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.

Current approved KRASG12C inhibitors covalently bind the inactive GDP-bound (OFF) form of KRASG12C. Recently, KRASG12C inhibitors that selectively bind to the GTP-bound (ON) form of both KRASG12C (ON) and (OFF) forms have been reported and entered clinical testing. In principle, KRASG12C (ON) inhibitors may be less susceptible to adaptive mechanisms that promote resistance to (OFF) inhibitors, however the specific mechanisms that differentiate the activity of (ON) versus (OFF) inhibition are not well understood. We profiled the activity of BBO-8520, a covalent dual inhibitor of GTP-bound (ON) and GDP-bound (OFF) KRASG12C, in KRASG12C-mutant non-small cell lung cancer models. BBO-8520 exerted more potent and sustained inhibition of KRASG12C and anti-tumor activity in vitro and in vivo compared with sotorasib, a KRASG12C (OFF)-only inhibitor. While cells treated with BBO-8520 or sotorasib both exhibited feedback reactivation of MAPK signaling driven by wild-type HRAS/NRAS isoforms, more durable suppression of KRASG12C by BBO-8520 was associated with decreased PI3K-AKT activation in vitro. Disruption of the interaction between RAS and PI3K using a novel protein:protein interaction inhibitor suppressed PI3K-AKT activation and increased the tumor response to sotorasib to a similar level as BBO-8520. Moreover, in some contexts, disruption of RAS-PI3K further increased the anti-tumor activity of BBO-8520 monotherapy. These results reveal mechanistic differences between KRAS (ON) and (OFF) inhibitors, highlight the importance of PI3K-AKT signaling in driving resistance to KRAS inhibition in lung cancer, and suggest combination strategies that suppress PI3K-AKT to improve the response to KRAS inhibitors.

Head and neck squamous cell carcinoma (HNSCC) is currently the sixth most prevalent cancer worldwide and is marked by a high tumor relapse frequency due to acquired chemoresistance, requiring alternative strategies to sensitize resistant tumor cell populations to treatment. Sacituzumab govitecan (SG), a TROP2-targeting antibody-drug conjugate, has been successful in limiting tumor progression in pretreated patients with triple-negative and hormone-receptor positive HER2-negative breast cancer. However, it has been ineffective as a monotherapy in HNSCC. This may be attributed to the promotion of senescence that could ultimately lead to tumor relapse. Senolytics, drugs inducing cell death in senescent cell populations, have been effective in sensitizing a variety of solid tumor types to standard of care chemotherapies in preclinical studies. Consequently, we investigated the effectiveness of SG treatment followed by the senolytic, ABT-263, as a "two-hit" therapeutic strategy against cisplatin-resistant HNSCC. We established that isogenic cisplatin-sensitive and -resistant HNSCC cells express high levels of TROP2 and undergo senescence following SG treatment, and found that TROP2 expression and the SN-38 SG warhead are necessary for SG to induce senescence. SG treatment supplemented with a panel of BCL-2 family targeting senolytics revealed that both cisplatin-sensitive and -resistant senescent HNSCC cells are sensitive to BCL-XL specific inhibitors, such as ABT-263. Furthermore, we determined that ABT-263 sensitized HNSCC cells to apoptosis via a BAK and BAX-dependent mechanism. In vivo studies confirmed that SG treatment followed by ABT-263 limited tumor progression and extended survival without notable toxicity. Thus, SG in combination with senolytic treatment may be an effective strategy for suppressing the growth of cisplatin-resistant HNSCC cells.

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.

