Molecular Cancer Therapeutics

Somatostatin receptor 2 (SSTR2) is highly expressed in neuroendocrine tumors including small cell lung cancer (SCLC) and represents a validated target for peptide receptor radionuclide therapy. The SSTR2 agonist [177Lu]Lu-DOTA-TATE is clinically approved, however, treatment resistance and relapse occur. The SSTR2 antagonist SSO110 (DOTA-JR11, OPS201) demonstrates higher tumor uptake and longer retention than DOTA-TATE both pre-clinically and clinically. We performed a systemic head-to-head comparison of SSO110 labeled with various radionuclides of distinct emission characteristics to identify the optimal radionuclide for SSO110 and to compare antagonist with agonist performance. MethodsSSO110 was radiolabeled with 177Lu, 161Tb, 212Pb, and 225Ac. Biodistribution was assessed in AR42J and NCI-H69 xenograft models. Therapeutic efficacy of single and fractionated [212Pb]Pb-SSO110 was compared with [177Lu]Lu-SSO110 in NCI-H69 tumors. Single-dose efficacy of 225Ac-, 161Tb-, and 177Lu-labeled SSO110 was evaluated in both models. [{superscript 2}{superscript 2}Ac]Ac-DOTA-TATE served as agonist comparator. Tumor growth, survival, safety parameters, and tumor absorbed doses were analyzed. ResultsAll SSO110 radioconjugates demonstrated comparable biodistribution with high tumor uptake and favorable tumor-to-kidney ratios. In NCI-H69 tumors, [212Pb]Pb-SSO110 induced dose-dependent tumor growth delay but did not improve anti-tumor efficacy compared with [177Lu]u-SSO110 under single or fractionated regimens. [161Tb]Tb-SSO110 showed efficacy comparable to [177Lu]Lu-SSO110 in NCI-H69 model and significantly improved tumor growth delay in high-SSTR2-expressing AR42J tumors. Across both models, [225Ac]Ac-SSO110 demonstrated the highest therapeutic potency, inducing durable tumor regression and 100% survival at clinically relevant activities. [225Ac]Ac-SSO110 also outperformed the agonist comparator [225Ac]Ac-DOTA-TATE. Dosimetry analysis revealed a 63-fold higher tumor absorbed dose per injected administered activity for [225Ac]Ac-SSO110 compared with [212Pb]Pb-SSO110. All treatments were well tolerated without significant renal or hepatic toxicity. ConclusionTherapeutic efficacy of SSTR2-targeted peptide receptor radionuclide therapy appears to benefit from alignment between radionuclide physical half-life and ligand tumor residence time. Among the radionuclides evaluated, [225Ac]Ac-SSO110 demonstrated the most pronounced and durable anti-tumor efficacy, outperforming [161Tb]Tb-SSO110, [177Lu]Lu-SSO110, and the short-lived -emitter [212Pb]Pb-SSO110. These findings support clinical investigation of [225Ac]Ac-SSO110 in SSTR2-positive malignancies.

BackgroundFluoropyrimidines, specifically 5-fluorouracil (5-FU), remain the cornerstone of colorectal cancer (CRC) therapy. However, intrinsic and acquired resistance, alongside dose-limiting systemic toxicities, often result in treatment failure and disease relapse. There is a pressing clinical need for next-generation fluoropyrimidines that can retain the antitumor activity in 5-FU-refractory CRC models while maintaining a favorable safety profile. MethodsWe evaluated the antitumor efficacy of CF10, a novel polymeric fluoropyrimidine designed for the sustained delivery of FdUMP, against equimolar 5-FU. We utilized a diverse panel of six patient-derived CRC organoid (PDO) models to assess 3D growth inhibition under both normoxic ([~]20% O2) and physioxic (5% O2) conditions. Mechanisms of action were investigated via {gamma}H2AX signaling (DNA damage), Annexin V/PI flow cytometry (death kinetics), and ALDEFLUOR assays (stem-like populations). Functional suppression of metastasis-associated phenotypes was evaluated using 3D Matrigel invasion assays. Finally, the therapeutic index and overall survival were validated in vivo using two independent patient-cell-derived xenograft (PCDX) models (TX-CC-199 and TX-CC-201). ResultsCF10 demonstrated significantly greater suppression of organoid growth compared to equimolar 5-FU across all patient-derived lines, regardless of morphological heterogeneity or oxygen tension. In 3D invasion assays, CF10 achieved superior anti-invasive activity even at a 10-fold lower molar dose than 5-FU. This functional advantage was mirrored by a marked depletion of the ALDH-high stem-like subpopulation, which was largely recalcitrant to 5-FU. Mechanistically, CF10 induced intensified replication stress, DNA damage and repair signaling ({gamma}H2AX, Top1cc/pRPA32, FANCD2), and pushed the CRC to irreversible/terminal, PI-positive death states. In vivo, CF10 treatment resulted in profound tumor growth inhibition and a robust survival advantage in two patient cell-derived xenograft (PCDX) models (Log-rank P<0.01) without inducing systemic weight loss or noticeable toxicity. ConclusionsBy integrating 3D patient-derived modeling with in vivo validation, we demonstrate that CF10 effectively overcomes the biological and pharmacological limitations of 5-FU. CF10 targets the aggressive, invasive, and stem-like subpopulations of CRC that drive clinical relapses. These findings provide a compelling translational rationale for the clinical development of CF10 as a superior alternative to standard fluoropyrimidines in both treatment-naive and refractory CRC. Significance StatementDespite the foundational role of 5-fluorouracil (5-FU) in colorectal cancer (CRC) therapy, resistance and systemic toxicity remain major barriers to curative outcomes. This study identifies CF10, a novel polymeric fluoropyrimidine, as a superior alternative that overcomes 5-FU resistance in biologically diverse patient-derived organoids and xenograft models. Crucially, CF10 demonstrates a unique capacity to suppress the invasive, aldehyde dehydrogenase (ALDH)-high stem-like subpopulations that likely survive standard chemotherapy (5-FU) by maintaining efficacy under physiological oxygen levels and providing a significant survival advantage in vivo with improved tolerability. CF10 represents a promising translational candidate for the treatment of both treatment-naive and refractory CRC.

