RT Journal Article SR Electronic T1 337 Treatment of ovarian cancer via induction of cellular stress and the unfolded protein response (UPR) JF International Journal of Gynecologic Cancer JO Int J Gynecol Cancer FD BMJ Publishing Group Ltd SP A136 OP A137 DO 10.1136/ijgc-2020-IGCS.289 VO 30 IS Suppl 3 A1 Paridon, A A1 Alvero, A A1 Rumman, M A1 Winer, I YR 2020 UL http://ijgc.bmj.com/content/30/Suppl_3/A136.3.abstract AB Introduction Ovarian cancer (OVCA) is a lethal gynecologic malignancy. Patients with high-grade and low-grade disease carry a poor prognosis from chemoresistance and decreased induction of apoptosis. We hypothesized persistent activation of the unfolded protein response (UPR) with upregulation of CHOP and XAF-1 arms, would overcome apoptotic arrest, leading to death in chemo-sensitive and resistant OVCA.Methods Patient-derived and commercially available HG and LG OVCA cells were cultured and treated with celastrol, a potent UPR activator. Cell viability was assessed using Incucyte. Protein lysates of cells treated with celastrol were analyzed using Western blot and Caspase-Glo. RNA was analyzed using real-time PCR. Transient knock down (KD) of XAF-1 and CHOP was performed using siRNA.Results Celastrol induced cell death in chemo-sensitive and resistant OVCA lines in the nanomolar range. Celastrol induced the UPR.CHOP was preferentially upregulated upstream of mitochondrial depolarization and induction of the intrinsic apoptotic pathway. There was a reciprocal rise in XAF-1 RNA/protein levels and fall in XIAP with UPR activation. KD of XAF-1 decreased the cytotoxic effect of celastrol. KD of CHOP resulted in a lack of rise in XAF-1 with UPR activation.Abstract 337 Figure 1 Conclusions Activating UPR with agents that upregulate the CHOP/XAF-1 axis induce death in chemo-sensitive/resistant OVCA lines. XAF-1 is presumptively regulated by CHOP and a major effector of UPR, required for full cytotoxic activity. The CHOP/XAF-1 arm of UPR is a promising targetable pathway for treating HG/LG OVCA.