Although the retinoblastoma protein (pRB) is functionally inactivated by hyperphosphorylation in the majority of colorectal cancers (CRC) - with RB1 rarely mutated and even amplified at the genomic level - three critical gaps remain unaddressed: no study has systematically compared which first-line chemotherapeutic agent best synergizes with CDK4/6 inhibition using head-to-head quantitative analysis; functional differences between palbociclib and abemaciclib in chemotherapy combinations have not been characterized in CRC; and direct genetic evidence of RB dependency in this combinatorial context is lacking. Here, we addressed these gaps by evaluating palbociclib and abemaciclib combined with oxaliplatin, 5-fluorouracil, and SN-38 in HCT116 CRC cells, with validation in SW480 cells, RB1-silenced HCT116 cells (shRNA-RB), and non-tumoral intestinal epithelial cells (IEC-6), using quantitative drug interaction analysis (Chou-Talalay), cell cycle profiling, apoptosis assessment, and pRB phosphorylation measurement. Oxaliplatin was the most consistently synergistic partner for both CDK4/6 inhibitors (CI < 1 across all tested concentrations), while combinations with SN-38 yielded variable results and 5-FU combinations approached additivity. The oxaliplatin combination reinforced G1 arrest and enhanced cell death, with abemaciclib producing more pronounced apoptotic induction than palbociclib - an effect not explained by differential pRB target engagement (both inhibitors reduced pRB Ser807/811 phosphorylation by [~]50%), likely reflecting abemaciclibs broader kinase inhibitory profile. shRNA-mediated RB1 silencing partially attenuated the combinatorial effect, providing direct genetic evidence that the synergy is RB-dependent. Importantly, the combination did not significantly potentiate oxaliplatin cytotoxicity in non-tumoral IEC-6 intestinal epithelial cells, in contrast to the pronounced enhancement observed in tumor cells, and synergistic benefit was preserved at sub-cytotoxic inhibitor concentrations. These findings identify oxaliplatin as the optimal chemotherapeutic partner for CDK4/6 inhibition in CRC, with a mechanism involving RB-dependent potentiation of apoptosis that is preferentially active against tumor cells and maintained at clinically relevant inhibitor doses.

While Trastuzumab emtansine (T-DM1) and other HER2-targeting antibody-drug conjugates (ADCs) are used to treat cancer patients with HER2-amplified tumors, there is a need to improve the efficacy through the understanding of their mechanism of uptake into cells. Flotillin-2 (FLOT2) regulates the internalization of epidermal growth factor receptor (EGFR), leading us to investigate FLOT2 effects on HER2 internalization. Higher FLOT2 expression in nine HER2 amplified cell lines correlated with a higher T-DM1 IC50 in vitro, and breast cancer patients with high FLOT2 expression had worse survival when receiving either T-DXd (16.2 months (m) vs 18.3 m, p=0.04) or T-DM1 (38.0 m vs 41.3 m, p=0.1) in real-world Caris Life Sciences data. FLOT2 interacts with HER2 and positively regulates HER2 activation and downstream signaling, while FLOT2 knockdown reduces the viability of HER2 amplified cancer cells. FLOT2 knockdown results in increased HER2 internalization upon binding of T-DM1, mediated by ubiquitination by the Cbl ubiquitin ligases. We investigated the effects of various small molecules and discovered that zoledronic acid binds to FLOT2 and disrupts the HER2/FLOT2 interaction, which enhances T-DM1 internalization and cytotoxicity. In conclusion, FLOT2 regulates the internalization and cytotoxicity of T-DM1 mediated by Cbl-dependent ubiquitination of HER2. Zoledronic acid disrupts the HER2/FLOT2 interaction, therefore increasing the internalization and cytotoxicity of T-DM1, providing proof of principle that a small molecule inhibitor of the HER2/FLOT2 interaction can enhance the activity of the HER2-targeting ADC.

BackgroundResistance to 5-fluorouracil (5-FU)-based chemotherapy is a major clinical obstacle in colorectal cancer (CRC), highlighting the urgent need to overcome established resistance mechanisms. MicroRNA-based therapeutics have emerged as compelling candidates in this context, given their inherently pleiotropic mode of action; however, their clinical translation remains hindered by poor stability and suboptimal delivery. MethodsTo address these limitations, Gem-miR-15a, a unique gemcitabine-modified tumor-suppressor microRNA-15a was designed to synergistically integrate the tumor-suppressive activity of miR-15a with the chemotherapeutic potency of gemcitabine into a single molecular entity. Therapeutic efficacy of Gem-miR-15a was evaluated across a spectrum of preclinical models, including parental and drug-resistant CRC cell lines, 3D tumor spheroids, patient-derived organoids and in vivo metastatic models. Cell viability, apoptosis and cell cycle analyses were performed, along with RNA sequencing and protein validation. Statistical analyses were conducted using Students t-test or two-way ANOVA with mixed effects, and data were presented as mean {+/-} SD. ResultsGem-miR-15a exhibited potent anti-proliferative activity with IC50 values in the low nanomolar range, achieving [~]100-5000-fold greater potency relative to 5-FU and oxaliplatin. Importantly, it retained efficacy in both 5-FU- and oxaliplatin-resistant CRC models, effectively overcoming acquired chemoresistance. Mechanistically, Gem-miR-15a induced S-phase cell cycle arrest, eliminated the G2-phase cell population, and triggered apoptosis, accompanied by suppression of key oncogenic targets including WEE1, CHK1, YAP1 and BMI1. RNA-seq analysis further demonstrated modulation of pathways such as p53 signaling and reversal of resistance-associated gene expression, that were corroborated at the protein level. In vivo, Gem-miR-15a significantly reduced tumor growth at a dose [~]12-fold lower than gemcitabine, with no observable toxicity. ConclusionGem-miR-15a represents a potent, multi-targeted therapeutic strategy capable of overcoming chemoresistance in CRC. Its enhanced stability, effective delivery and robust efficacy across resistant models and a favorable safety profile highlight its strong potential for clinical translation. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=119 SRC="FIGDIR/small/720825v1_ufig1.gif" ALT="Figure 1"> View larger version (41K): org.highwire.dtl.DTLVardef@c20034org.highwire.dtl.DTLVardef@9b8478org.highwire.dtl.DTLVardef@161f1dorg.highwire.dtl.DTLVardef@54d826_HPS_FORMAT_FIGEXP M_FIG C_FIG

