PO-300 Unveiling and exploiting cancer stem cell editing and immunogenicity for precision medicine

Introduction Immunogenic chemotherapy (IC) induces immunogenic cell death (ICD), which, similar to viral infection, leads to a cancer-cell autonomous Type-I-Interferon (IFN-I) signalling. This immunological signature is crucial for effective antitumor responses but may paradoxically promote the emergence of a rare population of cancer stem cells (CSCs) acting as a chemoresistant niche within the tumour and roots for metastasis and relapse. In this study, we have investigated the role of IFN-I during IC in inducing a cancer editing program resulting in the appearance of poor immunogenic CSCs. Material and methods Human and murine tumour cell lines were treated in vitro with ICD-inducers or IFN-I as control and the induction of CSC were analysed by cytofluorometry, quantitative real time (qRT)-PCR, 3D culture and functional assays. Free and vesicle-mediated nucleic acid transfer during ICD has been characterised by co-culture experiments. IC-induced CSC immunogenicity has been studied through cytofluorometry, microfluidic devices and in vivo experiments. All experiments have been done in triplicate and statistical significance evaluated by two-tailed Student's t test and two-way ANOVA. Results and discussions The transient/acute induction of IFN-I during ICD is followed by the appearance of a rare population of CSCs. Both free nucleic acids and extracellular vesicles are released during tumour ICD constituting the upstream inducers of IFN-I-mediated reprogramming of neighbouring cells. IC-induced CSCs display epithelial-to-mesenchymal transition traits, multidrug resistance and regenerative properties, and a significant tumorigenic potential when inoculated in immunodeficient and immunocompetent mice. As expected, tumour growth and size are reduced in the presence of an intact immune system. Experiments on microfluidic devices reveal a poor immunogenic potential of CSCs, further confirmed by the expression of immune checkpoint blockers. Conclusion Our results pinpoint a surprising link between ICD, IFN-I and CSCs. Elucidating the mechanisms of CSC editing together with a deep characterisation of CSC (immune) properties could be crucial to prevent tumour relapse. This could undoubtedly have dramatic implications for the clinical management of cancer in an era of terrific development of precision combined chemo-immune therapy