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Tazzyman S, Stewart GR, Yeomans J, Linford A, Lath D, Conner J, Muthana M, Chantry AD, Lawson MA. HSV1716 Prevents Myeloma Cell Regrowth When Combined with Bortezomib In Vitro and Significantly Reduces Systemic Tumor Growth in Mouse Models. Viruses 2023; 15:v15030603. [PMID: 36992311 PMCID: PMC10059747 DOI: 10.3390/v15030603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 02/24/2023] Open
Abstract
Multiple myeloma remains largely incurable due to refractory disease; therefore, novel treatment strategies that are safe and well-tolerated are required. Here, we studied the modified herpes simplex virus HSV1716 (SEPREHVIR®), which only replicates in transformed cells. Myeloma cell lines and primary patient cells were infected with HSV1716 and assessed for cell death using propidium iodide (PI) and Annexin-V staining and markers of apoptosis and autophagy by qPCR. Myeloma cell death was associated with dual PI and Annexin-V positivity and increased expression of apoptotic genes, including CASP1, CASP8, CASP9, BAX, BID, and FASL. The combination of HSV1716 and bortezomib treatments prevented myeloma cell regrowth for up to 25 days compared to only transient cell growth suppression with bortezomib treatment. The viral efficacy was tested in a xenograft (JJN-3 cells in NSG mice) and syngeneic (murine 5TGM1 cells in C57BL/KaLwRijHsd mice) systemic models of myeloma. After 6 or 7 days, the post-tumor implantation mice were treated intravenously with the vehicle or HSV1716 (1 × 107 plaque forming units/1 or 2 times per week). Both murine models treated with HSV1716 had significantly lower tumor burden rates compared to the controls. In conclusion, HSV1716 has potent anti-myeloma effects and may represent a novel therapy for multiple myeloma.
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Affiliation(s)
- Simon Tazzyman
- Sheffield Myeloma Research Team, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Mellanby Centre for Musculoskeletal Research, Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Department of Oncology and Metabolism, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
| | - Georgia R. Stewart
- Sheffield Myeloma Research Team, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Mellanby Centre for Musculoskeletal Research, Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Department of Oncology and Metabolism, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
| | - James Yeomans
- Sheffield Myeloma Research Team, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Mellanby Centre for Musculoskeletal Research, Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Department of Oncology and Metabolism, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
| | - Adam Linford
- Sheffield Myeloma Research Team, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Mellanby Centre for Musculoskeletal Research, Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Department of Oncology and Metabolism, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
| | - Darren Lath
- Sheffield Myeloma Research Team, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Mellanby Centre for Musculoskeletal Research, Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Department of Oncology and Metabolism, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
| | - Joe Conner
- Sorrento Therapeutics, 4955 Directors Place, San Diego, CA 92121, USA
| | - Munitta Muthana
- Department of Oncology and Metabolism, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
| | - Andrew D. Chantry
- Sheffield Myeloma Research Team, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Mellanby Centre for Musculoskeletal Research, Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Department of Oncology and Metabolism, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
| | - Michelle A. Lawson
- Sheffield Myeloma Research Team, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Mellanby Centre for Musculoskeletal Research, Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Department of Oncology and Metabolism, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- Correspondence: ; Tel.: +44-114-2159094
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2
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Kang KD, Bernstock JD, Totsch SK, Gary SE, Rocco A, Nan L, Li R, Etminan T, Han X, Beierle EA, Eisemann T, Wechsler-Reya RJ, Bae S, Whitley R, Yancey Gillespie G, Markert JM, Friedman GK. Safety and Efficacy of Intraventricular Immunovirotherapy with Oncolytic HSV-1 for CNS Cancers. Clin Cancer Res 2022; 28:5419-5430. [PMID: 36239623 PMCID: PMC9771977 DOI: 10.1158/1078-0432.ccr-22-1382] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/12/2022] [Accepted: 10/12/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE Oncolytic virotherapy with herpes simplex virus-1 (HSV) has shown promise for the treatment of pediatric and adult brain tumors; however, completed and ongoing clinical trials have utilized intratumoral/peritumoral oncolytic HSV (oHSV) inoculation due to intraventricular/intrathecal toxicity concerns. Intratumoral delivery requires an invasive neurosurgical procedure, limits repeat injections, and precludes direct targeting of metastatic and leptomeningeal disease. To address these limitations, we determined causes of toxicity from intraventricular oHSV and established methods for mitigating toxicity to treat disseminated brain tumors in mice. EXPERIMENTAL DESIGN HSV-sensitive CBA/J mice received intraventricular vehicle, inactivated oHSV, or treatment doses (1×107 plaque-forming units) of oHSV, and toxicity was assessed by weight loss and IHC. Protective strategies to reduce oHSV toxicity, including intraventricular low-dose oHSV or interferon inducer polyinosinic-polycytidylic acid (poly I:C) prior to oHSV treatment dose, were evaluated and then utilized to assess intraventricular oHSV treatment of multiple models of disseminated CNS disease. RESULTS A standard treatment dose of intraventricular oHSV damaged ependymal cells via virus replication and induction of CD8+ T cells, whereas vehicle or inactivated virus resulted in no toxicity. Subsequent doses of intraventricular oHSV caused little additional toxicity. Interferon induction with phosphorylation of eukaryotic initiation factor-2α (eIF2α) via intraventricular pretreatment with low-dose oHSV or poly I:C mitigated ependyma toxicity. This approach enabled the safe delivery of multiple treatment doses of clinically relevant oHSV G207 and prolonged survival in disseminated brain tumor models. CONCLUSIONS Toxicity from intraventricular oHSV can be mitigated, resulting in therapeutic benefit. These data support the clinical translation of intraventricular G207.
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Affiliation(s)
- Kyung-Don Kang
- Department of Pediatrics, Division of Pediatric Hematology
and Oncology, University of Alabama at Birmingham; Birmingham, AL, USA
| | - Joshua D. Bernstock
- Department of Pediatrics, Division of Pediatric Hematology
and Oncology, University of Alabama at Birmingham; Birmingham, AL, USA,Department of Neurosurgery, Brigham and Women’s
Hospital, Harvard University; Boston, MA, USA,Corresponding authors: Joshua D.
