Abstract 1664: Inhibition of arginase in combination with radiation therapy shows increased immune-activation and anti-tumor activity in syngeneic tumor models

The tumor microenvironment (TME) has multiple mechanisms of immune-suppression including recruitment of arginase (ARG) expressing myeloid cells. ARG is an enzyme that catalyzes hydrolysis of L-arginine into urea and L-ornithine. Given L-arginine is essential for optimal function of both T cells and natural killer (NK) cells, inhibition of ARG has been recognized as a potential therapeutic approach to reverse immune-suppression and optimize anti-tumor immunity. We recently presented development of a novel ARG inhibitor, AZD0011, and demonstrated immune activation and anti-tumor activity as single agent and in combination with a-PD-L1 in various tumor models. We now expand these findings demonstrating combination benefit with radiation therapy. Radiation therapy (5 gray on day 6 and 9 after tumor cell implant) demonstrated an increase of both the number of arginase expressing myeloid cells, and NK cells in the TME of Lewis Lung (LL) tumors. Immuno-histochemistry also demonstrated a redistribution of the location of ARG positive myeloid cells with a marked increase at the edge of the tumor. LL tumor bearing mice receiving either AZD0011 (30 mg/kg twice daily), or radiation therapy as monotherapy did not show a significant anti-tumor response reaching 0.3% and 28% tumor growth inhibition (TGI) respectively (p>0.05 versus vehicle). In contrast, combination treatment showed a marked increased efficacy averaging 60% TGI (p<0.05 versus either monotherapy). Combination treatment also further increased several markers of immune activation including a doubling of the number of IL2+ or IFNg+ CD4+ and CD8+ T-cells in tumor draining lymph nodes. In summary, our pre-clinical data demonstrates that radiation therapy increases the number and location of intra-tumoral ARG expression myeloid cells and increased anti-tumor activity when combining the ARG inhibitor AZD0011 with radiation therapy.

Citation Format: Alwin Schuller, Aatman Doshi, Susan Cantin, Matt Griffin, Maryann San Martin, Theresa Proia, Corinne Reimer, Scott Mlynarski, Ray Finlay, Wenlin Shao. Inhibition of arginase in combination with radiation therapy shows increased immune-activation and anti-tumor activity in syngeneic tumor models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1664.

Abstract 4523: Inhibition of arginase in combination with anti-PDL1 leads to increased infiltration and activation of CD8+ T cells, NK cells, and CD103+ dendritic cells in mouse syngeneic tumor models

The tumor microenvironment (TME) has multiple mechanisms of immune-suppression, one being recruitment of arginase (ARG) expressing myeloid cells. ARG is an enzyme that catalyzes hydrolysis of L-arginine into urea and L-ornithine. L-arginine is a semi-essential amino acid required for optimal function of T cells and natural killer (NK) cells. Arginine depletion in the TME inhibits T cell and NK cell function. Therefore, inhibition of ARG can reverse immune-suppression and optimize anti-tumor immunity. To determine the dependence to arginine, we cultured human T- and NK cells in arginine concentrations ranging from 0 to 150 µM. Both human CD8+ T cells and NK cells showed decreased proliferation with decreased L-arginine concentration, and a complete proliferation arrest in the absence of L-arginine. L-arginine threshold for optimal proliferation was determined to be ~30 µM for CD8+ T cells and ~ 9 µM for NK cells. Furthermore, both CD8+ T cells and NK cells showed decreases in cytotoxic molecules (e.g. granzyme A, granzyme B, perforin) when cultured under reduced arginine conditions. In addition, NK cells showed a decreased ability to kill target cells in low arginine conditions. We next explored whether arginase inhibition could reverse the immune-suppressive environment in vivo. Administration of arginase inhibitor to tumor bearing mice resulted in a dose dependent increase in both plasma (up to 4 fold) and tumor arginine (up to 12 fold) in all models tested including MC38-ova, CT26, and Lewis Lung. In addition, ARG inhibitor showed signs of in vivo immune cell activation including ~doubling of the number of CD8+ T cells, NK cells, and CD103+ dendritic cells in the tumor microenvironment. Combining with anti PD-L1 further increased the number of CD8+ T cells to ~4-fold of control levels. Arginase inhibitor also increased the activation state of CD8 T cell as determined by percent of granzyme, IFNg, and Ki67 positivity. Moreover, ARG inhibitor resulted in an increase of IFNg and TNFa producing CD8+ T cells in tumor draining lymph nodes. Treatment of tumor bearing mice with ARG inhibitor as monotherapy resulted in modest, but consistent, tumor growth inhibition (TGI) of ~30% in multiple syngeneic models (LL, MC38-ova, CT26). Combining ARG inhibitor with anti-PDL1 significantly improved efficacy reaching ~87% TGI in the MCA38-ova model, with 7/10 mice showing tumor regression. In summary, our pre-clinical data demonstrates that an ARG inhibitor in combination with a checkpoint inhibitor can increase plasma and tumor arginine levels and reverse tumor immune-suppression leading to strong immune activation and anti-tumor responses, suggesting arginase inhibitors could provide an opportunity to increase activity of checkpoint inhibitors clinically.

