Articoli di riviste: "Sin (deity)"

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Myers, C. Mason. "Free Will and the Problem of Evil". Religious Studies 23, n. 2 (giugno 1987): 289–94. http://dx.doi.org/10.1017/s0034412500018783.

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Hume after arguing for the compatibility of liberty and necessity, a view now known as soft determinism or compatibilism, noted that it is not ‘possible to explain distinctly, how the Deity can be the mediate cause of the actions of sin and moral turpitude’. It seems that Hume is correct if the explanation must show specifically why an omnipotent and omnibenevolent deity must permit certain actions that to human reason seem to be unnecessary evils. On the other hand if such specifity is not required, the soft determinist who also happens to be a theist can argue that it is possible that the actual world is the best of all possible worlds even though the reason for any specific apparent evil cannot be known. If seemingly evil choices are free in the soft determinist's sense but determined by an omnipotent and omniscient deity, then either that deity is not omnibenevolent or that deity has determined the world to have the maximum possible goodness through including seemingly evil choices in the scheme of things. Consequently if, as the traditional theist believes, the creator is omnibenevolent as well as omnipotent and omniscient, the occurrence of seemingly evil choices are necessary for maximizing the goodness of the whole.

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Mitchell, J. Allan. "Reading God Reading “Man”: Hereditary Sin and the Narrativization of Deity in Paradise Lost , Book 3". Milton Quarterly 35, n. 2 (maggio 2001): 72–86. http://dx.doi.org/10.1111/1094-348x.00011.

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Gasparov, Igor. "Evil and Free Will: Contemporary Free-Will Defense and Classical Theism". Philosophy. Journal of the Higher School of Economics IV, n. 4 (31 dicembre 2020): 15–34. http://dx.doi.org/10.17323/2587-8719-2020-4-15-34.

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The article considers contemporary free will defences, proposed by A. Plantinga, R. Swinburne, according to which the existence of a world in which there is free will is something more valuable than the existence of a world in which there is no free will. It is shown that contemporary forms of free will defences share with atheistic arguments from evil an anthropomorphic model of God, in which God is thought as an individual among other individuals, although endowed with attributes such as omniscience and omnipotence to an excellent degree. It has also been shown that another important point of similarity between contemporary free will defences and atheistic arguments from evil is that both attempt to assess what our world would be like if created by such an individual. In contrast to atheistic arguments from evil, contemporary free will defences argue that divine omnipotence and omniscience are subject to some greater restrictions, as usually assumed, especially due to God's desire to give some of his creations the ability of free choice, which logically implies the possibility and even necessity of the existence of evil. It is demonstrated that classical theism does not share the anthropomorphic model of deity typical for many contemporary philosophers of religion. Classical theism rejects both the anthropomorphic model of deity and the unaccountability of free will to God as the supreme good. On the contrary, it assumes that free decision was initially an opportunity for the voluntary consent of man which had an innate aspiration towards God as his supreme good. Nevertheless, due to the creation of man out of nothing, this consent could not be automatic but implied forming a virtuous character, and man's transition from a state in which he was able not to sin, to a state in which he would be not able to sin.

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Bischoff, Andreas M. "Name of thrones?" Altorientalische Forschungen 45, n. 1 (1 giugno 2018): 36–41. http://dx.doi.org/10.1515/aofo-2018-0003.

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AbstractThis article deals with the etymology of the Hattic throne-goddess dḪanwaašuit and the functions of the Hattic case ending with -(V)n. Usually, this case marks a noun for the genitive case in a phrase with two nouns N1-(V)n N2. In the Hattic corpus, there are nouns ending with -(V)n without having a second noun (N2) next to it (free n-case). This paper provides examples of free n-case words with possessive meanings, e. g. takeha=un „the lion’s one“ or wur=un „the country’s (people)“. A free n-case word is a denominal noun which is comparable with a possessive noun or a nominalized adjective. It is shown that the Hattic word for throne was not ḫanwaašuit but ḫanwaašuittun „dḪanwaašuit’s (throne)“. The goddess dḪanwaašuit seems to be a tutelary deity (hattic dWaašul, fem. *dWaašuit) and her name is probably related to (d)ḫanwaašu(i)sin(u) meaning aššu- „good“.

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Widya, Dhyana, e C. Dewi Hartati. "The Meaning of The Shen Nong Da Di's (神农大帝Shen Nong Da Di) Birthday Ceremony at Ngo Kok Ong Temple Cibarusah, West Java". Sinolingua: Journal of Chinese Studies 2, n. 1 (9 gennaio 2024): 30. http://dx.doi.org/10.20961/sinolingua.v2i1.79853.

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<p>This article discusses the meaning of the tradition Shen Nong Da di’s birthday ceremony (sejit) at Ngo Kok Ong Temple, Cibarusah, West Java. Ngo Kok Ong temple put Shennong Dadi in Hokkien dialect is called Sin Long Tay Te which means Agricultural Emperor as the main deity. The research methodology and data collection techniques used are qualitative methods. Data collection by indepth interviews and participant observations. Observations and participant observation carried out during the ceremony of Shen Nong's birthday from 26 June 2019 to 29 June 2019 with a descriptive analysis design. The purpose of this research is to describe the meaning of traditions at the Shen Nong’s birthday ceremony. The results of the research show that there are various traditions during this ceremony, prayer together, mediumship such as making amulet, slashing the tongue, stamping on coals lion dance and liong performances, and the tradition of electing locu. These various traditions have religious functions, social functions and psychological functions. Apart from that, the contained meaning in this tradition is the symbolic meaning and philosophical meaning for every Chinese community.</p>

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Ismail, Ahmad Munawar, e Ismail Mohd. "Understanding and Appreciation of the Concept of Shirk according to Mathematical Theory". Islamiyyat 44, n. 1 (1 giugno 2022): 241–52. http://dx.doi.org/10.17576/islamiyyat-2022-4401-21.

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Shirk means associating any partners with Allah SWT. Tawhid clearly teaches us that Allah SWT does not share His Rububiah (Lordship) or divine attributes with anything or any partner. A clear example of shirk is idolatry or polytheism, that is worship of deity, god or anything other than Allah. Shirk is a paramount sin in Islam, the one unforgivable sin. However, this term is in the holy verses of the Qur'an that are "difficult" for humans to understand and appreciate. Usually, the interpretation of the word shirk will be given a description of its meaning and consequences to the perpetrator. The common interpretation is that whoever associates anything with Allah, then he has indeed committed a great sin. Muslims are also warned that indeed Allah SWT will not forgive the sin of shirk while Allah SWT will forgive all sins other than shirk, for whom he wills. In effect, all doors of paradise are shut to those who commit shirk. This article is related to the debate on shirk and its significance according to Islamic law and mathematical measurements. The analysis and findings of the study in this article are obtained through the methods of content analysis, document analysis and vectors concept in mathematics. The vectors concept in mathematics has been chosen as a tool to decipher this term to the maximum extent possible. It was chosen because a vector has elastic properties, is easy to set up and is representative of the matter relating to shirk. Therefore, it can be used to explain the definition, interpretation and consequences of shirk. The results of the study show that shirk is not only placed in the category of major sins in Islamic law but also the position of the perpetrators of shirk is considered as insulting Allah SWT and the religion of Islam. This position can not only be assessed from the Islamic law viewpoint but also through mathematical measurements, formulas and arguments. Through mathematical measurements it is impossible for us to assign partners to Allah, except by those who are very stubborn and intend to insult Allah. In this paper, the arguments are given based on mathematical knowledge that indeed human beings should not commit shirk not only because of its consequences, but also because it involves Allah as the Creator of all creatures as well as all other creation.

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Sholahudin, Shofwan. "Zahirah al-Du’a al-Musytarak baina al-Mutadayyinin bi Indonesia: Nazrah min Manzur al-Islam". Journal of Comparative Study of Religions 3, n. 02 (19 maggio 2024): 89–111. http://dx.doi.org/10.21111/jcsr.v3i02.10499.

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This article examines the practice of interfaith prayers and Islamic perspective of it. The phenomenon of interfaith prayers in Indonesia is a result of the widespread understanding of religious pluralism propagated by liberals in this country. After a deeper examination using critical analysis, it is found that such prayers cannot be justified and are not acceptable to sound reason and true faith. Each religious community participating in joint prayers has their own diverse concepts of God, and each of them has their distinct ways to depict their deity and specific methods of expressing their prayers. Hence, it is highly improbable to reconcile these differences within a single religious ritual that is attended by various diverse religious communities. Interfaith prayers are a part of religious pluralism, as in these prayers, participants are compelled to believe in the legitimacy of prayers from other religious communities, indirectly validating the gods of different religions, despite their varying understanding of the divine. This contradicts the teachings of Islam and the Islamic creed. Islam firmly believes that truth lies solely in Islam, the teachings brought by Prophet Muhammad (peace be upon him) as the seal and completion of the teachings of all the prophets and messengers before him. Therefore, there is no salvation except through Islam, and believing in the truth of other religions amounts to believing in their gods, which is considered a grave sin of polytheism (shirk).

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Lumingkewas, Marthin Steven, Antonius Missa e Andreas Bayu Krisdiantoro. "GOLDEN CALF NARRATIVE: Deuteronomist Ideology of Jeroboam Reformation". MAHABBAH: Journal of Religion and Education 3, n. 1 (19 febbraio 2022): 67–81. http://dx.doi.org/10.47135/mahabbah.v3i1.24.

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Jeroboam 1st is depicted as the prototype for all future evil kings, who are regularly accused According to the books of Kings. Jeroboam accused of established two sanctuaries; Bethel and Dan to rival the temple of Solomon in Jerusalem. These shrines then provoke vehement censure and sin of Jeroboam become paradigmatic of northern apostasy. Underlying the negative depiction of Jeroboam’s cult, however, scholars have found subtle details suggesting that Jeroboam’s cult was traditional and even Yahwistic in nature. His calves may be best understood as familiar Canaanite vehicles for the invisible deity enthroned above them – in this case, Yahweh – comparable to the cherubim in southern cult of Judah. Jeroboam priesthood likely included Levites. And his choices of Dan and Bethel, too, apparently reflected a sensitivity to honor venerable memories of pre-monarchic era. This research aims to explain what Jeroboam did was not a violation of the Yahwistic system of Israel at that time. The establishment of God in Bethel and Dan did not disconcert the status of Yahweh in the treasures of Israel, instead of a form of a political assertion that separated Israel from the arrogance and the power of Judah. By using the method of analyzing historical criticism and literacy, the result is a new perspective of understanding Jeroboam’s reform in Israel - merely a political movement alone. Jeroboam never removed Yahweh from the treasury as the god of Israel. Instead, he retained Yahweh as God who was declared to have led Israel out of Egypt.

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Weisberger, A. M. "Depravity, Divine Responsibility and Moral Evil: A Critique of a New Free Will Defence". Religious Studies 31, n. 3 (settembre 1995): 375–90. http://dx.doi.org/10.1017/s0034412500023726.

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One of the most vexing problems in the philosophy of religion is the existence of moral evil in light of an omnipotent and wholly good deity. A popular mode of diffusing the argument from evil lies in the appeal to free will. Traditionally it is argued that there is a strong connection, even a necessary one, between the ability to exercise free will and the occurrence of wrong-doing. Transworld depravity, as characterized by Alvin Plantinga, is a concept which has gone far to explain this relationship. Essentially, the notion of transworld depravity involves the claim that in any world where a person is significantly free that person would, on some occasion, act morally wrongly, or as Plantinga phrases it: ‘If S' were actual, P would go wrong with respect to A’ (where S' is a possible world, P is a person and A is an action). Not only, Plantinga claims, is it possible that there are persons who suffer from transworld depravity, but ‘it is possible that everybody suffers from it’. If transworld depravity obtains, Plantinga notes, God ‘might have been able to create worlds in which moral evil is very considerably outweighed by moral good; but it was not within His power to create worlds containing moral good but no moral evil – and this despite the fact that He is omnipotent’. On this view, God could not instantiate perfect-person essences who would not ever sin. Although Plantinga argues that these instantiated beings are significantly free in that they could have done otherwise (i.e. not sinned), it does seem that his claim about transworld depravity amounts to a claim about transworld depravity amounts to a claim about the existence of a necessary connection obtaining between freedom and evil. For even though it makes sense to claim that an individual may have unactualized dispositions, to claim that everyone, past, present and future, has unactualized dispositions seems to be a significantly different claim. It is therefore difficult to see how this latter claim differs in substance from the claim of a necessary connection obtaining between the capacity for free will and the commission of evil acts.

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HUANG, Jiaofeng. "The Normal Standards and the Three Standards: Examining the New Situation of Mohist Religious Thought". Asia-Pacific Journal of Humanities and Social Sciences 3, n. 3 (15 settembre 2023): 035–45. http://dx.doi.org/10.53789/j.1653-0465.2023.0303.005.

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The chapter titled “Fa Yi” within the book Mozi delves into the religious doctrines of the Mohist belief in a higher deity, serving as the bedrock of legitimacy for the Mohist religion. In addition, the empirical principle of “San Biao,” found scattered throughout various chapters of Mozi, forms the basis for evaluating the effectiveness and utility of Mohist judgments and arguments, thus contributing to the establishment of Mohist religious thought. However, in the past, the religious significance of “Fa Yi” and “San Biao” has often been overlooked, leading to regrettable omissions. This article aims to rectify this by highlighting these two components as vital elements of Mohist religious thought.

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Drout, Michael D. C., e Caiden Kumar. "Aid from the Elf-Ruler: Line 1314a and the Pre-Christian Antecedents of Beowulf". Studies in Philology 121, n. 2 (marzo 2024): 209–35. http://dx.doi.org/10.1353/sip.2024.a923964.

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Abstract: Line 1314b of Beowulf is regularly emended to “alwalda” (Ruler of All) from the manuscript form “alf walda” (Ruler of Elves). But the other instances of “alwalda” in Beowulf do not have visible space between the l and the w , and no plausible motivation for the addition of an f and a space has been proposed if the exemplar read “alwalda.” We contend, therefore, that MS “alf walda” is correct, and that the compound refers to the pre-Christian deity Yngvi-Freyr (to use the more familiar Norse name) rather than to the Christian God. We note that in the same passage in which “alf walda” appears, the Danes are called the “Ingwine” (friends/followers of Ing) and that later in the poem Hrothgar’s daughter is named “Freawaru” (watchful care of Freyr). Connecting this material with archaeological finds at Gamle Lejre that indicate the sacrifice of pigs (Freyr’s sacred animal), the place name Hleiðra (“the place of the tent”), and the statement in line 175 that the Danes made sacrifices “æt hærgtrafum” (at the pagan tabernacles), we argue that “alf walda” is part of a larger pattern of connections between the Danes in Beowulf and pre-Christian Germanic practices that appear to have been understood by one of Beowulf’ s sources (and perhaps by the Beowulf -poet) but which were opaque to later scribes.

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Jordan, Nané. "Goddess Puja in California: Embodying Contemplation Through Women’s Spirituality Education". Contemplative Practice, Education, and Socio-Political Transformation (Part Two) 21, n. 1 (21 settembre 2020): 13–25. http://dx.doi.org/10.7202/1071571ar.