Bernstock MD, PhD, MPH, Department of Neurosurgery
- Harvard Medical School,
Brigham and Women’s Hospital
- Boston Children’s Hospital, Hale
Building
- 60 Fenwood Road
- Boston, MA 02115, USA, P: 914.419.7749
- F:
617.713.3050
- ; Gregory K. Friedman,
MD, Department of Pediatrics, University of Alabama at Birmingham, 1600 7th Ave
S, Lowder 512, Birmingham, AL 35233, USA, P: 205.638.9285
- F: 205.975.1941
| | - Stacie K. Totsch
- Department of Pediatrics, Division of Pediatric Hematology
and Oncology, University of Alabama at Birmingham; Birmingham, AL, USA
| | - Sam E. Gary
- Department of Pediatrics, Division of Pediatric Hematology
and Oncology, University of Alabama at Birmingham; Birmingham, AL, USA,Medical Scientist Training Program, University of Alabama
at Birmingham, Birmingham, AL, USA
| | - Abbey Rocco
- Department of Pediatrics, Division of Pediatric Hematology
and Oncology, University of Alabama at Birmingham; Birmingham, AL, USA
| | - Li Nan
- Department of Pediatrics, Division of Pediatric Hematology
and Oncology, University of Alabama at Birmingham; Birmingham, AL, USA
| | - Rong Li
- Department of Pathology, Children’s of Alabama;
Birmingham, AL, USA
| | - Tina Etminan
- Department of Pediatrics, Division of Pediatric Hematology
and Oncology, University of Alabama at Birmingham; Birmingham, AL, USA
| | - Xiaosi Han
- Department of Neurology, Division of Neuro-Oncology,
University of Alabama at Birmingham; Birmingham, AL, USA
| | | | - Tanja Eisemann
- Sanford Burnham Prebys Medical Discovery Institute; La
Jolla, CA, USA
| | | | - Sejong Bae
- Department of Medicine, Division of Preventative Medicine,
University of Alabama at Birmingham; Birmingham, AL, USA
| | - Richard Whitley
- Department of Pediatrics, Division of Infectious Diseases,
University of Alabama at Birmingham; Birmingham, AL, USA
| | - G. Yancey Gillespie
- Department of Neurosurgery, University of Alabama at
Birmingham; Birmingham, AL, USA
| | - James M. Markert
- Department of Neurosurgery, University of Alabama at
Birmingham; Birmingham, AL, USA
| | - Gregory K. Friedman
- Department of Pediatrics, Division of Pediatric Hematology
and Oncology, University of Alabama at Birmingham; Birmingham, AL, USA,Department of Neurosurgery, University of Alabama at
Birmingham; Birmingham, AL, USA,Corresponding authors: Joshua D.
Bernstock MD, PhD, MPH, Department of Neurosurgery
- Harvard Medical School,
Brigham and Women’s Hospital
- Boston Children’s Hospital, Hale
Building
- 60 Fenwood Road
- Boston, MA 02115, USA, P: 914.419.7749
- F:
617.713.3050
- ; Gregory K. Friedman,
MD, Department of Pediatrics, University of Alabama at Birmingham, 1600 7th Ave
S, Lowder 512, Birmingham, AL 35233, USA, P: 205.638.9285
- F: 205.975.1941
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3
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Oncolytic Viruses as Therapeutic Tools for Pediatric Brain Tumors. Cancers (Basel) 2018; 10:cancers10070226. [PMID: 29987215 PMCID: PMC6071081 DOI: 10.3390/cancers10070226] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 07/04/2018] [Indexed: 12/18/2022] Open
Abstract
In recent years, we have seen an important progress in our comprehension of the molecular basis of pediatric brain tumors (PBTs). However, they still represent the main cause of death by disease in children. Due to the poor prognosis of some types of PBTs and the long-term adverse effects associated with the traditional treatments, oncolytic viruses (OVs) have emerged as an interesting therapeutic option since they displayed safety and high tolerability in pre-clinical and clinical levels. In this review, we summarize the OVs evaluated in different types of PBTs, mostly in pre-clinical studies, and we discuss the possible future direction of research in this field. In this sense, one important aspect of OVs antitumoral effect is the stimulation of an immune response against the tumor which is necessary for a complete response in preclinical immunocompetent models and in the clinic. The role of the immune system in the response of OVs needs to be evaluated in PBTs and represents an experimental challenge due to the limited immunocompetent models of these diseases available for pre-clinical research.
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Studebaker AW, Hutzen BJ, Pierson CR, Haworth KB, Cripe TP, Jackson EM, Leonard JR. Oncolytic Herpes Virus rRp450 Shows Efficacy in Orthotopic Xenograft Group 3/4 Medulloblastomas and Atypical Teratoid/Rhabdoid Tumors. MOLECULAR THERAPY-ONCOLYTICS 2017. [PMID: 28649600 PMCID: PMC5472147 DOI: 10.1016/j.omto.2017.05.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Pediatric brain tumors including medulloblastoma and atypical teratoid/rhabdoid tumor are associated with significant mortality and treatment-associated morbidity. While medulloblastoma tumors within molecular subgroups 3 and 4 have a propensity to metastasize, atypical teratoid/rhabdoid tumors frequently afflict a very young patient population. Adjuvant treatment options for children suffering with these tumors are not only sub-optimal but also associated with many neurocognitive obstacles. A potentially novel treatment approach is oncolytic virotherapy, a developing therapeutic platform currently in early-phase clinical trials for pediatric brain tumors and recently US Food and Drug Administration (FDA)-approved to treat melanoma in adults. We evaluated the therapeutic potential of the clinically available oncolytic herpes simplex vector rRp450 in cell lines derived from medulloblastoma and atypical teratoid/rhabdoid tumor. Cells of both tumor types were supportive of virus replication and virus-mediated cytotoxicity. Orthotopic xenograft models of medulloblastoma and atypical teratoid/rhabdoid tumors displayed significantly prolonged survival following a single, stereotactic intratumoral injection of rRp450. Furthermore, addition of the chemotherapeutic prodrug cyclophosphamide (CPA) enhanced rRp450's in vivo efficacy. In conclusion, oncolytic herpes viruses with the ability to bioactivate the prodrug CPA within the tumor microenvironment warrant further investigation as a potential therapy for pediatric brain tumors.
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Affiliation(s)
- Adam W Studebaker
- Center for Childhood Cancer and Blood Diseases, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA
| | - Brian J Hutzen
- Center for Childhood Cancer and Blood Diseases, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA
| | - Christopher R Pierson
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH 43205, USA.,Department of Pathology, The Ohio State University College of Medicine, Columbus, OH 43210, USA.,Division of Anatomy, The Ohio State University, Columbus, OH 43210, USA
| | - Kellie B Haworth
- Center for Childhood Cancer and Blood Diseases, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA.,Division of Hematology/Oncology/Blood and Marrow Transplant, Nationwide Children's Hospital, Columbus, OH 43205, USA
| | - Timothy P Cripe
- Center for Childhood Cancer and Blood Diseases, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA.,Division of Hematology/Oncology/Blood and Marrow Transplant, Nationwide Children's Hospital, Columbus, OH 43205, USA
| | - Eric M Jackson
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Jeffrey R Leonard
- Department of Neurosurgery, Nationwide Children's Hospital, Columbus, OH 43205, USA
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5
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Friedman GK, Beierle EA, Gillespie GY, Markert JM, Waters AM, Chen CY, Denton NL, Haworth KB, Hutzen B, Leddon JL, Streby KA, Wang PY, Cripe TP. Pediatric cancer gone viral. Part II: potential clinical application of oncolytic herpes simplex virus-1 in children. MOLECULAR THERAPY-ONCOLYTICS 2015; 2:S2372-7705(16)30018-3. [PMID: 26436134 PMCID: PMC4589754 DOI: 10.1038/mto.2015.16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Oncolytic engineered herpes simplex viruses (HSVs) possess many biologic and functional attributes that support their use in clinical trials in children with solid tumors. Tumor cells, in an effort to escape regulatory mechanisms that would impair their growth and progression, have removed many mechanisms that would have protected them from virus infection and eventual virus-mediated destruction. Viruses engineered to exploit this weakness, like mutant HSV, can be safely employed as tumor cell killers, since normal cells retain these antiviral strategies. Many preclinical studies and early phase trials in adults demonstrated that oncolytic HSV can be safely used and are highly effective in killing tumor cells that comprise pediatric malignancies, without generating the toxic side effects of nondiscriminatory chemotherapy or radiation therapy. A variety of engineered viruses have been developed and tested in numerous preclinical models of pediatric cancers and initial trials in patients are underway. In Part II of this review series, we examine the preclinical evidence to support the further advancement of oncolytic HSV in the pediatric population. We discuss clinical advances made to date in this emerging era of oncolytic virotherapy.
