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The high rates of recurrence and low median survival in many B-cell cancers highlight a need for new targeted therapeutic modalities. In dividing cells, eukaryotic translation initiation factor 5A (eIF5A) is hypusinated and involved in regulation of protein synthesis and proliferation, whereas the non-hypusinated form of eIF5A is a potent inducer of cell death in malignant cells. Here, we demonstrate the potential of modulating eIF5A expression as a novel approach to treating B-cell cancers. SNS01-T is a nonviral polyethylenimine-based nanoparticle, designed to induce apoptosis selectively in B-cell cancers by small interfering RNA–mediated suppression of hypusinated eIF5A and plasmid-based overexpression of a non-hypusinable eIF5A mutant. In this study, we show that SNS01-T is preferentially taken up by malignant B cells, inhibits tumor growth in multiple animal models of B-cell cancers without damaging normal tissues, and synergizes with the current therapies bortezomib and lenalidomide to inhibit tumor progression. The results collectively demonstrate the potential of SNS01-T as a novel therapeutic for treatment of a diverse range of B-cell malignancies.

Despite recent advances in the first-line treatment of multiple myeloma, almost all patients eventually experience relapse with drug-resistant disease. New therapeutic modalities are needed, and to this end, SNS01, a therapeutic nanoparticle, is being investigated for treatment of multiple myeloma. The antitumoral activity of SNS01 is based upon modulation of eukaryotic translation initiation factor 5A (eIF5A), a highly conserved protein that is involved in many cellular processes including proliferation, apoptosis, differentiation and inflammation. eIF5A is regulated by post-translational hypusine modification, and overexpression of hypusination-resistant mutants of eIF5A induces apoptosis in many types of cancer cells. SNS01 is a polyethylenimine (PEI)-based nanoparticle that contains both a B-cell-specific expression plasmid expressing a non-hypusinable mutant of eIF5A and a small interfering RNA (siRNA) which depletes endogenous hypusinated eIF5A. Reducing hypusine-modified eIF5A levels was found to inhibit phosphorylation and activity of ERK MAPK and nuclear factor-κB (NF-κB), and thus sensitize myeloma cells to apoptosis resulting from transfection of a plasmid expressing eIF5AK50R. SNS01 exhibited significant antitumoral activity in both KAS-6/1 (95% inhibition; P < 0.05) and RPMI 8226 (59% inhibition; P < 0.05) multiple myeloma xenograft models following systemic administration. These results highlight the potential of using this approach as a new therapeutic strategy for multiple myeloma.

In both type 1 and type 2 diabetes, pancreatic islet dysfunction results in part from cytokine-mediated inflammation. The ubiquitous eukaryotic translation initiation factor 5A (eIF5A), which is the only protein to contain the amino acid hypusine, contributes to the production of proinflammatory cytokines. We therefore investigated whether eIF5A participates in the inflammatory cascade leading to islet dysfunction during the development of diabetes. As described herein, we found that eIF5A regulates iNOS levels and that eIF5A depletion as well as the inhibition of hypusination protects against glucose intolerance in inflammatory mouse models of diabetes. We observed that following knockdown of eIF5A expression, mice were resistant to beta cell loss and the development of hyperglycemia in the low-dose streptozotocin model of diabetes. The depletion of eIF5A led to impaired translation of iNOS-encoding mRNA within the islet. A role for the hypusine residue of eIF5A in islet inflammatory responses was suggested by the observation that inhibition of hypusine synthesis reduced translation of iNOS-encoding mRNA in rodent beta cells and human islets and protected mice against the development of glucose intolerance the low-dose streptozotocin model of diabetes. Further analysis revealed that hypusine is required in part for nuclear export of iNOS-encoding mRNA, a process that involved the export protein exportin1. These observations identify the hypusine modification of eIF5A as a potential therapeutic target for preserving islet function under inflammatory conditions.

Approximately 900,000 cases of sepsis occur annually in the United States, causing roughly 210,000 deaths and resulting in costs of almost 17 billion dollars [1]. Sepsis is characterized by an initial hyperinflammatory state, which is followed by a hypoinflammatory, immunosuppressive state during which apoptosis occurs [2]. Because of the dearth of therapeutics for sepsis, new strategies and tools are needed for sepsis management. Polyamines are important mediators of inflammation [3], and studies have indicated that polyamine biosynthesis is increased during sepsis [4, 5]. Although the functions of the up-regulated polyamines during sepsis and inflammation are not clear, we hypothesize that polyamine levels may increase during inflammation to help fuel hypusine biosynthesis, which is a polyamine-dependent reaction. Eukaryotic translation initiation factor 5A (eIF5A) is an abundant, constitutively expressed protein, and it is the only known protein to contain the unique amino acid hypusine. The hypusine residue is formed posttranslationally in a 2-step process that results in the mature, active form of eIF5A. The first step, catalyzed by deoxyhypusine synthase (DHS), involves the transfer of a butylamine group from the polyamine spermidine to a conserved lysine on eIF5A [6]. The second hydroxylation step, which is mediated by deoxyhypusine hydroxylase (DOHH), results in the formation of the mature hypusine-modified eIF5A [7]. Inhibitors of DHS and DOHH that block the hypusination reaction have been found to have anti-inflammatory properties [8, 9]. eIF5A is widely believed to have a function in regulated mRNA transport [10–12], protein translation [13, 14], and cell proliferation [15–21]. It also appears to be involved in the activation and/or proliferation of T lymphocytes [22] and seems to be required for the maturation and function of dendritic cells [23], thereby suggesting that eIF5A may be an important target in inflammatory diseases. eIF5A also has an important role in apoptosis [24–26], and small interference RNA (siRNA) targeting eIF5A can protect cells from apoptosis caused by tumor necrosis factor (TNF)–α [24] and genotoxic stress [26], thus making it a potential target for sepsis therapy. Many studies have identified apoptosis, particularly apoptosis of lymphocytes, as a risk factor for death due to sepsis [2, 27, 28]. Recent therapeutic strategies have used siRNA to knock down the genes that are involved in apoptosis and up-regulated during sepsis. For example, Fas ligand and caspases have been targeted in mice with sepsis, resulting in increased survival [29]. To determine whether a reduction in eIF5A expression may have anti-inflammatory effects, an siRNA targeting eIF5A was tested in murine models of severe sepsis and acute lung injury, and the effects on proinflammatory cytokine production and animal survival were monitored.

