# Alpha particles combined with ATR inhibition to activate the immune system: mechanisms and pre-clinical translation

> **NIH NIH R01** · UNIVERSITY OF TX MD ANDERSON CAN CTR · 2024 · $494,190

## Abstract

One strategy to enhance the immune response to tumors is radiotherapy (RT). Recent data support that RT-
induced micronuclei (MN) are intrinsically immunostimulatory, as ruptured MN releases double stranded DNA
(dsDNA) eliciting the cycling GMP-AMP synthase (cGAS) and stimulator of interferon genes (STING) pathway.
Although progress has been made in combining immune checkpoint blockade (ICB) with RT, relatively little is
known about the physical mechanisms of RT that elicit immunostimulatory signals and how they can be har-
nessed clinically in the context of DNA damage and DNA repair inhibition. Radiation with high ionization density
(or linear energy transfer, LET) induces more clustered DNA lesions, more MN and higher cell kill compared to
low-LET radiation. α-particles are characterized by their high-LET in contrast to photons and protons and may
be ideal for creating high levels of MN and downstream enhanced activation of immunostimulatory signals
through the cGAS-STING pathway. A novel modality to deliver α-particles has recently been successfully demon-
strated in a phase I clinical trial using a method called diffusing alpha-emitters radiation therapy (DaRT). DaRT
consists of interstitial radioactive seeds coated with radium-224, an α-particle emitter. The radium-224 decay
chain is unique in that the decay products also emit α-particles and diffuse, allowing the α-particles’ dose to be
deposited over 2-3 mm from the seed. Thus, multiple seeds implanted into a tumor allow the high-LET α-particle
dose to be deposited within the entire tumor volume. In addition to radiation, pharmacologic inhibition of DNA
repair affects the presence of MN. This inhibition of DNA repair can be created with drugs such as Ataxia telan-
giectasia and Rad3 related (ATR) inhibitors (ATRi). The combination of an ATRi with α-particle-induced clustered
DSB lesions may synergistically enhance the accumulation of MN, ultimately enhancing immunostimulatory sig-
nals. These will be investigated with ICB to determine how to synergistically augment RT-induced antitumor
immunity. We hypothesize that α-particles combined with an ATRi produces more MN, results in more cGAS
binding to dsDNA and consequently potentiate robust antitumor immunity. We propose to: 1) Elucidate the mech-
anisms by which cGAS binds to dsDNA in -particles+ATRi treated cells; 2) Elucidate the mechanisms by which
-particles+ATRi induces immune signaling; and 3) Evaluate antitumor immunity from -particles+ATRi in vivo.
Our research has the potential to define -particles as a tool to augment antitumor immune response, especially
for tumors that are known to be unresponsive to ICB. Our proposed research is of critical relevance to address
the poor prognosis associated with multiple advanced solid cancers that are immunologically cold. Our proposed
work is innovative, in that it aims to define the effects of -particle-induced clustered DNA damage on tumors in
the context of antitumor immunity. Our fin...

## Key facts

- **NIH application ID:** 10864973
- **Project number:** 5R01CA279119-02
- **Recipient organization:** UNIVERSITY OF TX MD ANDERSON CAN CTR
- **Principal Investigator:** Gabriel Oliveira Sawakuchi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $494,190
- **Award type:** 5
- **Project period:** 2023-06-12 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10864973

## Citation

> US National Institutes of Health, RePORTER application 10864973, Alpha particles combined with ATR inhibition to activate the immune system: mechanisms and pre-clinical translation (5R01CA279119-02). Retrieved via AI Analytics 2026-06-22 from https://api.ai-analytics.org/grant/nih/10864973. Licensed CC0.

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