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Targeting eIF4A triggers an interferon response to synergize with chemotherapy and suppress triple-negative breast cancer
Na Zhao, … , Charles M. Perou, Jeffrey M. Rosen
Na Zhao, … , Charles M. Perou, Jeffrey M. Rosen
Published October 24, 2023
Citation Information: J Clin Invest. 2023;133(24):e172503. https://doi.org/10.1172/JCI172503.
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Research Article Oncology

Targeting eIF4A triggers an interferon response to synergize with chemotherapy and suppress triple-negative breast cancer

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Abstract

Protein synthesis is frequently dysregulated in cancer and selective inhibition of mRNA translation represents an attractive cancer therapy. Here, we show that therapeutically targeting the RNA helicase eIF4A with zotatifin, the first-in-class eIF4A inhibitor, exerts pleiotropic effects on both tumor cells and the tumor immune microenvironment in a diverse cohort of syngeneic triple-negative breast cancer (TNBC) mouse models. Zotatifin not only suppresses tumor cell proliferation but also directly repolarizes macrophages toward an M1-like phenotype and inhibits neutrophil infiltration, which sensitizes tumors to immune checkpoint blockade. Mechanistic studies revealed that zotatifin reprograms the tumor translational landscape, inhibits the translation of Sox4 and Fgfr1, and induces an interferon (IFN) response uniformly across models. The induction of an IFN response is partially due to the inhibition of Sox4 translation by zotatifin. A similar induction of IFN-stimulated genes was observed in breast cancer patient biopsies following zotatifin treatment. Surprisingly, zotatifin significantly synergizes with carboplatin to trigger DNA damage and an even heightened IFN response, resulting in T cell–dependent tumor suppression. These studies identified a vulnerability of eIF4A in TNBC, potential pharmacodynamic biomarkers for zotatifin, and provide a rationale for new combination regimens consisting of zotatifin and chemotherapy or immunotherapy as treatments for TNBC.

Authors

Na Zhao, Elena B. Kabotyanski, Alexander B. Saltzman, Anna Malovannaya, Xueying Yuan, Lucas C. Reineke, Nadia Lieu, Yang Gao, Diego A. Pedroza, Sebastian J. Calderon, Alex J. Smith, Clark Hamor, Kazem Safari, Sara Savage, Bing Zhang, Jianling Zhou, Luisa M. Solis, Susan G. Hilsenbeck, Cheng Fan, Charles M. Perou, Jeffrey M. Rosen

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Figure 6

Zotatifin synergizes with carboplatin to suppress tumor progression.

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Zotatifin synergizes with carboplatin to suppress tumor progression.
(A)...
(A) Kaplan-Meier survival curves of 2153L tumor–bearing mice from treatment start time. (B) Survival regression analysis of 2153L tumor–bearing mice. Survival data were fitted using a parametric survival regression model with a log-normal distribution. The top table reports all possible pairwise comparisons using linear contrasts that are adjusted for multiple comparisons using Holm’s method. The bottom table tests for overall main effects and interactions. In A and B, data from 3 to 5 independent experimental batches are integrated. n = 24 for vehicle, n = 22 for zotatifin, n = 13 for carboplatin, and n = 24 for zotatifin + carboplatin. (C and D) Kaplan-Meier survival curves of 2225L-LM2 (C) or 2208L (D) tumor–bearing mice from treatment start time. Mice were randomized and treatment was initiated when 2225L-LM2 tumors reached approximately 130 mm3 volume or 2208L tumors reached approximately 210 mm3 volume. n = 5 biological replicates per group. (E) Left: Representative images of IF staining of γH2A.X (in red) in 2153L tumors that were treated with indicated drugs for 3 days. Scale bars: 50 μm. Right, quantification of IF staining. At least 2 representative views were analyzed for each tumor and at least 3 tumors for each treatment group were analyzed. Data are presented as mean ± SEM and were analyzed using 2-tailed, unpaired Student’s t test. (F) Kaplan-Meier survival curves of 2153L tumor–bearing mice treated with indicated drugs. n ≥ 4 biological replicates per group. (G) Kaplan-Meier survival curves of 2225L-LM2 tumor–bearing mice treated with indicated drugs. n ≥ 3 biological replicates per group. (H) Kaplan-Meier survival curves of 2208L tumor–bearing mice treated with indicated drugs. n = 4 biological replicates per group. In C, D, and F–H, the log-rank test (2-tailed) was used to test for the significant differences of curves between groups.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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