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This essay conveys an embodied, relational view of contemplative practice in education through my experience of a “Goddess puja.” I undertook this puja with two other women in the context of exploring and documenting the experiences of seven faculty and student alumni, myself included, within a Women’s Spirituality Master of Arts (WSMA) degree program located in the San Francisco Bay area. I highlight a holistic, ritual scope for considering “contemplative practices,” by engaging an embodied view of contemplative practice based from Women’s Spirituality education. The practice of Goddess puja or worship is a devotional, contemplative ritual offering of flowers and substances made to the deity in order to receive her blessing. The practice of supplicating Goddess impacts my work in midwifery and my lived philosophy, where ritual contemplation evokes further learning and inquiry about the nature of birth and birth-giving.

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Subba, Nawa Raj. "Tungdunge Mundhum Establishes a Link Between the Sen and the Samba Dynasties". IAR Journal of Humanities and Social Science 3, n. 01 (28 febbraio 2022): 1–10. http://dx.doi.org/10.47310/iarjhss.2022.v03i01.001.

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Mundhum is knowledge. Kirat's Mundhum is comparable to the Hindu Vedas. Some even consider it folklore. The culture of Kirat was formed by combining Mundhum's wisdom and philosophy with faith. Tungdunge Mundhum is the story of Kirat Samba's ancestral relationship, empowerment, and travel details. Tungdunge used to be their ancestral deity to be worshipped every three years. Kirat Limbu is an indigenous group living in Eastern Nepal, India, Bhutan, and abroad. Different surnames identify them, and one of them is Samba Phyang. The study attempted to examine facts to connect the epic and genealogy. This research investigated the historical, archaeological, and biological context. King Kokaha-Baraha used to be considered a god in history and genealogy. Tungdunge was the youngest son of King Kokaha-Baraha in Koshi Baraha region. He belonged to the Sen dynasty. His journey described in the myth began from Koshi-Baraha to the Mewa Khola in the 17th century. In the Socio-biological approach, the gene directs the path to kinship. He had travelled to Mewa Khola searching for his brother, and Samba welcomed him. This Mundhum attests to the Sen and Samba families' ties. It was a historical case of Eastern Nepal similar to the socio-biological model explained. The Shreng and Samba lineages arose from the Sen dynasty, according to history and mundhum. As a result, the Sen dynasty is the forefather of Samba families, including Phyang.

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Burley, Mikel. "Reproaching the Divine: Poetic Theologies of Protest as a Resource for Expanding the Philosophy of Religion". Journal of the American Academy of Religion 89, n. 4 (1 dicembre 2021): 1229–55. http://dx.doi.org/10.1093/jaarel/lfab101.

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Abstract Engaging with works of poetry is one effective, yet hitherto underdeveloped, means of diversifying the philosophy of religion beyond the standard preoccupations with narrow formulations of theism. This article explores and exemplifies this potential in relation to two major poetic figures, namely R. S. Thomas and Rāmprasād Sen. Despite their locations in very different religious contexts—Anglican Christianity in twentieth-century Wales, in the one case, and Hindu Goddess devotion in eighteenth-century Bengal, in the other—each of these poets voices sentiments that are redolent of a theology (or thealogy) of protest. Such protest is exhibited not in an outright rejection of the divine but in a troubled relationship through which the deity is questioned, reproached, and sometimes railed against. Attending to such materials affords the philosophy of religion, and the study of religion more broadly, an enriched appreciation of the possibilities both of religious viewpoints and of conceptions of divinity.

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Schaafsma, Polly. "Sandals as Icons: Representations in Ancestral Pueblo Rock Art and Effigies in Stone and Wood". Arts 5, n. 4 (7 ottobre 2016): 7. http://dx.doi.org/10.3390/arts5040007.

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Dating the late 1000s to the mid-1200s CE, petroglyphs of sandal images are among others that distinguish ancient Pueblo rock art in the San Juan and Little Colorado River drainages on the Colorado Plateau from Ancestral Pueblo rock art elsewhere across the Southwest. The sandal “track” also has counterparts as effigies in stone and wood often found in ceremonial contexts in Pueblo sites. These representations reflect the sandal styles of the times, both plain in contour and the jog-toed variety, the latter characterized by a projection where the little toe is positioned. These representations are both plain and patterned, as are their material sandal counterparts. Their significance as symbolic icons is their dominant aspect, and a ritual meaning is implicit. As a component of a symbol system that was radically altered after 1300 CE, however, there is no ethnographic information that provides clues as to the sandal icon’s meaning. While there is no significant pattern of its associations with other symbolic content in the petroglyph panels, in some western San Juan sites cases a relationship to the hunt can be inferred. It is suggested that the track itself could refer to a deity, a mythological hero, or the carver ’s social identity. In conclusion, however, no clear meaning of the images themselves is forthcoming, and further research beckons.

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Чандра, Л. "Deep Sand God". Iskusstvo Evrazii [The Art of Eurasia], n. 3(30) (30 settembre 2023): 264–67. http://dx.doi.org/10.46748/arteuras.2023.03.018.

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Статья посвящена иконографии Бога глубоких песков, гневного буддийского божества, защищавшего, согласно легенде, монаха Сюань-цзана в его путешествии по Центральной и Южной Азии. Приводятся изображения и тексты из Китайской Трипитаки, японского иконографического собрания «Дзёбодай сю» (Эйбан, 1094 г.), трактатов «Цзу-Энь чуань», «Сингон-миккё-зуин-сю», «Тан Сань-цзан чи», «Тем-бу-гё-дзо», «Дзузо-сё» (Ёгэн), «Бессон-закки» и «Сёсон-дзузо» (Синкаку), «Сикасё-дзузо» и «Асаба-сё» (Сёдзё), свитка Дайго-дзи, коллекции Какудзена, сведения из других источников. Перевод статьи Локеша Чандры из «Словаря буддийской иконографии» выполнен С.М. Белокуровой. The article is devoted to the iconography of the God of Deep Sands, an angry Buddhist deity who, according to legend, protected the monk Hüan-tsang on his journey through Central and South Asia. The article presents images and texts from the Chinese Tripitaka, Japanese iconographic collection Jōbodai shū (by Eiban, 1094), treatises Tz’u-en chuan, Shingon-mikkyō-zu-in-shū, T’ang San-tsang chi, Tem-bu-gyō-zō, Zuzō-shō (by Yōgen), Besson-zakki and Shoson-zuzō (by Shinkaku), Shika-shō-zuzō and Asaba-shō (by Shōchō), scroll of Daigo-ji, collection of Kakuzen, and data from other sources. Translation of an article by Lokesh Chandra from the Dictionary of Buddhist Iconography by S.M. Belokurova.

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COMPAINS SILVA, Eneko. "Venezuela: el debate sobre la legitimidad constitucional de la convocatoria a la Asamblea Nacional Constituyente realizada por el presidente Nicolás Maduro el 1 de mayo de 2017". RVAP 111, n. 111 (30 agosto 2018): 249–69. http://dx.doi.org/10.47623/ivap-rvap.111.2018.07.

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LABURPENA: 2017ko maiatzaren 1ean, herria pairatzen ari zen krisi ekonomiko eta politiko larria ikusita, Venezuelako Bolibartar Errepublikako presidenteak, Nicolás Maduro Morosek, Batzar Nazional Konstituziogilea deitu zuen, Konstituzioaren 347. eta 348. artikuluen babespean. Deialdiak, ordea, eztabaida handia ekarri zuen doktrinaren alorrean, ordura arte defendatu egin baitzuen halako deialdiak herriak baino ezin dituela egin, erreferendum baten bidez. Lan honek helburu du eztabaida juridiko aberats horretan dauden jarrerak aztertzea eta presidenteak egindako deialdiaren konstituzio-zilegitasunari buruzko ondorioak lantzea. RESUMEN: El pasado día 1 de mayo de 2017, ante la situación de grave crisis política y económica que vivía el país, el Presidente de la República Bolivariana de Venezuela, Nicolás Maduro Moros, convocó una Asamblea Nacional Constituyente al amparo de los artículos 347 y 348 de la Constitución. La convocatoria, sin embargo, generó una fuerte polémica en la doctrina, que ha venido defendiendo de forma mayoritaria que tal convocatoria sólo la puede hacer el pueblo vía referéndum. El presente trabajo pretende analizar las distintas posiciones en este rico debate jurídico y obtener conclusiones sobre la legitimidad constitucional de la convocatoria presidencial. ABSTRACT: On May 1, 2017, due to the deep political and economic crisis in the country, the President of the Bolivarian Republic of Venezuela, Nicolás Maduro Moros, convened a National Constituent Assembly under articles 347 and 348 of the Constitution. The call, however, generated a strong controversy in the doctrine which has generally been advocating for that call to be only made by the people by means of a referendum. This present work aims to analyze the different positions in this rich legal debate and to allow conclusions on the constitutional legitimacy of the presidential call.

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Tian, Xiaobing, e Wafik S. El-Deiry. "Abstract 3334: Combined treatment with PG3 and Nelfinavir induced synergistic apoptosis though sustained activation of integrated stress response". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 3334. http://dx.doi.org/10.1158/1538-7445.am2024-3334.

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Abstract Integrated stress response (ISR) activation has been linked to many human diseases, including cancer and neurological diseases. The ISR controls protein synthesis and proteostasis. ISR main effector ATF4 transcriptional factor regulates the balance between survival and cell death. Under acute ISR, ATF4 promotes cell adaptation and survival. Sustained ISR leads to ATF4-mediated apoptosis. In many cancers, mutations or overexpression of oncogenes, results in enhanced cell proliferation and increased protein synthesis, which activate the ISR. Therefore, protein translation is reduced to maintain proteostasis. In other words, many cancers are primed by the ISR. Therefore, additional push by small molecule ISR-inducers will disrupt the balance and force cancer cells to enter apoptosis. Nelfinavir activates ATF4 through inhibition of eIF2α specific phosphatases CReP and GADD34. PG3 upregulates ATF4 through the HRI/eIF2α/ATF4 pathway. We hypothesize that combined treatment of PG3 and Nelfinavir will sustain upregulation of ATF4, and lead to ATF4-mediated cell apoptosis. Cell viability assays indicated that the combined treatment potently and synergistically inhibited cell viability in colorectal cancer cell lines HT29, SW480 and HCT116 p53−/−, osteosarcoma cell line U2OS and breast cancer cell lines MCF7 and T47D. The combined treatment sustained the induction of ATF4 and enhanced the expression of its proapoptotic target genes, CHOP and PUMA, and cell apoptosis. We confirmed that the enhanced induction of ATF4, CHOP and PUMA is through the ISR because ISRIB (ISR inhibitor) blocked the combined treatment-induced upregulation of ATF4, CHOP and PUMA. Citation Format: Xiaobing Tian, Wafik S. El-Deiry. Combined treatment with PG3 and Nelfinavir induced synergistic apoptosis though sustained activation of integrated stress response [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 3334.

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Tummala, Tej, Ashley S. Sevilla Uruchurtu, Nicholas R. Liguori, E. Abbas, Christopher G. Azzoli e Wafik S. El-Deiry. "Abstract 4550: Synergistic combinations of lurbinectedin with ONC212 in pancreatic cancer". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 4550. http://dx.doi.org/10.1158/1538-7445.am2024-4550.

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Abstract Pancreatic cancer is a devastating disease with a poor five-year survival rate of approximately 12%. Given the poor prognosis of the disease, there is urgent need for novel therapeutic regimens. Lurbinectedin is chemotherapeutic compound that stalls and degrades RNA Polymerase II after binding to guanine-rich sequences in the minor groove of DNA. This stalls transcription machinery and leads to single- and double- stranded breaks in DNA and subsequent apoptosis. Our group recently described lurbinectedin’s potency as both a single agent and combinatorial agent with irinotecan and 5-fluorouracil in pancreatic cancer cell lines. We also recently discovered a synergistic interaction between lurbinectedin and ONC201/TIC10, a novel compound that induces the TRAIL apoptotic pathway, in small cell lung cancer cell lines. Synergy was accompanied by an activation of p-Chk1 and the integrated stress response. We now demonstrate a synergistic combination of lurbinectedin and ONC212, an imipridone and chemical derivative of ONC201, results in highly efficient killing of pancreatic tumor cells at sub-nanomolar concentrations of lurbinectedin and sub-micromolar concentrations of ONC212. We hypothesize that the integrated stress response underlies lurbinectedin and ONC212 synergy. We further hypothesize a combination of lurbinectedin and ONC212 will sensitize the tumor cells to CD8+ T-cell killing, which will be examined via co-culture assays. Our results are developing insights into a novel combinatorial therapeutic regimen while investigating the molecular mechanisms underlying synergism. Citation Format: Tej Tummala, Ashley S. Sevilla Uruchurtu, Nicholas R. Liguori, E. Abbas, Christopher G. Azzoli, Wafik S. El-Deiry. Synergistic combinations of lurbinectedin with ONC212 in pancreatic cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4550.

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Uruchurtu, Ashley Sanchez Sevilla, Tyler Roady, Agenxnie Anderson e Wafik S. El-Deiry. "Abstract 3191: Chk1/2 inhibition enhances response to lurbinectedin treatment in small cell lung cancer". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 3191. http://dx.doi.org/10.1158/1538-7445.am2024-3191.

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Abstract Small cell lung cancer (SCLC) remains a significant clinical concern, with only a 7% 5 year survival rate; therefore, there remains an unmet need for efficacious treatments. Lurbinectedin was FDA approved in 2019 to treat platinum-resistant SCLC. Preliminary experiments in SCLC cell lines indicated an increase in intracellular pChk1 when treated with lurbinectedin. Based on these data and our understanding of the role of checkpoint kinases in the DNA damage response (DDR), we hypothesize that the activity of Chk1 is indicative of upregulated DDR activity as a result of double stranded breaks and replicative stress induced by lurbinectedin. In subsequent experiments, we sought to identify the role of Chk1 and Chk2 in the tumor cell response to lurbinectedin by inhibiting their activity using prexasertib (LY2606368, Acrivon Therapeutics). Cell viability experiments indicate decreased tumor cell viability when three SCLC cell lines (H1048, H1105, H1417) are treated with prexasertib as a single agent and in combination with lurbinectedin. Western blot analysis of intracellular proteins from the same SCLC cell lines treated with both drugs demonstrate dose-dependent effects on cell death marker cPARP, DNA damage marker γH2AX, and DDR/cell cycle pathway kinases cdk1 and 2. Ongoing experiments seek to replicate results using alternative Chk1/2 inhibitors, and to explore the effect of lurbinectedin-Chk1/2 inhibitor combination treatment on antitumor immune effector function by in vitro co-culture. Citation Format: Ashley Sanchez Sevilla Uruchurtu, Tyler Roady, Agenxnie Anderson, Wafik S. El-Deiry. Chk1/2 inhibition enhances response to lurbinectedin treatment in small cell lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3191.

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Xia, Yutong Linda, Leiqing Zhang, Maryam Ghandali, Maximilian P. Schwermann e Wafik El-Deiry. "Abstract 5559: The anti-tumor efficacy and immune effects of combining of ceralasertib, an oral ATR kinase inhibitor, with imipridones, in prostate cancer treatment in vitro and in vivo". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 5559. http://dx.doi.org/10.1158/1538-7445.am2024-5559.

