DDEL-09. Therapeutic activation of primary CNS lymphoma immunity by BBB-penetrant c-Myc targeted biopolymer, and anti-PD-1: artificial intelligence guided pathway insights

Abstract Primary central nervous system lymphoma (PCNSL) is a lethal cancer with poor survival, especially in its recurrent form. This is mainly due to low penetrance of therapeutic agents across the blood brain barrier (BBB). We created a novel nano immunodrug (nanodrug) that can cross the BBB and deliver anti-cancer agents directly to the tumor. The RNA therapeutics based on N-(2-hydroxypropyl)methacrylamide copolymer nanoplatform that was designed to block lymphoma’s cell c-Myc protein synthesis and to ensure brain tumor targeting and BBB crossing. Inhibiting of c-Myc protein synthesis played a dual role as anti-tumor proliferative factor and immune stimulator. Angiopep-2 peptide is conjugated to the nano platform to provide BBB crossing and brain lymphoma cell targeting via LRP-1 receptor. The nanodrug also contains H6 (6 histidines for endosome escape) to release into lymphoma cell cytoplasm. We tested the nanodrug in a A20 intracranial brain lymphoma mouse model alone, and in combination with anti-PD-1 antibody. Treatment with nanodrug resulted in a significant survival advantage compared to control. Survival was significantly enhanced when the nanodrug was co-injected with anti-PD-1. Spectral flow cytometry and RNA-seq analysis of treated tumors showed robust activation of tumor-infiltrating T lymphocytes with enhanced interferon γ signaling and polarization to M1-type macrophages. Artificial Intelligence-assisted analysis of gene expression data from RNA-seq revealed novel immune pathways, molecular targets, and suggested effective multifunctional drugs. Overall, we created a novel nano therapeutic drug delivery system that inhibits tumor c-Myc protein to treat PCNSL. When used in conjunction with anti-PD-1 checkpoint inhibitor, the treatment results in enhanced survival of tumor bearing animals by activating both adaptive and immune responses. SUPPORT NIH grants: R01 CA246716, R01 CA206220, R01 CA209921, R01 CA284247