved antitumor efficacy and prolonged survival of tumor-bearing mice. Mechanistic investigation suggested that such benefit may be, in part, modulated by xevinapant enhanced antitumor immunity. Citation Format: Tsz-Lun Yeung, Feng Jiang, Hui Huang, Huakui Yu, Li-Ya Chiu, Mathilde Bonnemaison, Bo Marelli, Roberta Ferretti, Ralph Lindemann, Christina Esdar. Extended treatment with IAP inhibitor xevinapant post radiotherapy improves therapeutic efficacy and promotes antitumor immunity in preclinical models [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 2921.

Abstract 5735: Efficient and safe delivery of doxorubicin by DNA fragments: A full preclinical study

Abstract The clinical uses of anthracyclines (e.g., doxorubicin) are hampered especially by dose-dependent cardiac toxicity, resulting in a narrow therapeutic window. Doxorubicin formulations have marginally improved its therapeutic efficacy while suffering from difficult and costly manufacturing, poor characterization and quality control, limited scalability in production, and disappointingly low drug loading. This study employs DNA fragments extracted from the salmon sperm cells, which is known for high biocompatibility in various biomedical application, to self-assemble via intercalation by doxorubicin. DNA/DOX nanocomplexes are easy in manufacturing, high scalability, straightforward characterization and quantification, and efficiency in drug loading. Doxorubicin and DNA fragments were dissolved in water and mixed at the optimized 1:6 weight ratio, followed by stirring and incubation for 30 min. DNA/DOX nanocomplexes were characterized for doxorubicin loading and release, size, surface charge, and morphology by UV/fluorescence spectroscopy, stable isotope tracer ultrafiltration assay (SITUA), dynamic light scattering particle analysis, and transmission electron microscopy. The anticancer efficacy of the DNA/DOX nanocomplexes were tested in vitro and in vivo using syngeneic and PDX tumor models. Along with PD/PK studies, DNA/DOX nanocomplexes were also evaluated for their systemic and cardiac toxicity. Characterization and quantification studies revealed DNA/DOX nanocomplexes to be relatively monodisperse with a size of 40 nm in diameter, efficient for drug encapsulation (~100%) and drug loading (14.3%, w/w), and stable for storage while readily releasing doxorubicin in a cell. The self-assembled nanocomplexes were formed when doxorubicin inter- and intra-molecularly chelated DNA fragments. DNA/DOX nanocomplexes were more efficient in killing cancer cells in vitro than both doxorubicin and the liposomal doxorubicin Doxil. PD/PK studies demonstrated that DNA/DOX nanocomplexes circulated longer with less accumulation in the heart than doxorubicin, which altogether lower toxicity. A repeated administration of the DNA/DOX nanocomplexes to Sprague-Dawley rats exhibited a substantially lower cardiotoxicity score than that of doxorubicin. The improved anti-tumor efficacy of the DNA/DOX nanocomplexes were finally confirmed using a syngeneic lymphoma mouse model and PDX mouse models of triple-negative breast and ovarian cancers. Complexing doxorubicin with DNA fragments addresses the current technological challenges in achieving an efficient and safe therapy for a broad range of cancers. DNA/DOX nanocomplexes are amenable to rigorous chemistry, manufacturing, and controls (CMC) evaluation with proven anti-cancer efficacy and improved safety profiles. Clinical trials on DNA/DOX nanocomplexes for cancer chemotherapy are warranted to fully validate their clinical utilities. Citation Format: Minhyeong Park, Youngwoo Kim, Hyunchu Cho, Saad Mohammad, Yeon Su Choi, Hyunjoo Lee, Seonah Lee, Edward Cedrone, Barry Neun, Maria Dobrovolskaia, David Fruman, Juwan Kim, Young Jik Kwon. Efficient and safe delivery of doxorubicin by DNA fragments: A full preclinical study [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 5735.

Abstract 4484: Discovery of a potential first-in-class Za targeted small molecule inhibitor of ADAR1 p150 which demonstrates strong anti-tumor efficacy