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Abstract Prostate cancer is the most common cancer and the second leading cause of cancer death among men in the United States. There is an estimated 10% to 50% of cases progress to metastatic castration resistant prostate cancer (mCRPC) state within 3 years of diagnosis. mCPRC remains lethal despite therapeutic advances. There is approximately 20% of mCRPC patients present somatic DNA damage repair (DDR) gene mutations. Ceralasertib, formerly known as AZD6738, is a potent and selective orally bioavailable inhibitor of the ataxia tenlangiectasia and Rad3-related (ATR) kinase, which is involved in DNA repair in response to DNA damage and replication stress. Preclinical studies have demonstrated ATRi sensitizing alterations in DNA damage response (DDR) genes. Ceralasertib’s antitumor activity as a monotherapy in treating prostate cancer is moderate. Thus, we combined ceralasertib with imipridones (ONC201 and ONC206), which target mitochondrial caseinolytic protease P (ClpP) and the integrated stress response, resulting in enhanced antitumor efficacy in vitro. Prior data have demonstrated sensitivity of 4 prostate cancer lines to ceralasertib and imipridones monotherapies, synergistic activities with the combination treatments, and immune enhancement effects with the combination treatments when co-cultured with NK92MI cell line. We proceeded to a short term in-vivo study validating the combination treatment efficacy. Preliminary results include cytokine profiling using the Luminex 200 technology to understand treatment induced changes in the tumor microenvironment (TME) from both in vitro and in vivo studies. Our results guide novel clinical trials for effective clinical responses in mCPRC patients. Citation Format: Yutong Linda Xia, Leiqing Zhang, Maryam Ghandali, Maximilian P. Schwermann, Wafik El-Deiry. The anti-tumor efficacy and immune effects of combining of ceralasertib, an oral ATR kinase inhibitor, with imipridones, in prostate cancer treatment in vitro and in vivo [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 5559.

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Srinivasan, Praveen R., Arielle J. De La Cruz, Maximilian Pinho-Schwermann, Andrew George, William J. MacDonald, Shengliang Zhang e Wafik S. El-Deiry. "Abstract 672: Small molecule NSC59984 stimulates mitochondria-dependent ferroptosis and overcomes integrated stress response pro-survival signaling in pre-clinical pancreatic and colorectal cancer models". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 672. http://dx.doi.org/10.1158/1538-7445.am2024-672.

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Abstract Pancreatic and colorectal cancer are leading causes of cancer deaths worldwide. Resistance to current therapeutics is a significant challenge in treating these cancers. Ferroptosis, a non-apoptotic iron-dependent form of cell death characterized by overwhelming lipid peroxidation, has emerged as a potential strategy to overcome drug resistance. Our lab previously identified the small-molecule NSC59984 as a p53 pathway restoring compound that induces reactive oxygen species, requires p73, and targets mutant p53 for ubiquitin-mediated proteolysis involving MDM2 and HSP90. In pre-clinical models of pancreatic and colorectal cancer, we now show that the small-molecule NSC59984 induces lipid peroxidation and causes reactive oxygen species-dependent apoptosis as monotherapy. However, when combined with ferroptosis inducers or cystine deprivation, NSC59984 potently induces ferroptosis in a mitochondrial complex III-dependent manner. Using CRISPR/Cas9 in pancreatic cancer cells, we further show that HRI, an EIF2-alpha kinase responsible for the cellular response to mitochondrial stress, induces the integrated stress response (ISR) upon treatment with NSC59984 or ferroptosis inducers. The ISR serves as a mechanism for resistance to cell death induced by NSC59984 or ferroptosis inducers, causing upregulation of key anti-oxidative stress and anti-ferroptosis proteins, including the cystine importer SLC7A11 and the GPX4-stabilizing protein HSPA5/BIP/GRP78. The combination therapy overcomes the ISR to induce potent cell death. Our work demonstrates the importance of the interplay between mitochondria and the ISR during ferroptosis induction in pancreatic and colorectal cancer cells. Citation Format: Praveen R. Srinivasan, Arielle J. De La Cruz, Maximilian Pinho-Schwermann, Andrew George, William J. MacDonald, Shengliang Zhang, Wafik S. El-Deiry. Small molecule NSC59984 stimulates mitochondria-dependent ferroptosis and overcomes integrated stress response pro-survival signaling in pre-clinical pancreatic and colorectal cancer 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 672.

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Zhao, Shuai, Lanlan Zhou, Shengliang Zhang e Wafik S. El-Deiry. "Abstract 376: Targeting the convergence on HIF-1α of CDK4/6 and MAPK pathway: Implications for enhanced anticancer strategies". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 376. http://dx.doi.org/10.1158/1538-7445.am2024-376.

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Abstract Hypoxia-inducible factor 1-alpha (HIF-1α) plays a pivotal role in orchestrating cellular responses to hypoxia, influencing cancer cell survival and progression. Our previous work identified a non-canonical mechanism wherein Smurf2 mediates HIF-1α degradation under CDK4/6 inhibition. Through proteomic analysis, we discovered that serine 451 phosphorylation occurs on HIF-1α but not in palbociclib-treated samples. Point mutations at this site, substituting serine with alanine, resulted in decreased HIF-1α levels and enhanced interaction with Smurf2. Intriguingly, under palbociclib treatment, we observed phosphorylation at the serine 643 site. This site has been previously associated with MAPK-dependent regulation of HIF-1α localization and activity (Ilias Mylonis, et al., 2006), particularly relevant given the reported MAPK reliance in acquired CDK4/6 inhibitor-resistant scenarios (Renée de Leeuw, et al., 2018). To explore therapeutic implications, we investigated the impact of combined CDK4/6 (palbociclib) and MEK1/2 inhibition (trametinib, selumetinib, PD98059, U0126). Dual inhibition robustly reduced HIF-1α expression in colorectal cancer cells (HCT116, SW480) and suppressed HIF-1α activity in luciferase reporter assays. This effect extended to synergistic inhibition of cell viability under both normoxia and hypoxia in HCT116 and SW480 cells. Such effect is also applicable to other cancer types and cell lines (e.g. U251). In summary, our findings unveil a phosphorylation site on HIF-1α associated with CDK4/6 activity, influencing its protein stabilization. This discovery supports the rationale for combining CDK4/6 and MEK1/2 inhibition as a promising strategy in the treatment of solid tumors. Citation Format: Shuai Zhao, Lanlan Zhou, Shengliang Zhang, Wafik S. El-Deiry. Targeting the convergence on HIF-1α of CDK4/6 and MAPK pathway: Implications for enhanced anticancer strategies [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 376.

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Purcell, Connor, Praveen Srinivasan, Maximilian Pinho-Schwermann, William MacDonald, Elizabeth C. Ding, Vida Tajiknia e Wafik El-Deiry. "Abstract 7228: In-vitro efficacy of Dordaviprone/GSK126 combination therapy on castration resistant and neuroendocrine prostate cancer". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 7228. http://dx.doi.org/10.1158/1538-7445.am2024-7228.

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Abstract Neuroendocrine prostate cancer (NEPC) is an aggressive histologic subtype associated with poor prognosis that commonly arises in later stages as a mechanism of treatment resistance. Activation of oncogenic drivers, in combination with epigenetic changes (such as EZH2 overexpression and DNA methylation) further promotes tumor proliferation and expression of downstream neuroendocrine lineage pathways (in part controlled by transcription factors, including SOX2, ASCL1, and BRN2). Importantly, EZH2 inhibitors (EZH2i) can restore AR expression in CRPC (Ku et al., 2017). Imipridones, including Dordaviprone (ONC201), show promise in treating neuroendocrine tumors by interacting with DRD2 and CLpP (Anderson et al., 2022). These results warrant investigation into the potential for synergism in imipridone/EZH2i combination therapies. In the PCa cell lines LNCap, PC3, 22Rv1, and DU145 the combination of ONC201 and EZH2i GSK126 was assessed. Cell viability data after treatment with ONC201 and GSK126 reveals several dose ranges with potential synergistic activity after 72h. Preliminary western blots after 72 hours of GSK126 treatment indicate modulation of proteins relevant to the mechanism of action of imipridones, specifically DR5 and CLpP, in LNCap, PC3, and 22Rv1. Notably, the decrease in DR5 expression warrants investigation into the effects of EZH2i on TRAIL sensitivity and whether imipridones may rescue DR5 expression to maintain TRAIL sensitivity. Subsequent experiments will investigate dosing and time point-based effects on viability and protein expression, in addition to assessing the synergy of other imipridones and EZH2i’s. Further, while the cell lines PC3, 22Rv1, and DU145 are castration-resistant, the neuroendocrine prostate cell line NCI-H660 will be used as a positive control as it expresses higher neuroendocrine features, including DRD2. Additionally, the modulation in DR5 expression warrants inquiry into the effects of combination therapy on tumor-immune cell interactions. Further, we will manipulate the expression of neuroendocrine transcription factors to assess changes in therapy sensitivity. Citation Format: Connor Purcell, Praveen Srinivasan, Maximilian Pinho-Schwermann, William MacDonald, Elizabeth C. Ding, Vida Tajiknia, Wafik El-Deiry. In-vitro efficacy of Dordaviprone/GSK126 combination therapy on castration resistant and neuroendocrine prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7228.

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Roady, Tyler J., Nolan Stubbs, Josephine Chen, Yutong Xia, Ashley Sanchez Sevilla Uruchurtu, Xiaobing Tian, Lanlan Zhou e Wafik S. El-Deiry. "Abstract 3173: Impact of hypoxia on the integrated stress response activated by imipridones ONC201 and ONC206 in pediatric diffuse midline glioma cells". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 3173. http://dx.doi.org/10.1158/1538-7445.am2024-3173.

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Abstract Diffuse midline gliomas (DMGs) are highly aggressive, high-grade gliomas which typically arise in children and young adults. With currently approved treatments the median survival from time of diagnosis for pediatric DMG is 8-10 months with only 10% of children living to 2 years post diagnosis. Despite being only 15% of the cases it makes up 40% of the pediatric brain cancer deaths making it the leading cause of death for all pediatric glioma cases. Two recent clinical studies, NCT03416530 and NCT03134131, have shown the clinical efficacy of Dordaviprone (ONC201/TIC10) for the treatment of DMG; increasing median survival to 22 months in patients following radiation treatment prior to recurrence. Imipridone ONC206, a chemical derivative of ONC201, is under clinical development for treatment of pediatric and adult patients with primary brain tumors (NCT04732065 and NCT04541082). To further improve treatment, we must continue to study how the tumor microenvironment impacts the efficacy of imipridones. One crucial aspect of all brain cancers is hypoxia, so the IC50s of the SU-DIGP-25, SU-DIPG-XIII and SU-DIPGIV pediatric DMG cell lines treated with ONC201 or ONC206 were measured using the CellTiter-Glo assay under conditions of hypoxia and normoxia. Imipridones mediate apoptosis through the upregulation of the TRAIL death receptor DR5 and the activation of the integrated stress response (ISR), so western blots were used to show changes in the ISR protein expression in ONC201 treated DMG cells at multiple different degrees of hypoxia. To understand how hypoxia inducible factors (HIFs) play a role in resistance and susceptibility to ONC201 or ONC206, HIF-1a, HIF-2a, and HIF-3a were knocked down showing altered ISR protein expression after treating with the imipridones under hypoxic and normoxic conditions. Citation Format: Tyler J. Roady, Nolan Stubbs, Josephine Chen, Yutong Xia, Ashley Sanchez Sevilla Uruchurtu, Xiaobing Tian, Lanlan Zhou, Wafik S. El-Deiry. Impact of hypoxia on the integrated stress response activated by imipridones ONC201 and ONC206 in pediatric diffuse midline glioma 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 3173.

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Ghandali, Maryam, Praveen Srinivasan, Yutong Xia, Eric T. Wong, Robert W. Sobol, Lanlan zhou, Benedito A. Carneiro, Stephanie L. Graff e Wafik S. El-Deiry. "Abstract 7591: Tumor Treating Fields (TTFields) show efficacy in Triple-Negative breast cancer (TNBC) cells alone and in combination with PARP inhibitor Talazoparib". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 7591. http://dx.doi.org/10.1158/1538-7445.am2024-7591.

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Abstract Breast cancer is the most common cancer in women worldwide, and the fifth leading cause of cancer-related deaths globally. Triple-negative breast cancer (TNBC), the most aggressive form of breast cancer, is usually treated with surgery, chemotherapy, and radiation. Tumor Treating Fields therapy are FDA-approved for the treatment of glioblastoma (GBM) and malignant pleural mesothelioma (MPM).TT Fields use alternating electric fields to inhibit tumor growth through mitotic disruption, cellular damage, integrated stress response activation, and immune mechanisms and inhibit cell proliferation, induce cell death, and cause cell cycle arrest.TT Fields can induce BRCAness and when combined with PARP inhibition, this combination may result in synthetic lethality. We explored the effect of TTFields on two TNBC cell lines MDA-MB436 (BRCA1-mutant, p53-null) and MDA-MB468 (BRCA1 wild-type, p53-mutant) treated with TTFields (150 kHz) for 24 hours. Western blot analysis showed elevation of p21 independent of p53 mutational status. We examined the combination of PARP inhibitor (Talazoparib) with TTFields in MDA-MB468 cells to determine the effect of the combination in BRCA wild-type cancer cells. Western blot analysis showed p21 upregulation after 24 hours in combination without an increase in p53. p21 acts as a G1-checkpoint protein and loss of p21 expression has been observed in a high percentage of human breast cancer cells. Our results suggest a rational and potentially effective therapy that could be further developed and used for the treatment of breast cancer. Our ongoing studies are exploring potential mechanisms of synergy between PARP inhibitor Talazoparib and TTFields using various TNBC models, and the effect of the combination on cell cycle arrest in cell culture and in vivo. Citation Format: Maryam Ghandali, Praveen Srinivasan, Yutong Xia, Eric T. Wong, Robert W. Sobol, Lanlan zhou, Benedito A. Carneiro, Stephanie L. Graff, Wafik S. El-Deiry. Tumor Treating Fields (TTFields) show efficacy in Triple-Negative breast cancer (TNBC) cells alone and in combination with PARP inhibitor Talazoparib [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 7591.

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Zhou, Lanlan, Leiqing Zhang, Jun Zhang, Shengliang Zhang e Wafik S. El-Deiry. "Abstract 3331: Preclinical combination of ONC206 with radiotherapy and temozolomide in a GBM mouse orthotopic model". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 3331. http://dx.doi.org/10.1158/1538-7445.am2024-3331.

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Abstract Glioblastoma multiforme (GBM) is the most common form of primary malignant brain tumor in adults. It is also the most aggressive and lethal. Standard of care therapy comprises maximal safe surgical resection followed by adjuvant alkylating agent temozolomide (TMZ) and radiotherapy (RT). There have only been five drugs and one device ever approved by the FDA for the treatment of GBM. The five-year survival rate for GBM patients has shown no notable improvement in the last three decades. We previously reported that the first-in-class imipridone small-molecule Dordaviprone (ONC201) decreases protein chaperone ClpX to unleash mitochondrial protease ClpP activity, integrated stress response and cell death. Preclinical combination of ONC201 (100 mg/kg weekly) with radiotherapy and Temozolomide in a GBM mouse orthotopic model results in reduced tumor burden and prolonged survival. The second generation imipridone ONC206 also activates integrated stress response and decreases ClpX in GBM cells but ONC206 is approximately 20 times more potent than its parent imipridone ONC201. ONC206 0.08 uM in combination with 12.5 uM TMZ and 2 Gy RT reduced the cell viability of GBM cells significantly compared to all single treatments and double treatments. During a short-term treatment of a GBM mouse orthotopic model, ONC206 (50 mg/kg weekly, half of ONC201 doses) synergizes with TMZ and RT to induce more tumor cell apoptosis and inhibits more tumor cell proliferation compared to other groups with single or double treatments. There are two ongoing clinical trials with ONC206: single weekly or multiple-day weekly dose regimens of single-agent, oral ONC206 in patients with recurrent, primary central nervous system (CNS) neoplasms (NCT04541082) and ONC206 alone or in combination with radiation therapy in treating patients with diffuse midline gliomas that is newly diagnosed or has come back (recurrent) or other recurrent primary malignant CNS tumors (NCT04732065). Future studies evaluating the role of immune function, mitochondrial metabolism, dopamine receptors, the ISR and TRAIL pathway in the synergistic effect would support further development of the triple combination regimen of ONC206, TMZ and radiation therapy for GBM clinical trial. Citation Format: Lanlan Zhou, Leiqing Zhang, Jun Zhang, Shengliang Zhang, Wafik S. El-Deiry. Preclinical combination of ONC206 with radiotherapy and temozolomide in a GBM mouse orthotopic model [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 3331.

