Abstract B011: MTA-cooperative PRMT5 inhibition (BMS-986504) induces <i>MTAP</i> del tumor cell-intrinsic immune evasion and regulation

Abstract Homozygous deletion of MTAP gene (MTAP del) occurs in ∼10% of all cancers. BMS- 986504 is a second-generation MTA-cooperative PRMT5 inhibitor designed to preferentially bind to the PRMT5-MTA complex which accumulates in MTAP del cancer cells and has demonstrated clinical proof-of-concept (POC) for selectively inhibiting PRMT5 activity in MTAP del patients as monotherapy. While immunotherapy (IO) has increased patient survival in many cancers and is now the standard of care in first and later lines, most patients ultimately relapse. Thus, there remains an unmet need to improve response for these patients receiving IO. BMS-986504 in combination with anti- PD1 has the potential to increase efficacy, but there is a limited understanding of the interaction between MTAP/PRMT5 biology and PD-1 blockade. Here, we evaluated the BMS-986504-induced immunological and cell killing effects on MTAP del tumor cells and T cells to understand potential mechanisms to support BMS-986504 combination opportunities with anti-PD1 therapy. Using a panel of human PBMC-derived T cells, we first demonstrate that non-activated T cells and T cells activated via anti-CD3/CD28 are insensitive to BMS-986504-induced cell killing at in vitro concentrations equivalent to clinical exposure, supporting the significantly improved selectivity margin of BMS- 986504 relative to first-generation PRMT5 inhibitors that showed T cell toxicity in vitro and on-target dose-limiting hematological toxicity in the clinic. Since previous studies have suggested that MTAP wild-type cells may be affected by MTA secreted from surrounding MTAP del tumors, we assessed T cell viability in the presence of MTA. We found that inactivated T cells maintain insensitivity to BMS-986504 treatment with or without extracellular MTA, but T cells activated via anti-CD3/CD28 are partially sensitive to BMS-986504-induced killing in the presence of MTA only. Using flow cytometry, we characterized the surface expression of immune-related markers on tumor cells treated with BMS-986504 and identified that BMS-986504 dose-dependently increases PD-L1 expression on MTAP del tumor cells, suggesting a potential immune evasion mechanism. Next, using human PBMC-derived T cell and tumor cell co-culture assays, we evaluated the ability of BMS-986504 and anti-PD1 combination to mediate both tumor-intrinsic killing and anti-tumor immune activation in MTAP del cancer cell lines. Taken together, we provide translational proof-of-concept data demonstrating that BMS- 986504 induces tumor cell-intrinsic immunological effects in MTAP del tumors, while having limited impact on T cell viability. This data supports the rationale for BMS- 986504 and IO combination, which may potentially lead to anti-tumor immune activation and improved outcome for MTAP del patients. Citation Format: Josephine Hai, Stephanie Xavier, Sangeeth George, Lars Engstrom, Pete Olson, Tyler Simpson, Ming Lei, Benjamin Chen. MTA-cooperative PRMT5 inhibition (BMS-986504) induces MTAP del tumor cell-intrinsic immune evasion and regulation [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Tumor Immunology and Immunotherapy; 2024 Oct 18-21; Boston, MA. Philadelphia (PA): AACR; Cancer Immunol Res 2024;12(10 Suppl):Abstract nr B011.