Abstract P3-10-19: Precise targeting of POLR2A for treating triple negative breast cancer with Chr17p loss
Authors: Lu Xiongbin , Li Yujing , Sun Yifan , Van der Jeught Kevin , Kulke Michael , Andreas Pahl , Zhang Xinna , He Xiaoming , Zhang Chi 
Published: March 2020

Abstract
Triple-negative breast cancer (TNBC) is a molecularly diverse and clinically heterogeneous disease. The challenges for developing novel treatment approaches for TNBC are the paucity of actionable targets, lack of targeted therapies, and poor prognosis of patients. Breast cancer genomics revealed that heterozygous deletion of chromosome 17p (Chr17p) is the most prevalent (53%) event in TNBC. Within the 17p deletion region is the tumor suppressor TP53 (encoding p53), whose deletion or mutation has been long known as a primary tumorigenic driver. However, it remains unclear whether the deletion event, which often includes as many as 200 genes, impacts tumorigenesis beyond TP53 loss alone. While p53 aberrancy promotes proliferation, metabolism and metastatic potential of the TNBC cells, we found that heterozygous deletion of Chr17p is tightly correlated with poor cytotoxicity of tumor infiltrating lymphocytes (TILs) and poor clinical outcomes in patients with TNBC. This result suggests that selective advantage due to Chr17p loss reflects the combined impact of TP53 loss and the reduced dosage of co-deleted genes.
Our recent study also identified POLR2A in the TP53-neighboring region as a collateral vulnerability target in the TNBC tumors with Chr17p loss, suggesting that inhibition of POLR2A may be a precision therapy approach for TNBC. As a proof-of-concept, we designed pH-activated nanoparticles (termed as nanobomb) for delivery of POLR2A siRNA, which enhances bioavailability and improves endo/lysosomal escape of the siRNA. In this study (Nature Nanotechnology, 2019)1, we demonstrated that suppressing POLR2A expression with the siRNA-laden nanoparticles led to marked growth reduction of TNBC tumors with 17p loss. Despite recent success of the first FDA-approved RNAi-based therapy for polyneuropathy, the issues of RNAi-based drugs, such as non-specific and incomplete knockdown, can make RNAi unpredictable, slow, and risky, in particular in drug discovery, where speed and reliability of results are crucial factors. To accelerate the translational development of our important finding, we will use α-amanitin, a natural small compound isolated from Amanita phalloides, to specifically inhibit POLR2A (Kd ∼10−9 M). However, free form of α-amanitin causes liver toxicity via the interaction with the hepatocyte-specific OATP1B3 transporter, limiting its clinical applications. To overcome the drug toxicity of α-amanitin, we have been developing α-amanitin-based antibody-drug conjugates (ADC). This approach inhibits the specific uptake of α-amanitin into hepatocytes and increases tumor-specific targeting using tumor-specific monoclonal antibodies. This type of ADC showed significant efficacy in inhibiting the growth of colorectal tumors with heterozygous deletion of TP53 and POLR2A (Nature, 2015)2. Here, we propose that heterozygous deletion of Chr17p not only contributes to TNBC tumorigenesis, but also confers therapeutic vulnerabilities, which can be utilized to develop novel targeted cancer therapy.
Refernces
1. Xu,J. et al. Precise targeting of POLR2A as a therapeutic strategy for human triple negative breast cancer. Nat. Nanotechnol. 14, 388-397 (2019).
2. Liu,Y. et al. TP53 loss creates therapeutic vulnerability in colorectal cancer. Nature 520, 697-701 (2015).
Citation Format: Xiongbin Lu, Yujing Li, Yifan Sun, Kevin Van der Jeught, Michael Kulke, Pahl Andreas, Xinna Zhang, Xiaoming He, Chi Zhang. Precise targeting of POLR2A for treating triple negative breast cancer with Chr17p loss [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P3-10-19.