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Srinivasan, Praveen R., Andrew George, Charissa Chou, Maximilian Pinho-Schwermann, Maryam Ghandali, Vida Tajiknia, Yaara Porat et al. "Abstract 587: Tumor treating fields induce the integrated stress response, alter the transcriptional signatures of cellular metabolism, and modulate immune-related cytokines dependent and independent of p53". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 587. http://dx.doi.org/10.1158/1538-7445.am2024-587.

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Abstract Tumor treating fields (TTFields) are an FDA-approved therapy for the treatment of glioblastoma and pleural mesothelioma. TTFields employ alternating electric fields delivered by cutaneous transducer arrays to induce cytostatic and cytotoxic effects on solid tumors. Additionally, recent studies suggest that TTFields may enhance anti-tumor immunity. We performed RNA-seq and multiplexed cytokine profiling in HCT116 wild-type and HCT116 p53-/- human colorectal cancer cells to elucidate TTFields’ effects on the transcriptome and secretome. TTFields lead to profound changes in the transcriptome related to metabolism, including downregulation of transcripts coding for multiple enzymes involved in the Krebs cycle, fatty acid synthesis, and glycolysis. Furthermore, though only HCT116 p53-wild type cells strongly induced the p53 pathway, both cell types’ transcriptomes showed strong downregulation of cell cycle progression. Our cytokine data showed that key tumor-promoting cytokine IL-8 was downregulated independently of p53. We identified upregulation of immunomodulatory cytokines MIF and MICB independently of p53. While MICB promotes NK cell activation, MIF drives tumor progression. Therefore, MICB may be one way in which TTFields enhance anti-tumor immunity; targeting MIF during TTFields treatment may lead to synergy by abolishing its pro-tumor effects. We also identified a p53-dependent decrease in the TRAIL decoy receptor DcR3, which normally protects tumor cells from TRAIL-induced apoptosis. Further mechanistic work showed that TTFields induce EIF2-alpha phosphorylation, the central protein involved in activating the integrated stress response (ISR), across multiple cancer types, leading to suppression of global protein translation. TTFields treatment also resulted in increased expression of surface calreticulin, an endoplasmic reticulum stress marker, which activates the ISR. Future mechanistic work will explore the impact of identified cytokines and the ISR on anti-tumor immunity both in vitro and in vivo, as well as metabolic alterations induced by TTFields. This work identifies potential biomarkers and rationales for therapeutic combinations exploiting TTFields-induced molecular alterations. Citation Format: Praveen R. Srinivasan, Andrew George, Charissa Chou, Maximilian Pinho-Schwermann, Maryam Ghandali, Vida Tajiknia, Yaara Porat, Moshe Giladi, Andrea Armstead, Alper Uzun, Eric T. Wong, Wafik S. El-Deiry. Tumor treating fields induce the integrated stress response, alter the transcriptional signatures of cellular metabolism, and modulate immune-related cytokines dependent and independent of p53 [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 587.

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Tajiknia, Vida, Praveen Srinivasan, Maximilian PInho-Schwermann, William MacDonald, Connor Purcell e Wafik El-Deiry. "Abstract 2093: Co-treatment with KRAS G12D inhibitor MRTX1133 plus TTFields against human pancreatic and Colorectal cancer cell lines results in synergistic up-regulation of cleaved PARP in KRAS G12D & unexpectedly in KRAS G12V as well". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 2093. http://dx.doi.org/10.1158/1538-7445.am2024-2093.

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Abstract Background: Both colorectal and pancreatic cancers are major global health issues and among deadliest cancers with great disease burden. The most commonly mutated oncogenic alteration in human cancers is KRAS, which is prevalent in pancreatic malignancies. The KRAS G12D mutation subtype is present in more than 40% of pancreatic ductal adenocarcinoma (PDAC). To this date there is no available targeted therapy options for patients with KRAS subtype mutations. MRTX1133 has been identified as a non-covalent, potent, and selective inhibitor of KRASG12D. This small molecule inhibitor has been shown to suppress KRASG12D signaling in cells and in vivo. Tumor Treating Fields (TTFields) therapy is a novel approach to treating cancer, the electric fields alter the behavior of cancer cells and prevent them from growing and dividing. We hypothesize that the co-application of MRTX1133 with TTFields will enhance the effects of MRTX1133 in PDAC and colorectal cancer (CRC). Martials and Methods: PDAC cell line CFPAC1 with KRAS G12 V mutation and LS513 CRC cell line with KRAS G12D Mutation were treated with same dose of MRTX1133 (500 nM) and were co-treated with 150kHz TTFields. After 48 hours western blot was used to probe for cleaved PARP, cleaved C3, phosphor-ERK and DUSP6. Results: In both KRAS G12D & KRAS G12V cell lines, synergistic upregulation of cPARP was observed following 48-hour co-treatment. Synergistic inhibition of pERK happened in KRAS G12D cell line but no change in pERK level following TTFields or MRTX1133 treatment was seen. Upregulation of cC3 in KRAS G12D happened in only co-treatment conditions. DUSP6 levels increased following MRTX1133 treatment in KRAS G12V cell line. Conclusions: The surprising synergistic upregulation of cPARP in both KRAS G12V and G12D cells following co-treatment of KRAS G12D inhibitor MRTX1133 and TTFields can bring hope for other KRAS mutation subtypes as well as G12D. the increase in cPARP in KRAS G12V with no effect on pERK is particularly interesting and demonstrates the need of more studies to investigate the mechanisms of this synergy. Citation Format: Vida Tajiknia, Praveen Srinivasan, Maximilian PInho-Schwermann, William MacDonald, Connor Purcell, Wafik El-Deiry. Co-treatment with KRAS G12D inhibitor MRTX1133 plus TTFields against human pancreatic and Colorectal cancer cell lines results in synergistic up-regulation of cleaved PARP in KRAS G12D & unexpectedly in KRAS G12V as well [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 2093.

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Zhang, Shengliang, Lanlan Zhou, Leiqing Zhang, Maximilian Pinho-Schwermann, Benedito Carneiro, John Sedivy e Wafik S. El-Deiry. "Abstract 5941: Small molecule NSC59984 synergizes with PARP inhibitors in BRCA1 wild type ovarian cancer". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 5941. http://dx.doi.org/10.1158/1538-7445.am2024-5941.

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Abstract PARP inhibitors (PARPi) targeting poly (ADP-ribose) polymerase are the first clinically approved drugs designed to apply synthetic lethality in BRCA1 mutant/deficient cancer. However, the treatment can cause reversion of BRCA mutation which results in drug resistance. To explore new strategies to improve antitumor efficacy of PARPi, we applied PARPi in combination with a small molecule NSC59984 for cancer therapy. NSC59984 is a small molecular targeting mutant p53 degradation and activating p73 via ROS-ERK2-MDM2 pathway. The treatments with radiation or hydrogen peroxide showed that NSC59984 enhanced DNA comet tails and gamma-H2AX, correlated to reduction of rad51 foci in cancer cells. These results suggest that NSC59984 impairs DNA damage repair via abrogation of homologous recombination (HR). We further applied the combinational treatment of NSC59984 and PARPi in BRCA1 wild-type ovarian cancer cells and found that NSC59984 synergized with PARPi to reduce cell viability, inhibit colony formation, and increase cell death. The combination treatment enhanced DNA damage and correlated with reduction of BRCA1 at the protein level. These results, taken together, suggest that the induction of BRCAness causes a synthetical lethality with PARPi in BRCA1 wild-type cancer cells. Cell cycle profiling showed that the cells were arrested at the G2/M phase in response to combinational treatment. At the G2 phase arrest, the high doses of the combinational drugs led to cell death via mitotic catastrophe, and the intermediate doses induced cellular senescence defined by senescence phenotypic hallmarks including senescence-associated beta-gal staining and a secretome consistent with senescence-associated secretory phenotype (SASP). Therapy-induced senescence (TIS) in cancer cells is considered as one of the mechanisms of tumor recurrence and drug resistance. To reduce the risk of TIS in treatment, we applied senolytic treatment to target senescent cells in the combinational treatment. The senolytic drug ABT263 treatment eliminated the senescent cancer cells from the combinational treatment. ABT263, NSC59984 + PARPi combinational treatment further reduced cell viability. Our study provides a rationale for small molecular compounds targeting HR deficiency in combination with PARPi to treat BRCA1wild-type ovarian cancer cells, and additional senolytic treatment may be required to limit resistance by removal of the TIS. Citation Format: Shengliang Zhang, Lanlan Zhou, Leiqing Zhang, Maximilian Pinho-Schwermann, Benedito Carneiro, John Sedivy, Wafik S. El-Deiry. Small molecule NSC59984 synergizes with PARP inhibitors in BRCA1 wild type ovarian cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5941.

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Weiskittel, Taylor, Kelsey Huntington, Leiqing Zhang, Austin Koukol, Benedito A. Carneiro, Hu Li, Andrey Ugolkov, Wafik El-Deiry e Andrew Mazar. "Abstract 6426: Identification of potential immune biomarkers for GSK-3 inhibitor elraglusib (9-ING-41) in patients with relapsed/refractory metastatic cancer". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 6426. http://dx.doi.org/10.1158/1538-7445.am2024-6426.

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Abstract Cytokines mediate strong immunomodulatory effects in cancer. Elraglusib (9-ING-41), an inhibitor of GSK-3, is a potent antitumor and immune-modulatory agent in phase 2 clinical trials for the treatment of various cancers. Here, we examined the immune environment of elraglusib-treated cancer patients by measuring peripheral blood protein levels to explore whether the expression level of cytokines/chemokines/soluble cell receptors/growth factors (CCSG) is correlated with clinical outcome. Using a customized Luminex platform, the expression of forty CCSG hypothesized to be linked to GSK-3 activity was assessed in pre-dose plasma samples obtained from 45 cancer patients with relapsed/refractory metastatic disease (NCT03678883; the 1801 trial). All patients in the 1801 trial were treated with elraglusib (dose range: 1-15 mg/kg) either as a single agent (Part 1; n=21) or in combination with chemotherapy (Part 2; n=24). Pre-dose peripheral blood protein levels were examined as binary predictors of clinical outcome using optimal cutoff points determined by maximally selected rank statistics. In the aggregate Part 1 and 2 populations (n=45), we identified 13 CCSG that significantly stratified the cohort by overall survival (OS). High pre-dose levels of CD95 and TNFRSF10C were associated with better OS. CD95 was a better prognostic of OS than TNFRSF10C (HR: 2.27, 95% CI: 1.10-4.67, p-value: 0.023). Low pre-dose levels of 11 CCSG were also significantly associated with favorable OS, with IL-8 being the most predictive (HR: 0.137, 95% CI: 0.0545-0.346, p-value: <0.0001). Part 1 and 2 predose samples were also analyzed separately, and many of the biomarkers identified in the aggregate analysis retained significance in the separated analysis. In Part 1, CXCL5, IFN-alpha, and IL-18 emerged as unique markers, and in Part 2, CCL22 was the single unique marker.The results of our exploratory study identified several putative biomarkers of elraglusib clinical benefit and demonstrated potential immunomodulatory mechanisms of elraglusib that will be used to inform the further clinical development of elraglusib for the treatment of metastatic cancer. Citation Format: Taylor Weiskittel, Kelsey Huntington, Leiqing Zhang, Austin Koukol, Benedito A. Carneiro, Hu Li, Andrey Ugolkov, Wafik El-Deiry, Andrew Mazar. Identification of potential immune biomarkers for GSK-3 inhibitor elraglusib (9-ING-41) in patients with relapsed/refractory metastatic cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6426.

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Costeas, Christos P., Connor Purcell e Wafik S. El-Deiry. "Abstract 2918: Potential for a novel therapeutic target: Effects of lactate & lactylation in expression of key regulatory cancer proteins". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 2918. http://dx.doi.org/10.1158/1538-7445.am2024-2918.

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Abstract The purpose of our study is to investigate the immunologic, metastatic, and gene regulation effects of lactate in the context of cancer in normoxic and hypoxic conditions to identify novel biomarkers and potential therapeutic targets. We aim to modify the in-vitro cancer microenvironment to show how lactate and lactylation can be exploited using existing cancer treatments. While hyperlactatemia is defined as lactate levels between 2 mmol/L and 4 mmol/L (Foucher et al 2023), tumor biopsies have demonstrated extracellular concentrations as high as 40 mM (Pérez-Tomás et al 2020). Through CTG viability assays we identified lactate concentrations that PANC1 cells can survive, which are in agreement with the in-vivo findings of Brizel et al (2001). We observed pancreatic cancer cells achieving over 50% viability for 5 days at 50 mM lactate concentrations while at 30 mM on day 5 they proliferated past their initial plating numbers. Furthermore, Brizel et al (2001) found that patients with high tumor lactate concentrations had a significantly higher incidence of metastatic relapse. Through our scratch assay, we show qualitative evidence of increased mobility and inferred migration potential of PANC1 at 7.5mM [lactate] compared to the absence of lactate. We have also observed increased migration at higher lactate concentrations for which we are pursuing quantitative measurements to evaluate significance. Migration experiments will be followed by the investigation of gene regulation (eg. mRNA seq, lactylation profile) involved in the observed increased mobility. Lactate has been shown to affect immune regulation, namely suppression of iNKT (Fu et al, 2020), macrophages (Yang et al, 2020), dendritic cell differentiation and antigen recognition/presentation (Wang et al, 2022), however not much is known about its effect on NK cells and their cytokine expression. Through NK92MI/PANC1 cocultures we show the effects of lactate concentration on the killing ability of NK cells (in the works). And plan on investigating the cytokine profile leading to the phenotypic killing differences. Lastly, via lactate-titrated incubation of PANC1 cells in normoxia we have demonstrated a positive correlation of HIF1a expression, pan-lactyllysine lactylation, and microenvironment lactate concentration. We speculate HIF1a inhibition post-lactate-sensitization may induce cancer killing and we will investigate this theory in normoxia and hypoxia using existing treatment options. Citation Format: Christos P. Costeas, Connor Purcell, Wafik S. El-Deiry. Potential for a novel therapeutic target: Effects of lactate & lactylation in expression of key regulatory cancer proteins [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 2918.

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Chen, Josephine, Tyler J. Roady, Lanlan Zhou e Wafik S. El-Deiry. "Abstract 7226: Synergy between ONC201 and temozolomide on ATF4 integrated stress response in glioblastoma". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 7226. http://dx.doi.org/10.1158/1538-7445.am2024-7226.