CD4+ T helper cells are required for CD8+ killer T cells to suppress tumor growth. An orally-available small molecule surrogate of alpha-1 antitrypsin, Alphataxin, was previously demonstrated to elevate the numbers of circulating and tumor-infiltrating CD4+ T cells and to suppress kidney tumor growth in mice. To determine whether Alphataxin might be effective in other T cell-responsive cancers, mice orthotopically implanted with colon tumors were treated using Alphataxin and anti-PD-1 as monotherapies or in combination. Combination therapy significantly suppressed tumor growth (ORR = 37.5%) and increased tumor-infiltrating CD4+ T cells, CD8+ T cells, NK cells, M2 macrophages, and DC2 dendritic cells. Release of IFN-{gamma} by helper T cells in the tumor microenvironment appeared to contribute to the effectiveness of killer T cells in suppressing tumor growth. Toxicology studies in rats revealed no untoward effects. Alphataxin, to our knowledge the first and only drug developed to rapidly and sustainably increase the number of circulating and tumor-infiltrating CD4+ helper T cells, is a powerful therapeutic that provides long-term remission in T cell-responsive cancers in combination with anti-PD-1.

As potent triggers of innate immunity, STING agonists hold promise as active immunotherapeutic agents for cancer treatment. Second-generation STING agonists, suitable for systemic delivery, are being investigated in preclinical research and have entered clinical trials. Here, the novel synthetic STING agonist, BI-1703880 (STINGa), which was designed for intravenous delivery, was investigated for anti-tumour and immunological effects. We show that STINGa activates the STING pathway and results in a transient and dose-dependent upregulation and secretion of interferons and proinflammatory cytokines in vitro and in vivo. We show that intravenous administration of repeated dosing with low-dose STINGa is well tolerated. We report that radiotherapy (RT) and STING agonism synergizes to generate innate immune cell and CD8+ T cell responses that control tumour growth. Anti-tumour activity induced by combined RT / STINGa was reduced in mice lacking a functional immune system. RT / STINGa combination treatment also initiated development of protective immune memory. RT / STINGa upregulated PD-L1, PD-1 and CTLA-4 in the tumour microenvironment. Our findings show that combining RT / STINGa with immune checkpoint inhibitors further increases therapeutic benefit. Our data confirm STING as a therapeutic target in cancer and support the clinical development of BI-1703880 STING agonist, thereby suggesting radiotherapy as a potential combination for enhancing anti-tumour efficacy.

The MET receptor tyrosine kinase is mutated or amplified in [~]6% of non-small cell lung cancer (NSCLC) and overexpressed in [~]80% of all NSCLC cases. A theranostic agent that can both see and treat MET-altered NSCLC has never been described before in the literature. Here, we report a shark-derived single-domain variable new antigen receptor (VNAR) for MET with theranostic applications. Following the immunization of a juvenile nurse shark (Ginglymostoma cirratum) with the extracellular domain of human MET, we identified a VNAR clone that specifically engaged MET with high affinity. Engineering the lead VNAR into a bivalent human Fc, vMET1-Fc, yielded a construct that selectively targeted and was internalized by MET-positive cells without affecting cell viability or downstream MET signaling. When radiolabeled with the positron emitting isotope Zr-89, [89Zr]Zr-vMET1-Fc enabled longitudinal PET/CT imaging. High tumor uptake with low background was observed in MET-positive NSCLC xenografts administered [89Zr]Zr-vMET1-Fc. As a targeted beta-particle radiotherapy, [{superscript 1}Lu]Lu-vMET1-Fc resulted in marked tumor-growth delay and exhibited a favorable toxicity profile, collectively improving progression-free survival in NSCLC mouse models. Non-human primate PET/CT imaging studies with ([Zr]Zr-vMET1-Fc in healthy rhesus macaques confirmed favorable biodistribution and dosimetry, predictable clearance, and minimal off-target uptake. Additional blood chemistry analysis found no significant immune response or cytotoxicity. Together, these findings establish vMET1-Fc as a theranostic agent for imaging and treating MET-altered NSCLC. Statement of SignificanceA shark-derived antibody selectively targeting MET shows preclinical efficacy as a theranostic agent for MET-altered cancer.

