Abstract 2040: Targeting MUS81 endonuclease to enhance chemo-immunotherapy response in head and neck squamous cell carcinoma

Abstract Background: In advanced head and neck squamous cell carcinoma (HNSCC), immune checkpoint inhibitors are only effective in 15-20% of cases. Defects in replication stress response represent a promising avenue for enhancing the therapeutic efficacy of immunotherapy through DNA damage and the release of immunostimulatory DNA. MUS81, a DNA structure-specific endonuclease involved in resolving replication stress, is upregulated in many cancer types including HNSCC, and MUS81-associated cytosolic DNA is implicated in triggering cGAS-STING mediated innate immunity. The objectives of this study were to assess the impact of targeting MUS81 on HNSCC cell sensitivity to cisplatin, and investigate its role in enhancing immunotherapy response in HNSCC, through the cell viability and cell cycle analysis, differential gene expression, and DNA release within small extracellular vesicles (exosomes). Methods and Results: We used HNSCC cell lines and patient-derived organoids (PDOs) to investigate the consequences of CRISPR/Cas9-mediated MUS81 knockout (KO). We demonstrated that MUS81 KO increased HNSCC cell sensitivity to cisplatin, inducing a G2/M cell cycle arrest. Transcriptomic analysis of differentially expressed genes (DEG) in MUS81 KO vs control cells highlighted upregulation of ANXA6 (tumor suppressor gene encoding for Annexin A6), MACROH2A2 (involved in the quiescent phenotype acquisition of malignant HNSCC cells) and CDA (encoding for cytidine deaminase, implicated in replication stress). MUS81 KO was also associated with downregulation of LCP1 (encoding for lymphocyte cytosolic protein 1, upregulated in oral cancer and controlling cellular proliferation, invasiveness, and migratory activities). Gene Set Enrichment Analysis (GSEA) of RNA-seq data, revealed positive enrichment in MUS81 KO cells treated with cisplatin in genes involved in the hallmark interferon alpha (Normalized Enrichment Score (NES) 3.03, p-value < 0.001) and interferon gamma (NES 2.83, p- value < 0.001) pathways, indicative of innate and adaptive immune responses. Additionally, the pathway of hallmark inflammatory response was positively enriched (NES 2.22, p < 0.001). In addition, cisplatin treatment in MUS81 KO was associated with notable alterations in the concentration and length of exosomal DNA, with implications for immune response modulation within the tumor microenvironment. Conclusions: Our study underscores the potential significance of MUS81 as a novel therapeutic target in HNSCC. In addition to sensitizing HNSCC cells to chemotherapeutic agents, targeting MUS81 may influence the dynamics of the tumor microenvironment, thereby enhancing the prospects of immunotherapy in this context. Further in-depth investigations are imperative to validate these observations and facilitate the development of innovative therapeutic strategies tailored to targeting MUS81 in HNSCC. Citation Format: Ali Abdulnabi Suwaidan, Anna Pasto, Caitlin McCarthy, Teng Pan, Jinhai Deng, Luigi Dolcetti, Giovanna Alfano, Rami Mustapha, James Monypenny, Martin Forster, Tony Ng. Targeting MUS81 endonuclease to enhance chemo-immunotherapy response 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 2040.