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Abstract Glioblastoma multiforme (GBM) is the most common primary brain tumor in adults, with a median survival of 15 months. The standard of care involves surgical resection followed by chemoradiotherapy. Even with the full course of treatment, GBM is uncurable, and patients eventually relapse. Although temozolomide (TMZ) is the first-choice chemotherapeutic for GBM, tumor drug resistance limits the effects of the treatment. There is a growing need for new therapies with enhanced efficacy on GBM tumors. Dordaviprone (ONC201) is a TNF-related apoptosis inducing ligand (TRAIL)-inducing compound that is increasingly being studied for GBM treatment. This imipridone small molecule induces apoptosis by activating the integrated stress response, which involves transcription factors ATF4 and CHOP. Subsequently, these transcription factors upregulate proapoptotic protein TRAIL and its receptor, Death Receptor 5 (DR5). This study aims to investigate the combinatory effects of chemotherapeutics TMZ and ONC201 on GBM. Preliminary studies examined the cell viability of GBM cell line U251MG after dual treatment of 0 to 10uM of ONC201 and 0 to 200uM of TMZ using the CellTiter-Glo assay. Synergy was observed between the two drugs at higher concentrations of TMZ. This synergistic interaction was further characterized using western blots. When 0, 2, and 4uM of ONC201 were administered alone or in combination with 0, 60, and 120uM of TMZ, greater ATF4 expression was observed with the dual treatments than with the monotherapies. Subsequent western blots were conducted using three GBM cell lines (U251MG, T98G, and SNB19-GFP) at three time points (8, 24, and 48 hours). All cell lines were treated with 0 and 5uM of ONC201 alone or in combination with 0 and 200uM of TMZ. For all three cell lines, ATF4 expression increased in the combined presence of TMZ and ONC201. However, the effects of TMZ on ONC201-induced ATF4 expression were most pronounced in U251MG and least conclusive in T98G. Additionally, the time points in which this increase in ATF4 expression occurred varied among cell lines. CHOP expression was also probed and was seen to increase with the combination treatment in U251MG. These observations suggest a potential synergistic relationship between chemotherapeutics ONC201 and TMZ in the ATF4 integrated stress response pathway in GBM. By exploring the effects of this dual treatment on upstream and downstream factors in the pathway, we can identify, characterize, and potentially target the root cause of this synergy. Citation Format: Josephine Chen, Tyler J. Roady, Lanlan Zhou, Wafik S. El-Deiry. Synergy between ONC201 and temozolomide on ATF4 integrated stress response in glioblastoma [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 7226.

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Carlsen, Lindsey, Maximilian Pinho-Schwermann, Leiqing Zhang, Andrew Elliott, Kelsey E. Huntington, William J. MacDonald, Brooke Verschleiser, Laura Jinxuan Wu e Wafik S. El-Deiry. "Abstract 1189: Modulation of the MSS and MSI colorectal cancer immune microenvironment with FOLFOX and FOLFIRI -/+ anti-PD-1 immunotherapy". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 1189. http://dx.doi.org/10.1158/1538-7445.am2024-1189.

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Abstract Metastatic colorectal cancer (mCRC) is a deadly disease with a five-year survival rate of 14%. Most patients receive 5-FU (F) and folinic acid (FOL) combined with oxaliplatin (OX), irinotecan (IRI), or both (OXIRI). Immune checkpoint inhibitors (ICIs) are effective against microsatellite instable (MSI) tumors, but 95% of mCRC tumors are microsatellite stable (MSS) and ICI-resistant. Though the primary targets of 5-FU, irinotecan, and oxaliplatin are well-understood, their effects on the tumor microenvironment (TME) remain incompletely characterized. Chemotherapy-mediated immune stimulation in MSS CRC has been observed in preclinical models and clinical trials. We hypothesize that combination chemotherapy treatment modulates the immune microenvironment of CRC -/+ ICI, with differences across subtype and treatment regimen. Chemotherapy-dependent changes in cancer cell gene expression, PD-L1 levels, cytokine secretion, and T cell activation were measured using in vitro models of MSS and MSI CRC. A preliminary evaluation of spleen and tumor T cells and dendritic cells (DCs) in murine models of MSS and MSI CRC after immunotherapy -/+ chemotherapy was conducted. CD8+ T cells, DCs, PD-L1, CD69, and GM-CSF expression were measured in clinical specimens of chemotherapy-treated MSS mCRC patients. In MSS CRC, FOX increased GM-CSF and activated CD8+ T cells in vitro and activated splenic CD8+ and CD4+ T cells in vivo. FOX and FIRI suppressed an anti-PD-1-mediated enhancement of type 1 cDCs in the tumor in vivo. FOLFOX was associated with increased tumor CD8+ T cells and decreased GM-CSF in MSS mCRC biopsies. FIRI treatment increased PD-L1 in vitro. FOLFIRI was not associated with increased tumor CD8+ T cells in MSS mCRC biopsies. In MSI CRC, FOX increased tumor CD8+ T cells in vivo. Here, we elucidate novel effects of clinically relevant chemotherapy combinations on the TME in MSS and MSI CRC. These data point to a FOX-specific mechanism by which CD8+ T cell infiltration into MSS mCRC tumors is enhanced, but their activation is halted potentially by GM-CSF suppression and/or type 1 cDC depletion in the TME. These findings contribute to our understanding of the mechanisms of chemotherapy-dependent immune modulation and bring the field closer to harnessing these effects for therapeutic gain. Citation Format: Lindsey Carlsen, Maximilian Pinho-Schwermann, Leiqing Zhang, Andrew Elliott, Kelsey E. Huntington, William J. MacDonald, Brooke Verschleiser, Laura Jinxuan Wu, Wafik S. El-Deiry. Modulation of the MSS and MSI colorectal cancer immune microenvironment with FOLFOX and FOLFIRI -/+ anti-PD-1 immunotherapy [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 1189.

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Louie, Anna D., Rani Chudasama, Sharon Wu, Marzia Capelletti, Daniel Magee, W. Michael Korn, Virginia Kaklamani et al. "Abstract PD6-04: Mutational landscape and immune infiltration of breast cancer metastases to gynecologic and other organs". Cancer Research 82, n. 4_Supplement (15 febbraio 2022): PD6–04—PD6–04. http://dx.doi.org/10.1158/1538-7445.sabcs21-pd6-04.

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Abstract Introduction: Breast cancer metastases (BCM), which cause most breast cancer (BC)-associated mortality, have increased genetic complexity compared to early-stage disease. However, the contribution of genetic alterations to site of BCM is not well-understood. Different breast cancer subtypes have varying patterns of BCM, e.g., lobular carcinoma more frequently spreads to gynecologic (Gyn) organs and the GI tract, perhaps hinting at selection pressures wherein some organs are hospitable to tumors with certain genetic alterations. Methods: Relationships between BCM site and mutations detected by DNA next-generation sequencing (NGS; NextSeq 592 gene panels or NovaSeq whole exome sequencing) were investigated using 12,464 BC samples sequenced at Caris Life Sciences (sample sizes, Table 1). PD-L1 expression was tested through IHC (Clone SP-142 (cut-off ≥1, 1%)). Tumor mutational burden (TMB) was measured by totaling somatic mutations per tumor (high ≥ 10 mutations per MB). Immune cell fractions were calculated by deconvolution of whole-transcriptome data (NovaSeq) using Quantiseq (reference). Statistical significance was determined using chi-square and Wilcoxon rank sum tests adjusted for multiple comparisons. Results: Compared to primary breast tumors, BCM had increased frequency of TMB-H (10.08% vs. 4.94%), decreased PD-L1 positivity (21.09% vs. 35.82%), and were enriched for PIK3CA (34.62% vs 30.53%) and ESR1 mutations (13.34% vs 2.17%) (all P<0.001). PD-L1 positivity was highest in BCM to lymph nodes (43.06%) and axilla (39.77%). BCM to Gyn organs had more lobular histology, the highest rate of hormone receptor (HR)+ tumors (77.17%), and rarely had high TMB (6.73%) or were PD-L1 positive (11.39%). Double dendrogram hierarchical clustering of BCM site by mutation frequency and pathway alterations revealed BCM to Gyn organs as a simplicifolious clade with a unique mutational pattern. Compared to BC in breast, BCM to Gyn organs had higher rates of mutations of PIK3CA, AKT1, and BRAF; more mutations in DNA repair (0.79% vs 0.06%), transcription factor (4.72% vs 0.93%), and Wnt signaling pathways (2.36% vs 1.47%); but no increase in BRCA mutations. BCM to brain had the most p53 pathway and homologous recombination (HR) pathway mutations (64.71% and 14.01%), while Gyn had the least (19.69% and 7.09%). Quantiseq RNA deconvolution revealed differences in tumor immune cell infiltrate by BCM site. Gyn metastases vs breast tumors had increased B cells (6.20% vs 5.40%), M2 macrophages (5.71% vs 4.07%), and NK cells (3.82% vs 3.18%) (all P<0.01) and a M2/M1 macrophage ratio of 22.8:1 vs 1.3:1. Conclusions: BCM to Gyn organs have a unique mutational and immune suppression profile. Integrating the profiling with clinical outcomes may extend this prognostic signature and set the stage for improved treatment strategies for these patients. Confirmation from matched or sequential specimens could clarify tumor evolution. Our data support repeat biopsy of Gyn site metastases since more targetable mutations might be revealed. Targeting mechanisms of immunosuppression in Gyn BCM could expand therapeutic options. Table 1.Breast Cancer TumorsTumor SiteTotalPredominant Breast Cancer SubtypeAll12464HR+/HER2- (51.6%)Breast5014HR+/HER2- (46.5%)Liver2003HR+/HER2- (63.3%)Bone1132HR+/HER2- (69.4%)Axilla1051HR+/HER2- (47.7%)Lung823HR+/HER2- (46.1%)Lymph Node647HR+/HER2- (43.4%)Chest/Chest Wall375HR+/HER2- (44.8%)Brain359TNBC (38.2%)Other315HR+/HER2- (57.1%)Skin282HR+/HER2- (50.7%)Connective Tissue193HR+/HER2- (51.8%)GI Organs143HR+/HER2- (69.9%)Gynecologic Organs127HR+/HER2- (76.4%) Citation Format: Anna D Louie, Rani Chudasama, Sharon Wu, Marzia Capelletti, Daniel Magee, W. Michael Korn, Virginia Kaklamani, Antoinette R Tan, Pavani Chalasani, Wafik S El-Deiry, Don Dizon, Stephanie L. Graff. Mutational landscape and immune infiltration of breast cancer metastases to gynecologic and other organs [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr PD6-04.

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Tian, Xiaobing, Praveen Srinivasan e Wafik S. El-Deiry. "Abstract 610: ClpP-dependent and -independent activation of HRI kinase by small molecules". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 610. http://dx.doi.org/10.1158/1538-7445.am2024-610.

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Abstract HRI was initially identified as a kinase essential for maintaining heme-globin balance within red blood cells as well as for controlling the ISR in response to oxidative stress. HRI also responds to a broad range of stresses such as osmotic stress, heat shock, proteasome inhibition. The recently discovered unexpected functions of HRI include innate immunity, translational control of immune evasion in cancer by upregulating PD-L1, proteostasis, mitochondrial stress, inhibition of histone H3 lysine 27 (H3K27) demethylase (KDM6A) and iron deficiency. Importantly, recent evaluation of patient data uncovered high expression of HRI mRNA in a subset of epithelial tumors versus normal tissues. Elevated expression of HRI protein in these tumor cells lead to cell death when BIRC6 ubiquitin complex is inhibited, which mediates degradation of HRI and is required for the survival of the tumors. These further broaden the importance of this member of the eIF2α kinase family as a cancer therapeutic strategy. Dordaviprone (ONC201), an imipridone small molecule, binds to and activates mitochondrial protease ClpP leading to integrated stress response (ISR) and ATF4 transcription factor activation. PG3, a prodigiosin analog, induces ATF4 and pro-apoptotic PUMA. Our data indicate that PG3 activates ATF4 through ISR via eIF2α kinase HRI. ALAS1 (5'-aminolevulinate synthase 1) catalyzes the first rate-limiting step in heme (Iron-protoporphyrin) biosynthesis. ONC201 treatment leads to potent downregulation and inhibition of ALAS1, indicating that ONC201 inhibits heme biosynthesis. It is well known that reduced heme results in activation of the HRI kinase. We show that an inhibitor of heme biosynthesis or knockdown of ALAS1 results in HRI activation, while silencing of HRI or knockout of HRI gene potently inhibit the eIF2α phosphorylation and upregulation of ATF4, CHOP and PUMA by PG3 and imipridones. Knockdown of ClpP rescues ONC201-induced downregulation of ALAS1 which blocks ONC201-induced upregulation of CHOP. Also, silencing of ClpP significantly reduced PARP cleavage in HCT116 p53−/- and MDA-MB-468 cancer cells. Our studies identify a novel link between ClpP activation induced by ONC201 treatment and ATF4 upregulation, via the ClpP/ALAS1/HRI/ATF4 pathway. However, PG3 treatment did not lead to degradation of ALAS1, indicating that PG3 does not activate ClpP. PG3 potently induced cell apoptosis through ISR via HRI/ATF4/PUMA pathway independent of ClpP. We are further investigating the targets of PG3 and the signaling pathway that leads to PG3-induced activation of HRI. Our results suggest that different small molecule inducers of the ISR such as ONC201 and PG3 can achieve an anti-tumor effect through different pathways converging on kinase HRI ultimately leading to ATF4 activation and tumor cell death. Citation Format: Xiaobing Tian, Praveen Srinivasan, Wafik S. El-Deiry. ClpP-dependent and -independent activation of HRI kinase by small molecules [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 610.

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Holder, Sheldon L., Robert A. Winn e Wafik S. El-Deiry. "Abstract 1002: The historically black colleges and universities cancer trial consortium: A way forward to diversifying cancer clinical trials". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 1002. http://dx.doi.org/10.1158/1538-7445.am2024-1002.

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Abstract The National Comprehensive Cancer Center Network cancer guidelines state that the best management for a cancer patient is on a clinical trial. However, the demographics of 74 registration trials for oral cancer therapies from 2009 - 2019 show only 2.5% of participating patients were Black. Similarly, of the 3,593 patients enrolled in all registration trials for new cancer drugs approved by the FDA in 2019, only 4% were Black patients. A third analysis showed that between 2008 and 2018, only 3.1% of cancer trial patients were Black. The underrepresentation of Black patients in cancer clinical trials is a complex issue that requires a multifaceted solution. Complicated, interdependent causes include, but are not limited to system, provider, and patient bias. Increasing globalization of clinical trials also contributes to a widening gap in Black patient enrollment. Achieving diversity among clinical trial participants requires intention in study design regarding accrual sites and outreach, and involvement of a diverse trial workforce. The ideal clinical trial system would minimize system, provider, and patient biases. Such a system already exists in the Historically Black Colleges and Universities (HBCU) system. HBCUs represent 3% of institutions of higher education in the USA, yet they enroll 16% of Black students and confer 24% of all baccalaureate degrees earned by Black students. 40% of Black engineers, 50% of Black lawyers, 70% of Black physicians, and a staggering 80% of Black judges attended an HBCU. HBCUs are exceptional at impacting communities of Color and have been doing so for centuries. The HBCU Cancer Trials Consortium (HBCU CTC) is a network of HBCUs and Ally institutions that aims to bring innovative cancer clinical trials to historically underserved communities and honor the legacy of HBCUs, which have consistently and successfully served underserved communities for over a century. The HBCU CTC will oversee and conduct cancer clinical trials at member institutions. We envision founding flagship members to include HBCUs that provide graduate medical education and training, such as Howard, Meharry, Charles Drew, and Morehouse. Non-HBCUs committed to the mission are invited to join the consortium as Ally institutions (eg. MSIs). Membership is not exclusive of membership in other cancer consortia. The HBCU CTC will provide shared resource services for member institutions that lack expertise or funding to conduct services locally (eg. data management, DSMB, biostatistics, a cancer focused IRB, central radiology, and central pathology). The Consortium will also work to develop local infrastructure support for the conduct of cancer clinical trials at member institutions. Citation Format: Sheldon L. Holder, Robert A. Winn, Wafik S. El-Deiry. The historically black colleges and universities cancer trial consortium: A way forward to diversifying cancer clinical trials [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 1002.