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Affiliation(s)
- Gregory K Friedman
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Elizabeth A Beierle
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - James M Markert
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Alicia M Waters
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Chun-Yu Chen
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA ; Center for Childhood Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Nicholas L Denton
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Kellie B Haworth
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA ; Center for Childhood Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Brian Hutzen
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Jennifer L Leddon
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Keri A Streby
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA ; Center for Childhood Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Pin-Yi Wang
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Timothy P Cripe
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA ; Center for Childhood Cancer and Blood Diseases, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
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6
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Friedman GK, Moore BP, Nan L, Kelly VM, Etminan T, Langford CP, Xu H, Han X, Markert JM, Beierle EA, Gillespie GY. Pediatric medulloblastoma xenografts including molecular subgroup 3 and CD133+ and CD15+ cells are sensitive to killing by oncolytic herpes simplex viruses. Neuro Oncol 2015; 18:227-35. [PMID: 26188016 DOI: 10.1093/neuonc/nov123] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 06/08/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Childhood medulloblastoma is associated with significant morbidity and mortality that is compounded by neurotoxicity for the developing brain caused by current therapies, including surgery, craniospinal radiation, and chemotherapy. Innate therapeutic resistance of some aggressive pediatric medulloblastoma has been attributed to a subpopulation of cells, termed cancer-initiating cells or cancer stemlike cells (CSCs), marked by the surface protein CD133 or CD15. Brain tumors characteristically contain areas of pathophysiologic hypoxia, which has been shown to drive the CSC phenotype leading to heightened invasiveness, angiogenesis, and metastasis. Novel therapies that target medulloblastoma CSCs are needed to improve outcomes and decrease toxicity. We hypothesized that oncolytic engineered herpes simplex virus (oHSV) therapy could effectively infect and kill pediatric medulloblastoma cells, including CSCs marked by CD133 or CD15. METHODS Using 4 human pediatric medulloblastoma xenografts, including 3 molecular subgroup 3 tumors, which portend worse patient outcomes, we determined the expression of CD133, CD15, and the primary HSV-1 entry molecule nectin-1 (CD111) by fluorescence activated cell sorting (FACS) analysis. Infectability and cytotoxicity of clinically relevant oHSVs (G207 and M002) were determined in vitro and in vivo by FACS, immunofluorescent staining, cytotoxicity assays, and murine survival studies. RESULTS We demonstrate that hypoxia increased the CD133+ cell fraction, while having the opposite effect on CD15 expression. We established that all 4 xenografts, including the CSCs, expressed CD111 and were highly sensitive to killing by G207 or M002. CONCLUSIONS Pediatric medulloblastoma, including Group 3 tumors, may be an excellent target for oHSV virotherapy, and a clinical trial in medulloblastoma is warranted.
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Affiliation(s)
- Gregory K Friedman
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham (UAB), Birmingham, Alabama (G.K.F., B.P.M., L.N., V.M.K.); Science and Technology Honors Program, Department of Chemistry, University of Alabama at Birmingham, Birmingham, Alabama (T.E.); Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama (C.P.L., J.M.M., G.Y.G.); Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama (H.X.); Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama (X.H.); Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama (E.A.B.)
| | - Blake P Moore
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham (UAB), Birmingham, Alabama (G.K.F., B.P.M., L.N., V.M.K.); Science and Technology Honors Program, Department of Chemistry, University of Alabama at Birmingham, Birmingham, Alabama (T.E.); Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama (C.P.L., J.M.M., G.Y.G.); Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama (H.X.); Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama (X.H.); Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama (E.A.B.)
| | - Li Nan
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham (UAB), Birmingham, Alabama (G.K.F., B.P.M., L.N., V.M.K.); Science and Technology Honors Program, Department of Chemistry, University of Alabama at Birmingham, Birmingham, Alabama (T.E.); Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama (C.P.L., J.M.M., G.Y.G.); Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama (H.X.); Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama (X.H.); Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama (E.A.B.)
| | - Virginia M Kelly
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham (UAB), Birmingham, Alabama (G.K.F., B.P.M., L.N., V.M.K.); Science and Technology Honors Program, Department of Chemistry, University of Alabama at Birmingham, Birmingham, Alabama (T.E.); Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama (C.P.L., J.M.M., G.Y.G.); Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama (H.X.); Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama (X.H.); Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama (E.A.B.)
| | - Tina Etminan
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham (UAB), Birmingham, Alabama (G.K.F., B.P.M., L.N., V.M.K.); Science and Technology Honors Program, Department of Chemistry, University of Alabama at Birmingham, Birmingham, Alabama (T.E.); Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama (C.P.L., J.M.M., G.Y.G.); Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama (H.X.); Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama (X.H.); Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama (E.A.B.)
| | - Catherine P Langford
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham (UAB), Birmingham, Alabama (G.K.F., B.P.M., L.N., V.M.K.); Science and Technology Honors Program, Department of Chemistry, University of Alabama at Birmingham, Birmingham, Alabama (T.E.); Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama (C.P.L., J.M.M., G.Y.G.); Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama (H.X.); Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama (X.H.); Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama (E.A.B.)
| | - Hui Xu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham (UAB), Birmingham, Alabama (G.K.F., B.P.M., L.N., V.M.K.); Science and Technology Honors Program, Department of Chemistry, University of Alabama at Birmingham, Birmingham, Alabama (T.E.); Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama (C.P.L., J.M.M., G.Y.G.); Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama (H.X.); Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama (X.H.); Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama (E.A.B.)
| | - Xiaosi Han
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham (UAB), Birmingham, Alabama (G.K.F., B.P.M., L.N., V.M.K.); Science and Technology Honors Program, Department of Chemistry, University of Alabama at Birmingham, Birmingham, Alabama (T.E.); Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama (C.P.L., J.M.M., G.Y.G.); Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama (H.X.); Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama (X.H.); Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama (E.A.B.)
| | - James M Markert
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham (UAB), Birmingham, Alabama (G.K.F., B.P.M., L.N., V.M.K.); Science and Technology Honors Program, Department of Chemistry, University of Alabama at Birmingham, Birmingham, Alabama (T.E.); Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama (C.P.L., J.M.M., G.Y.G.); Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama (H.X.); Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama (X.H.); Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama (E.A.B.)
| | - Elizabeth A Beierle
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham (UAB), Birmingham, Alabama (G.K.F., B.P.M., L.N., V.M.K.); Science and Technology Honors Program, Department of Chemistry, University of Alabama at Birmingham, Birmingham, Alabama (T.E.); Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama (C.P.L., J.M.M., G.Y.G.); Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama (H.X.); Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama (X.H.); Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama (E.A.B.)
| | - G Yancey Gillespie
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham (UAB), Birmingham, Alabama (G.K.F., B.P.M., L.N., V.M.K.); Science and Technology Honors Program, Department of Chemistry, University of Alabama at Birmingham, Birmingham, Alabama (T.E.); Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama (C.P.L., J.M.M., G.Y.G.); Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama (H.X.); Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama (X.H.); Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama (E.A.B.)
