Childhood Cancer

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STING Pathway Activation: The Missing Link between Genomic Instability and Antitumor Immunity in Osteosarcoma

Institution: 
University of California San Francisco
Researcher(s): 
Elizabeth Young, MD
Grant Type: 
Young Investigator Grants
Year Awarded: 
2021
Type of Childhood Cancer: 
Osteosarcoma
Project Description: 

Osteosarcoma is a bone tumor occurring most often in children and young adults. These patients have a 5-year survival rate of less than 20% if the cancer has spread to distant sites at the time of diagnosis. Unfortunately, the remaining 80% of these patients are suspected to have spread of the cancer which is undetectable. The treatment strategy for this disease has not seen significant improvement in 30 years, and there is no specific treatment to target tumors that have spread throughout the body. These distant tumors, particularly those in the lung, are responsible for causing the death of most patients with osteosarcoma. Therefore, understanding how and why these tumors spread to distant sites and learning how to target them is vital to extending the lives of patients. New treatments to be used concurrently with the standard chemotherapy to help prevent the cancer from spreading are desperately needed in pediatric osteosarcoma.

Project Goal:

In our laboratory, a major goal is to identify factors that control the spread of osteosarcoma so that we can help develop new therapies to extend the lives of patients. We use the genetic information found in patient tumors that have spread to distant sites to learn more about how the cancer cells are able to travel and grow in new locations. Using this information, we can modify the osteosarcoma cells in specific ways to see whether this will change their ability to spread. Currently, we are investigating whether osteosarcoma cells block the activation of one part of the patient’s immune system, protecting the cancer cells from an immune attack and allowing them to spread. Our project goal is to determine how several different modifications will affect the ability of osteosarcoma cells to spread. Our work has the potential to uncover new targeted therapies, including immunotherapies, which could benefit patients suffering with this devastating disease.

Project Update 2024:

In cancers including osteosarcoma (OS), malfunctioning DNA replication results in a warning signal to the immune system via the cGAS-STING pathway, which we believe is modified in OS tumors to evade immune-mediated tumor killing. We have identified that about 50% of OS patient-derived cell lines respond to cGAS-STING activation with a drug treatment, whereas the other half do not. Additionally, using RNA sequencing, we defined the specific genetic changes that occur in OS upon activation of the cGAS-STING pathway. Our preliminary studies of a STING activating drug in animal models have shown that this therapy can slow tumor growth and increase anti-tumor immunity. Overall, we have discovered two subsets of OS with differing capacity to generate an anti-tumor immune signal and demonstrated the benefits of activating STING in patients and in immune assays. Our proposed ongoing work will confirm the effects of STING activation, supporting the translation of this novel approach to activating immune surveillance in osteosarcoma.