Background Eukaryotic translation initiation factor 5A (eIF5A) has been implicated in the regulation of cell proliferation, apoptosis, and inflammation. SNS01-T is a novel therapeutic with a dual mechanism of eIF5A modulation: inducing cell death via siRNA-mediated inhibition of hypusinated eIF5A while simultaneously causing over-expression of pro-apoptotic eIF5AK50R via a DNA plasmid with a B-cell promoter to induce tumor cell death, using a PEI vector. SNS01-T significantly inhibits tumor growth and increases survival in mouse models of myeloma (MM), mantle cell and diffuse large B-cell lymphoma. Methods This is an open label, phase 1-2 dose escalation study in pts with refractory B-cell cancers, comprising 4 SNS01-T dose cohorts: 0.0125, 0.05, 0.2 and 0.375 mg/kg twice weekly IV for 6 weeks. Key inclusion criteria are: MM per IMWG criteria or lymphomas or plasma cell leukemia with histologic confirmation; measurable disease, relapsed or refractory after ≥2 prior regimens; not eligible for standard therapy known to extend life expectancy. Primary endpoints are safety and tolerability of SNS01-T. Secondary endpoints include pharmacokinetics, tumor response (M protein, % plasma cells, radiologic response) and time to relapse or progression. Efficacy assessments were performed at baseline and after 12 infusions in all pts (week 6); myeloma pts were also assessed at week 3. Results All cohorts will have completed enrollment in August 2014 and dosing in cohort 4 will be complete by September. A total of 21 pts have been treated, of whom 18 currently have data available. Demographics are provided in Table 1. Abstract 4464. Table 1:DemographicsSNS01-T DoseOverall(n=18)0.0125 mg/kg(n=6)0.05 mg/kg(n=4)0.2 mg/kg(n=4)0.375 mg/kg(n=4)Median age (range)63 (55-77)61.5 (57-66)63 (60-77)68 (66-74)58 (55-71)Male, n (%)12 (67)5 (83)03 (75)4 (100)Caucasian, n (%)17 (94)6 (100)3 (75)4 (100)4 (100)Median weight in kg (range)84 (53-117)81 (69-103)58 (53-87)86 (77-92)97 (81-117)Median performance status (range)1 (0-2)1 (0-1)1 (0-2)0 (0-2)1 (0-1)Cancer type, n (%) Multiple myeloma DLBCL15 (83) 3 (17)6 (100) 03 (75) 1 (25)2 (50) 2 (50)4 (100) 0Median prior therapies (range)5 (2-17)4.5 (3-12)6.5 (2-13)7.5 (2-17)7 (5-14) Treatment-emergent adverse events (TEAE) were reported for all pts. The most frequently reported System Organ Classes were General Disorders and Administration Site Conditions (72%) and Gastrointestinal Disorders (56%), with somewhat higher reporting frequency in dose cohorts 3 and 4. The most commonly reported AEs were fatigue (50%), nausea (33%), infusion-related reaction (33%), chills (28%), thrombocytopenia (22%) and pyrexia (17%). Thrombocytopenia, nausea, fatigue, infusion reaction appeared to show some degree of dose relationship. Grade ≥3 TEAEs occurred in 50% of pts with no obvious dose relationship. The only grade ≥3 TEAE reported in >1 pt was thrombocytopenia (17%). There have been no treatment-related deaths. There was 1 DLT at dose level 4 (0.375 mg/kg). Pt 51-001 did not receive premedication prior to the third infusion of SNS01-T and consequently experienced a grade 4 infusion reaction, from which all symptoms resolved within 24 hours. Study treatment was discontinued and the protocol was amended to require the following premedication at each SNS01-T infusion: a corticosteroid, antihistamine and acetaminophen are obligatory, plus an opioid as clinically indicated. Preliminary efficacy was explored. To date, 2 pts have shown stable disease of myeloma at week 3 with some decrease in serum and urine disease markers and one pt with DLBCL had a 15% decrease in small lymph node disease with approximately a 5 month duration. These patients were in cohorts 3 and 4. Conclusions SNS01-T administration was feasible in all 4 dose cohorts with prophylaxis for infusion reactions. Early signs of potential efficacy are encouraging. Expansion of efficacy testing to more patients and combination studies are planned. Disclosures Siegel: Senesco: PI Other. McDonald:Senesco: PI Other. Novitzky:Senesco: PI Other. Bensinger:Senesco: PI Other. Craig:Senesco: PI Other. van Rhee:Senesco: PI Other. Gutierrez:Senesco: PI Other. Libby:Senesco: PI Other. Thompson:Senesco: Consultancy, Employment, Equity Ownership, Membership on an entity's Board of Directors or advisory committees, Patents & Royalties, Research Funding. Bexon:Senesco: Consultancy. Barranco:Senesco: Consultancy. Taylor:Senesco: Research Funding. Dondero:Senesco: Employment. Browne:Senesco: Employment. Kurman:Senesco: Consultancy. Lust:Senesco: PI Other.