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.

Protein arginine methyltransferase 5 (PRMT5) is a synthetic lethal target in methylthioadenosine phosphorylase-deleted (MTAP-null) cancers. Second-generation MTA-cooperative PRMT5 inhibitors preferentially target MTAP-null cells while largely sparing MTAP-wildtype (MTAP-WT) cells, thereby improving tumor selectivity over first-generation PRMT5 inhibitors. Despite encouraging efficacy and safety signals in early clinical studies, the modest objective response rates (ORRs) observed with these inhibitors suggest that intrinsic or acquired resistance may limit their clinical benefit. Here, we investigated mechanisms of acquired resistance to the MTA-cooperative PRMT5 inhibitor BMS-986504/MRTX1719 in MTAP-null non-small cell lung cancer (NSCLC) cells and sought to identify therapeutic vulnerabilities that emerge upon resistance. Using multiple in vitro-derived resistant models, we found that acquired resistance was not fully explained by alterations in PRMT5 activity or reduced MTA levels. Instead, resistance was associated with collateral sensitivity to MEK inhibition and enrichment of MAPK-related transcriptional programs. Together, these findings identify MEK inhibition as an actionable collateral vulnerability in MTAP-null NSCLC cells that acquire resistance to PRMT5 inhibition.

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.

BackgroundOpportunistic nutrient uptake is a hallmark of cancer metabolism. Cancer cells upregulate macropinocytosis to acquire extracellular nutrients to support growth and stress adaptation. We previously showed that extracellular ATP (eATP) is internalized by macropinocytosis and promotes multiple cancer phenotypes. Here, we tested whether eATP uptake is prevalent across cancers and whether eATP also induces senescence through purinergic receptor (PR) signaling. MethodsIntracellular ATP (iATP) levels were measured following eATP exposure across multiple cancer cell lines. eATP internalization was visualized in vitro and in vivo using a non-hydrolyzable fluorescent ATP analog together with high-molecular-weight dextran as a macropinocytosis marker. Senescence was quantified using three SA-{beta}-galactosidase assays and flow cytometry. Pharmacologic inhibitors of macropinocytosis and purinergic receptors were used to define pathway dependence. Combination treatments with the glucose transporter inhibitor DRB18 and the senolytic navitoclax were evaluated for antiproliferative effects. ResultseATP produced dose- and time-dependent increases in iATP across diverse cancer cell types. Imaging demonstrated widespread macropinocytic internalization of ATP in vitro and in tumor xenografts. eATP induced senescence in NSCLC cells, confirmed by multiple {beta}-gal assays and flow cytometry. PR inhibition significantly reduced senescence, whereas macropinocytosis inhibition had minimal effect on senescence induction. ConclusionseATP acts through dual pathways in cancer cells: macropinocytic internalization that elevates iATP and PR signaling that drives senescence. Targeting metabolic uptake together with senolytic therapy may offer a novel anticancer strategy.

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.

