Tumors with homologous repair deficiencies (HRD) are sensitive to agents interrupting DNA repair. The deubiquitinase USP1 involves in the DNA damage response by translesion synthesis and Fanconi anemia pathway. And the synthetic lethality of USP1 and HRD is well reported. Moreover, deficiency of USP1 or its downstream pathway leads to hypersensitivity of HRD tumors to PARP inhibition. In addition, target-related hematotoxicity is widely observed in serval DNA Damage Response (DDR) pathway inhibitors, including PARP and ATR inhibitors, which limits the combination therapy. Here, we reported SP-002, a highly selective USP1 inhibitor, displayed monotherapy potential and combination activity with PARP inhibitor in HRD cancers. In the biochemical assay, SP-002 strongly inhibited USP1 enzyme with IC50 of 15.7 nM, and potently inhibited proliferation of BRCA1-mutant MDA-MB-436 breast cell (GI50, 47.4 nM). SP-002 demonstrated synergistic anti-proliferation effects in combination of olaparib, a PARP inhibitor, in MDA-MB-436 cells. And further results revealed that the combination significantly enhances the DNA damage burden and cells apoptosis. Moreover, synergistic activities of SP-002 and olaparib also were observed in a panel of HRD cell lines, such as UWB1.289, Capan-1, MDA-MB-453 and NCI-H292. In a human hematopoietic stem cells based in vitro hematotoxicity assay, SP-002 showed no significant inhibition on lineage-specific (myeloid, erythroid, and megakaryocytic) cell differentiation and survival. In comparison, positive controls, 5-fluorouracil and olaparib significantly attenuated those primary cells both on differentiation and survival, which was consistent with the hematological toxicity observed in human. Oral administration of SP-002 led to completely tumor growth inhibition in MDA-MB-436 xenograft model, and combination of SP-002 and olaparib resulted in tumor regression. In conclusion, SP-002, a selective and potent USP1 inhibitor without significant hematotoxicity, that demonstrated excellent efficacy on treatment of HRD cancers.

Citation Format: Feng Zhou, Zhengtao Li, Lei Zhou, Wei Zhu, Jiyan Zhang, Wenqing Yang, Liting Xue, Xiaokang Qin, Ping Chen, Renhong Tang. Identification of SP-002, a highly selective USP1 inhibitor effectively inhibits HRD tumor growth and displays low hematotoxicity risk [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 6201.