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Strandberg, Jillian, Anna Louie, William MacDonald, Praveen Srinivasan, Leiqing Zhang, Lanlan Zhou, Seulki Lee e Wafik El-Deiry. "Abstract 710: Post-exposure suppression of radiation pneumonitis suggests non-redundant independent effects of TGF-beta and TRAIL/DR5". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 710. http://dx.doi.org/10.1158/1538-7445.am2024-710.

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Abstract Radiation pneumonitis is one of the most common but challenging toxicities seen in patients that are receiving ionizing radiotherapy for thoracic malignancies. While radiation effectively eliminates cancer cells, the damage it causes to surrounding healthy lung tissue leads to an immune response that can impact treatment regimen and lead to long term fibrotic tissue formation. The mechanism of radiation pneumonitis and the inflammatory response in the lungs is poorly understood. However, it is known that the TRAIL pathway plays an important role in inflammatory and fibrotic response. Through our previous work, it was discovered that modulating the TRAIL pathway via pegylated recombinant long-acting TRAIL (TLY012) in both WT and TRAIL-/- C57Bl/6 could suppress radiation pneumonitis in mice that were exposed to 20 Gy of thoracic radiation with shielding of other organs as early two weeks post exposure. In addition to the TRAIL pathway, transforming growth factor-beta (TGF-β) is a cytokine that is known to play a key role in fibrosis. Broad spectrum integrin inhibitor GLPG0187 is known to inhibit the activation of TGF-β via binding to specific integrin receptors. In order to determine if the inhibition of TGF-β could suppress radiation pneumonitis without stimulation of the TRAIL pathway, DR5 null mice were utilized for the experiment. Male DR5-/- C57Bl/6 mice received a single 20 Gy thoracic radiation dose with shielding of other organs and were treated with 100 mg/kg of GLPG-0187 or control twice a week via IP injection with the first dose being administered 1 hour before radiation (n = 4/treatment/group). 13 days post-irradiation, lungs, sternal bone marrow, and peripheral serum were collected. Upon histological analysis, it was observed that there were thinner alveolar borders and lessened inflammation compared to the control mice. Mice were weighed every three days, and it was discovered that mice treated with GLPG-0187 maintained steady weight compared to the control group. Additional analysis including immunohistochemistry, cytokine profiling, and quantification needs to be conducted. As the TRAIL pathway could not be modulated in the DR5 null mice, these findings suggest that GLPG-0187 was able to suppress radiation pneumonitis via inhibition of TGF-β. While some rescue from radiation pneumonitis was observed via GLPG0187, it was to a lesser extent compared to treatment of WT and TRAIL-/- C57Bl/6 mice with TLY012. Future directions include investigating the synergistic effects between TLY012 and GLPG0187 in suppressing radiation pneumonitis and decreasing fibrotic response to radiation. Citation Format: Jillian Strandberg, Anna Louie, William MacDonald, Praveen Srinivasan, Leiqing Zhang, Lanlan Zhou, Seulki Lee, Wafik El-Deiry. Post-exposure suppression of radiation pneumonitis suggests non-redundant independent effects of TGF-beta and TRAIL/DR5 [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 710.

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Clark, Jasmine S., Jorge Jimenez-Macias, Philippa Vaughn-Beaucaire, Shengliang Zhang, Wafik El-Deiry, Rishi Lulla e Sean Lawler. "Abstract 5110: Exploring the effects of Indirubins in pediatric diffuse high grade glioma models". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 5110. http://dx.doi.org/10.1158/1538-7445.am2024-5110.

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Abstract Diffuse midline glioma (DMG) is an invasive pediatric brain tumor which grows in the pons of the brainstem. The current course of treatment is focal radiation however, DMG continues to have a very poor prognosis with a median survival of less than 10 months. A major barrier for chemotherapeutic treatment of DMG is the blood brain barrier (BBB) which tightly controls access of molecules to the brain. This limits the efficacy of drugs to treat brain cancer and other diseases of the central nervous system. Previous studies from the Lawler lab and others have shown that the indirubin derivative, 6-bromoindirubin-3′-acetoxime(BIO-acetoxime/BIA), has anti-invasive properties and can enhance survival in glioblastoma xenograft models. Here, we investigated the effects of BIA on pediatric glioma models using a range of relevant assays. In an in vitro collagen migration assay, BIA was observed to significantly slow cell migration at a concentration of 1µM in DIPG 36 cells, over 72 hours. Furthermore, we have also shown that BIA modulates the tumor vasculature, which could limit tumor growth, and improves drug delivery to tumors by targeting tight junctions in tumor associated endothelium. The effect on BBB drug penetration was assessed in a multicellular 3D in vitro BBB model and effects of BIA on endothelial barrier functions was determined using trans-endothelial resistance assays (TEER). BIA treatment increased dextran uptake into 3D BBB models, and also lowered endothelial cell permeability in vitro via a reduction in the expression of tight junction proteins as shown by staining and a decrease in TEER values. In order to assess potential synergistic interactions, a drug screen was performed on a panel of distinct pediatric glioma cell lines (DIPG 36 and KNS42). This identified several FDA approved drugs that combine well with BIA. From this screen, BIA was shown to synergize with DNA damaging chemotherapy to enhance toxicity and in combination with cisplatin promote DNA damage in pediatric glioma cell lines. Other drugs identified in the screen are currently under investigation and details will be reported. Thus, our hypothesis is that BIA may provide an effective approach for further development as a DMG therapeutic through targeting invasion and enhancing drug potency and delivery via modulation of endothelial cell tight junctions. Interrogating the mechanisms involved and developing drug formulations informed by the drug screen for in vivo studies to determine the translational potential of this approach is our focus for future studies. Citation Format: Jasmine S. Clark, Jorge Jimenez-Macias, Philippa Vaughn-Beaucaire, Shengliang Zhang, Wafik El-Deiry, Rishi Lulla, Sean Lawler. Exploring the effects of Indirubins in pediatric diffuse high grade glioma 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 5110.

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MacDonald, William J., Praveen R. Srinivasan, Maximilian Pinho-Schwermann, Vida Tajiknia, Connor Purcell, Lindsey Carlsen e Wafik S. El-Deiry. "Abstract 5140: ITGB6 as a predictive biomarker for overall prognosis and PD-(L)1 immune checkpoint blockade response in various cancer types". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 5140. http://dx.doi.org/10.1158/1538-7445.am2024-5140.

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Abstract Our previous work studying the effects of integrin αvβ6 knockdown in cancer cells demonstrated αvβ6 as a method of T cell suppression in a co-culture model. ITGB6, the gene encoding the β6 subunit of αvβ6, is a potent prognostic marker across multiple cancer types. As a major activator of latent TGFβ, αvβ6, and consequently, ITGB6, has considerable therapeutic implications due to the immunosuppressive effect that activated TGFβ has on the tumor microenvironment. A Human Protein Atlas search of ITGB6 expression surveyed the upregulation of ITGB6 across cancer types. Cancer ITGB6 expression was then compared to expression in paired adjacent normal tissue using the TNMplot tool (Bartha, 2021) on a concatenated set of GEO, GTex, TCGA, and TARGET RNA-seq databases. Kaplan-Meier curves were generated using TCGA mRNA data through the cBio portal, splitting the cohorts according to an ITGB6 mRNA expression threshold of one standard deviation above the mean (z-score ± 1.0). ITGB6 expression and immune checkpoint blockade (ICB) response were evaluated with the Kaplan-Meier Plotter tool (Kovacs, 2023). ITGB6 expression levels between ICB responders and non-responders were quantified using the ROC Plotter tool (Fekete, 2023), and the figures were generated using Matplotlib in Python. Lung, bladder, head and neck, pancreatic, and cervical cancer all demonstrated high expression of ITGB6. Head and neck squamous cell carcinoma (median fold change 2.70, p<0.0001), bladder urothelial carcinoma (FC 2.41, p<0.001), cholangiocarcinoma (FC 5.33, p<0.01), and esophageal carcinoma (FC 2.72, p<0.03) showed strong upregulation of ITGB6 compared to normal tissue. Interestingly, lung adenocarcinoma (FC 0.77, p<0.04) and lung squamous cell carcinoma (FC 0.55, p<0.0001) showed downregulation of ITGB6 compared to normal tissue. Survival data revealed that ITGB6 was a potent marker of a poor prognosis in pancreatic adenocarcinoma (high ITGB6 median survival 16.79 mos, vs. low ITGB6 21.88 mos, p<0.004) and head and neck squamous cell carcinoma (high ITGB6 30.06 mos vs. low ITGB6 57.42 mos, p<0.03). However, no significant prognostic difference was observed in non-small cell lung cancers. Finally, high pan-cancer expression of ITGB6 led to poorer response to αPD-1 (high ITGB6 Hazard Ratio 1.37, p<0.05) and αPD-L1 (high ITGB6 HR 1.50, p<0.001). In vitro and in vivo experiments to validate the benefit of ITGB6 as a biomarker and as a therapeutic target are underway. Citation Format: William J. MacDonald, Praveen R. Srinivasan, Maximilian Pinho-Schwermann, Vida Tajiknia, Connor Purcell, Lindsey Carlsen, Wafik S. El-Deiry. ITGB6 as a predictive biomarker for overall prognosis and PD-(L)1 immune checkpoint blockade response in various cancer types [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 5140.

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MacDonald, William J., Praveen R. Srinivasan, Maximilian Pinho-Schwermann, Shengliang Zhang, Vida Tajiknia, Connor Purcell, Jillian Strandberg, Nolan Stubbs e Wafik S. El-Deiry. "Abstract 6528: Integrin ɑvβ6 upregulation as a mechanism of T-cell evasion in head and neck squamous cell carcinoma". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 6528. http://dx.doi.org/10.1158/1538-7445.am2024-6528.

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Abstract Head and neck squamous cell carcinoma (HNSCC) encompasses malignancies of the mucosal epithelium in the oral cavity, pharynx, and larynx. The lack of effective screening strategies and the typically late stage of detection are contributors to a considerable annual death toll of HNSCC. Additionally, the anatomical proximity of the malignancy to delicate structures of the head and neck leads to tremendous treatment-related morbidity. Therefore, there is great interest in developing life-saving therapies and strategies for treatment de-escalation. The immune checkpoint inhibitor pembrolizumab (αPD-1) has been approved for recurrent or metastatic HNSCC and as a frontline therapy for unresectable disease. However, only about a quarter of patients respond to αPD-1 therapy. The immunosuppressive effect of TGFβ has been widely described as relevant to the HNSCC tumor microenvironment. However, attempts to blockade TGFβ have failed mainly due to the widespread side effects of disrupting a highly promiscuous cytokine. Integrin αvβ6 is a major activator of the inert latent TGFβ into the active, immunosuppressive form. With its high relative specificity to HNSCC tissue, inhibition of αvβ6 could offer a safer approach for disrupting TGFβ to overcome resistance to immune checkpoint blockade. After screening ɑvβ6 expression levels of HNSCC cell lines via flow cytometry, cell lines FaDu and CAL27 were selected for further investigation due to high endogenous ITGB6 expression (FaDu 35.57% cells ITGB6+, CAL27 95.69% cells ITGB6+). The cell lines were transduced with a doxycycline-inducible short hairpin RNA (shRNA) knockdown of αvβ6 using a lentiviral system. Both knockdown and control shRNA cell lines were pretreated with 1 μg/mL of doxycycline for five days to induce the shRNA and subsequently co-cultured with TALL-104 T-cells. Quantitative fluorescence microscopy of the co-culture revealed that the knockdown of αvβ6 substantially increased T-cell killing over 24hrs (FaDu CTRL shRNA 6.72%±2.49 dead vs. FaDu ITGB6 shRNA 12.80%±3.16 dead, p<0.001). However, treatment of FaDu and CAL27 cell lines with active-TGFβ showed no change in PD-L1 expression via flow cytometric analysis. To determine whether the T cell evasive effect of αvβ6 is driven by other immune checkpoints on the cancer cells or by the direct effect that TGFβ has on immune cells, we show the generation of relevant mouse αvβ6 shRNA knockdown cells. These syngeneic in vivo studies will facilitate cytokine profiling to uncover the dynamics of tumor-immune cell interactions in response to αvβ6 inhibition. Citation Format: William J. MacDonald, Praveen R. Srinivasan, Maximilian Pinho-Schwermann, Shengliang Zhang, Vida Tajiknia, Connor Purcell, Jillian Strandberg, Nolan Stubbs, Wafik S. El-Deiry. Integrin ɑvβ6 upregulation as a mechanism of T-cell evasion in head and neck squamous cell carcinoma [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 6528.

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Schwermann, Maximilian, Benedito Carneiro, Shaolei Lu, Andre De Souza, Matthew Hadfield, Anthony Mega, Galina Lagos et al. "Abstract 4248: Patient-derived MTAP-deleted bladder cancer organoid model: A unique platform for drug development". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 4248. http://dx.doi.org/10.1158/1538-7445.am2024-4248.

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Abstract Introduction: Approximately 30% of advanced bladder cancer (BCa) tumors exhibit MTAP gene deletion, which has been associated with luminal subtype BCa, poor response to chemotherapy, and shorter progression to metastatic disease (De Souza 2023). MTAP deletion has been proposed as a potential biomarker for response to pemetrexed and an emerging class of PRMT5 and MAT2A inhibitors in development for MTAP-deleted tumors. Here, we describe the first patient-derived 3D model of BCa with MTAP deletion and its translational potential as a drug sensitivity platform. Methods: A patient (pt) with metastatic BCa harboring MTAP deletion underwent a pelvic lymph node biopsy. A fresh tumor sample was processed under collagenase/dispase solution for 30 minutes and filtered through a 70-um cell strainer. Cells were cultures in low attachment plates with MammoCult™ Basal Medium (Stem Cell Technologies). After 5 passages and 3D spheroid formation, immunostaining for cytokeratin (CK) 5 and 6, GATA3, CK20, and Ki67 staining were performed to confirm the urothelial origin. The MTAP-del was confirmed by a western blot of the organoid specimen and compared to other BLCa cell lines (UMUC, RT4, J82, and 5637). The viability assays were performed using the CellTiter-Glo® 3D Cell kit. Next-generation sequencing (NGS) of primary BCa tumor revealed deletion of MTAP, CDKN2A, CDKN2B, and mutations in p53, TERT, and KDM6A. Results: The patient organoid sample was positive for the luminal CK5/6 markers and negative for GATA3. Ki67 and CK20 were primarily expressed in the nucleus of the same sample. The organoid retained morphologic and immunohistochemical features of the patient’s primary bladder tumor, showing the same squamous differentiation and similar Ki-67 proliferative index. The organoid displayed no evidence of the MTAP protein by western blot (similar findings with the MTAP-del cell lines UMUC and RT4). The organoid showed sensitivity to pemetrexed [pemetrexed IC50=0.12 uM (other MTAP-del BLCa IC50: 0.1-0.23 uM)] and resistance to gemcitabine and cisplatin [Gem IC50=55 nM (other BLCa IC50: 1-29 nM), Cis IC50=90.5 uM (other BLCa IC50: 2-17 uM). Conclusions: We describe the first patient-derived MTAP-deleted BCa organoid recapitulating the features of the primary tumor. The organoid displayed sensitivity to pemetrexed as described with MTAP-deleted BCa. The organoid represents a unique platform for testing novel therapeutic strategies for MTAP-deleted BCa. Citation Format: Maximilian Schwermann, Benedito Carneiro, Shaolei Lu, Andre De Souza, Matthew Hadfield, Anthony Mega, Galina Lagos, Sari Khaleel, Dragan Golijanin, Sheldon Holder, Praveen Srinivasan, William MacDonald, Andrew George, Lanlan Zhou, Leiqing Zhang, Wafik El-Deiry. Patient-derived MTAP-deleted bladder cancer organoid model: A unique platform for drug development [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 4248.

