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Xanthine oxidase is an enzyme that catalyzes the oxidation of hypoxanthine to xanthine, and xanthine to uric acid, producing reactive oxygen species (ROS) such as superoxide and hydrogen peroxide as byproducts. Native bovine xanthine oxidase is being developed as a novel cancer therapeutic by Odin Therapeutics (now Viska Bio). The therapeutic mechanism relies on inducing lysosome-induced immunogenic cell death (LIICD). When administered, the enzyme generates localized ROS in the tumor microenvironment, leading to lysosomal membrane permeabilization and leakage of degradative enzymes. This process triggers tumor cell death and the release of immunogenic markers (damage-associated molecular patterns) such as surface-expressed calreticulin, extracellular ATP, and HMGB1, which prime the host's adaptive immune system to recognize tumor neoantigens and prevent recurrence.
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