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7
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Cockle JV, Picton SV, Melcher A. Future clinical potential of oncolytic virotherapy for pediatric CNS tumors. CNS Oncol 2015; 2:307-10. [PMID: 25054575 DOI: 10.2217/cns.13.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Julia V Cockle
- Leeds Institute of Cancer Studies & Pathology, St James's Hospital, Leeds University, LS9 7TF, UK
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8
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Zemp FJ, McKenzie BA, Lun X, Maxwell L, Reilly KM, McFadden G, Yong VW, Forsyth PA. Resistance to oncolytic myxoma virus therapy in nf1(-/-)/trp53(-/-) syngeneic mouse glioma models is independent of anti-viral type-I interferon. PLoS One 2013; 8:e65801. [PMID: 23762429 PMCID: PMC3675064 DOI: 10.1371/journal.pone.0065801] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 04/28/2013] [Indexed: 12/18/2022] Open
Abstract
Despite promising preclinical studies, oncolytic viral therapy for malignant gliomas has resulted in variable, but underwhelming results in clinical evaluations. Of concern are the low levels of tumour infection and viral replication within the tumour. This discrepancy between the laboratory and the clinic could result from the disparity of xenograft versus syngeneic models in determining in vivo viral infection, replication and treatment efficacy. Here we describe a panel of primary mouse glioma lines derived from Nf1+/−Trp53+/− mice in the C57Bl/6J background for use in the preclinical testing of the oncolytic virus Myxoma (MYXV). These lines show a range of susceptibility to MYXV replication in vitro, but all succumb to viral-mediated cell death. Two of these lines orthotopically grafted produced aggressive gliomas. Intracranial injection of MYXV failed to result in sustained viral replication or treatment efficacy, with minimal tumour infection that was completely resolved by 7 days post-infection. We hypothesized that the stromal production of Type-I interferons (IFNα/β) could explain the resistance seen in these models; however, we found that neither the cell lines in vitro nor the tumours in vivo produce any IFNα/β in response to MYXV infection. To confirm IFNα/β did not play a role in this resistance, we ablated the ability of tumours to respond to IFNα/β via IRF9 knockdown, and generated identical results. Our studies demonstrate that these syngeneic cell lines are relevant preclinical models for testing experimental glioma treatments, and show that IFNα/β is not responsible for the MYXV treatment resistance seen in syngeneic glioma models.
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Affiliation(s)
- Franz J. Zemp
- Department of Oncology, Clark H. Smith Brain Tumor Center, University of Calgary, Tom Baker Cancer Centre, Southern Alberta Cancer Research Institute, Calgary, Alberta, Canada
- Clark H. Smith Brain Tumor Center, University of Calgary, Alberta, Canada
| | - Brienne A. McKenzie
- Department of Oncology, Clark H. Smith Brain Tumor Center, University of Calgary, Tom Baker Cancer Centre, Southern Alberta Cancer Research Institute, Calgary, Alberta, Canada
- Clark H. Smith Brain Tumor Center, University of Calgary, Alberta, Canada
| | - Xueqing Lun
- Department of Oncology, Clark H. Smith Brain Tumor Center, University of Calgary, Tom Baker Cancer Centre, Southern Alberta Cancer Research Institute, Calgary, Alberta, Canada
- Clark H. Smith Brain Tumor Center, University of Calgary, Alberta, Canada
| | - Lori Maxwell
- Department of Oncology, Clark H. Smith Brain Tumor Center, University of Calgary, Tom Baker Cancer Centre, Southern Alberta Cancer Research Institute, Calgary, Alberta, Canada
- Clark H. Smith Brain Tumor Center, University of Calgary, Alberta, Canada
| | - Karlyne M. Reilly
- Mouse Cancer Genetics Program, National Cancer Institute, Frederick, Maryland, United States of America
| | - Grant McFadden
- Department of Molecular Genetics and Microbiology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - V. Wee Yong
- Departments of Clinical Neurosciences and Oncology, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada
| | - Peter A. Forsyth
- Department of Oncology, Clark H. Smith Brain Tumor Center, University of Calgary, Tom Baker Cancer Centre, Southern Alberta Cancer Research Institute, Calgary, Alberta, Canada
- Clark H. Smith Brain Tumor Center, University of Calgary, Alberta, Canada
- Moffitt Cancer Center and Research Institute and University of Southern Florida, Tampa, Florida, United States of America
- * E-mail:
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9
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Friedman GK, Cassady KA, Beierle EA, Markert JM, Gillespie GY. Targeting pediatric cancer stem cells with oncolytic virotherapy. Pediatr Res 2012; 71:500-10. [PMID: 22430386 PMCID: PMC3607376 DOI: 10.1038/pr.2011.58] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cancer stem cells (CSCs), also termed "cancer-initiating cells" or "cancer progenitor cells," which have the ability to self-renew, proliferate, and maintain the neoplastic clone, have recently been discovered in a wide variety of pediatric tumors. These CSCs are thought to be responsible for tumorigenesis and tumor maintenance, aggressiveness, and recurrence due to inherent resistance to current treatment modalities such as chemotherapy and radiation. Oncolytic virotherapy offers a novel, targeted approach for eradicating pediatric CSCs using mechanisms of cell killing that differ from conventional therapies. Moreover, oncolytic viruses have the ability to target specific features of CSCs such as cell-surface proteins, transcription factors, and the CSC microenvironment. Through genetic engineering, a wide variety of foreign genes may be expressed by oncolytic viruses to augment the oncolytic effect. We review the current data regarding the ability of several types of oncolytic viruses (herpes simplex virus-1, adenovirus, reovirus, Seneca Valley virus, vaccinia virus, Newcastle disease virus, myxoma virus, vesicular stomatitis virus) to target and kill both CSCs and tumor cells in pediatric tumors. We highlight advantages and limitations of each virus and potential ways in which next-generation engineered viruses may target resilient CSCs.
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Affiliation(s)
- Gregory K. Friedman
- Department of Pediatrics [G.K.F., K.A.C.], University of Alabama at Birmingham, Birmingham, AL 35233
| | - Kevin A. Cassady
- Department of Pediatrics [G.K.F., K.A.C.], University of Alabama at Birmingham, Birmingham, AL 35233
| | - Elizabeth A. Beierle
- Department of Surgery [E.A.B, J.M.M., G.Y.G], University of Alabama at Birmingham, Birmingham, AL 35233
| | - James M. Markert
- Department of Surgery [E.A.B, J.M.M., G.Y.G], University of Alabama at Birmingham, Birmingham, AL 35233
| | - G. Yancey Gillespie
- Department of Surgery [E.A.B, J.M.M., G.Y.G], University of Alabama at Birmingham, Birmingham, AL 35233
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10
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Preclinical evaluation of a genetically engineered herpes simplex virus expressing interleukin-12. J Virol 2012; 86:5304-13. [PMID: 22379082 DOI: 10.1128/jvi.06998-11] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Herpes simplex virus 1 (HSV-1) mutants that lack the γ(1)34.5 gene are unable to replicate in the central nervous system but maintain replication competence in dividing cell populations, such as those found in brain tumors. We have previously demonstrated that a γ(1)34.5-deleted HSV-1 expressing murine interleukin-12 (IL-12; M002) prolonged survival of immunocompetent mice in intracranial models of brain tumors. We hypothesized that M002 would be suitable for use in clinical trials for patients with malignant glioma. To test this hypothesis, we (i) compared the efficacy of M002 to three other HSV-1 mutants, R3659, R8306, and G207, in murine models of brain tumors, (ii) examined the safety and biodistribution of M002 in the HSV-1-sensitive primate Aotus nancymae following intracerebral inoculation, and (iii) determined whether murine IL-12 produced by M002 was capable of activating primate lymphocytes. Results are summarized as follows: (i) M002 demonstrated superior antitumor activity in two different murine brain tumor models compared to three other genetically engineered HSV-1 mutants; (ii) no significant clinical or magnetic resonance imaging evidence of toxicity was observed following direct inoculation of M002 into the right frontal lobes of A. nancymae; (iii) there was no histopathologic evidence of disease in A. nancymae 1 month or 5.5 years following direct inoculation; and (iv) murine IL-12 produced by M002 activates A. nancymae lymphocytes in vitro. We conclude that the safety and preclinical efficacy of M002 warrants the advancement of a Δγ(1)34.5 virus expressing IL-12 to phase I clinical trials for patients with recurrent malignant glioma.