TPS8616 Background: eIF5A has been implicated in the regulation of cell proliferation, apoptosis, and inflammation. It is the only known protein to be modified by hypusination, and is highly conser...

SNS01-T is a novel nanoparticle that is designed to selectively initiate apoptosis in B-cell cancers such as multiple myeloma and non-Hodgkins B-cell lymphomas. SNS01-T comprises a plasmid DNA (pExp5A) encoding a pro-apoptotic form of the eukaryotic translation initiation factor 5A (eIF5A) containing a single-point mutation that prevents hypusination, an eIF5A siRNA that inhibits expression of the pro-survival hypusine-eIF5A protein, and a polymer that serves to assemble the nucleic acids into a nanoparticle. SNS01-T is currently being investigated in a multi-site, open-label Phase1b/2a dose escalation study in subjects with relapsed or refractory multiple myeloma (MM), mantle cell lymphoma (MCL), or diffuse large B cell lymphoma (DLBCL). SNS01-T has demonstrated activity in MM xenograft models as well as in B cell lymphoma models of MCL and DLBCL, when administered twice weekly at doses ≥ 0.18 mg(nucleic acid)/kg. In this study we compared the ability of SNS01-T to transfect, regulate eIF5A expression, and kill MM, DLBCL, and MCL cell lines. Furthermore, the activity of SNS01-T in normal B cells was investigated. A previous study using a KAS-6/1 MM xenograft model demonstrated that the eIF5A siRNA and plasmid pExp5A both have anti-tumoral activity in MM but had a greater impact on tumour growth when combined together as SNS01-T. This finding was confirmed in this study in a second MM model (RPMI 8226) as well as in a DLBCL xenograft model. To determine the efficiency of SNS01-T transfection into malignant or normal B cells, the pExp5A plasmid and eIF5A siRNA were labeled with FITC and DY547, respectively, packaged into nanoparticles using polyethylenimine polymer, and used to transfect cultured cells. FACS analysis was used to determine the percent of the cell population transfected with plasmid, siRNA, or both. RT-qPCR was used to assess biological activity of SNS01-T by quantifying the expression of eIF5AK50R mRNA transgene and endogenous eIF5A mRNA in a variety of B cell lines. The IC50 of SNS01-T in a panel of MM, MCL, and DLBCL cell lines was determined by XTT assay. SCID mice bearing either RPMI 8226 MM tumours or SuDHL6 GCB DLBCL tumours were treated with pExp5A plasmid (formulated with PEI and control siRNA), eIF5A siRNA (formulated with PEI and a control plasmid), or SNS01-T at 0.375 mg/kg twice per week by intravenous injection. SNS01-T was able to transfect MM, MCL, and DLBCL cell lines, although the proportion of cells transfected with both plasmid and siRNA was higher in MM cells. Transfection of SNS01-T resulted in expression of the transgene as well as a statistically significant reduction in expression of eIF5A mRNA compared to untreated controls for all three cell types. In contrast, normal B cells were found to take up fluorescently-labeled SNS01-T with reduced efficiency compared to RPMI 8226 MM cells. Futhermore, SNS01-T was observed to induce cell death in RPMI 8226 MM cells but not in normal B cells. In the RPMI 8226 xenograft model, treatment with either the pExp5A plasmid alone or eIF5A siRNA alone resulted in a 66 % reduction (p < 0.0001) or 44 % reduction (p < 0.05) in tumor volume compared to the control group at day 24 of the study. In contrast, treatment with SNS01-T, which contains both the pExp5A plasmid and the eIF5A siRNA, resulted in an 86 % (p < 0.0001) reduction in tumor volume. A similar result was observed in the SuDHL6 model with a 14 % reduction or 27 % reduction (p < 0.05) in tumor volume compared to the control group at day 20 of the study following treatment with pExp5A plasmid or eIF5A siRNA, respectively. In contrast, treatment with SNS01-T resulted in a 79 % (p < 0.0001) reduction in tumor volume. Collectively, these preclinical studies indicate that SNS01-T therapy has significant potential against MM, MCL, and DLBCL. Disclosures: Taylor: Senesco Technologies: stock options Other. Dondero:Senesco Technologies: Employment. Thompson:Senesco Technologies: Consultancy, Equity Ownership, Membership on an entity’s Board of Directors or advisory committees, Research Funding.

