CFI-402257, a TTK inhibitor, effectively suppresses hepatocellular carcinoma

Proc Natl Acad Sci U S A. 2022 Aug 9;119(32):e2119514119. doi: 10.1073/pnas.2119514119. Epub 2022 Aug 1.


Deregulation of cell cycle is a typical feature of cancer cells. Normal cells rely on the strictly coordinated spindle assembly checkpoint (SAC) to maintain the genome integrity and survive. However, cancer cells could bypass this checkpoint mechanism. In this study, we showed the clinical relevance of threonine tyrosine kinase (TTK) protein kinase, a central regulator of the SAC, in hepatocellular carcinoma (HCC) and its potential as therapeutic target. Here, we reported that a newly developed, orally active small molecule inhibitor targeting TTK (CFI-402257) effectively suppressed HCC growth and induced highly aneuploid HCC cells, DNA damage, and micronuclei formation. We identified that CFI-402257 also induced cytosolic DNA, senescence-like response, and activated DDX41-STING cytosolic DNA sensing pathway to produce senescence-associated secretory phenotypes (SASPs) in HCC cells. These SASPs subsequently led to recruitment of different subsets of immune cells (natural killer cells, CD4+ T cells, and CD8+ T cells) for tumor clearance. Our mass cytometry data illustrated the dynamic changes in the tumor-infiltrating immune populations after treatment with CFI-402257. Further, CFI-402257 improved survival in HCC-bearing mice treated with anti-PD-1, suggesting the possibility of combination treatment with immune checkpoint inhibitors in HCC patients. In summary, our study characterized CFI-402257 as a potential therapeutic for HCC, both used as a single agent and in combination therapy.

Keywords: CFI-402257; STING pathway; TTK inhibitor; cytosolic DNA sensing; senescence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • CD4-Positive T-Lymphocytes / metabolism
  • CD8-Positive T-Lymphocytes / metabolism
  • Carcinoma, Hepatocellular* / drug therapy
  • Carcinoma, Hepatocellular* / genetics
  • Cell Cycle Proteins / metabolism
  • Cell Line, Tumor
  • Cell Proliferation
  • Killer Cells, Natural / metabolism
  • Liver Neoplasms* / drug therapy
  • Liver Neoplasms* / genetics
  • Mice
  • Protein Kinase Inhibitors* / therapeutic use
  • Protein Serine-Threonine Kinases
  • Protein-Tyrosine Kinases / metabolism
  • Pyrazoles* / therapeutic use
  • Pyrimidines* / therapeutic use


  • CFI-402257
  • Cell Cycle Proteins
  • Protein Kinase Inhibitors
  • Pyrazoles
  • Pyrimidines
  • Protein-Tyrosine Kinases
  • Protein Serine-Threonine Kinases