Abstract 4530: Nuclear export inhibitor cooperates with PARP inhibitor to suppress the growth of metastatic castration resistant prostate cancer in vivo
Authors: Uddin Md Hafiz , Aboukameel Amro , Khan Husain Y. , Bannoura Sahar F. , Cackowski Frank , Beydoun Rafic , Dyson Gregory , Kim Seongho , Boerner Julie , Shidham Vinod , Mohammad Ramzi M. , Pasche Boris C. , Azmi Asfar S. , Heath Elisabeth I. 
Published: March 2024

Abstract
Background: Aberrant nuclear protein transport, often observed in cancer, causes mislocalization-dependent inactivation of critical cellular proteins. Earlier we showed that overexpression of nuclear export protein exportin 1 (XPO1) is linked to higher grade and Gleason score in metastatic castration resistant prostate cancer (mCRPC). The network topology computational approach (NTCP) determined a higher synthetic lethal score between XPO1 and poly (ADP-ribose) polymerase (PARP1). We showed that selective inhibitor of nuclear export (SINE) could synergized with PARP inhibitors in mCRPC cell lines. Here we evaluated the efficacy of SINE and PARP inhibitor (PARPi) combination in cell line derived as well as patient derived xenograft (CDX and PDX) models and deciphered the mechanism of synergy.
Methods: For CDX model, the 22rv1 mCRPC cells were grown as subcutaneous xenografts in ICR-SCID male mice. For PDX model, tissue was collected from Champions Oncology (CTG-3581) and grown subcutaneously in CEIA/NOG male mice. SINE dosed orally at 10-15 mg/kg twice a week and PARPi dosed orally at 50 mg/kg daily. For in vitro mechanistic study, 22rv1 cells were subjected to RNAseq and proteomic analysis after treatment. Data analysis was performed using iPathwayGuide (advaitabio.com).
Results: The CDX and PDX showed pronounced anti-cancer efficacy by this combination compared to single agents without any significant weight loss. Survival analysis in CDX model demonstrated enhanced benefits to the mice of combination group. Immunohistochemistry (IHC) revealed apoptotic cell death in the combination group which is evident from cleaved caspase 3 staining and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL). To decipher the mechanism of synergy we performed transcriptomic (RNAseq) and proteomic analysis in vitro. We observed downregulation of DNA replication related gene minichromosome maintenance complex component 6 (MCM6) and cell division cycle 6 (CDC6) in the combination treatment. Gene set enrichment analysis (GSEA) also showed low enrichment scores for DNA replication. Proteomic analysis revealed a down regulation of DNA replication modulators such as HMGB2 and DNAJC9 which work on DNA coiling and histone respectively.
Conclusions: Taken together, this study revealed the therapeutic potential of SINE-PARPi combination via targeting DNA damage response pathway in mCRPC. Further evaluation of molecular synergy in the xenograft models are underway through RNA interference (RNAi) technique and Digital Spatial Profiling (DSP).
Citation Format: Md Hafiz Uddin, Amro Aboukameel, Husain Y. Khan, Sahar F. Bannoura, Frank Cackowski, Rafic Beydoun, Gregory Dyson, Seongho Kim, Julie Boerner, Vinod Shidham, Ramzi M. Mohammad, Boris C. Pasche, Asfar S. Azmi, Elisabeth I. Heath. Nuclear export inhibitor cooperates with PARP inhibitor to suppress the growth of metastatic castration resistant prostate cancer in vivo [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 4530.