ABSTRACT
Non-small cell lung cancer (NSCLC) is the leading cause of cancer mortality in both men and women. Despite
rapid therapeutic advances, the 5-year survival rate of EGFR-mutant NSCLC remains a dismal 16% for the
past several decades. In particular, the rapid emergence of resistance to widely used treatments, such as the
tyrosine kinase inhibitor (TKI), is the key obstacle to achieving long-term NSCLC patient survival. Further,
patients with EGFR mutated tumors fail to respond to immune checkpoint inhibitors (ICIs), leaving them with
little to no hope of a long-term remission. Therefore, identifying the molecular determinants of resistance and
developing a therapeutic that targets the chemo- and immune-resistant pathways, is the best chance to
improve survival rates in NSCLC patients with an EGFR mutation. We hypothesize that MU-CN29, the lead
targeted siRNA nanoconjugate, restores sensitivity to tyrosine kinase inhibitors in resistant NSCLC. We further
postulate that MU-CN29 will induce a systemic immune response, priming the tumor microenvironment for
immunotherapy via ICIs. Therefore, the central objective of this TTNCI proposal is to develop, evaluate, and
validate MU-CN29 as an effective therapeutic agent for resistant NSCLC. Our promising in vitro and in vivo
experimental results confirmed the crosstalk between the resistance-driving receptor tyrosine kinase AXL and
FN14 pathways in drug resistant NSCLC. Additionally, we found that the co-knockdown of both AXL and FN14,
using MU-CN29, covalently attached with the dual siRNAs, sensitized the resistant tumors to tyrosine kinase
inhibitor (TKI), in vitro and in vivo. To enable translation of MU-CN29 to human trials, in this proposal, we will
manufacture the nanoparticles as per FDA guidelines, perform detailed toxicology studies in murine and canine
subjects, and evaluate the therapeutic efficacy in clinically relevant animal models. The specific aims of this
applications are: (1) Determine MU-CN29 clinical-grade production protocols; (2) Determine the safety and
efficacy of MU-CN29 in murine NSCLC models; (3) Establish safety of MU-CN29 in canine cancer patients.
The data will validate MU-CN29 nanoparticle platform as a promising strategy to combat drug resistance in
NSCLC and catalyze clinical trials in the future.