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11
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Hammill AM, Conner J, Cripe TP. Oncolytic virotherapy reaches adolescence. Pediatr Blood Cancer 2010; 55:1253-63. [PMID: 20734404 DOI: 10.1002/pbc.22724] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Accepted: 06/01/2010] [Indexed: 01/11/2023]
Abstract
Lytic viruses kill cells as a consequence of their normal replication life cycle. The idea of harnessing viruses to kill cancer cells arose over a century ago, before viruses were even discovered, from medical case reports of infections associated with cancer remissions. Since then, there has been no shortage of hype, hope, or fear regarding the prospect of oncolytic virotherapy for cancer. Early developments in the field included encouraging antitumor efficacy both in animal studies in the 1920s-1940s and in human clinical trials in the 1950s-1970s. Despite its long-standing history, oncolytic virotherapy was an idea ahead of its time. Without needed advances in molecular biology, virology, immunology, and clinical research ethics, early clinical trials resulted in infectious complications and were fraught with controversial research conduct, so that enthusiasm in the medical community waned. Oncolytic virotherapy is now experiencing a major growth spurt, having sustained numerous laboratory advances and undergone multiple encouraging adult clinical trials, and is now witnessing the emergence of pediatric trials. Here we review the history and salient biology of the field, including preclinical and clinical data, with a special emphasis on those agents now being tested in pediatric cancer patients.
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Affiliation(s)
- Adrienne M Hammill
- Division of Hematology/Oncology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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12
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Kaur B, Lesinski GB, Chaudhury AR. From Concept to the Clinics: Development of Novel Large Molecule Cancer Therapeutics. PHARMACEUTICAL SCIENCES ENCYCLOPEDIA 2010. [DOI: 10.1002/9780470571224.pse402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
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13
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Saito K, Shirasawa H, Isegawa N, Shiiba M, Uzawa K, Tanzawa H. Oncolytic virotherapy for oral squamous cell carcinoma using replication-competent viruses. Oral Oncol 2009; 45:1021-7. [DOI: 10.1016/j.oraloncology.2009.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 08/29/2009] [Accepted: 09/02/2009] [Indexed: 01/02/2023]
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14
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Friedman GK, Pressey JG, Reddy AT, Markert JM, Gillespie GY. Herpes simplex virus oncolytic therapy for pediatric malignancies. Mol Ther 2009; 17:1125-35. [PMID: 19367259 DOI: 10.1038/mt.2009.73] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Despite improving survival rates for children with cancer, a subset of patients exist with disease resistant to traditional therapies such as surgery, chemotherapy, and radiation. These patients require newer, targeted treatments used alone or in combination with more traditional approaches. Oncolytic herpes simplex virus (HSV) is one of these newer therapies that offer promise for several difficult to treat pediatric malignancies. The potential benefit of HSV therapy in pediatric solid tumors including brain tumors, neuroblastomas, and sarcomas is reviewed along with the many challenges that need to be addressed prior to moving oncolytic HSV therapy from the laboratory to the beside in the pediatric population.
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Affiliation(s)
- Gregory K Friedman
- Department of Pediatrics, Children's Hospital of Alabama, University of Alabama at Birmingham, USA.
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15
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Haseley A, Alvarez-Breckenridge C, Chaudhury AR, Kaur B. Advances in oncolytic virus therapy for glioma. ACTA ACUST UNITED AC 2009; 4:1-13. [PMID: 19149710 DOI: 10.2174/157488909787002573] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The World Health Organization grossly classifies the various types of astrocytomas using a grade system with grade IV gliomas having the worst prognosis. Oncolytic virus therapy is a novel treatment option for GBM patients. Several patents describe various oncolytic viruses used in preclinical and clinical trials to evaluate safety and efficacy. These viruses are natural or genetically engineered from different viruses such as HSV-1, Adenovirus, Reovirus, and New Castle Disease Virus. While several anecdotal studies have indicated therapeutic advantage, recent clinical trials have revealed the safety of their usage, but demonstration of significant efficacy remains to be established. Oncolytic viruses are being redesigned with an interest in combating the tumor microenvironment in addition to defeating the cancerous cells. Several patents describe the inclusion of tumor microenvironment modulating genes within the viral backbone and in particular those which attack the tumor angiotome. The very innovative approaches being used to improve therapeutic efficacy include: design of viruses which can express cytokines to activate a systemic antitumor immune response, inclusion of angiostatic genes to combat tumor vasculature, and also enzymes capable of digesting tumor extra cellular matrix (ECM) to enhance viral spread through solid tumors. As increasingly more novel viruses are being tested and patented, the future battle against glioma looks promising.
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Affiliation(s)
- Amy Haseley
- Dardinger Laboratory for Neuro-oncology and Neurosciences, Department of Neurological Surgery, College of Medicine, The Ohio State University Medical Center, Columbus, OH 43210, USA
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16
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Mace ATM, Ganly I, Soutar DS, Brown SM. Potential for efficacy of the oncolytic Herpes simplex virus 1716 in patients with oral squamous cell carcinoma. Head Neck 2008; 30:1045-51. [PMID: 18615711 DOI: 10.1002/hed.20840] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND : Herpes simplex virus (HSV) 1716 is a selectively replicating oncolytic virus. Our objective was to assess the potential efficacy of HSV1716 in patients with oral squamous cell carcinoma (SCC) by intratumoral injection. METHODS : Twenty patients with oral SCC had a single intratumoral injection of HSV1716 at a dose of 105 pfu (plaque forming unit) or 5 x 105 pfu. Injections were done at 1, 3, or 14 days before surgical resection. The tumors were assessed for evidence of viral replication and necrosis. Immunologic response to virus and toxicity was also assessed. RESULTS : Intratumoral injections were well tolerated with no adverse effects. Evidence of biological activity was lacking, with no increase in detectable virus in tumor samples. CONCLUSION : Intratumoral injection of HSV1716 is safe but with little evidence for viral replication or efficacy. Further studies at higher doses are required to determine the potential efficacy of this virus in head and neck cancer.
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Affiliation(s)
- Alastair T M Mace
- Department of Otolaryngology, Glasgow University, Glasgow, Scotland, United Kingdom.