Eukaryotic translation initiation factor 5A (eIF5A) has been implicated in the regulation of cell proliferation, apoptosis, and inflammation, and is the only known protein to be modified by hypusination. Hypusinated eIF5A, the predominant form of eIF5A in cancer cells, is involved in cell survival and activation of inflammatory pathways. In contrast, accumulation of the unhypusinated form of eIF5A is associated with apoptosis and mutants of eIF5A that cannot be hypusinated (e.g. eIF5AK50R) are pro-apoptotic. SNS01-T was designed to treat B-cell cancers and consists of two active components: a plasmid DNA expressing the pro-apoptotic eIF5AK50R under the control of a B cell-specific promoter, and an siRNA against an untranslated region of native eIF5A mRNA. When these two components are combined with linear polyethyleneimine (PEI), the nucleic acids are condensed into nanoparticles for protection from degradation in the blood and enhanced cellular delivery. The mode of action of SNS01-T is siRNA-mediated inhibition of hypusinated eIF5A and simultaneous over-expression of pro-apoptotic eIF5AK50R to induce cell death. In vitro cell studies and in vivo xenograft studies have demonstrated the efficacy of this approach. The safety and tolerability of intravenous administration of SNS01-T is being investigated in a first-in-human Phase1b/2a study in patients with relapsed or refractory multiple myeloma (MM), mantle cell lymphoma (MCL) or diffuse large B cell lymphoma (DLBCL). Eligible patients are being enrolled sequentially into four cohorts at increasing doses. Each patient receives an intravenous infusion of SNS01-T twice weekly for 6 consecutive weeks. Eligible patients must have been diagnosed with MM according to IMWG criteria, or with MCL or DLBCL with histologic confirmation. Patients also must have measurable disease, have relapsed or refractory disease after two or more prior treatment regimens, have a life expectancy of at least 3 months, and not be eligible to receive any other standard therapy known to extend life expectancy. The primary objective is to evaluate the safety and tolerability of multiple escalating doses of SNS01-T. Secondary objectives include analysis of pharmacokinetics, immunogenicity, pro-inflammatory cytokines, and therapeutic efficacy. The required 3 patients per cohort have completed the dosing schedule in cohorts 1 and 2 from a total of 10 patients enrolled (9 patients with MM and 1 with DLBCL). Of the ten patients enrolled, four completed the full treatment period, two did not complete dosing but were evaluable for safety, and four (three in cohort 1 and one in cohort 2) discontinued treatment after fewer than 8 doses and were not evaluable. There were no drug-related serious adverse events or dose limiting toxicities in either cohort 1 or 2. In cohort 1 (0.0125 mg/kg SNS01-T), two of three evaluable patients did not progress on treatment and were considered stable at week 3 and week 6, the end of the dosing regimen. The third patient progressed after receiving 10 of the 12 doses and was evaluable for safety. In cohort 2 (0.05 mg/kg), 3 patients (2 with MM and 1 with DLBCL) were evaluable for safety. Stabilization of serum monoclonal protein levels was observed in one MM patient of cohort 2. Two patients (1 with MM and 1 with DLBCL) progressed after receiving 8 of the 12 doses and were evaluable for safety. Results from ongoing pharmacokinetic studies, immunogenicity studies, and quantification of pro-inflammatory cytokines will be discussed. The planned dose levels for the third and fourth groups are 0.2 and 0.375 mg/kg, respectively. The results to date of this first-in-human clinical trial indicate that SNS01-T can be administered safely and the MTD has not yet been reached (Clinical Trials.gov Identifier: NCT01435720). Disclosures: Barranco: Senesco Technologies: Consultancy. Usmani:Celgene, Onyx, Millenium: Consultancy, Research Funding, Speakers Bureau. van Rhee:Jansen&Jansen: Research Funding. Thompson:Senesco Technologies: Consultancy, Equity Ownership, Membership on an entity’s Board of Directors or advisory committees, Research Funding. Taylor:Senesco Technologies: stock options Other. Dondero:Senesco Technologies: Employment. Browne:Senesco Technologies Inc.: Employment, Equity Ownership, Membership on an entity’s Board of Directors or advisory committees. Siegel:Celgene, Millenium, Onyx (same for all): Honoraria, Membership on an entity’s Board of Directors or advisory committees, Speakers Bureau.