Citation Format: Alwin Schuller, Aatman Doshi, Susan Cantin, Michael Secinaro, Yanjun Wang, Laura Prickett, Sharon Tentarelli, Eric Gangl, Horma Ghadially, Kristina Ilieva, Theresa Proia, Scott Mlynarski, Ray Finlay, Wenlin Shao. Inhibition of arginase in combination with anti-PDL1 leads to increased infiltration and activation of CD8+ T cells, NK cells, and CD103+ dendritic cells in mouse syngeneic tumor models [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4523.

Abstract LB-C20: Lead generation and optimisation of a series of novel glutaminase (GLS) inhibitors

Glutamine is an essential nutrient for cancer cells and is used to support cancer cell growth. Glutamine is converted to glutamate by the enzyme glutaminase, which is then converted into alpha-ketoglutarate, a metabolic intermediate within the TCA cycle which serves as a precursor for the biosynthesis of ATP, NADPH, fatty acids, glutathione, nucleic acids and amino acids. As such, we regarded glutaminolysis as a key pathway for therapeutic intervention.

At the outset of the project there were several reported inhibitors of glutaminase known in the literature; however, they possess undesirable drug like properties. We describe here our efforts to discover novel inhibitors of glutaminase with a promising development profile. From a high throughput screen of approximately 900,000 compounds in the AstraZeneca collection, we were able to identify three series of glutaminase inhibitors. One of these series has been optimised to deliver cell potent, selective and orally bioavailable inhibitors of glutaminase 1.

Citation Format: Mark D. Charles, Ceri Cairnduff, Joanna Brookfield, Verity Sabin, Tennyson Ekwuru, Neil Jones, Attilla Ting, James Smith, Willem Nissink, Ray Finlay, Steve Powell, Susan Critchlow, Richard Ward, Matthew Wood, Linette Ruston, Jon Winter, Ian Hollingsworth. Lead generation and optimisation of a series of novel glutaminase (GLS) inhibitors. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2015 Nov 5-9; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2015;14(12 Suppl 2):Abstract nr LB-C20.

Afforestation of abandoned farmland with conifer seedlings inoculated with three ectomycorrhizal fungi - impact on plant performance and ectomycorrhizal community

The aim of a 3-year study was to investigate whether inoculation of Pinus sylvestris L. and Picea abies (L.) Karst. seedlings with mycorrhizas of Cenococcum geophilum Fr., Piceirhiza bicolorata, and Hebeloma crustuliniforme (Bull.) Quel. has any impact on: 1) survival and growth of outplanted seedlings on abandoned agricultural land, and 2) subsequent mycorrhizal community development. For inoculation, the root system of each plant was wrapped in a filter paper containing mycelium, overlaid with damp peat-sand mixture and wrapped in a paper towel. In total, 8,000 pine and 8,000 spruce seedlings were planted on 4-ha of poor sandy soil in randomized blocks. Already after the first year natural mycorrhizal infections prevailed in the inoculated root systems, and introduced mycorrhizas were seldom found. Yet, the seedlings that had been pre-inoculated with C. geophilum and the P. bicolorata during the whole 3-year period showed significantly higher survival and growth as compared to controls. Moreover, the independent colonization of roots by C. geophilum and the P. bicolorata from natural sources was also observed. A diverse mycorrhizal community was detected over two growing seasons in all treatments, showing low impact of inoculation on subsequent fungal community development. A total of 19 additional ectomycorrhizal morphotypes was observed, which clustered into two well-separated groups, according to host tree species (pine and spruce). In conclusion, the results showed limited ability to increase tree survival and growth, and to manipulate the mycorrhizal community even by extensive pre-inoculations, indicating that fungal community formation in root systems is governed mainly by environmental factors.

Psychiatric emergencies in general practice

A psychiatric emergency may be identified by the patient, family, friends, statutory authorities or the treating physician. Good management involves careful assessment. Although this article does not attempt to detail specific treatment of any disorders it outlines some of the basic principles on which a good outcome may well depend.

A comparison of psychotropic drug use between the general population and clients of health and social service agencies

The purpose of this research was to study the epidemiology of psychotropic drug use among the general population and to draw comparisons to drug use among clients of medical, mental health, and social services in the same jurisdiction. Results showed considerably higher percentages of users for all drug categories among agency clientele. Age and sex differences in drug use replicated previous research in the general population but were noticeably absent among the clients of local services. Notably, the proportion of long-term daily users of minor tranquilizers in the agency population was about three times that of the general population. However, tranquilizer users in the two populations were similar in many respects. Results of the study are discussed in terms of the need for screening for persons with psychotropic drug problems in health and social services.