RE: SRA73721 Dec 2022 05:55
Adding gemcitabine chemotherapy to SRA737 enhances the effect of PD-L1 blockade by modulating the immune microenvironment in SCLC
Gemcitabine-based chemotherapy has been used for relapsed SCLC patients, but its activity is limited to a minority of patients when used as a monotherapy at standard doses1, highlighting the limitations of this treatment paradigm. In contrast to standard cytotoxic doses, low doses of gemcitabine induce RS and increase reliance on CHK1 without overt DNA damage and cytotoxicity. This mechanism synergizes with CHK1 inhibition to induce potent tumor cell death while also avoiding the potential for overlapping toxicities.
To explore this combination further, we tested the SRA737+LDG in the HT-29 in vivo model of colon cancer. In order to mimic the treatment schedule used in the current SRA737+LDG clinical trial (NCT02797977), mice were treated with RS-inducing LDG (40mg/kg) on the first day, followed by inhibition of CHK1 by SRA737 (50mg/kg) for two consecutive days and a dose holiday for the last 4 days of the week. This combination led to a strong inhibition of tumor growth after 3 weeks of treatment (TGI = 83%) highlighting the intrinsic anti-tumor activity of this combination in HT-29 immunodeficient model (Fig. S3A).
Finally,
Next, we expanded our study to an immunocompetent SCLC model to explore both the intrinsic and immune-mediated anti-tumor effects of SRA737+LDG regimen in combination with anti-PD-L1. We first determined that SCLC cell lines H209, H524 and RPP were resistant to monotherapy gemcitabine in vitro (Fig. S3B), with the RPP tumor model described above selected for further in vivo testing. RPP tumor bearing B6129F1 immunocompetent mice were treated with LDG (40mg/kg, 1/7, first day of week), SRA737 (100mg/kg, 2/7 first and second days of week) and anti-PD-L1 (300µg, 1/7, third day of week) as single agents or in combination. SRA737+LDG regimen mimicked the schedule currently being used in the clinical trial described above with or without anti-PD-L1 on the third day of a weekly cycle. We did not observe a significant anti-tumor effect with any single agent treatments (anti-PD-L1, SRA737 or LDG), and only a moderately delayed tumor growth with combined SRA737 and PD-L1 treatment (Fig 4A). However, we observed remarkable tumor regressions when we combined SRA737+LDG with anti-PD-L1. All mice achieved some level of tumor regressions and 80% of mice (8/10) had complete tumor regressions which were sustained up to 60 days post treatment (Fig 4A
Undoubtedly will be interest in this area.
Progression by SO I feel most likely to have led to cloinical trial and resultant patent protection in this area.
Basic intended form of 737 and LDG patented.
Plenty of scope in some cancers for SRA plus ICB
'Remarkable' results in LDG 737 and ICB in this case PD-1 inhibitor.