Phosphodiesterase 10 (PDE10) was previously reported to be overexpressed in various cancers and essential for cancer cell proliferation and survival. Here, we studied a novel PDE10 inhibitor, ADT-030, and found it to potently and selectively inhibit KRAS mutant PDAC cell proliferation and clonogenicity by inducing G2/M arrest and apoptosis. ADT-030 also inhibited motility of PDAC cells in vitro. These effects were mediated by increased cAMP/cGMP levels and activation of PKA/PKG. The growth inhibitory activity of ADT-030 was associated with reduced {beta}-catenin and RAS signaling. Notably, ADT-030 also inhibited the growth of KRASG12D and KRASG12C mutant PDAC cells resistant to allele-specific KRAS inhibitors. Oral administration of ADT-030 significantly suppressed tumor growth, reduced lung and liver metastasis, and increased survival without systemic toxicity in syngeneic and patient-derived xenograft (PDX) PDAC models. ADT-030 also increased chemotherapy response in orthotopic PDAC models. Immune phenotyping and single-cell RNA sequencing revealed remodeling of the tumor microenvironment by ADT-030 with a more favorable immune suppressive profile to activate anti-tumor immunity. These results show that ADT-030 is a promising drug development candidate for the treatment of KRAS-mutant PDAC capable of simultaneously targeting key oncogenic signaling pathways, resulting in tumor-intrinsic and immunomodulatory effects.

BackgroundDrug responses in pancreatic ductal adenocarcinoma (PDAC) vary sharply across in vitro culture formats, but most 2D-3D comparisons conflate microenvironmental cues with time-dependent cellular adaptation. As a result, conventional assays frequently overestimate drug efficacy and poorly reflect clinical pharmacology. Main findingsWe profiled MiaPaCa-2, PANC-1, and CFPAC-1 grown in an extracellular-matrix (ECM) hydrogel for 1-12 days, defining extended 3D cultures ([&ge;]10 days) as mature tumoroids, and quantified 72 h drug responses to a multi-class oncology panel using growth-rate (GR) metrics to normalize for proliferation across formats and durations. Prolonged 3D pre-culture induced broad tolerance, with typical 10-100x reductions in sensitivity to standards of care (5-fluorouracil, SN38, oxaliplatin, gemcitabine, paclitaxel), following a reproducible susceptibility hierarchy (MiaPaCa-2 > PANC-1 > CFPAC-1) after GR correction. In mature tumoroids, GR values closely approximated clinically observed plasma exposures (e.g., within <4x for 5-FU and <0.5x for gemcitabine), whereas 2D and short-term organoid assays markedly underestimated resistance, often by >100x, thereby overstating drug activity. Notably, CFPAC-1 exhibited increased sensitivity to SN38 and trametinib under mature-organoid conditions, demonstrating that microenvironmental conditioning can invert responses for selected mechanisms. Transcriptomic profiling revealed coordinated up-regulation of multiple ABC transporters with extended 3D residence, tracking resistance phenotypes across lines and implicating transporter-linked tolerance programs. SignificanceTogether, these data identify time-in-3D and the emergence of mature tumoroids as dominant, previously under-controlled determinants of PDAC pharmacology that both induce tolerance and unmask context-dependent vulnerabilities. We propose incorporating both short-term and mature-tumoroid screening arms into preclinical workflows, reporting pre-culture duration alongside GR-normalized effect sizes, and leveraging transporter-informed biomarkers to guide regimen prioritization and sequencing. This framework enhances physiological relevance, reproducibility, and translational fidelity in PDAC drug discovery.