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17
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Mace ATM, Harrow SJ, Ganly I, Brown SM. Cytotoxic effects of the oncolytic herpes simplex virus HSV1716 alone and in combination with cisplatin in head and neck squamous cell carcinoma. Acta Otolaryngol 2007; 127:880-7. [PMID: 17763002 DOI: 10.1080/00016480601075381] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONCLUSIONS HSV1716 alone and combined with cisplatin was efficacious in destroying head and neck squamous cell carcinoma (HNSCC) cells. Combination treatment with HSV1716 and cisplatin gave additive efficacy. These results indicate that HSV1716 in combination with cisplatin could be of therapeutic value in HNSCC and warrants further investigation. OBJECTIVES HSV1716 is a replication competent herpes simplex virus which selectively replicates and lyses actively dividing cells but not normal or terminally differentiated cells. The objective of this study was to determine the efficacy of HSV1716 alone and in combination with cisplatin in HNSCC. MATERIALS AND METHODS Three HNSCC cell lines were studied; UM-SCC 14C, UM-SCC 22A and UM-SCC 22B. The permissivity of HSV1716 in these cell lines was determined using multicycle growth experiments. In vitro, cytotoxicity of HSV1716 and cisplatin was determined using an MTS proliferation assay. Isobologram analysis was used to determine the interaction between HSV1716 and cisplatin combination treatment. RESULTS The three HNSCC cell lines studied were permissive for HSV1716 replication. Cytotoxicity increased in a dose-dependent fashion in all three cell lines. Cisplatin was non-toxic to the virus. Isobologram analysis showed additive cytotoxicity when HSV1716 was combined with cisplatin in all three cell lines.
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Affiliation(s)
- A T M Mace
- Department of Otolaryngology, Glasgow University, Glasgow, UK.
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18
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Abstract
Cancer remains a serious threat to human health, causing over 500 000 deaths each year in US alone, exceeded only by heart diseases. Many new technologies are being developed to fight cancer, among which are gene therapies and oncolytic virotherapies. Herpes simplex virus type 1 (HSV-1) is a neurotropic DNA virus with many favorable properties both as a delivery vector for cancer therapeutic genes and as a backbone for oncolytic viruses. Herpes simplex virus type 1 is highly infectious, so HSV-1 vectors are efficient vehicles for the delivery of exogenous genetic materials to cells. The inherent cytotoxicity of this virus, if harnessed and made to be selective by genetic manipulations, makes this virus a good candidate for developing viral oncolytic approach. Furthermore, its large genome size, ability to infect cells with a high degree of efficiency, and the presence of an inherent replication controlling mechanism, the thymidine kinase gene, add to its potential capabilities. This review briefly summarizes the biology of HSV-1, examines various strategies that have been used to genetically modify the virus, and discusses preclinical as well as clinical results of the HSV-1-derived vectors in cancer treatment.
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Affiliation(s)
- Y Shen
- Mary Crowley Medical Research Center, Dallas, TX 75201, USA
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19
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Arrese I, González P, Miranda P, Pérez-Núñez A, Pascual B, Lobato RD. [Oncolytic viral therapy of gliomas: review of the literature]. Neurocirugia (Astur) 2005; 16:158-68. [PMID: 15915305 DOI: 10.1016/s1130-1473(05)70421-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Gliomas are the most frequent primary tumors of the brain. The standard treatment includes surgery, radiotherapy and chemotherapy, but the outcomes of patients with these tumors have remained nearly unchanged for past years. Hopefully, recent advances in molecular biology are rising new clinical expectation for patients with brain tumors. Among the novel techniques in this new field of research a new field of research, the use of oncolytic viruses has been explored in different trials during last years. In the present review we analyze the advances in the understanding of the oncolytic viral therapy of gliomas.
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Affiliation(s)
- I Arrese
- Servicio de Neurocirugía, Hospital Universitario 12 de Octubre, Madrid
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20
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Rueger MA, Winkeler A, Miletic H, Kaestle C, Richter R, Schneider G, Hilker R, Heneka MT, Ernestus RI, Hampl JA, Fraefel C, Jacobs AH. Variability in infectivity of primary cell cultures of human brain tumors with HSV-1 amplicon vectors. Gene Ther 2005; 12:588-96. [PMID: 15674397 DOI: 10.1038/sj.gt.3302462] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
We investigated the variability in infectivity of cells in primary brain tumor samples from different patients using an HSV-1 amplicon vector. We studied the infectivity of HSV-1 amplicon vectors in tumor samples derived from neurosurgical resections of 20 patients. Cells were infected with a definite amount of HSV-1 amplicon vector HSV-GFP. Transduction efficiency in primary tumor cell cultures was compared to an established human glioma line. Moreover, duration of transgene expression was monitored in different tumor cell types. All primary cell cultures were infectable with HSV-GFP with variable transduction efficiencies ranging between 3.0 and 42.4% from reference human Gli36 Delta EGFR glioma cells. Transduction efficiency was significantly greater in anaplastic gliomas and meningiomas (26.7+/-17.4%) compared to more malignant tumor types (glioblastomas, metastases; 11.2+/-8.5%; P=0.05). To further investigate the possible underlying mechanism of this variability, nectin-1/HevC expression was analyzed and was found to contribute, at least in part, to this variability in infectability. The tumor cells expressed the exogenous gene for 7 to 61 days with significant shorter expression in glioblastomas (18+/-13 d) compared to anaplastic gliomas (42+/-24 d; P<0.05). Interindividual variability of infectivity by HSV-1 virions might explain, at least in part, why some patients enrolled in gene therapy for glioblastoma in the past exhibited a sustained response to HSV-1-based gene- and virus therapy. Infectivity of primary tumor samples from respective patients should be tested to enable the development of efficient and safe herpes vector-based gene and virus therapy for clinical application.
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Affiliation(s)
- M A Rueger
- Department of Neurology, University of Cologne, Max-Planck Institute for Neurological Research, Center for Molecular Medicine, European Molecular Imaging Laboratory, Cologne 50931, Germany
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21
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Broberg EK, Peltoniemi J, Nygårdas M, Vahlberg T, Röyttä M, Hukkanen V. Spread and replication of and immune response to gamma134.5-negative herpes simplex virus type 1 vectors in BALB/c mice. J Virol 2004; 78:13139-52. [PMID: 15542666 PMCID: PMC525003 DOI: 10.1128/jvi.78.23.13139-13152.2004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We have previously shown that intracranial infection of herpes simplex virus type 1 (HSV-1) vector R8306 expressing interleukin-4 (IL-4) can abolish symptoms of experimental autoimmune encephalomyelitis, which is used as a model for human multiple sclerosis (Broberg et al., Gene Ther. 8:769-777, 2001). The aim of the current study was to search for means other than intracranial injection to deliver HSV-derived vectors to the central nervous system of mice. We also aimed to study the replication efficiency of these vectors in nervous system tissues and to elucidate the effects of the viruses on the immune response. We studied the spread and replication of the following viruses with deletions in neurovirulence gene gamma(1)34.5: R3616, R849 (lacZ transgene), R3659 (alpha-tk), R8306 (murine IL-4 transgene), and R8308 (murine IL-10 transgene). The samples were taken from trigeminal ganglia and brains of BALB/c mice after corneal, intralabial, and intranasal infection, and the viral load was examined by viral culture, HSV DNA PCR, and VP16 reverse transcription (RT)-PCR. The results show that (i) intranasal infection was the most efficient means of spread to the central nervous system (CNS) besides intracranial injection; (ii) the viruses did not grow in the culture from the brain samples, but the viral DNA persisted even until day 21 postinfection; (iii) viral replication, as observed by VP16 mRNA RT-PCR, occurred mainly on days 4 and 7 postinfection in trigeminal ganglia and to a low extent in brain; (iv) R3659, R8306, and R8308 showed reactivation from the trigeminal ganglia in explant cultures; (v) in the brain, the vectors spread to the midbrain more efficiently than to other brain areas; and (vi) the deletions in the R3659 genome significantly limited the ability of this virus to replicate in the nervous system. The immunological studies show that (i) the only recombinant to induce IL-4 mRNA expression in the brain was R8306, the gamma interferon response was very low in the brain for R3659 and R8306, and the IL-23p19 response to R8306 decreased by day 21 postinfection, unlike for the other viruses; (ii) Deltagamma(1)34.5 HSV vectors modulated the subsets of the splenocytes differently depending on the transgene; (iii) R3659 infection of the nervous system induces expression and production of cytokines from the stimulated splenocytes; and (iv) HSV vectors expressing IL-4 or IL-10 induce expression and production of both of the Th2-type cytokines from splenocytes. We conclude that the intranasal route of infection is a possible means of delivery of Deltagamma(1)34.5 HSV vectors to the CNS in addition to intracranial infection, although replication in the CNS remains minimal. The DNA of the HSV vectors is able to reside in the brain for at least 3 weeks. The features of the immune response to the vectors must be considered and may be exploited in gene therapy experiments with these vectors.
