Abstract 5166: Intratumoral delivery of mRNA encoding USP6 activates multiple immuno-stimulatory pathways simultaneously and inhibits local and distal tumor growth in murine models
Authors: Henrich Ian , Billingsley Margaret , Jain Kanika , Quick Laura , Young Rob , Chou Margaret , Mitchell Michael 
Published: April 2023

Abstract
Advances in immunotherapy have revolutionized cancer treatment, with patients with otherwise incurable disease having long-lasting responses. Unfortunately, deep remissions only occur in a select subset of patients. Cancer progression is common as many current immunotherapies only target one or two pathways, which can quickly lead to tumor resistance. Novel approaches that target several pathways concurrently are therefore needed to promote stronger responses in a wider patient population.
Our group has recently discovered that the protein Ubiquitin-specific protease 6 (USP6) upregulates multiple, distinct immunostimulatory pathways. Tumor cell-specific expression of USP6 significantly increases CXCL9, CXCL10, and CCL5 chemokine production that enhances cytotoxic immune cell recruitment. Simultaneously, USP6 also upregulates several ligands and receptors that promote immune cell activation and killing of tumor cells such as CD112, MICA/B, ICAM1, and MHC Class I. In addition, USP6 increases the tumor cell’s sensitivity to immune-derived factors such as Type I and Type II interferons and TRAIL by raising the surface expression of their respective receptors. USP6 is hominid-specific and therefore requires xenografting human tumor cells into athymic, T-cell deficient nude mice. Despite the immunocompromised model, USP6 expression was found to increase immune cell recruitment to the tumor while repolarizing the immune microenvironment toward a more activated, tumor-suppressive state. Strikingly, immune cells in the peripheral blood were also affected with an increase in natural killer cell (NK) activation and a skewing of the myeloid population away from an immunosuppressive phenotype. Our group subsequently demonstrated that a USP6+ tumor was able to inhibit the growth of a USP6− distal tumor, with a concordant increase in NK, macrophage, and dendritic cell activation in the distal USP6− tumor.
Given our data, we sought to translate USP6 into a novel immunotherapy. Delivery of mRNA encoding the USP6 protein recapitulates the immunostimulatory effects of USP6 in vitro. Intratumoral (I.T) injection of a lipid nanoparticle (LNP) encapsulating USP6 mRNA significantly inhibited Ewing sarcoma and acute myeloid leukemia growth in athymic mice, despite the model lacking a fully functional immune system. Moreover, I.T injection of USP6 mRNA LNPs inhibited the growth of a non-injected, distal tumor. Altogether, these data support that USP6 is a potentially powerful target and continued development of I.T USP6 mRNA LNPs as a novel immunotherapy.
Citation Format: Ian Henrich, Margaret Billingsley, Kanika Jain, Laura Quick, Rob Young, Margaret Chou, Michael Mitchell. Intratumoral delivery of mRNA encoding USP6 activates multiple immuno-stimulatory pathways simultaneously and inhibits local and distal tumor growth in murine models. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5166.