BackgroundIMV-M is a MUC16xDR5 bispecific antibody has demonstrated MUC16-selective anti-tumor activity. However, it remained unclear whether multiple binding of IMV-M on a single MUC16 molecule was required for IMV-M cytotoxicity, whether circulating CA125 could attenuate its efficacy or cause off-target toxicity, and whether anti-drug antibodies might induce IMV-M aggregation and related adverse effects. MethodsA comparative analysis of three bispecific antibodies, IMV-M (sofituzumabxDR5), 11D10xDR5, and fluorxDR5, sharing an identical IgG1-anti-DR5 scFv architecture, was performed. Sofituzumab binds to multiple epitopes on a single MUC16 molecule, whereas 11D10 binds a single MUC16 epitope, and fluor does not bind any human antigen. Antibody binding to shed and cell-surface MUC16 was evaluated by ELISA and flow cytometry. Cytotoxicity was assessed in a MUC16+/DR5+ tumor cell line and MUC16-/DR5+ hepatic cell lines. Additional studies examined the effects of soluble CA125 and Fc-directed polyclonal antibodies on IMV-M activity. ResultsIMV-M bound MUC16 to a markedly higher extent than the 11D10xDR5 comparator, consistent with its multivalent engagement, while binding of fluorxDR5 to MUC16 was negligent. Only IMV-M induced potent cytotoxicity in MUC16+ tumor cells, whereas 11D10xDR5 and fluorxDR5 control antibodies were inactive, demonstrating that multivalent clustering on MUC16 is required for apoptosis. IMV-M showed no significant cytotoxicity toward hepatic cell lines, even in the presence of Fc-directed polyclonal antibodies or clinically relevant concentrations of soluble CA125. ConclusionsThese findings indicate that IMV-M cytotoxic activity requires clustering on MUC16, that CA125 at clinically relevant concentrations does not mediate IMV-M neutralization, and that aggregate formation with secondary antibodies or soluble MUC16 does not induce off-target toxicity.

BackgroundNeuroendocrine Prostate Cancer (NEPC) is an incurable malignancy, originating from the trans-differentiation of prostate adenocarcinoma (PRAD). Compared to PRAD, NEPC shows over-activation of Polycomb Repressive complex-1(PRC1) and-2 (PRC2), which are multiprotein epigenetic writers that drive cancer progression via tumour suppressor gene silencing. Tazemetostat is a PRC2 inhibitor approved for the treatment of sarcomas and lymphomas. ORIC-944 is a novel EED (Embryonic Ectoderm Development) inhibitor, which is being tested in clinical trials. EED is an attractive target as it functions as a key component of both PRC1 and PRC2. Objective and MethodsWe compared the anticancer effects of tazemetostat and ORIC-944 in NEPC and PRAD cells. Cells were exposed to various concentrations of the two compounds to measure effects on cell viability (IC50) and apoptosis (flow cytometry). PRC2 inhibition was confirmed by measuring histone H3 Lys 27 trimethylation (H3K27me3) via ELISA and Western Blot. RNA Sequencing and pathway analysis was conducted to study modes of actions of tazemetostat vs ORIC-944. ResultsUnlike tazemetostat, ORIC-944 causes dose-dependent growth inhibition in both NEPC and PRAD cells. In this context, EED targeting achieves IC50 values that are comparable to those of compounds used for the clinical treatment of advanced prostate cancer. Moreover, ORIC-944 (but not tazemetostat) causes significant apoptosis in NEPC cells. Both tazemetostat and ORIC-944 reduce H3K27me3. Mechanistically, both compounds reactivate the expression of known PRC2 targets, such as genes that control neural differentiation. However, the EED inhibitor also reactivates PRC1 targets, including pro-apoptotic and anti-proliferating genes (e.g. metallothionines). This evidence suggests that EED inhibition is a promising therapeutic strategy for NEPC.

It has been hypothesized that effective cellular internalization is required for the retention of 225Ac daughter radionuclides. The complex decay chain of 225Ac and recoil-mediated release of daughters, particularly 213Bi (half-life (t1/2) = 46 min), raise concerns about redistribution that may reduce tumor absorbed dose (TAD) and increase off-target radiation exposure. Because somatostatin receptor subtype 2 (SSTR2) antagonists such as SSO110 are not internalized, it has been proposed that the daughter radionuclides are less effectively retained compared to internalizing agonists such as DOTA-TATE. We therefore performed a direct and quantitative comparison of daughter radionuclide redistribution following administration of [225Ac]Ac-SSO110 and [225Ac]Ac-DOTA-TATE. MethodsBiodistribution and 213Bi redistribution were evaluated in Balb/c nude mice bearing NCI-H69 small cell lung cancer xenografts. Repeated gamma counting combined with bi-exponential modeling was used to quantify 225Ac and 213Bi activity in tumor, blood, bone marrow, kidneys, liver, and intestines up to 96 h post-injection. TAD was calculated with and without accounting for experimentally-derived 213Bi redistribution. Real-time in vitro binding assays were conducted to characterize cellular retention of [225Ac]Ac-SSO110. Results[225Ac]Ac-SSO110 demonstrated higher tumor uptake and prolonged retention compared with [225Ac]Ac-DOTA-TATE, resulting in a 1.9-fold higher tumor-to-kidney ratio at 96 h and a 2.8-fold higher TAD. Redistribution of 213Bi from tumor was minimal and comparable between agonist and antagonist, with maximum tumor loss of 3.5% for [225Ac]Ac-SSO110 and 2% for [225Ac]Ac-DOTA-TATE. Accounting for daughter redistribution reduced TAD by less than 5% for both radioconjugates. No sustained 213Bi accumulation was observed in blood, kidneys, or liver, and only minimal activity was detected in bone marrow and intestines. Real-time binding studies demonstrated sustained cell-associated {beta}- signal following incubation with [225Ac]Ac-SSO110. ConclusionReceptor-mediated internalization is not required for effective retention of 225Ac daughter radionuclides. Despite negligible internalization, [225Ac]Ac-SSO110 achieved superior TAD and higher tumor-to-kidney ratio without increased daughter redistribution compared with the internalizing agonist [225Ac]Ac-DOTA-TATE. These findings question the necessity of internalization for daughter retention and support further evaluation of antagonist-based 225Ac radioligand therapy.