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Affiliation(s)
- Eeva K Broberg
- Department of Virology, University of Turku, Kiinamyllynkatu 13, FIN-20520 Turku, Finland
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22
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Abstract
Oncolytic viruses have been considered as a potential form of cancer treatment throughout the last century because of their ability to lyse and destroy tumor cells both in tissue culture and in animal models of cancer. However, it is only during the past decade that new molecular technologies have become available and understanding of genetic and molecular components of these viruses has increased to the point that they can be manipulated and made safe for use in treatment in humans. Thus there has been a revival of the concepts of conditionally replication-competent viruses and suicide gene therapy to supplement currently existing cancer therapies. While a wide variety of viruses have been closely studied for this purpose, herpes simplex virus type-1 (HSV-1) has received particularly close attention. The inherent cytotoxicity of this virus, if harnessed and made to be selective in the context of a tumor microenvironment, makes this an ideal candidate for further development. Furthermore, its large genome size, ability to infect cells with a high degree of efficiency, and the presence of an inherent viral-specific thymidine kinase gene add to its potential capabilities. This review explores work performed in this field and its potential for application in the treatment of cancers in humans.
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Affiliation(s)
- Emil Lou
- Department of Microbiology and Immunology, SUNY Upstate Medical University, College of Medicine, Syracuse, NY 13210, USA.
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23
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Hu JCC, Coffin RS. Oncolytic herpes simplex virus for tumor therapy. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2003; 55:165-84. [PMID: 12968536 DOI: 10.1016/s0074-7742(03)01007-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Jennifer C C Hu
- Cancer Cell Biology, Hammersmith Hospital Campus, Imperial College School of Medicine, London W12 0NN, United Kingdom
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24
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Harland J, Dunn P, Cameron E, Conner J, Brown SM. The herpes simplex virus (HSV) protein ICP34.5 is a virion component that forms a DNA-binding complex with proliferating cell nuclear antigen and HSV replication proteins. J Neurovirol 2003; 9:477-88. [PMID: 12907392 DOI: 10.1080/13550280390218788] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The replicative ability of ICP34.5-null herpes simplex virus (HSV) is cell type and state dependent. In certain cells, ICP34.5 interacts with protein phosphatase 1 to preclude host cell protein synthesis shutoff by dephosphorylation of the eukaryotic initiation factor eIF-2alpha. However, host cell shutoff is not induced by ICP34.5-null HSV in most cells, irrespective of type and state. In general, dividing cells support replication of ICP34.5-null HSV; nondividing cells cannot. Previously the authors showed that ICP34.5 binds to proliferating cell nuclear antigen (PCNA), a protein necessary for cellular DNA replication and repair. Here the authors demonstrate that (1) the interaction between ICP34.5 and PCNA involves two regions of the virus protein; (2) ICP34.5 forms a complex with HSV replication proteins that is DNA binding; (3) at early times in infection, ICP34.5 colocalizes with PCNA and HSV replication proteins in cell nuclei, before accumulating in the cytoplasm; and (4) ICP34.5 is a virion protein. In light of ongoing clinical trials assessing the safety and efficacy of ICP34.5-null HSV, it is vital that the roles of ICP34.5 in HSV replication are understood. The authors propose that in nondividing cells, ICP34.5 is required to switch PCNA from repair to replication mode, a prerequisite for the initiation of HSV replication.
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Affiliation(s)
- June Harland
- Glasgow University, Neurovirology Research Laboratories, Institute of Neurological Sciences, Southern General Hospital, Glasgow, United Kingdom
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25
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Papanastassiou V, Rampling R, Fraser M, Petty R, Hadley D, Nicoll J, Harland J, Mabbs R, Brown M. The potential for efficacy of the modified (ICP 34.5(-)) herpes simplex virus HSV1716 following intratumoural injection into human malignant glioma: a proof of principle study. Gene Ther 2002; 9:398-406. [PMID: 11960316 DOI: 10.1038/sj.gt.3301664] [Citation(s) in RCA: 254] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2001] [Accepted: 01/07/2002] [Indexed: 11/09/2022]
Abstract
We have previously demonstrated the safety of intratumoural administration of the selectively replication-competent herpes simplex virus mutant HSV1716 in patients with high-grade glioma (HGG). Here we show its potential for efficacy by demonstrating that the virus survives and replicates when injected into the tumours of patients. Since HSV replication is a cytolytic process it must result in tumour cell killing. Twelve patients with biopsy-verified HGG received an intratumoural injection of 10(5) plaque-forming units (p.f.u.) of HSV1716. Four to 9 days after inoculation, tumours were removed and assayed for evidence of viral replication. In two patients, HSV1716, in excess of the input dose was recovered from the injection site. HSV DNA was detected by PCR at the sites of inoculation in 10 patients and at distal tumour sites in four. HSV-specific antigen was detected in tumour tissue from two patients. In five patients an immunological response to HSV1716, as detected by changes in levels of IgG and IgM, was demonstrated. This study demonstrates that HSV1716 replicates in HGG without causing toxicity in both HSV-seropositive and -seronegative patients.
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Affiliation(s)
- V Papanastassiou
- Department of Neurosurgery, University of Glasgow, Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK
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26
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Affiliation(s)
- N S Markovitz
- M.B. Kovler Viral Oncology Laboratories, University of Chicago, Illinois 60637, USA
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27
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Miller CG, Krummenacher C, Eisenberg RJ, Cohen GH, Fraser NW. Development of a syngenic murine B16 cell line-derived melanoma susceptible to destruction by neuroattenuated HSV-1. Mol Ther 2001; 3:160-8. [PMID: 11237672 DOI: 10.1006/mthe.2000.0240] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
HSV-1 ICP34.5 mutants can slow progression of preformed tumors in rodent models. However, the current models available for study are limited due to the lack of a syngenic, low-immunogenic tumor model susceptible to HSV-1. Thus we have developed a new model to determine the role of the immune response in viral-mediated tumor destruction. The human herpesvirus entry (Hve) receptors (HveA, HveB, and HveC) and a control plasmid were transfected into B78H1 murine melanoma cells. Transfection of HveA and HveC conferred sensitivity to HSV-1 to these cells. A10 (HveA), C10 (HveC), and control cells were able to form tumors reproducibly in vivo. The transfection of the receptors into B78H1 cells did not induce a detectable in vivo immunogenicity to the tumors. Finally, A10 and C10 tumor-bearing mice treated with HSV-1 1716 had significant prolongation of survival compared to mock-treated mice. These data suggest that A10 and C10 will be useful as in vivo models for studying the role of the immune response in viral-mediated tumor destruction.