Abstract 2973 Eukaryotic translation initiation Factor 5A (eIF5A) has been implicated in the regulation of apoptosis and is the only known protein to be modified by hypusination. Hypusinated eIF5A is the predominant form of eIF5A in cancer cells. However, in its unhypusinated form, eIF5A is pro-apoptotic. SNS01-T, designed to treat B-cell cancers, consists of two active components: a plasmid DNA expressing eIF5AK50R (human eIF5A containing a lysine to arginine substitution at position 50) which remains pro-apoptotic because it cannot be hypusinated, and an siRNA against an untranslated region of native eIF5A mRNA. When these two components are combined with linear polyethyleneimine (PEI), the nucleic acids are condensed into nanoparticles for protection from degradation in the blood and enhanced delivery to tissues. The eIF5AK50R transgene is under the control of the B29 promoter and enhancer, which restricts expression to B cells. The mode of action of SNS01-T is to use an eIF5A-specific siRNA to deplete the pool of hypusinated eIF5A in myeloma cells while simultaneously adding pro-apoptotic eIF5AK50R. In vitro cell studies and in vivo xenograft studies have demonstrated the efficacy of this approach. Eligible patients are enrolled sequentially into four cohorts of increasingly higher doses. Each cohort will receive SNS01-T by intravenous infusion twice weekly for 6 consecutive weeks and then be observed every 4 weeks during a 24-week follow-up period. Eligible patients must have been diagnosed with multiple myeloma according to IMWG criteria, have measurable disease, have relapsed disease after two or more prior treatment regimens, have a life expectancy of at least 3 months, and not be eligible to receive any other standard therapy known to extend life expectancy. The primary objective is to evaluate the safety and tolerability of multiple ascending doses of SNS01-T. Secondary objectives include pharmacokinetics, immunogenicity studies, proinflammatory cytokine quantitation, and therapeutic efficacy. The required number of 3 patients completed the dosing schedule in Cohort 1 from a total of 6 patients enrolled. Two of three patients had not progressed on treatment, based on standard response criteria including the monoclonal protein, and were considered stable at week 3 and week 6 the end of the dosing regimen. Three patients were withdrawn from the study by their physicians due to disease progression before completing treatment. One of the responding patients has continued to have stable disease at week 10, a month after the end of treatment with SNS01-T. The first group of patients received 0.0125 mg/kg, approximately 1 mg per patient by intravenous infusion. The planned dose levels for the second, third and fourth groups are 0.05, 0.2 and 0.375 mg/kg, respectively. The results to date of this first in man clinical trial indicate that SNS01-T was safely administered without dose-limiting toxicities in the first group of multiple myeloma patients. The MTD has not yet been reached. (Clinical Trials.gov Identifier: NCT01435720.) Disclosures: Hamadani: Celgene Corp: Speakers Bureau; American Cancer Society 116837-IRG-09–061–01: Research Funding; ASBMT & Millennium New Investigator Award: Research Funding; Conquer Cancer Foundation of ASCO: Research Funding. Barranco:Senesco Technologies: Employment. Thompson:Senesco Technologies Inc.: Employment, Equity Ownership, Membership on an entity's Board of Directors or advisory committees. Taylor:Senesco Technologies Inc.: stock options Other. Dondero:Senesco Technologies Inc.: Employment.

Abstract 4223 SNS01-T is a novel nanoparticle that is designed to selectively initiate apoptosis in B-cell cancers such as multiple myeloma and B-cell lymphomas. SNS01-T is comprised of a plasmid encoding a pro-apoptotic form of the eukaryotic translation initiation factor 5A (eIF5A) containing a single-point mutation that prevents hypusination, an siRNA that inhibits expression of the pro-survival hypusine-eIF5A protein, and a polymer that serves to assemble the nucleic acids into a nanoparticle. SNS01-T is currently being investigated in a multi-site, open-label Phase1b/2a dose escalation study in subjects with relapsed or refractory multiple myeloma (MM). SNS01-T and its preclinical precursors have been studied extensively in multiple myeloma and B cell lymphoma tumor models. In this study we tested the in vitro and in vivo anti-cancer activity of SNS01-T in combination with the immunomodulatory drug lenalidomide. The combination of low doses of SNS01-T and lenalidomide synergistically reduced viability of RPMI 8226 MM cells and induced apoptosis to a greater degree than either drug alone. To determine whether SNS01-T treatment increases the anti-myeloma activity of lenalidomide in vivo, 0.375 mg/kg SNS01-T was combined with either 15 or 50 mg/kg lenalidomide in a RPMI 8226 xenograft model of multiple myeloma. Mice were dosed for two cycles of treatment for a total of 11 weeks of dosing. Mice with no measurable tumor at the end of the first cycle of treatment did not receive treatment in the second cycle but were monitored closely for tumor recurrence. A two-week observation period at the end of the study allowed monitoring of tumor growth after the cessation of the second cycle of treatment. At the end of the second cycle of dosing, tumor growth was inhibited by 84 % (p < 0.0001), 34 % (p = 0.05), and 98.1 % (p << 0.0001) in animals treated with SNS01-T, 50 mg/kg lenalidomide, and SNS01-T plus 50 mg/kg lenalidomide, respectively. Complete tumor regression (undetectable tumor) was achieved in 40% of mice treated with SNS01-T, 0% of mice treated with 50 mg/kg lenalidomide, and 83% of mice treated with the combination therapy of SNS01-T and 50 mg/kg lenalidomide. Complete regression of tumors treated with the combination therapy was maintained for more than 8 weeks without treatment until the end of the study in 4 of 6 (67%) of treated mice. Combining SNS01-T treatment with 50 mg/kg lenalidomide inhibited tumor growth more effectively than either drug alone and prolonged survival with 100% of mice surviving to the end of the 102-day study. Combination therapy with SNS01-T and 15 mg/kg lenalidomide also demonstrated significant activity in a murine JMV-2 mantle cell lymphoma (MCL) xenograft model. Treatment of mice with the drug combination of SNS01-T and lenalidomide resulted in a statistically significant increase in survival compared to either SNS01-T (p = 0.002; logrank test) or lenalidomide (p = 0.007) alone. Collectively, these preclinical studies indicate that the combination therapy of SNS01-T and lenalidomide is well tolerated, has significant activity against MM and MCL, and provides a strong rationale to evaluate SNS01-T and lenalidomide combination therapy to improve patient outcome in MM and B cell lymphomas. Disclosures: Taylor: Senesco Technologies Inc.: stock options Other. Dondero:Senesco Technologies Inc.: Employment. Thompson:Senesco Technologies Inc.: Employment, Equity Ownership, Membership on an entity's Board of Directors or advisory committees.