PurposePDPK1 functions downstream of PI3K and is essential for activating AKT and other AGC kinases. Although PDPK1 has a central role in the PI3K/AKT/mTOR signaling pathway, there has been limited evaluation of it as a target for cancer therapy. Anaplastic thyroid cancer (ATC) has one of the highest mortality rates of all human malignancies. Although combined BRAF and MEK inhibition in BRAF V600E-mutant ATC (45% of cases) results in response, resistance is common, and there is no curative treatment. The majority (up to 95.8%) of ATC cases have activation in the PI3K/AKT/mTOR and RAS/RAF/MEK/MAPK pathways due to genetic alterations (including driver mutations and genomic gains/losses), involved in these pathways. In this study, we investigated PDPK1 as a therapeutic target for ATC. Experimental designWe used in vitro, ex vivo, and in vivo ATC models to evaluate the effect of targeting PDPK1 (BX795) alone and in combination with mutated BRAF V600E inhibition (dabrafenib), and the mechanism of action that resulted in ATC cell death. ResultsBX795 monotherapy significantly reduced ATC cell proliferation, invasion, colony formation, and spheroid size. The combination of BX795 with dabrafenib produced strong synergistic antitumor activity in BRAF V600E-mutant ATC models. Dual inhibition led to simultaneous and sustained suppression of PDPK1/AKT and MAPK signaling, preventing the compensatory pathway reactivation observed with single-agent treatment. This integrated blockade induced pronounced oxidative stress, DNA damage, and G2-phase cell-cycle arrest, accompanied by mitochondrial dysfunction and robust activation of apoptotic cascades. These effects translated into marked tumor regression in in vitro, ex vivo, and in vivo experimental systems. ConclusionsOur findings identify PDPK1 as a critical and therapeutically tractable vulnerability in anaplastic thyroid cancer. Co-targeting PDPK1 and BRAF V600E produces potent synergistic antitumor activity by shutting down convergent oncogenic signaling nodes and amplifying apoptotic stress responses. These data support PDPK1 inhibition--alone and in combination with BRAF blockade acts as a promising strategy to improve outcomes for patients with BRAF V600E-mutant ATC.

BackgroundImmune checkpoint blockade (ICB) therapies demonstrate low efficacy in microsatellite stable (MSS) colorectal cancer (CRC) due to an immune-desert tumor microenvironment (TME) characterized by low antigen presentation and limited tumor-infiltrating lymphocytes (TILs). Harmine, a natural small-molecule and its promising derivatives ACB1801 have shown anti-tumor potential in preclinical models; however, their potential to reprogram the TME and overcome ICB resistance in MSS CRC remains unexplored. This study investigates whether and how ACB1801 can reshape TME to sensitize MSS CRC to ICB therapies. MethodsWe used the CT26 MSS colorectal cancer mouse model to evaluate the ability of the harmine derivative ACB1801 to enhance the efficacy of anti-PD-1 therapy. To characterize its mode of action, we performed immune landscape analysis and transcriptomic profiling of both CD45- and CD45+ tumor-derived cells. In parallel, mechanistic studies were conducted in vitro using mouse and human MSS CRC cell lines. ResultsWe demonstrate that the harmine derivative ACB1801 enhances the effectiveness of anti-PD-1 therapy in an MSS CRC mouse model. Combination therapy significantly increased CD8+ T cell infiltration and reduced regulatory T-cell (Treg) density in the TME. Transcriptomic profiling of CRC cells isolated from tumors treated with either anti-PD-1 alone or in combination with ACB1801 revealed significant enrichment of metabolic pathways in the combination group, characterized by reduced glycolysis and enhanced ferroptosis signatures. These findings were supported by in vitro data showing that ACB1801 reduces tumor cell glycolytic activity and promotes ferroptotic vulnerability. Mechanistically, ACB1801 induced STAT1 signaling, promoted CXCL10 release, and enhanced major histocompatibility complex class I (MHC-I)-dependent antigen presentation on tumor cells, thereby increasing tumor susceptibility to anti-PD-1 therapy. ConclusionCollectively, our findings indicate that combination therapy with harmine derivatives and ICBs represents a promising strategy for treating MSS CRC patients.