CD47 is a "dont eat me" signal that suppresses macrophage-mediated phagocytosis. Its upregulation in lung and other cancers facilitates tumour immune escape, making CD47 a promising immunotherapeutic target. Studies have demonstrated anti-tumour efficacy of CD47 blockade in preclinical lung cancer models, but monoclonal antibodies targeting CD47 have had limited efficacy as monotherapy in solid tumour patients to date. This discrepancy may in part reflect the use of human tumour xenografts in mice that do not have fully-functioning immune systems in preclinical efficacy studies. Thus, understanding tumour responses to CD47 inhibition using immune competent lung cancer models is needed to inform strategies to harness its therapeutic potential. Here, we characterized the effects of CD47 knockout (KO) on tumour growth and immune responses in two syngeneic, orthotopic murine lung cancer models, LLC-Luc (LLC) and CMT167 (CMT). As expected, CD47 KO impaired the fitness of LLC and CMT cells in vivo. Mice with CD47-deficient tumours exhibited prolonged survival and increased infiltration of anti-tumour leukocytes. However, although CD47 KO impaired lung tumour growth in syngeneic mice, KO tumours were ultimately lethal. Immunophenotyping revealed an increased prevalence of PD-L1+ cells in CD47-deficient tumours, nominating PD-L1-mediated suppression of tumour immunity as an acquired mechanism of resistance to CD47 blockade. Concordantly, dual inhibition of CD47 and PD-L1 extended the survival of CMT tumour-bearing mice compared to inhibition of either alone. These findings suggest that PD-L1 blockade could be leveraged to overcome resistance and potentiate the efficacy of CD47-targeted immunotherapy in lung 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.

BackgroundAntibody-mediated blockade of innate receptor-MHC-I interactions represents a promising strategy to enhance anti-tumor immunity, particularly against metastatic cancers resistant to conventional checkpoint inhibitors. In this study, we investigated the effects of the pan anti-MHC-I monoclonal antibody M1/42, which targets MHC-I interactions with Ly49, selectively expressed on murine NK cell subsets. MethodsWe administered M1/42 to mice and assayed the proliferation and activation immune cells. Anti-tumor activity of growth and metastasis of checkpoint inhibitor-resistant pancreatic ductal adenocarcoma (PDAC) and B16F10 melanoma were assessed, complemented by extensive cellular phenotypic and RNA expression analysis. Binding and cryo-electron microscopic (cryo-EM) and X-ray crystallographic structural studies of M1/42 complexed with the mouse MHC-I molecule, H2-Dd, examined the Ab interaction site in comparison with those of Ly49 inhibitory receptors. ResultsM1/42 administration in mice robustly unleashed the proliferation and activation of natural killer (NK) cells, memory CD4+ and CD8+ T cells, dendritic cells, and macrophages in both lymphoid and non-lymphoid tissues, independent of Fc{gamma} receptors. M1/42 significantly restricted the growth and metastasis of checkpoint inhibitor-resistant pancreatic ductal adenocarcinoma (PDAC) and B16F10 melanoma in the liver and lungs, accompanied by increased tumor infiltration of effector CD8+ T cells, reduction of T regulatory cells, and a pro-inflammatory cytokine milieu. The anti-tumor effects of M1/42 depend on NK cells and are associated with upregulation of genes involved in antigen processing, interferon gamma responsiveness, and Th1 cytokine production, while downregulating inhibitory PD1/11 signaling. Structural analysis indicated that the effect of M1/42 on Ly49/MHC-I interactions was not due to direct steric competition. ConclusionsCollectively, these findings demonstrate that M1/42 unleashes coordinated innate and adaptive immune responses, overcoming tumor-induced immunosuppression and resistance to checkpoint blockade. This approach represents a paradigm shift in cancer immunotherapy, offering potential for more effective treatment of metastatic cancers that evade immune surveillance through MHC-I modulation. KEY MESSAGESO_ST_ABSWhat is already known on this topicC_ST_ABSA pan anti-mouse MHC-I mAb (M1/42) blocks interaction with several NK inhibitory receptors (Ly49A or Ly49C) resulting in NK cell activation and anti-viral and anti-tumor responses in vitro and in vivo. Other pan anti-human MHC-I mAbs (DX17 and W6/32) function similarly, blocking LILRB inhibitory receptor interaction of myeloid cells and NK cells. These stimulate human immune cells in humanized mouse models. What this study addsThis study analyzes the effects of the pan anti-mouse MHC-I mAb on NK and myeloid cell activation in detail, in the absence of T or B cells, and independent of FcR interaction. Additionally we analyze several mouse models of metastatic tumor progression, indicative of the progressive activation not only of the innate immune response, but also adaptive responses. The molecular mechanism of the mAb blocking of inhibitory receptors is revealed by cryo-EM and X-ray structures of M1/42 Fab/MHC-I (H2-Dd) complexes. How this study might affect research, practice, or policyElucidation of the details of the inhibitory effects of the mouse pan anti-mouse MHC-I mAb provides not only a more advanced understanding of the murine model system, but suggests additional functional avenues to be explored using the parallel an anti-human MHC-I mAbs.