Abstract 5962: Novel xCT-targeted biologics significantly suppress metastasis, improve survival, and sensitize primary tumors to chemotherapy in TNBC xenograft models

Abstract Background: Triple negative breast cancer (TNBC) is a highly heterogeneous subset of breast cancer, which has the worst prognosis and lacks specifically targeted therapeutic options. The TNBC subtype termed M/MSL is enriched with cells of high mesenchymal state and increased stemness, and is particularly resistant to current therapies1,2. But this cancer cell phenotype is susceptible to ferroptosis, hence targeting these aggressive tumors with ferroptosis inducers such as xCT inhibitors (xCTi) is an attractive alternative. The cystine/glutamate exchanger xCT/SLC7A11 plays a key role in maintaining redox homeostasis in cancer cells. xCT is expressed on subsets of most solid tumors, including stem/progenitor and metastatic tumor cells. xCT inhibition yields a variety of anti-proliferative phenotypes including death by ferroptosis3. xCT knockout mice exhibit normal development and lifespan. Altogether, targeting xCT outside of CNS may potentially have widespread clinical utility in cancer treatment. Results: We present preclinical data demonstrating development of novel, first-in-class xCT-targeted biotherapeutics (AX68c, AX76c) using studies in TNBC cell lines in vitro and in xenograft. We find that these agents have highly favorable pharmacokinetics, with FcRn-dependent serum half-lives greatly exceeding those of known small molecule xCTi. In vitro, AX68c or AX76c reduces glutathione levels in TNBC cells in accord with inhibition of xCT function. Analysis of anti-proliferative effects in a panel of TNBC cell lines revealed particular potency against those of M/MSL phenotype (IC50s 0.3-1uM). We further tested the susceptibility of the mesenchymal phenotype to AX68c and found that EMT induction in epithelial cancer cells significantly increased sensitivity in a ferroptosis-dependent manner. In wildtype and immunodeficient mice, AX68c is well tolerated at steady-state serum concentrations that are 15-300 fold of its in vitro IC50s in tested TNBC cells. In orthotopic MDA-MB-231 xenografts, AX68c treatment significantly reduced tumor metastasis and sensitized primary tumors to cisplatin and paclitaxel. Bulk RNAseq and GSEA analysis on primary tumors revealed treatment associated alterations in key cancer signaling pathways such as TGFβ, INFγ and TNFα/NFκB. In MDA-MB-436 orthotopic xenografts, AX68c alone led to significantly improved survival primarily through abrogating metastasis. Combining AX68c and cisplatin further prolonged survival through concurrent suppression of metastasis and primary tumor growth. Conclusions: We conclude that our anti-xCT biologics may provide novel targeted therapies for M/MSL-subtype TNBC and metastatic tumors with a large mesenchymal component. 1. Viswanathan, et al., Nature, 2017; 2. Wang, et al., npj Precision Oncology, 2021; 3. Koppula, et al., Protein and Cell, 2021 (review). Citation Format: He Gong, Jun Li, Cyrus Becker, Luika Timmerman, Shaheen Sikandar, Yong Huang. Novel xCT-targeted biologics significantly suppress metastasis, improve survival, and sensitize primary tumors to chemotherapy in TNBC xenograft 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 5962.