Immune checkpoint inhibitors, particularly T cell targeting anti-PD(L)1 therapies, have revolutionized the treatment landscape for solid malignancies, but challenges related to non-responsiveness and the development of treatment resistance continue to be observed. An additional immunosuppressive axis relates to prostaglandin signaling downstream of cyclooxygenase-2 (COX2), where COX2 inhibitors have shown clinical promise in re-engaging both T and non-T cell immune compartments, yet have suffered from toxicity concerns. We report here the preclinical characterization of OKN4395, a highly potent and specific first-in-class triple antagonist of EP2, EP4, and DP1, major tumor immunosuppressive receptors downstream of COX2. OKN4395 restores immune function on both T cells and NK cells in vitro. Additionally, OKN4395 acts synergistically with anti-PD1 to increase speed and depth of antitumor activity. Overall, these findings robustly support the clinical investigation of OKN4395 in an ongoing Phase 1 trial (NCT06789172) as an innovative cancer immunotherapy for solid tumors, as a single agent and in combination with anti-PD1 therapy. Statement of significanceOKN4395, a first-in-class oral EP2/EP4/DP1 antagonist, reverses prostanoid-driven immunosuppression to restore antitumor immunity. Integrated pharmacology defines mechanism, translational biomarkers as well as both monotherapy and anti-PD1 combination strategies. These data position prostanoid tri-receptor antagonism as a translatable strategy in solid tumors. A global Phase 1 study is underway (NCT06789172).

BackgroundHepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide, highlighting the urgent need for effective therapies. Niclosamide, an FDA-approved anthelmintic, reverses HCC gene expression profile to that of normal hepatocytes, and exhibits promising anti-tumor activity in HCC in vitro; however, its clinical translation is limited by poor aqueous solubility, low bioavailability, and short systemic exposure, resulting in lack of in vivo activity. We previously used an established phosphate prodrug approach to provide proof-of-concept that increasing oral bioavailability was essential for niclosamide to achieve in vivo anti-tumor activity. MethodsWe designed a panel of novel niclosamide prodrugs and screened eight candidates for water solubility, chemical stability, and in vitro anti-proliferative activity in HCC cell lines. The lead compound, SSL-0024, was further evaluated for its pharmacokinetics and anti-tumor efficacy in immunodeficient mice bearing orthotopic HCC patient-derived xenografts (PDX). Mechanisms underlying its observed activity were assessed through protein-level analysis of AKT-mTOR-STAT3, RAF, Wnt/{beta}-catenin signaling pathways, vasorin-associated pathways, and PD-L1. ResultsSSL-0024 demonstrated markedly improved aqueous solubility and stability in gastric and plasma conditions, supporting oral administration. Pharmacokinetic analyses revealed a plasma half-life of [~]24 hours, dramatically extended relative to native niclosamide. Once daily oral administration of SSL-0024 (100 mg/kg) in orthotopic HCC PDX mice achieved [~]60% tumor growth inhibition at only [~]46.8% of the dose required for the positive control (niclosamide ethanolamine), with minimal systemic toxicity. Mechanistically, SSL-0024 concurrently suppressed AKT-mTOR-STAT3 signaling, RAF kinases, Wnt, and VASN-associated pathways, with additional downregulation of PD-L1, resulting in reduced proliferation, survival, and immune-evasion signaling. ConclusionThrough rational design and systematic screening, we have identified a lead niclosamide prodrug candidate, SSL-0024, which exhibited improved water solubility and stability, extended plasma half-life, enhanced oral bioavailability, and preservation of biological activity in vitro and in vivo. Future studies will include combination therapy with standard-of-care treatments, as well as safety and formulation studies to enable its clinical translation for the treatment of HCC and other solid tumors impacted by the multiple oncogenic pathways modulated by niclosamide.

Poly(ADP-ribose) polymerase 1 (PARP1) is a central mediator of DNA damage repair and an established therapeutic target in homologous recombination-deficient cancers. Radiolabelled PARP inhibitors provide a strategy to deliver cytotoxic radiation directly to tumour DNA by exploiting PARP overexpression and trapping at sites of DNA damage. Here, we describe the design, radiosynthesis, and in vitro evaluation of [123I]Italia, a talazoparib-derived Auger electron-emitting agent for PARP-targeted radionuclide therapy. Stereochemically pure [123I]Italia, (8S,9R)-5-fluoro-8-(4-(iodo-123I)phenyl)-9-(1-methyl-1H-1,2,4-triazol-5-yl)-2,7,8,9-tetrahydro-3H-pyrido[4,3,2-de]phthalazin-3-one was synthesised in one step via copper-mediated iodo-deboronation, achieving activity yields >80% and molar activities >6.2 {+/-} 3.1 GBq/{micro}mol (n=8). UPLC analysis confirmed radiochemical purity >97%. Italia exhibited potent PARP1 inhibition (IC50 0.48 nM) and in silico predicted binding affinity comparable to talazoparib. In a panel of PARP-expressing cancer cell lines, [123I]Italia demonstrated highest uptake at 60 min, PARP-selective uptake, predominant nuclear localisation (up to 60% of added activity) and chromatin association consistent with PARP trapping (up to 15% of total activity recorded). Uptake was reduced more than 50-fold by addition of an excess of any PARP inhibitor (e.g. olaparib, talazoparib, and rucaparib) and in PARP1 knockout cells, confirming target specificity. Clonogenic assays showed a marked, added activity-dependent reduction in survival of PARP-expressing cells following a brief one-hour exposure, whereas PARP1-deficient cells were resistant. Collectively, these findings identify [123I]Italia as a promising PARP-targeted Auger electron-emitting theranostic candidate that warrants further in vivo evaluation.