TPS8116 Background: Eukaryotic translation initiation Factor 5A (eIF5A) has been implicated in the regulation of apoptosis and is the only known protein to be modified by hypusination. Hypusinated eIF5A is the predominant form of eIF5A in cancer cells. However, in its unhypusinated form, eIF5A is pro-apoptotic. SNS01-T, designed to treat myeloma, consists of two components: a plasmid DNA expressing eIF5AK50R (human eIF5A containing a lysine to arginine substitution at position 50) which remains pro-apoptotic because it cannot be hypusinated, and an siRNA against an untranslated region of native eIF5A mRNA. When these two components are combined with linear polyethyleneimine (PEI), the nucleic acids are condensed into nanoparticles for protection from degradation in the blood and enhanced delivery to tissues. The eIF5AK50R transgene is under the control of the B29 promoter and enhancer, which restricts expression to B cells. The mode of action of SNS01-T is to use an eIF5A-specific siRNA to deplete the pool of hypusinated eIF5A in myeloma cells while simultaneously adding pro-apoptotic eIF5AK50R. In vitro cell studies and in vivo xenograft studies have demonstrated the efficacy of this approach. Methods: Eligible patients are enrolled sequentially into four cohorts of increasingly higher doses. Each cohort will receive SNS01-T by intravenous infusion twice weekly for 6 consecutive weeks and then be observed every 4 weeks during a 24-week follow-up period. Eligible patients must have been diagnosed with multiple myeloma according to IMWG criteria, have measurable disease, have relapsed disease after two or more prior treatment regimens, have a life expectancy of at least 3 months, and not be eligible to receive any other standard therapy known to extend life expectancy. The primary objective is to evaluate the safety and tolerability of multiple escalating doses of SNS01-T. Secondary objectives include pharmacokinetics, immunogenicity studies, proinflammatory cytokine quantitation, and therapeutic efficacy. Two of the planned 15 patients have been enrolled. (Clinical Trials.gov Identifier: NCT01435720.)

Abstract 2051 Eukaryotic translation initiation factor 5A (eIF5A) has been implicated in the regulation of cell proliferation, inflammation, differentiation, and apoptosis and is the only known protein to be post-translationally modified with a hypusine residue. Both hypusinated eIF5A and deoxyhypusine synthase, the enzyme that mediates eIF5A hypusination, have been identified as markers of neoplastic growth and metastasis. Accumulation of unmodified eIF5A is generally only observed during apoptosis and mutants of eIF5A that cannot be hypusinated (eIF5AK50R) are pro-apoptotic. In vitro cell studies and in vivo xenograft models have demonstrated that simultaneous small interfering RNA (siRNA)–mediated suppression of native eIF5A expression and over-expression of eIF5AK50R potently induces apoptosis in multiple cancer cell types, including myeloma, and inhibits human myeloma tumor growth in murine xenograft models. SNS01-T is a nanoparticle comprising: 1) a plasmid encoding the pro-apoptotic eIF5AK50R driven by a B cell specific promoter; 2) an siRNA that inhibits pro-survival hypusine-eIF5A expression; and 3) a polymer that assembles the nucleic acids into a nanoparticle. Pharmacokinetic, pharmacodynamic, biodistribution, and toxicology studies have been conducted with SNS01-T to support studies in multiple myeloma patients. The pharmacokinetics and biodistribution of SNS01-T were evaluated in mice using RT-qPCR to assess the distribution and persistence of plasmid DNA and siRNA. Toxicology includes acute and 6-week studies with twice weekly administration of SNS01-T in male and female mice and dogs. Clinical signs, hematology, histopathology, clinical pathology, pharmacokinetics, and serum cytokines were measured. SNS01-T reached all tissues examined including the bone marrow. No evidence of accumulation of the plasmid or siRNA was observed and levels declined rapidly after the end of treatment. Toxicological findings of SNS01-T administration in mice at 0.25 and 0.5 mg/kg for 6 weeks included clinical signs limited to the injection site, increases in organ weight, increases in IFN-g and GRO, and hematological changes, that could not be attributed solely to the test article. Toxicological findings of SNS01-T administration in beagles at 0.375 and 0.75 mg/kg for 6 weeks included a dose-dependent increase in incidences of clinical signs, resulting in a NOAEL of 0.375 mg/kg. A multiple ascending dose Phase 1b/2a open-label study has been initiated to evaluate the safety and tolerability of six weeks of twice-weekly administration of SNS01-T by intravenous infusion in patients with relapsed or refractory multiple myeloma. Approximately 12–15 patients are being enrolled and administered escalating doses of SNS01-T (Table 1). The patient starting dose is based upon the lower dose evaluated in the mouse toxicology study (0.25 mg/kg). The initial dosage in the clinical study was selected by reducing by a factor of 20 to 0.0125 mg/kg. The primary safety endpoints are the frequency, severity, and duration of treatment-related adverse events in patients following treatment with SNS01-T. Although safety is the primary endpoint of this study, efficacy is being evaluated by time to progression and by changes in values of the following biomarkers: monoclonal (M) protein, hemoglobin, bone marrow plasma cell percentage, plasma cell labeling index, C-reactive protein, and free light chain. Pharmacokinetics of SNS01-T are being assessed by monitoring levels of pExp5A pDNA and eIF5A siRNA in the blood and bone marrow by RT-qPCR. Immunogenicity of SNS01-T is also being assessed in patient samples by monitoring induction of pro-inflammatory cytokines and antibodies to SNS01-T. It is expected that results from the first group of patients will be presented.Table 1:Dose Escalation Schedule by GroupGroupNumber of PatientspExp5A pDNA DoseeIF5A siRNA DoseTotal Nucleic Acid Dose (SNS01-T)130.0083 mg/kg0.0042 mg/kg0.0125 mg/kg230.0333 mg/kg0.0167 mg/kg0.05 mg/kg330.1333 mg/kg0.0667 mg/kg0.2 mg/kg43–60.25 mg/kg0.125 mg/kg0.375 mg/kg Disclosures: Dondero: Senesco Technologies Inc.: Employment, Membership on an entity's Board of Directors or advisory committees, Patents & Royalties. Thompson:Senesco Technologies Inc.: Consultancy, Equity Ownership, Membership on an entity's Board of Directors or advisory committees, Patents & Royalties, Research Funding.

