Preclinical evaluation of LCK as a novel therapeutic target in YAP-activated and FGFR2-altered cholangiocarcinoma.

Authors

null

Caitlin Conboy

Mayo Clinic, Division of Medical Oncology, Rochester, MN

Caitlin Conboy , Jennifer Yonkus , EeeLN Buckarma , Dong-Gi Mun , Nathan Werneburg , Ryan Watkins , Yi Guo , Juan Wang , Daniel O'Brien , Rogier Buijsman , Diep Vu , Jos De Man , Sumera Ilyas , Mark J. Truty , Mitesh J. Borad , Akhilesh Pandey , Gregory J. Gores , Rory L. Smoot

Organizations

Mayo Clinic, Division of Medical Oncology, Rochester, MN, Mayo Clinic, Department of Surgery, Rochester, MN, Mayo Clinic, Department of Laboratory Medicine and Pathology, Rochester, MN, Mayo Clinic, Division of Gastroenterology and Hepatology, Rochester, MN, Mayo Clinic, Department of Biochemistry and Molecular Biology, Rochester, MN, Mayo Clinic, Department of Health Sciences Research, Rochester, MN, NTRC B.V., Oss, Netherlands, Netherlands Translational Research Center, Oss, Netherlands, Mayo Clinic, Rochester, MN, Division of Medical Oncology, Mayo Clinic, Phoenix, AZ

Research Funding

Other Government Agency

Background: Molecularly targeted therapy is gaining traction in cholangiocarcinoma with the first FDA approval of a targeted agent in 2020, the FGFR inhibitor pemigatinib. Yet response rates and efficacy are modest, and most cholangiocarcinoma patients still lack targeted therapy options. The hippo pathway effector, YAP, is an oncogene that is activated in the majority of cholangiocarcinoma, yet attempts to develop YAP inhibitors have not yet been clinically successful. Recently, we described a novel mechanism of YAP regulation, via tyrosine phosphorylation by the Src-family kinase LCK. Therefore we hypothesized that LCK inhibition by may be therapeutic in cholangiocarcinoma through suppression of YAP activity. Methods: NTRC 0652-0 is a novel tyrosine kinase inhibitor with specificity for LCK. In vitro pharmacodynamics were defined. In cholangiocarcinoma cells, specificity for LCK inhibition was determined by mass spectrometry-based unbiased analysis of the tyrosine phosphoproteome following treatment with NTRC 0652-0 or genetic deletion of LCK. YAP phosphorylation and cotranscriptional activity, cell viability, and apoptosis were assessed. A panel of eight cholangiocarcinoma patient derived organoids (PDO) were characterized and tested for sensitivity to NTRC 0652-0. Two patient-derived xenograft (PDX) models bearing FGFR2-rearrangements were utilized for in vivo assessment of pharmacokinetics, toxicity, and efficacy. Results: NTRC 0652-0 demonstrated selectivity for LCK inhibition in vitro and in cholangiocarcinoma cells. NTRC 0652-0 treatment led to YAP inhibition and apoptotic cell death in cholangiocarcinoma cell lines, associated with inhibition of MCL1 expression. PDOs demonstrated variable sensitivity to NTRC 0652-0, correlated with basal YAP tyrosine phosphorylation and drug-induced suppression of YAP co-transcriptional activity. FGFR2-altered cholangiocarcinoma was also identified as a subset with enrichment of YAP target genes. Cells from an FGFR2-altered PDX were sensitive to NTRC 0652-0 despite being primarily resistant to pemigatinib. In two PDX models of FGFR2-altered cholangiocarcinoma, daily oral treatment with NTRC 0652-0 inhibited YAP tyrosine phosphorylation, and resulted in stable plasma and tumor drug levels, acceptable toxicity, and significantly decreased tumor growth. Conclusions: A novel LCK inhibitor, NTRC 0652-0, reduced YAP signaling and demonstrated preclinical efficacy in multiple patient-derived models of cholangiocarcinoma. LCK is a novel therapeutic target in cholangiocarcinoma, and YAP activation or FGFR2-alteration are potential biomarkers for response.

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Abstract Details

Meeting

2022 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Cancers of the Pancreas, Small Bowel, and Hepatobiliary Tract

Track

Pancreatic Cancer,Hepatobiliary Cancer,Neuroendocrine/Carcinoid,Small Bowel Cancer

Sub Track

Therapeutics

DOI

10.1200/JCO.2022.40.4_suppl.463

Abstract #

463

Poster Bd #

D2

Abstract Disclosures

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