Adoptive cell therapies used to treat advanced prostate cancer are being developed to target several tumor-associated antigens, including prostate-specific membrane antigen (PSMA). Chimeric antigen receptor (CAR) T cell therapy using the single chain variable fragment (scFv) derived from the humanized murine mAb clone, J591, as the antigen-binding domain has shown promising anti-tumor activity. However, it has also been associated with macrophage activation syndrome and other unwanted toxicities, highlighting the need for more specific and human-derived antigen-binders with optimized construct designs for improved safety and efficacy. Here, we optimize a human scFv-based PSMA-targeted CAR (hPSMA-CAR) with highly selective PSMA targeting. We further introduce a membrane-bound IL-12 (mbIL12) molecule, which enhances potency with increased T cell expansion, IFNy production and anti-tumor cell activity in vitro. Using two clinically-relevant bone-metastatic prostate cancer models, we show that mbIL12-engineered hPSMA-CAR T cells drive potent in vivo anti-tumor responses. In summary, we have developed a promising therapeutic that has potential to promote safe and effective treatment of advanced PSMA+ prostate cancer.

Ewing sarcoma (ES) is an aggressive bone tumor that primarily affects children, adolescents, and young adults. EWS-FLI1 oncogenic fusion protein is indispensable for ES tumor survival and progression. Casein kinase II (CK2) is a serine/threonine kinase that plays an essential role in apoptosis, DNA damage repair, and the cell cycle. CK2 is highly expressed in ES and associated with metastatic disease and poor 5-year overall survival. Here, we show that CK2 inhibitor CX-4945 (silmitasertib) induced K48-specific ubiquitination and subsequent proteasomal degradation of EWS-FLI1. CK2 inhibition effectively altered fusion protein abundance and disrupted the ES oncogenic signaling, specifically repressing metastasis-associated gene programs. Phenotypically, CK2-depleted ES cells showed decreased migration and invasion in vitro. In the metastatic ES xenograft model, CX-4945 significantly suppressed tumor growth, reduced tumor burden in the lungs, and extended overall survival. CK2 genetic depletion phenocopied CX-4945 effects both in vitro and in vivo. Molecular analysis of treated tumors confirmed robust target engagement, characterized by significant decrease in CK2 substrate phosphorylation levels. CX-4945 showed synergistic cytotoxicity with Irinotecan, a commonly used chemotherapy for the treatment of relapsed ES. Our findings establish CK2 as a novel therapeutic target in ES and provide a mechanistic rationale for combining CK2 inhibitor with chemotherapy regimens. Given the established safety profile of CX-4945, these results support clinical testing of the CK2 inhibitor fusion for treatment of metastatic ES. A Phase 1/2 trial (NCT06541262) is currently evaluating CX-4945 in combination with chemotherapy for pediatric and young adults with relapsed or refractory solid tumors, including ES. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=133 SRC="FIGDIR/small/677357v2_ufig1.gif" ALT="Figure 1"> View larger version (41K): org.highwire.dtl.DTLVardef@96e51aorg.highwire.dtl.DTLVardef@9b353eorg.highwire.dtl.DTLVardef@1c49da8org.highwire.dtl.DTLVardef@14abe06_HPS_FORMAT_FIGEXP M_FIG C_FIG Statement of Translational RelevanceOur study identifies Casein Kinase 2 (CK2) as a novel therapeutic target in Ewing Sarcoma (ES). We demonstrate that CK2 inhibition triggers K48-specific ubiquitination and subsequent proteasomal degradation of EWS-FLI1 oncoprotein. Additionally, CX-4945 simultaneously targets multiple oncogenic signaling pathways and EWS-FLI1 regulators, resulting in sustained suppression of proliferation and metastasis. In metastatic ES models, oral CX-4945 showed robust efficacy, significantly reducing tumor volume and lung metastasis while extending survival. These findings provide the mechanistic rationale for integrating CK2 inhibition into current chemotherapy regimens. The translational impact is immediate: CX-4945 has an established clinical development pathway, and its safety in combination with chemotherapy is currently being evaluated in an ongoing Phase 1 multicenter trial (NCT06541262), offering a novel targeted strategy for patients with metastatic Ewing Sarcoma.