Introduction: The eukaryotic translation initiation factor 5A (eIF5A) is the only known protein to be regulated by post-translational addition of a hypusine residue. Both hypusinated eIF5A and the enzyme that mediates eIF5A hypusination have been identified as markers of neoplastic growth and metastasis. However, recent studies have indicated that, in its unhypusinated form, eIF5A is pro-apoptotic and thus functionally distinct from hypusine-modified eIF5A. In vitro cell studies and in vivo xenograft studies have demonstrated that simultaneous suppression of eIF5A expression and overexpression of a non-hypusinable mutant of eIF5A potently induces apoptosis in multiple cancer cell types. SNS01 is a nanoparticle specifically designed for the treatment of multiple myeloma. SNS01 is comprised of three components: a DNA vector containing a B-cell-specific (B29) promoter driving expression of a pro-apoptotic mutant of eIF5A (eIF5AK50R) that cannot be hypusinated; an siRNA that targets the native hypusinated eIF5A that promotes growth of cancer cells; and a synthetic polymer called polyethylenimine (PEI). Methods: Ethidium-bromide agarose gel electrophoresis was used to detect heparin-mediated release of nucleic acids from nanoparticles. Dynamic light scattering (DLS) was used to assess the short-term stability of SNS01 by monitoring changes in size distribution, polydispersity, and zeta potential. In vitro biological activity of SNS01 was assessed using RT-qPCR to measure eIF5A and eIF5AK50R transgene expression as well as FACS detection of AnnexinV-FITC labeled apoptotic cells. Anti-tumoral activity of SNS01 was evaluated using a subcutaneous human myeloma model (KAS-6/1 cells) in SCID mice with twice-weekly intra-venous injections of SNS01. Results: SNS01 nanoparticles were found to be relatively stable for as long as 48 hours at room temperature with no significant loss in nucleic acid integrity. The nanoparticles had an average diameter of 146.2 nm, a polydispersity of 0.287 and an average zeta potential of 35.3+0.7 mV. These parameters were quite stable over 48 hours. SNS01 could also be frozen at − 80°C for at least one month with no observable loss in biological activity. Twice-weekly intra-venous injections into myeloma tumor-bearing mice of a frozen SNS01 preparation was found to have anti-tumoral activity comparable to freshly prepared SNS01 (frozen SNS01: 89 % tumor inhibition, p = 0.00158; SNS01: 84 % tumor inhibition, p = 0.00003). Conclusions: SNS01 is relatively stable at room temperature and was also found to be stable and biologically active following freezing. Citation Information: Mol Cancer Ther 2009;8(12 Suppl):A196.

Abstract 2462 Poster Board II-439 The eukaryotic translation initiation factor 5A (eIF5A) is highly conserved and the only known protein to contain the amino acid hypusine. Hypusinated eIF5A and deoxyhypusine synthase, one of the enzymes mediating eIF5A post-translational hypusination, have been identified as markers of neoplastic growth and metastasis, respectively. However, recent studies have indicated that, in its unhypusinated form, eIF5A is pro-apoptotic and thus functionally distinct from hypusine-modified eIF5A. SNS01 is a cancer gene therapy biologic targeted to the treatment of multiple myeloma. SNS01 is comprised of three components: a DNA vector containing a B-cell-specific (B29) promoter driving expression of a pro-apoptotic mutant of eIF5A (eIF5AK50R) that cannot be hypusinated; an siRNA that targets the native hypusinated eIF5A that promotes growth of cancer cells; and a synthetic polymer called polyethylenimine (PEI). RT-qPCR experiments demonstrated that treatment of the human myeloma cell line, KAS-6/1, with SNS01 results in a 90 % reduction in the expression of eIF5A mRNA (mediated by the siRNA) as well as the accumulation of ∼ 22,000 copies of the plasmid-derived eIF5AK50R mRNA per ng of total RNA. SNS01 was found to induce apoptosis in both IL-6-dependent (KAS-6/1) and IL-6-independent (U266) myeloma cell lines and was found to be more effective at inducing apoptosis than PEI nanoparticles carrying either the eIF5A siRNA or the eIF5AK50R plasmid alone. Apoptosis assays were used to optimize the ratio of DNA:siRNA in the nanoparticles and a ratio of 2:1 was found to be optimal for the induction of apoptosis in myeloma cells. The anti-tumoral activity of SNS01 was assessed in SCID mice bearing subcutaneous human multiple myeloma (KAS-6/1) tumors using twice-weekly intra-venous injections and a dose range between 0.15 mg/kg and 1.5 mg/kg. Control mice treated with PEI nanoparticles containing a non-expressing plasmid and a non-targeting siRNA had an average tumor volume of 284 mm3 at the time of sacrifice, whereas mice treated with 1.5 mg/kg or 0.75 mg/kg SNS01 exhibited significant tumor regression and had average tumor volumes of 13 mm3 (95 % inhibition; *p = 0.026) and 24.5 mm3 (91 % inhibition; *p = 0.03), respectively. In addition, for mice treated with 1.5 mg/kg SNS01, there was no evidence of tumors under the skin. Lower doses of SNS01 also demonstrated anti-tumoral activity with mice treated with 0.38 mg/kg and 0.15 mg/kg exhibiting a 73 % and 61 % inhibition of tumor growth, respectively. TUNEL-labeling revealed evidence of apoptotic cells in the treated tumors indicating that tumor regression occurs through the induction of apoptosis. Twice weekly dosing of SNS01 was found to be critical for effective tumor control. In a separate study, twice weekly dosing of SNS01 at 1.5 mg/kg was found to inhibit tumor growth by 88 % (p = 0.01) while once weekly dosing did not significantly reduce tumor burden. Since SNS01 is intended as a therapy for multiple myeloma, a bone marrow neoplasm, the biodistribution of PEI nanoparticles containing a GFP plasmid with the B-cell-specific B29 promoter and a fluorescently (DY547)-labeled siRNA was assessed following i.v. administration in Balb/c mice. The fluorescent siRNA was observed in the liver, lung, spleen, and bone marrow, while GFP expression was primarily observed in the bone marrow. In summary, our preclinical data indicate that systemic administration of SNS01 is an effective anti-cancer therapy in an animal model of multiple myeloma. Additionally, since PEI nanoparticles are taken up by cells of the bone marrow following systemic delivery, SNS01 may be an effective treatment option for multiple myeloma patients and is currently being evaluated for use in clinical trials. Disclosures: Taylor: Senesco Technologies Inc.: Patents & Royalties, stock options. Lust:Senesco Technologies Inc.: Research Funding. Dondero:Senesco Technologies Inc.: Employment, Equity Ownership, Patents & Royalties. Galton:Senesco Technologies Inc.: Employment, Equity Ownership, Membership on an entity's Board of Directors or advisory committees, Patents & Royalties. Donovan:Senesco Technologies Inc.: Research Funding. Thompson:Senesco Technologies Inc.: Consultancy, Equity Ownership, Membership on an entity's Board of Directors or advisory committees, Patents & Royalties, Research Funding.

Background: Hypusine is a unique amino acid present in all eukaryotes but found in only one highly conserved protein, eukaryotic translation initiation factor 5A. It is formed during a two-step post-translational modification of eIF5A. eIF5A has been identified as a critical factor for cell proliferation in yeast, as a modulator of p53, and recent studies indicate that the unhypusinated form of eIF5A is a pro-apoptotic protein. Because myeloma remains incurable, we hypothesized that induction of apoptosis by modulation of eIF5A may be a useful therapeutic approach. In this study we utilized PEI nanoparticles to deliver plasmid DNA and siRNA to myeloma tumor cells in vitro and in vivo. Methods: An siRNA was used to suppress levels of endogenous hypusinated eIF5A in tumors while an RNAi-resistant plasmid expressing a mutant of eIF5A (eIF5AK50R), that cannot be hypusinated, was used to increase levels of unhypusinated eIF5A which is proapoptotic. In vitro, KAS-6/1 myeloma cells were incubated with control siRNA/control plasmid, eIF5A siRNA alone, or eIF5A siRNA/eIF5AK50R for 72 hours in the presence or absence of IL-6. Apoptosis was quantitated using flow cytometry to detect annexin V/propidium iodide stained cells; results were corrected for percent apoptosis of the mock control to enable comparison between experiments. In vivo, SCID mice (3/group) were injected with 10 million KAS-6/1 cells SQ in the right flank and approximately 6 weeks later injected intratumorally twice weekly as follows: Group 1 control mice received 20 μg empty vector and 10 μg control siRNA. Group 2 received 20 μg eIF5AK50R plasmid and 10 μg control siRNA. Group 3 received 20 μg eIF5AK50R plasmid and 10 μg eIF5A siRNA. Tumor volumes were quantitated in mm3 using a2b/2 where a is the smaller dimension. Results: The in vitro results showed the following % apoptosis: Absence of IL-6 - Control: 6.5%, eIF5A siRNA/eIF5AK50R 30.3%. Presence of IL-6–Control:8.2%; eIF5A siRNA alone 36.5%; eIF5A siRNA/eIF5AK50R 45.2%. Western analysis demonstrated that the siRNA successfully inhibited the production of endogenous eIF5A. In vivo, after 24 days of monitoring tumor volume: group 1 mice showed that the KAS-6/1 cells grew from a mean tumor volume of 7±1 up to 102±16 mm3; tumors in group 2 mice remained relatively stable in size from 21±9 to 26±10 mm3. Group 3 mice showed a mean 92% tumor regression from 99±21 down to 7±1 mm3. Conclusions: Delivery of eIF5A siRNA and eIF5AK50R plasmid by PEI nanoparticles results in significant anti-tumoral reponses in vitro and in vivo. These studies may provide a novel therapy for myeloma patients with end stage disease that have failed standard treatments.