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Tajiknia, Vida, Praveen Srinivasan, Maximilian Pinho-Schwermann, William MacDonald, Connor Purcell e Wafik El-Deiry. "Abstract 7596: (TTFields) and imipridone ONC206 co-treatment inhibits p-AKT and spheroid growth and upregulates caspase-10 in human GBM cell lines". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 7596. http://dx.doi.org/10.1158/1538-7445.am2024-7596.

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Abstract Background: Glioblastoma (GBM) is the most common primary brain malignancy with dismal prognosis. Tumor Treating Fields (TTFields) therapy is available for the treatment of both newly diagnosed and recurrent glioblastoma and represents a new category of treatment modalities in oncologic therapy. Despite decades of study, few FDA approved modalities are available for GBM and provide limited survival improvements for patients. AKT functions as a key serine/threonine kinase in the RTK/PTEN/PI3K pathway, and extensive genomic analysis of GBM has revealed that this pathway is mutated in a significant majority of GBM cases. Activation of this pathway ultimately leads to the activation of AKT, and p-AKT levels are elevated in the majority of GBM tumor samples and cell lines. Studies have shown that increased p-AKT levels contribute to uncontrolled growth, resistance to apoptosis, and enhanced invasive capabilities of glioma cells, which are characteristics of tumor progression in GBM. AKT serves as a critical hub in this pathway, enabling the amplification of growth signals, thereby making the inhibition of AKT an appealing and promising therapeutic target for treating GBM. Imipridone ONC206 is under clinical development for treatment of pediatric and adult patients with primary brain tumors (NCT04732065 and NCT04541082). Here we show inhibition of p-AKT as well as upregulation of CHOP and caspase-10 following cotreatment of ONC206 and TTFields. Materials & Methods: We investigated the effect of ONC206 (at IC50s) plus TTFields in U251 and T98G human GBM cell lines at different time points. Effect of treatment on cPARP, BCL-2, CHOP, caspase-10, and p-AKT were investigated using western blot. Neurospheres were generated using mentioned cell lines and used for investigating effect of co-treatment on 3D structure. Results: Treatment with ONC206 at the IC50 in T98G cells with TTFields at 24h showed synergistic upregulation of cPARP as well as inhibition of BCL-2. At 96hour time point, inhibition of p-AKT was observed following all treatments (ONC206, TTFields, and co-application compared to control. In U251 cells, following treatment of ONC206 and TTFields, inhibition of BCL-2 was observed at 24h time point at all treatment conditions. Upregulation of CHOP and Casapse-10 at 96h time point was seen, as well as inhibition of p-AKT. Spheroid models showed structure disruption and growth arrest following combination treatment. Conclusion: Here we showed cotreatment results in inhibition of p-AKT, the key node in GBM growth pathway. Also, the upregulation of CHOP and caspase-10 that has not been discussed before can be the key to focus on novel therapeutic targets for GBM More studies are needed to elaborate the exact mechanism of synergy but these new findings can be used to develop novel treatment combination Citation Format: Vida Tajiknia, Praveen Srinivasan, Maximilian Pinho-Schwermann, William MacDonald, Connor Purcell, Wafik El-Deiry. (TTFields) and imipridone ONC206 co-treatment inhibits p-AKT and spheroid growth and upregulates caspase-10 in human GBM cell lines [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7596.

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Sun, Grace, Alexis J. Lannigan, Jasper Chan, Maximilian Schwermann, Varun V. Prabhu, Lanlan Zhou, Wafik S. El-Deiry e Alexander Grenander Raufi. "Abstract 4604: Imipridones ONC201 and ONC212 exhibit anti-tumor activity in biliary tract cancers and synergy when combined with trametinib and olaparib in vitro". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 4604. http://dx.doi.org/10.1158/1538-7445.am2024-4604.

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Abstract Background: Biliary tract cancers (BTCs) are an aggressive group of malignancies affecting 220,000 new individuals globally each year. Despite advances in immunotherapy and targeted therapies, 5-year survival remains at 2% for those with metastatic disease. Thus, new therapies are desperately needed. The novel imipridone class of antineoplastic agents show promising activity in preclinical pancreatic ductal adenocarcinoma models; however, have not been investigated in BTC. Dordaviprone (ONC201) is a dopamine receptor D2 and mitochondrial protease ClpP modulator that induces apoptosis in cancer cells through both upregulation of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and the integrated stress response. ONC212 is a second-generation imipridone that targets orphan GPCR 132 and ClpP, leading to reduced oxidative phosphorylation from ClpX suppression. We hypothesized that the ONC201 and ONC212 would demonstrate antitumor effects in BTCs, both alone, and in combination with MEK and PARP inhibition. Methods: Two established BTC cell lines, RBE and HuCCT1, were used for these experiments. Sensitivity of RBE and HuCCT1 cells to ONC201, ONC212, MEK inhibition (trametinib), and PARP inhibition (olaparib) was assessed using CellTiter-Glo® luminescent cell viability assay. Each cell line was plated on 96-well plates and treated with ONC201 concentrations ranging from 0uM to 40uM for RBE and 0uM to 32uM for HuCCT1; ONC212 ranging from 0nM to 752nM for RBE and 0nM to 640nM for HuCCT1; trametinib ranging from 0nM to 24nM for RBE and 0nM to 16nM for HuCCT1; and olaparib ranging from 0uM to 256uM for RBE and 0uM to 124uM for HuCCT1. Results were analyzed after 72 hours of incubation. Synergy studies were conducted in both cell lines, combining each imipridone with either trametinib or olaparib, and SynergyFinder® was used to evaluate synergy. Western blotting was performed on lysates generated from treated cell lines. Results: Both ONC201 and ONC212 demonstrated antineoplastic effects in two BTC cell lines. Half maximal inhibitory concentrations (IC50) of ONC201 in RBE and HuCCT1 cell lines were 2.5uM and 2.0uM, respectively. The IC50 of ONC212 in RBE and HuCCT1 was 47nM and 39nM, respectively, which was similar to IC50s demonstrated with cytotoxic chemotherapy (gemcitabine IC50 = 7.57nM (RBE) and 9.84nM (HuCCT1)). Both lines also demonstrated sensitivity to trametinib (IC50 = 5.9nM (RBE) and 3.7nM (HCCT1)), and to a lesser extent olaparib (IC50 = 64uM (RBE) and 31uM (HuCCT1)). Although synergy was noted with several combinations, this was most striking with the combination of ONC212 and either trametinib or olaparib. Further analysis of key signal transduction pathways, including MAPK and PI3K, as well as analysis of mechanisms of cell-death through apoptosis, autophagy, ferroptosis, and necroptosis is underway Citation Format: Grace Sun, Alexis J. Lannigan, Jasper Chan, Maximilian Schwermann, Varun V. Prabhu, Lanlan Zhou, Wafik S. El-Deiry, Alexander Grenander Raufi. Imipridones ONC201 and ONC212 exhibit anti-tumor activity in biliary tract cancers and synergy when combined with trametinib and olaparib in vitro [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 4604.

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Chan, Jasper, Alexis J. Lannigan, Grace Sun, Varun V. Prabhu, Robert Edwards, Leiqing Zhang, Lanlan Zhou, Wafik S. El-Deiry e Alexander Grenander Raufi. "Abstract 2078: The imipridone ONC212 cooperates with MEK and immune checkpoint inhibition to elicit in vivo regression of KPC mouse pancreatic tumors". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 2078. http://dx.doi.org/10.1158/1538-7445.am2024-2078.

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Abstract Background: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease with limited therapeutic options. ONC212 is a second-generation imipridone with antitumor effects in human PDAC cell lines. ONC212 has been shown to bind to mitochondrial protease ClpP, suppress ClpX, and impair oxidative phosphorylation by decreasing ATP production. While ONC212 has been evaluated in immunocompromised mice xenografted with human pancreatic tumors, ONC212 has not been evaluated, either alone or in combination with MEK and/or immune checkpoint inhibition (ICI), in immunocompetent mice bearing notoriously aggressive KrasLSL.G12D/+; Tp53LSL.R172H/+; Pdx1Cretg/+ (KPC) murine PDAC tumors. We hypothesized that, like human PDAC cells, KPC cells would demonstrate sensitivity to ONC212 both in vitro and in vivo. Our group has previously shown that ONC212 synergizes with trametinib to induce tumor cell death in human PDAC cells. We therefore hypothesized that this combination, together with ICI, would enhance KPC tumor cell death in vivo. Methods: We determined in vitro sensitivity of the KPC cells to ONC212 alone and in combination with trametinib using CellTiter-Glo® luminescent cell viability assays. Results were analyzed after 72 hours of incubation using Compusyn and Combenefit. In vivo experiments involved C57BL/6 mice that were injected subcutaneously with 3 × 105 KPCy cells in 100 mL of PBS/matrigel. To determine the ideal ONC212 dose, we tested five different doses/dosing frequencies (50 mg/kg; 25 mg/kg; 12.5 mg/kg given by oral gavage weekly or twice weekly) in tumor-bearing (50-75 mm3) mice. Mouse weight and tumor size was measured every four days. Treatment was stopped once tumor volumes reached 3,000 mm3 or if ulceration occurred. Once the ideal dose of ONC212 was determined, a study treating KPC tumor-bearing C57BL/6 mice with ONC212, trametinib, and ICI (anti-PD-1 mAb) alone and all possible doublet/triplet combinations was performed using the same methods. Results: We found that the combination of ONC212 and trametinib exhibited synergy in the KPC cell line in vitro. Our in vivo experiments revealed that ONC212 controlled KPC tumor growth in a dose-dependent manner, however, toxicity was also noted at higher, more frequent doses. While both 25 mg/kg and 50 mg/kg twice weekly were equally effective, 25 mg/kg was better tolerated and determined to be the ideal dose. In the combination therapy study, all treatments resulted in tumor reduction, as compared to the vehicle control; however, the triple therapy group had the lowest average tumor size at day twenty. Toxicity was noted in mice receiving at least two treatments, reflected by reduced weights and mobility. Further analysis of the tumor immune microenvironment using multiplex cytokine and immunofluorescence are ongoing. Citation Format: Jasper Chan, Alexis J. Lannigan, Grace Sun, Varun V. Prabhu, Robert Edwards, Leiqing Zhang, Lanlan Zhou, Wafik S. El-Deiry, Alexander Grenander Raufi. The imipridone ONC212 cooperates with MEK and immune checkpoint inhibition to elicit in vivo regression of KPC mouse pancreatic tumors [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 2078.

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Ding, Elizabeth C., Maximilian Pinho-Schwermann, Shengliang Zhang, Connor Purcell e Wafik S. El-Deiry. "Abstract 3036: Sensitivity of ONC201/TIC10 cancer therapeutic on neuroendocrine prostate cancer (NEPC) and neuroendocrine differentiation (NED)". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 3036. http://dx.doi.org/10.1158/1538-7445.am2024-3036.

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Abstract Although androgen deprivation therapy and androgen receptor (AR) blockade are highly effective therapies for metastatic prostate cancer (PCa), most patients develop resistance, leading to castration-resistant prostate cancer (CRPC). A subset of CRPC shows neuroendocrine prostate cancer (NEPC) features, which are associated with poor prognosis and limited therapeutic strategies. NEPC is characterized by oncogenic driver activation and epigenetic changes, partly controlled by transcription factors like BRN2 and SOX2. AR has been shown to suppress BRN2 transcription, which is required for NEPC, and BRN2-dependent regulation of the NEPC marker SOX2 (Bishop et al., 2017). Dordaviprone (ONC201/TIC10) is a first-in-class small molecule that antagonizes DRD2, induces tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), and activates the integrated stress response (ISR). Neuroendocrine tumors express significant DRD2 levels, suggesting ONC201 as a potential therapeutic strategy in NEPC or when drivers for disease progression are overexpressed (OE). PCa cell lines PC3, DU145, LNCaP, and 22RV1 are ONC201 sensitive, with IC50=2.87 μM, 3.18 μM, 1.31 μM, and 1.16 μM, respectively (Ding et al., 2023). To characterize the association of BRN2/SOX2 dysregulation with ONC201 sensitivity, we transiently OE BRN2/SOX2 in PCa. We hypothesized that markers of neuroendocrine differentiation (NED), activation of the ISR, TRAIL, and ClpP and dopamine receptor expression contribute to NEPC cell death and sensitivity to ONC201. We performed CellTiter-Glo experiments to assess viability after 96 hours ± BRN2 OE. DU145 cells with BRN2 OE increased their sensitivity to ONC201 (IC50=2.75 µM) compared to empty vector (IC50=3.03 µM). Colony formation assays were conducted in PCa and analyzed 7 days after ONC201 treatment to show ONC201 effect on PCa cell lines. DU145 was treated at 0.5, 1, and 2 µM of ONC201. There were 95 ± 3.22 colonies for the control group, 83 ± 5.22 colonies with 0.5 µM, 74 ± 3.64 colonies with 1 µM, and 8 ± 2.03 colonies with 2 µM ONC201. DU145 showed a significant reduction in colony-forming ability when treated with 1 and 2 uM ONC201 compared to the control, with P values of <0.05 and <0.0001, respectively. We OE BRN2 and observed changes in NED markers and ISR pathway. In PC3, FoxO1 and ATF4 levels increased. In DU145, FoxO1, ENO2, PGP9.5, CgA, and ATF4 levels decreased. We reveal that DU145 OE at 48 hours does not result in greater expression of NEPC markers. BRN2 OE significantly increased PCa cell sensitivity to ONC201 and was evident without an increase in common phenotypical markers used for NEPC assessment (FoxO1, ENO2, PGP9.5, CgA). Expression change was not shown when PCa had an integral AR pathway. Ongoing efforts are observing ONC201 treatment effects on NED markers and the TRAIL pathway due to BRN2 OE and showing increased sensitivity of PCa to ONC201 with BRN2 OE. Citation Format: Elizabeth C. Ding, Maximilian Pinho-Schwermann, Shengliang Zhang, Connor Purcell, Wafik S. El-Deiry. Sensitivity of ONC201/TIC10 cancer therapeutic on neuroendocrine prostate cancer (NEPC) and neuroendocrine differentiation (NED) [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 3036.