BackgroundLung cancer, including Non-Small Cell Lung Carcinoma (NSCLC), is the leading cause of cancer mortality worldwide. Platinum salts are the gold standard chemotherapy for NSCLC but many patients develop resistance leading to disease progression. Identifying new therapeutic strategies to counteract resistance is crucial. Pharmacological compounds targeting core components of the spliceosome machinery have emerged as promising anti-cancer agents. However, their mechanisms of action remain to be elucidated in NSCLC. MethodsVarious NSCLC cell lines were used in 2D and 3D cultures or clonogenic assays. NSCLC Patient-Derived Xenografts were also used. SF3B1 was silenced by siRNA. Flow cytometry was performed to analyze cell cycle distribution and apoptosis. Western-blot, immunofluorescence, SIRF analysis and DNA repair assays were done to assess globally the DNA damage response. RNA-Seq, RT-qPCR and RT-PCR studies were performed to identify gene and splicing events impacted by SF3B1 inhibition. Publicly available transcriptomic and proteomic data were analyzed. ResultsSF3B1 is a core component of the spliceosome machinery. We show that NSCLC cells with acquired resistance to platinum salts are vulnerable to pladienolide B, a SF3B1 inhibitor, or SF3B1 knock-down. Importantly, pladienolide B also slows down tumor growth of NSCLC Patient-Derived Xenografts (PDXs) poorly responsive to platinum salts. Mechanistically, we show that pladienolide B leads to genomic instability and apoptosis, that correlate with early transcription-dependent replication stress and DNA-PKcs activation, followed by the shutdown of ATR/DNA-PKcs-dependent signaling. In addition, pladienolide B profoundly regulates the expression and/or splicing, particularly exon skipping, of numerous genes involved in DNA repair, leading to decreased repair capacities of DNA double strand breaks. Although exon skipping events are mostly transient, skipping of exon 8 of MLH3, a gene involved in mismatch DNA repair, persisted along time. Finally, we show that pladienolide B counteracts resistance to platinum salts in NSCLC cells as well as PDXs, which correlates with enhanced MLH3 exon 8 skipping and decrease of ATR, DNA-PKCs and MLH3 protein levels. ConclusionsAs a whole, our data highlight the targeting of SF3B1 as a potential therapeutic strategy, alone or in combination, in NSCLC patients who escape platinum salts-based chemotherapy.

The limited efficacy of current therapies against cholangiocarcinoma (CCA) necessitates the development of novel treatment strategies. Src family kinases (SFKs) contribute significantly to tumor progression and resistance in CCA. Therefore, we investigated the novel, first-in-class SFK OFF inhibitor NXP900 in diverse preclinical CCA models, including those with acquired resistance. This study evaluated the therapeutic effects of NXP900 and detailed adaptive molecular responses to SFK inhibitor therapy. We also aimed to identify biomarkers predictive of drug sensitivity using integrated multiomic profiling and develop strategies to overcome resistance. NXP900 inhibited YAP activity through direct inhibition of tyrosine phosphorylation and indirect activation of the Hippo pathway via LATS. These effects were associated with decreased tumor cell viability in CCA cell lines and several in vivo models. Notably, IDH-mutant patient-derived xenograft CCA models were particularly sensitive to NXP900. NXP900 also synergized with gemcitabine/cisplatin chemotherapy, enhancing antitumor efficacy in both in vitro and in vivo models. Multiomic analyses combining transcriptomics, global proteomics, and phosphoproteomics identified molecular features associated with primary response and acquired resistance. IL13RA-AKT signaling was upregulated in resistant models; NXP900 sensitivity could be restored with AKT or IL13RA2 inhibition. Together, these findings demonstrate the therapeutic potential of NXP900 as a novel YAP inhibitor in CCA and support further investigation in a clinical trial. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=101 SRC="FIGDIR/small/699926v1_ufig1.gif" ALT="Figure 1"> View larger version (24K): org.highwire.dtl.DTLVardef@1cb9e6eorg.highwire.dtl.DTLVardef@10e50e2org.highwire.dtl.DTLVardef@e04dfaorg.highwire.dtl.DTLVardef@1f7334_HPS_FORMAT_FIGEXP M_FIG C_FIG

CDK12 and CDK13 (CDK12/13) regulate transcription by phosphorylating Serine 2 (S2) of the C-terminal domain of RNA polymerase II and have been proposed as therapeutic targets in cancer. Here we report the development of CTX-439, a novel, orally bioavailable, ATP-competitive small-molecule CDK12/13 inhibitor. CTX-439 specifically inhibits S2 phosphorylation and downregulates many genes including those involved in DNA damage repair, thereby exerting a profound anti-cancer effect in vitro and in vivo including breast cancer PDX models. A CRISPR activation screen identified BCL-2 and BCL-xL, anti-apoptotic BCL-2 family members, as genes that when upregulated confer resistance to CTX-439. Simultaneous inhibition of BCL-2/BCL-xL and CDK12/13 rapidly induced apoptosis and significantly suppressed xenograft tumor growth. Mechanistically, CTX-439 downregulates MCL1 protein levels through transcriptional readthrough, shifting cell survival dependency to BCL-2 and BCL-xL. Our study provides novel insights into the anti-tumor effect of CDK12/13 inhibition and proposes a new combination therapy strategy with anti-apoptotic BCL-2 family inhibitors, which may improve therapeutic outcomes in cancer treatment.