WEE1 inhibitor and ataxia telangiectasia and RAD3-related inhibitor trigger stimulator of interferon gene-dependent immune response and enhance tumor treatment efficacy through programmed death-ligand 1 blockade

Cancer Sci. 2021 Nov;112(11):4444-4456. doi: 10.1111/cas.15108. Epub 2021 Aug 31.

Abstract

WEE1 plays an important role in the regulation of cell cycle G2/M checkpoints and DNA damage response (DDR). Inhibition of WEE1 can increase the instability of the genome and have anti-tumor effects in some solid tumors. However, it has certain limitations for multiple cancer cells from different lineages. Therefore, we consider the use of synthetic lethal interactions to enhance the therapeutic effect. Our experiments proved that WEE1 inhibitor (WEE1i) can activate the ataxia telangiectasia and RAD3-related (ATR) pathway and that blockage of ATR dramatically sensitized the WEE1i-induced cell death. The tumor-selective synthetic lethality between bioavailable WEE1 and ATR inhibitors led to tumor remission in vivo. Mechanistically, the combination promoted the accumulation of cytosolic double-strand DNA, which subsequently activated the stimulator of the interferon gene (STING) pathway and induced the production of type I interferon and CD8+ T cells, thereby inducing anti-tumor immunity. Furthermore, our study found that immune checkpoint programmed death-ligand 1 is upregulated by the combination therapy, and blocking PD-L1 further enhances the effect of the combination therapy. In summary, as an immunomodulator, the combination of WEE1i with ATR inhibitor (ATRi) and immune checkpoint blockers provides a potential new approach for cancer treatment.

Keywords: ATR inhibitor; WEE1 inhibitor; anti-PD-L1; cancer immunotherapy; stimulator of interferon genes.

MeSH terms

  • Animals
  • Ataxia Telangiectasia Mutated Proteins / antagonists & inhibitors*
  • Ataxia Telangiectasia Mutated Proteins / metabolism
  • B7-H1 Antigen / antagonists & inhibitors*
  • B7-H1 Antigen / metabolism
  • CD8-Positive T-Lymphocytes
  • Cell Cycle Proteins / antagonists & inhibitors*
  • Cell Death
  • Cell Line, Tumor
  • Colorectal Neoplasms / drug therapy*
  • DNA / metabolism
  • DNA Damage
  • DNA, Neoplasm / biosynthesis
  • Disease Models, Animal
  • Drug Synergism
  • Female
  • G2 Phase Cell Cycle Checkpoints / drug effects
  • Genomic Instability
  • Humans
  • Immunity
  • Immunotherapy / methods
  • Indoles / therapeutic use
  • Interferon Type I / biosynthesis
  • M Phase Cell Cycle Checkpoints / drug effects
  • Membrane Proteins / metabolism
  • Mice
  • Mice, Inbred C57BL
  • Molecular Targeted Therapy / methods*
  • Morpholines / therapeutic use
  • Ovarian Neoplasms / drug therapy*
  • Protein Kinase Inhibitors / therapeutic use*
  • Protein-Tyrosine Kinases / antagonists & inhibitors*
  • Pyrazoles / therapeutic use
  • Pyrimidines / therapeutic use
  • Pyrimidinones / therapeutic use
  • Sulfonamides / therapeutic use
  • Tumor Microenvironment / immunology
  • Tumor Stem Cell Assay
  • Up-Regulation

Substances

  • B7-H1 Antigen
  • CD274 protein, human
  • Cell Cycle Proteins
  • DNA, Neoplasm
  • Indoles
  • Interferon Type I
  • Membrane Proteins
  • Morpholines
  • Protein Kinase Inhibitors
  • Pyrazoles
  • Pyrimidines
  • Pyrimidinones
  • STING1 protein, human
  • Sulfonamides
  • ceralasertib
  • DNA
  • Protein-Tyrosine Kinases
  • WEE1 protein, human
  • ATR protein, human
  • Ataxia Telangiectasia Mutated Proteins
  • adavosertib