Abstract 2791: Biomarker strategy for a phase 1 study of ORIC-944, a potent and selective allosteric PRC2 inhibitor, in patients with metastatic prostate cancer

Abstract Background: Polycomb repressive complex 2 (PRC2) tri-methylates histone H3 at lysine 27 (H3K27me3) leading to transcriptionally silenced genes. ORIC-944 is a potent, highly selective allosteric small molecule inhibitor of PRC2’s embryonic ectoderm development (EED) subunit that is undergoing clinical development as an orally bioavailable monotherapy in patients with metastatic prostate cancer. We previously reported strong tumor growth inhibition with ORIC-944 in enzalutamide-resistant 22Rv1 prostate cancer xenografts. Here, to devise and implement a biomarker strategy aimed at ORIC-944 dose selection in the ongoing phase 1 study (NCT05413421), we undertook preclinical pharmacology studies and assay development. Methods: Naïve and 22Rv1-tumor bearing male mice were treated with vehicle, 10, 30 or 100 mg/kg ORIC-944 PO for up to 37 days. H3K27me3 was evaluated in dorsal skin (epidermal layer) and peripheral monocytes by IHC and an alphaLISA test, respectively. Since dying tumor cells release nucleosomes to circulation, cell-free (cf)-nucleosomal H3K27me3 levels normalized to cf-H3.1 were also assessed in plasma using a proprietary magnetic bead-based sandwich immunoassay. Tumors were profiled by RNA-sequencing and H3K27me3 chromatin immunoprecipitation sequencing. Results: In the epidermal skin layer, H3K27me3 was present in vehicle-treated naïve animals but strongly depleted in ORIC-944-treated mice in a dose-dependent manner. Likewise in monocytes, H3K27me3 was reduced to undetectable levels in 100 mg/kg ORIC-944-treated mice. In plasma, normalized cf-nucleosomal H3K27me3 levels significantly decreased in response to ORIC-944 in a dose- and time-dependent manner, selectively in 22Rv1-tumor bearing mice compared to non-tumor bearing mice. Putative PRC2 target genes were identified in 22Rv1 xenografts by focusing on those genes with H3K27me3 binding in the promoter, whose expression was de-repressed by ORIC-944 in a time-dependent manner and then re-expressed after dose suspension. In the ongoing phase 1 study, H3K27me3 levels are being evaluated in the stratum spinosum of skin and in blood-derived monocytes using a proprietary IHC assay and alphaLISA test, respectively. Modulation in the expression of the putative PRC2 target genes is being assessed in blood-derived peripheral blood mononuclear cells by RNA-sequencing. Conclusion: This comprehensive biomarker strategy enables us to establish target engagement and capture exposure-dependent pharmacodynamics in the ongoing phase 1 study evaluating ORIC-944 as a best-in-class PRC2 inhibitor for the treatment of patients with advanced prostate cancer. Citation Format: Anneleen Daemen, Natalie Yuen, Aleksandr Pankov, Eric A. Ariazi, Subhash D. Katewa, Frank L. Duong, Amber Wang, Shravani Barkund, Shelly Kaushik, Jessica D. Sun, Lori S. Friedman, Melissa R. Junttila. Biomarker strategy for a phase 1 study of ORIC-944, a potent and selective allosteric PRC2 inhibitor, in patients with metastatic prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2791.