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Muquith, Maishara, Magdalena Espinoza, Andrew Elliott, Joanne Xiu, Andreas Seeber, Wafik El-Deiry, Emmanuel S. Antonarakis et al. "Abstract 1213: Tissue-specific thresholds and microenvironment correlates of tumor mutation burden associated with immunotherapy benefit and prognosis in microsatellite stable cancers". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 1213. http://dx.doi.org/10.1158/1538-7445.am2024-1213.

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Abstract Background: Immune checkpoint inhibitors (ICIs) targeting anti-PD-1/L1 have expanded the treatment landscape against cancers, but are only effective in a subset of patients across all cancer types. Tumor mutation burden (TMB) is postulated to be a generic determinant of ICI dependent-tumor rejection. Here, we clarify the association between TMB and survival outcomes among microsatellite-stable cancers in a real-world clinicogenomic cohort including 70,698 patients distributed across 27 histologies. Methods: Patients were segregated into mutually exclusive anti-PD-1/L1 (N=14,736, immune checkpoint inhibitor, ICI) and non-ICI cohorts (N=55,962) if they had received pembrolizumab, nivolumab, atezolizumab, durvalumab, avelumab, or cemiplimab, and non-ICI therapies, respectively, during the course of treatment for individual cancer types. Patients treated with chemo-immunotherapy combination regimens were included in the ICI cohorts, but anti-CTLA-4 agents were excluded from both cohorts. For both ICI and non-ICI cohorts, patients were reiteratively categorized as TMB-high or -low using increasing TMB thresholds up to the 90th percentile TMB for individual cancer types. Outcomes were then assessed using Cox regression analyses of overall survival (OS). Results: Across 27 histologies, 12 cancer types had at least one TMB cutoff associated with survival benefit upon ICIs (melanoma, NSCLC, SCLC, bladder, cervical, colorectal, gastric, ovarian, head and neck, vulvar cancers, as well as carcinoma of unknown primary, and sarcoma), and these associations were generally conserved across sex and age groups, although not necessarily significant in all cases. In two cancer types (cholangiocarcinoma and neuroendocrine tumors), TMB cutoffs were associated with worse OS with ICIs. The lowest TMB cutoff in which a survival benefit could be detected with ICIs ranged from 2 mut/Mb in melanoma to 9 mut/Mb in colorectal cancer. TMB thresholds with the greatest predictive value (defined as the lowest survival hazard ratio) were frequently near the highest TMB examined for individual cancer types, suggesting that TMB may scale with ICI benefit. Conclusion: TMB was associated with survival benefit or detriment depending on tissue and treatment context. Detectable survival benefits were noted over a broad range of TMB cutoffs across cancer types, and a dose-dependent relationship between TMB and outcomes was observed in a subset of cancers. These results may have implications for cancer-agnostic and universal TMB cutoffs to guide the use of anti-PD-1/L1 therapies, and underline the importance of tissue context in the clinical development of ICI biomarkers. Citation Format: Maishara Muquith, Magdalena Espinoza, Andrew Elliott, Joanne Xiu, Andreas Seeber, Wafik El-Deiry, Emmanuel S. Antonarakis, Stephanie Graff, Michael J. Hall, Hossein Borghaei, Dave S. Hoon, Stephen V. Liu, Patrick C. Ma, Rana R. McKay, Trisha Wise-Draper, John Marshall, George W. Sledge, David Spetzler, Hao Zhu, David Hsieh. Tissue-specific thresholds and microenvironment correlates of tumor mutation burden associated with immunotherapy benefit and prognosis in microsatellite stable cancers [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 1213.

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Lannigan, Alexis J., Jasper Chan, Maximilian Schwermann, Lanlan Zhou, Varun V. Prabhu, Michael Dame, Dean Brenner, Wafik S. El-Deiry e Alexander G. Raufi. "Abstract 4780: TRAIL-inducing imipridone ONC201/TIC10 demonstrates anti-neoplastic effects in colonic adenoma-derived organoids". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 4780. http://dx.doi.org/10.1158/1538-7445.am2024-4780.

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Abstract Background: Colorectal cancer (CRC) is the second leading cause of cancer-related death inthe United States and screening is the most effective method to reduce mortality. Chemoprevention, which aims to prevent CRC through eradication or prevention of precursor colonic adenomas, represents an alternative strategy to address this problem. The imipridone dordaviprone (ONC201) has been shown to induce apoptosis in cancer cells through both upregulation of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and the integrated stress response. More recently, we have shown that ONC201 induces TRAIL and apoptosis in a dose-dependent manner and reduces adenoma formation in the Apcmin/+ CRC mouse model. We hypothesized that ONC201 would similarly enhance human colonic adenoma cell death through both TRAIL-dependent and TRAIL-independent mechanisms. We therefore evaluated the effects of ONC201 in two adenoma-derived organoid lines: one developed from an adenoma obtained from an individual with familial adenomatous polyposis (FAP) and the second from a sessile serrated adenoma (SSA). Methods: Sensitivity of the FAP and SSA organoid lines to ONC201 was assessed using CellTiter-Glo® luminescent cell viability assay. Organoids were plated in triplicates and treated with ONC201 (concentration ranging from 0 uM to 20 uM). Results were analyzed after 72 hours of incubation. Western blotting was performed on lysates generated from organoids treated with either 1.69 uM DMSO, 1.69 uM ONC201, or 3.38 uM ONC201 for FAP and 1.23 uM DMSO, 1.23 uM ONC201, or 2.46 uM ONC201 for SSA for 0, 24, or 48 hours. Co-culture experiments were performed with the adenoma-derived organoids (dyed using blue CMAC dye) and human NK-92MI cells (dyed with green CMFDA dye) treated with either 845 nM DMSO, 845 nM ONC201, or 1.69 uM ONC201 for FAP and 615 nM DMSO, 615 nM ONC201, or 1.23 uM ONC201 for SSA. Fluorescent images following administration of red live/dead dye were performed using DAPI, FITC, and cherry red channels on ImageXpress® at 0, 24, 48, and 72hours. Results: ONC201 demonstrated antineoplastic effects in adenoma-derived FAP and SSA organoids. Half maximal inhibitory concentrations (IC50) of ONC201 in FAP and SSA organoids were 1.69 uM and 1.23 uM, respectively. As was noted in rodent studies, the mechanism of action of ONC201 appears to be mediated through modulation of multiple pathways including the TRAIL pathway (TRAIL and DR5 were both upregulated) and the integrated stress response (ATF4 was upregulated). Co-culture with NK cells revealed an increase in NK-mediated organoid cell death. The ability of ONC201 to enhance NK-mediated killing is still being evaluated. Further analysis of the effects of ONC201 on stemness markers and on T-cell-mediated organoid cell killing are currently underway and may reveal other potential biomarkers and chemopreventive strategies for ONC201. Citation Format: Alexis J. Lannigan, Jasper Chan, Maximilian Schwermann, Lanlan Zhou, Varun V. Prabhu, Michael Dame, Dean Brenner, Wafik S. El-Deiry, Alexander G. Raufi. TRAIL-inducing imipridone ONC201/TIC10 demonstrates anti-neoplastic effects in colonic adenoma-derived organoids [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 4780.

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Schwermann, Maximilian, Matthew Hadfield, Shaolei Lu, Praveen Srinivasan, Vida Tajiknia, William MacDonald, Andrew George et al. "Abstract 2954: Androgen deprivation therapy (ADT) and senescence-associated secretory phenotype (SASP) in vitro: Correlation with SASP in tumor specimens as well as in the serum of patients after ADT". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 2954. http://dx.doi.org/10.1158/1538-7445.am2024-2954.

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Abstract Introduction: Androgen Deprivation Therapy (ADT) is a highly effective treatment for prostate cancer. However, resistance to ADT develops in most patients, leading to a lethal state of castration-resistant prostate cancer (CRPC). Senescent prostate cancer (SPC) cells can arise after ADT and contribute to therapy resistance. SPCs can restore replicative function and alter the tumor microenvironment through pro-tumorigenic senescence-associated secretory phenotype (SASP). We aimed to characterize changes in SASP in prostate cancer cell lines and serum samples from patients receiving ADT. Methods: SASP factors (Luminex 100/200 System, xMAP Instruments) were analyzed in patients undergoing ADT. To correlate SASP with the sensitivity to ADT, we sought to evaluate the regulation of SASP in vitro using PCa cell lines. The PC3 (AR resistant) and LNCaP (AR sensitive) cell lines were used in the experiments. We performed an analysis of archival tumor tissue (paired) from 18 patients with or without alterations in DNA repair genes (BRCA1, BRCA2, and CDK12). We performed immunohistochemical (IHC) staining of known SASP markers, such as P16, uPAR, gamma-H2AX, and Lamin B1. Results: In a cohort of patients (n=8) with pre and post-ADT matched status, we demonstrate increased levels of SASP factors such as IL-6 (pre-ADT: 1.54±0.24 pg/ml, post-ADT: 5.23±1.3 pg/ml p=0.001), IL-7 (pre-ADT: 3.11±0.6 pg/ml, post-ADT: 13.5±2.7 pg/ml p=0.01), IL-1 alpha (pre-ADT: 1.06±0.3 pg/ml, post-ADT: 15.3±3.5 pg/ml p=0.001), IL-15 (pre-ADT: 15.6±3.1 pg/ml, post-ADT: 37.1±4.8 pg/ml p=0.002), MIF (pre-ADT: 1036±67.6pg/ml, post-ADT: 2362±55.5 pg/ml p=0.003), and IL-15 (pre-ADT: 5±2.1 pg/ml, post-ADT: 37.5±5.1 pg/ml p=0.002). In vitro, the AR-responsive LNCaP cell line, exposed to AR blockade, showed similar findings in upregulating IL-6, IL-7, and IL-15 but not the PC3 cell line. We also demonstrate measurable differences between the expression of u-PAR, gamma-2AX, p16, and loss of Lamin B1 expression in tumor specimens from patients with advanced castration-resistant prostate cancer (n=18). The expression of p16 was significantly upregulated post-treatment irrespective of DDR status (p=0.0417). Other SASP factors showed a trend in upregulation but were insignificant (u-PAR p=0.056, gamma-H2AX p=0.62, Lamin B1 p=0.72) Conclusion: These results provide evidence of systemic increases in SASP-related cytokines following treatment with ADT. The in vitro results suggest that secretion of SASP is promoted by an AR-mediated mechanism. Preliminary results from tumor specimens suggest increased senescence marker p16 expression induced by therapy. Ongoing experiments are further characterizing the senescence markers in prostate tumor specimens and correlated to treatment effect. Citation Format: Maximilian Schwermann, Matthew Hadfield, Shaolei Lu, Praveen Srinivasan, Vida Tajiknia, William MacDonald, Andrew George, Shengliang Zhang, Leiqing Zhang, Kimberly Meza, Andre De Souza, Dragan Golijanin, Elias Hyams, Galina Lagos, Sheldon Holder, Anthony Mega, John Sedivy, Howard Safran, Wafik El-Deiry, Benedito Carneiro. Androgen deprivation therapy (ADT) and senescence-associated secretory phenotype (SASP) in vitro: Correlation with SASP in tumor specimens as well as in the serum of patients after ADT [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 2954.

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Schwermann, Maximilian, Praveen Srinivasan, William MacDonald, Vida Tajiknia, Andrea Schmidt, Shengliang Zhang, Lindsey Carlsen et al. "Abstract 3602: TRAIL-NK-92 MI as a novel adoptive therapy for castration-resistant prostate cancer (CRPC): Preliminary in vitro results". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 3602. http://dx.doi.org/10.1158/1538-7445.am2024-3602.

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Abstract Introduction: Natural killer (NK) cell tumor infiltration and higher expression of activating receptors NKp30 and NKp46 are associated with improved clinical outcomes in prostate cancer (PC). Activation of NK cells by androgen receptor inhibitors enhanced the killing of PC cell lines (Schwermann 2023). These findings support the therapeutic potential of strategies inducing NK cell activation to treat CRPC. NK cells induce apoptosis of cancer cells via TNF-related apoptosis-inducing ligand) (TRAIL) binding of death receptor 5 (DR5), which is overexpressed in PC cells. This is the first report of adoptive therapy utilizing high expression of TRAIL as a novel therapeutic strategy. Methods: We transduced NK-92-MI and CD4+ (Jurkat) cell lines with human TRAIL (pLVX-EF1alpha-TRAIL-IRES-eGFP).Transduced cells were pre-treated with simvastatin or atorvastatin (4uM) for 36h, followed by stimulation (IL-2 100 IU/ml and IL-12 100 ng/ml) for 2h. The eGFP-expressing cells were then sorted by FACS. PC (PC3, DU145, LNCaP, and 22Rv1), fibroblast (IMR-90), and brain endothelial (hCMEC/D3) cell lines were used in co-culture experiments with non-transduced and transduced NK cells and CD4+ cells. These experiments were quantified using the ImageXpress Confocal HT instrument. Viability assays were performed using Annexin-PI and flow cytometry staining for caspases 3/7. Results: Transduced NK-92 MI cells with TRAIL displayed increased surface expression of TRAIL (control[C]: 4.38%±1; TRAIL-overexpression[NK-TRAIL]: 78.54%±3.76; p<0.001). Co-culture of PC cell lines with TRAIL-NK-92 MI cells resulted in significant tumor-induced apoptosis compared to co-culture with non-transduced NK cells after 48 hours (LNCaP + NK [C]: 16.52%±5, LNCaP + NK-TRAIL: 73.19%±6; PC [C]: 14.4%±3, PC3 + NK-TRAIL: 79%±8; 22Rv1 [C]: 16.78%±1.7, 22Rv1 + NK-TRAIL: 76%±8; DU145 [C]: 13%±4, DU145 + NK-TRAIL: 59.1%±10; p<0.001). This enhanced cytotoxic function was also observed in CD4+ cells expressing high levels of TRAIL. Annexin-PI staining as well as Caspase 3 and 7 showed increased apoptosis in PC co-cultured with NK-TRAIL. Co-culture of NK-TRAIL cells did not affect the viability of the non-malignant cells (IMR-90 and hCMEC/D3) over 48h (IMR-90 + NK: 4.6%±1, IMR-90 + NK-TRAIL: 4.47±2, p=0.9; hCMEC/D3 + NK: 2.7%±0.8, hCMEC/D3 + NK-TRAIL: 2.2±0.5, p>0.99). These results align with the lower expression of DR5 on non-malignant cells compared to PC cell lines (IMR-90: 1.46%±0.5, hCMEC/D3: 1.9%±0.8, LNCaP: 92.3%±4.5). Conclusion: Transduced NK-92 MI cells with human TRAIL-induced higher levels of apoptosis of PC cell lines compared with non-transduced NK cells in co-culture experiments. The results highlight the potential of TRAIL-expressing adoptive cell therapy for CRPC. Engaging adoptive therapies with specific targets (anti-PSMA CAR) might increase the therapeutic potential of this strategy. Citation Format: Maximilian Schwermann, Praveen Srinivasan, William MacDonald, Vida Tajiknia, Andrea Schmidt, Shengliang Zhang, Lindsey Carlsen, Andrew George, Connor Purcell, Shaolei Lu, Matthew Hadfield, Anthony Mega, Benedito Carneiro, Wafik El-Deiry. TRAIL-NK-92 MI as a novel adoptive therapy for castration-resistant prostate cancer (CRPC): Preliminary in vitro results [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 3602.

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