Abstract 3716: Enhancing anti-tumor responses in triple-negative breast cancer by combining SIRPα inhibition with immunogenic chemotherapy or antibody-drug conjugates
Authors: Ma Xingru , Tsao Li-Chung , Wang Tao , Liu Cong-Xiao , Gajda Melissa , Yang Xiao , Lei Gangjun , Wei Junping , Hartman Zachary 
Published: March 2024

Abstract
Background: Triple-negative breast cancer (TNBC) is a subtype of breast cancer defined by the absence of hormone receptors and HER2 receptor on tumor cells. Because of a lack of targetable receptors and poor response to PD1/PDL1 immunotherapy, TNBC has limited systemic treatment options. In previous work using a genomic screen (Shuptrine et al., 2017), we identified CD47 as one of the leading factors that contributes to TNBC immune evasion. The CD47-SIRPα axis is an innate immune checkpoint that primarily regulates myeloid cells. In the context of cancer, tumor cells upregulate CD47 to engage SIRPα inhibitory signaling to block phagocytosis. While CD47 or SIRPα blockade alone show limited antitumor effect, therapies that combine blockade of this axis with other treatment agents, such as tumor-antigen specific antibodies, show superior tumor inhibition. Thus, we hypothesize that the addition of SIRPα inhibition to existing TNBC treatments (chemotherapy and Trop2-antibody drug conjugates (ADC)) will improve their treatment efficacy.
Methods: To ascertain the impact of SIRPα inhibition combined with chemotherapy and Trop2-ADC, we utilized and validated a novel SIRPα KO mouse, along with SIRPα mAbs, in our previously utilized models of Triple-Negative Breast Cancer (TNBC) (Crosby et al., 2018). Using both in vitro and in vivo tumor models, we tested the therapeutic impact of SIRPα inhibition/blockade combined with different immunogenic chemotherapies (doxorubicin/cyclophosphamide) and Sacituzumab govitecan (SG) in TNBC.
Results: After validating the loss of SIRPα in KO mice, we found that E0771 TNBC cells had comparable growth rates in WT and SIRPα KO mice. Similarly, we did not observe different anti-tumor responses to Doxorubicin between WT and SIRPα-KO mice. However, we observed more profound suppression of E0771 tumors after cyclophosphamide treatment in SIRPα KO mice than in WT mice. To evaluate the efficacy of SG in inducing antibody-dependent cellular phagocytosis (ADCP), we co-cultured SIRPα KO and WT mouse macrophages with a syngeneic mouse TNBC model (MM3MG-Trop2-WT). We found that SG promotes ADCP in WT macrophages, and SIRPα loss further increased this ADCP, suggesting the potential importance of antibody-mediated phagocytosis as a mechanism of action for SG. In vivo, we implanted human TNBC cells (MDA-MB-468) in mice and treated them with SG with and without SIRPα antibody blockade. These studies demonstrated an anti-tumor effect from SG that was potentially enhanced by SIRPα blockade, suggesting the clinical potential of this combination in TNBC.
Conclusion: Our study demonstrates that the addition of SIRPα inhibition to chemotherapy or SG may promote tumor phagocytosis and stimulate stronger antitumor immunity in TNBC. These results support further investigation of SIRPα-targeting combination therapies for TNBC.
Citation Format: Xingru Ma, Li-Chung Tsao, Tao Wang, Cong-Xiao Liu, Melissa Gajda, Xiao Yang, Gangjun Lei, Junping Wei, Zachary Hartman. Enhancing anti-tumor responses in triple-negative breast cancer by combining SIRPα inhibition with immunogenic chemotherapy or antibody-drug conjugates [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 3716.