Abstract Background: Adenosine deaminase, RNA specific (ADAR1), catalyzes the hydrolytic deamination of adenosine (A) to inosine (I) in double-stranded (ds) RNAs. ADAR1 has two isoforms: p110 in the nucleus and p150 in the cytoplasm. Both isoforms alter the coding and non-coding sections of self-dsRNA. The ADAR1 p150 isoform is expressed from an interferon (IFN)-response promoter and has a Z-DNA/Z-RNA binding domain at the N-terminus. ADAR1 has been implicated in promoting cell survival and resistance to immune response in several cancer types like multiple myeloma, breast, lung, liver, and skin cancer. Inhibition of ADAR1 p150 has the potential to enhance anti-tumor efficacy as monotherapy and in combination with other therapeutic modalities. The Zα domain of ADAR1 p150 provides exclusivity to p150 compared to the other isoforms. Herein, we outline the discovery of a potential first-in-class Zα targeted ADAR1 p150 inhibitor and degrader for cancer immunotherapy. Methods: AVA-ADR-001 was identified through a high throughput p110 knockout cell-based assay. The ability of AVA-ADR-001 to induce interferons was confirmed in various cell lines. The anti-tumor efficacy of AVA-ADR-001 was evaluated in B16F10 syngeneic melanoma mice model as monotherapy and in combination with anti-PD-1. PROTAC AVA-ADR-703 was used to demonstrate selective degradation of the ADAR1 p150 protein. Results: We have discovered AVA-ADR-001, a novel small molecule inhibitor of ADAR1 which significantly increases the IFN response in vitro in an MDA5-dependent manner. In vitro binding studies confirm that AVA-ADR-001 binds to the Zα domain of ADAR1 with low nM potency. AVA-ADR-001 demonstrates anti-tumor efficacy 1.5X superior to anti-PD1 ICB non-responsive tumor models. In addition, the AVA-ADR-001 monotherapy and combination groups showed a significant upregulation of numerous interferon-stimulated genes, including IFIH1, IFN-β, and CXCL-10. Finally, targeted protein degradation of ADAR1 p150 while sparing ADAR1 p110 was confirmed when cells were treated with AVA-ADR-703 with nM DC50, the PROTAC variant of AVA-ADR-001. Conclusions: To our knowledge, AVA-ADR-001 and AVA-ADR-703 are the first selective Zα-targeted small molecule inhibitor and degrader of ADAR1 p150 respectively to be disclosed. As a powerful and targeted first-in-class ADAR1 inhibitor, AVA-ADR-001 has demonstrated a strong induction of interferon (IFN) in a number of cancer cell lines and in vivo. AVA-ADR-001 has also demonstrated strong in vivo anti-tumor efficacy as monotherapy and in combination with anti-PD1. Furthermore, AVA-ADR-703 demonstrates selective and highly efficient degradation of ADAR1 p150 while sparing ADAR1 p110. Given that ADAR1 has a pro-metastatic and immune-suppressive role, AVA-ADR-001 and AVA-ADR-703 have significant potential to emerge as strong cancer immunotherapy candidates. Citation Format: Avijit Goswami, Sandeep Goyal, Kawaljit Singh, Princy Khurana, Barnali Deb, Aditya Kulkarni. Discovery of a potential first-in-class Za targeted small molecule inhibitor of ADAR1 p150 which demonstrates strong anti-tumor efficacy [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 4484.

Abstract 5938: Development of HH044, an orally bioavailable nNOS inhibitor, for the treatment of cutaneous melanoma

Abstract Background: Human cutaneous melanoma is one of the few cancers in which the incidence rate continues to increase, and despite recent advances in immune and targeted therapies, the 5-year survival rate of metastatic disease remains low. Neuronal nitric oxide synthase (nNOS) has been identified to contribute to melanoma development, stimulating disease progression, and facilitating escape of melanoma cells from the immune response. We developed a novel small molecule, HH044, which specifically inhibits nNOS activity and reduced nitric oxide production in melanoma cells. We aim to conduct a proof-of-concept study using our nNOS inhibitor administered orally for anti-melanoma treatment. Methods: Human melanoma cell lines (A375, Sk-Mel-28, wm3211) were employed to analyze the anti-cancer activities of HH044 in vitro. An immune-competent syngeneic melanoma mouse model was used to determine the anti-tumor activity of HH044 when administered orally (50 mg/kg/day) or intraperitoneally (10 mg/kg/day) for 21 days. A pharmacokinetic study of drug levels in serum and tumor samples was conducted after a single dose given intraperitoneally or orally using LC-MS/MS analysis at different time points. Results: HH044 has high selectivity of nNOS over iNOS (340-fold) and eNOS (540-fold). The IC50 of HH044 in melanoma cell lines was 5.27 ± 3.3 μM, while iNOS inhibitor 1200W did not exhibit any cytotoxicity up to 100 μM concentration. Of note, nNOS blockade by HH044 did not result in reactivation of iNOS, and expression levels of iNOS were not changed after HH044 treatment. In vivo studies demonstrated that HH044 treatment given intraperitoneally exhibited potent anti-tumor activity and reduced tumor weight to 45% of control. When administered orally, HH044 at 50 mg/kg significantly reduced tumor growth to 61% of control and extended mice median survival from 32 days to 53 days. Pharmacokinetic analysis showed that oral administration achieved sufficient drug levels in xenograft tumors, which were well above the Ki value (0.005 μM) despite a wide range of bioavailability. The drug level peaked at 2 hours after a single dose (2.27 ± 0.666 μM in the tumor and 23.68 ± 17.43 μM in the serum). Intraperitoneal injection achieved much higher levels in serum and tumor samples, which also declined slower compared to oral gavage administration. By 24 hours, the drug levels in serum and xenograft tumors remained at 1.55 ± 0.12 μM and 1.77 ± 0.24 μM concentration, respectively. No significant systemic toxicities were observed with HH044 treatments either given via i.p. injection or orally. Further in vivo studies combining nNOS inhibitors with immune checkpoint blockade are currently underway. Conclusions: HH044, as the first-in-class nNOS inhibitor, exhibits potent anti-melanoma activity by oral administration. Developing selective nNOS inhibitors has shown to be a novel therapeutic strategy to improve melanoma treatment. Citation Format: Anika Patel, Shirley Tong, Richard B. Silverman, Sun Yang. Development of HH044, an orally bioavailable nNOS inhibitor, for the treatment of cutaneous melanoma [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 5938.