Abstract B063: Elucidating treatment induced tumor antigen presentation in pancreatic cancer
Authors: Adhikari Emma , Weeden Andrew , Brennan Emily , Polera Christopher , Victoria lzumi  , Fang Bin , Koomen John , Stewart Paul , Jaeger Alex 
Published: September 2024

Abstract
Introduction Pancreatic ductal adenocarcinoma (PDAC), the most common form of pancreatic cancer, is projected to become the second leading cause of cancer-related deaths by 2030. The 5-year survival rate remains stubbornly low at just 13%. These discouraging statistics primarily stem from the lack of effective treatments till date. Despite the success of immunotherapy for several malignancies, immunotherapy for PDAC has yielded disappointing results alone or in combination with other therapies. Successful immunotherapy will require a deeper understanding of PDAC immunobiology and immune recognition of cancer during its progression, and treatment regimens. Immunosurveillance of cancer requires the presentation of peptide antigens on Major Histocompatibility complex class I (MHC-I). Understanding the repertoire of MHC-I associated peptides (pMHC-I), collectively termed as the “immunopeptidome”, is essential for anti-tumor immunity and successful immunotherapies. Using a collection of preclinical tools and human cell lines, we aim to uncover treatment induced antigens in PDAC that can be used for targeted immunotherapy approaches. Methods To understand the biogenesis of the immunopeptidome, our group has developed a novel genetically engineered mouse model (GEMM), which integrates inducible affinity tags on MHC-I (KbStrep) and ribosomes (RiboTag) into the Kras LSL-G12D/+ ; P53 fl/fl (KP) mouse model (KP/RiboMHC). This approach enabled us to precisely measure protein synthesis and antigen presentation in malignant PDAC cells in vivo with paired ribosome profiling and mass spectrometry based immunopeptidomics. In parallel we have employed a collection of human PDAC cell lines for immunopeptidomics analysis. About 93% of PDACs have KRAS mutation, with G12D mutation being the most common. In addition, PDAC is subjected to a deregulated metabolic milieu, with a strong dependence on glutamine utilization. Therefore, to examine treatment induced changes in PDAC antigen presentation, we examined the impact of KRAS inhibition (MRTX1133) and glutamine antagonism (6-diazo-5-oxo-L-norleucine, DON) on the biogenesis of the immunopeptidome in vitro and in vivo. Results Using our GEMM model, we have started to uncover MRTX1133 and DON induced alterations in protein synthesis and in pMHC-I repertoire in vivo using the KP/RiboMHC model and in vitro in mouse and human cell lines. We have identified unique antigen peptides that are induced by MRTX1133 and DON, including those derived from non-canonical translation events that were defined by ribosome profiling. Conclusions Our data demonstrates that KRAS inhibition with MRTX1133 or glutamine antagonism with DON reshapes the antigen landscape of PDAC. We are actively exploring which of the induced peptides harbor potential to mount an anti-tumor CD8+ T cell response. Collectively, these results could pave the way forward for rationally designed treatment regimens that pair targeted therapies with antigen specific immunotherapy in PDAC.
Citation Format: Emma Adhikari, Andrew Weeden, Emily Brennan, Christopher Polera, Victoria lzumi, Bin Fang, John Koomen, Paul Stewart, Alex Jaeger. Elucidating treatment induced tumor antigen presentation in pancreatic cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr B063.