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MESH Headings
- Animals
- Cell Line
- Cells, Cultured
- Chlorocebus aethiops
- Disease Models, Animal
- Enzyme-Linked Immunosorbent Assay
- Female
- Herpesvirus 1, Human/genetics
- Melanoma, Experimental/genetics
- Melanoma, Experimental/therapy
- Mice
- Mice, Inbred C57BL
- Neoplasm Transplantation
- Plasmids/metabolism
- Receptors, Tumor Necrosis Factor/genetics
- Receptors, Tumor Necrosis Factor, Member 14
- Receptors, Virus/genetics
- Time Factors
- Transfection
- Tumor Cells, Cultured
- Vero Cells
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Affiliation(s)
- C G Miller
- Department of Microbiology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
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28
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Todo T, Rabkin SD, Sundaresan P, Wu A, Meehan KR, Herscowitz HB, Martuza RL. Systemic antitumor immunity in experimental brain tumor therapy using a multimutated, replication-competent herpes simplex virus. Hum Gene Ther 1999; 10:2741-55. [PMID: 10584921 DOI: 10.1089/10430349950016483] [Citation(s) in RCA: 166] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Replication-competent, attenuated herpes simplex virus (HSV) vectors have been developed for viral oncolytic therapy of primary and metastatic malignant brain tumors. However, the role of the host immune responses in the brain has not been elucidated. N18 neuroblastoma cells were used as a tumor model in syngeneic A/J mice to test the therapeutic efficacy of G207, a conditionally replicating HSV vector, in an immunocompetent condition. G207 inoculated intraneoplastically exhibited a prominent oncolytic antitumor effect in mice harboring N18 tumors in the brain or subcutaneously, and, in addition, elicited a systemic antitumor immune response. Subcutaneous tumor therapy with G207 caused regression of a remote, established tumor in the brain or in the periphery, which was potentially mediated by the systemic antitumor immune response, and provided persistent tumor-specific protection against N18 tumor rechallenge in the brain as well as in the periphery. Antitumor immunity was associated with an elevation of specific CTL activity against N18 tumor cells that persisted for at least 13 months. The results suggest that the oncolytic antitumor action of replication-competent HSV may be augmented by induction of specific and systemic antitumor immunity effective both in the periphery and in the brain.
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Affiliation(s)
- T Todo
- Department of Neurosurgery, Georgetown University Medical Center, Washington, DC 20007, USA.
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29
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Jacobs A, Breakefield XO, Fraefel C. HSV-1-based vectors for gene therapy of neurological diseases and brain tumors: part II. Vector systems and applications. Neoplasia 1999; 1:402-16. [PMID: 10933055 PMCID: PMC1508111 DOI: 10.1038/sj.neo.7900056] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/1999] [Accepted: 08/06/1999] [Indexed: 11/09/2022]
Abstract
Many properties of HSV-1 are especially suitable for using this virus as a vector to treat diseases affecting the central nervous system (CNS), such as Parkinson's disease or malignant gliomas. These advantageous properties include natural neurotropism, high transduction efficiency, large transgene capacity, and the ability of entering a latent state in neurons. Selective oncolysis in combination with modulation of the immune response mediated by replication-conditional HSV-1 vectors appears to be a highly promising approach in the battle against malignant glioma. Helper virus-free HSV/AAV hybrid amplicon vectors have great promise in mediating long-term gene expression in the PNS and CNS for the treatment of various neurodegenerative disorders or chronic pain. Current research focuses on the design of HSV-1-derived vectors which are targeted to certain cell types and support transcriptionally regulatable transgene expression. Here, we review the recent developments on HSV-1-based vector systems and their applications in experimental and clinical gene therapy protocols.
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Affiliation(s)
- A Jacobs
- Department of Neurology at the University and MPI for Neurological Research, Cologne, Germany.
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30
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Tal-Singer R, Pichyangkura R, Chung E, Lasner TM, Randazzo BP, Trojanowski JQ, Fraser NW, Triezenberg SJ. The transcriptional activation domain of VP16 is required for efficient infection and establishment of latency by HSV-1 in the murine peripheral and central nervous systems. Virology 1999; 259:20-33. [PMID: 10364486 DOI: 10.1006/viro.1999.9756] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The herpes simplex virus (HSV) transactivator VP16 is a structural component of the virion that activates immediate-early viral gene expression. The HSV-1 mutant in1814, which contains a 12-bp insertion that compromises the transcriptional function of VP16, replicated to a low level if at all in the trigeminal ganglia of mice (I. Steiner, J. G. Spivack, S. L. Deshmane, C. I. Ace, C. M. Preston, and N. W. Fraser (1990). J. Virol. 64, 1630-1638; Valyi-Nagy et al., unpublished data). However, in1814 did establish a latent infection in the ganglia after corneal inoculation from which it could be reactivated. In this study, several HSV-1 strains were constructed with deletions in the VP16 transcriptional activation domain. These viruses were viable in cell culture, although some were significantly reduced in their ability to initiate infection. A deletion mutant completely lacking the activation domain of VP16 (RP5) was unable to replicate to any detectable level or to efficiently establish latent infections in the peripheral and central nervous systems of immunocompetent mice. However, similar to in1814, RP5 formed a slowly progressing persistent infection in immunocompromised nude mice. Thus RP5 is severely neuroattenuated in the murine model of HSV infection. However, the activation domain of VP16 is not essential for replication in the nervous system, since we observed a slow progressive infection persisting in the absence of an immune response.
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Affiliation(s)
- R Tal-Singer
- The Wistar Institute, 3601 Spruce Street, Philadelphia, Pennsylvania 19104, USA
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31
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Toda M, Rabkin SD, Kojima H, Martuza RL. Herpes simplex virus as an in situ cancer vaccine for the induction of specific anti-tumor immunity. Hum Gene Ther 1999; 10:385-93. [PMID: 10048391 DOI: 10.1089/10430349950018832] [Citation(s) in RCA: 211] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The success of cancer gene therapy is likely to require the targeting of multiple antitumor mechanisms. One strategy involves the use of attenuated, replication-competent virus vectors, such as herpes simplex virus type 1 (HSV-1) mutant G207, which is able to replicate in human tumor cells with resultant cell death and tumor growth inhibition, yet is nonpathogenic in normal tissue. In this study, we demonstrate that infection of established tumors with G207 also induces a highly specific systemic anti-tumor immune response. In a syngeneic, bilateral established subcutaneous tumor model, with mouse CT26 colorectal carcinoma cells in BALB/c mice or M3 melanoma cells in DBA/2 mice, unilateral intratumoral inoculation with G207 caused a significant reduction in the growth of both the inoculated and contralateral noninoculated tumors. This elicited anti-tumor response is dependent on viral infection of the tumor, as intradermal inoculation of G207 in BALB/c mice had no effect on CT26 tumor growth. Treatment of subcutaneous CT26 tumors by intratumoral inoculation of G207 induced a tumor-specific T cell response. CD8+ cytotoxic T lymphocyte (CTL) activity was generated that recognized a dominant "tumor-specific" major histocompatibility complex (MHC) class I-restricted epitope (AH1) from CT26 cells. In immune-competent animals, G207 is acting as an in situ tumor vaccine. Therefore, intratumoral G207 inoculation is able to inhibit tumor growth both by local cytotoxic viral replication in tumor cells and induction of a systemic anti-tumor immune response.
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Affiliation(s)
- M Toda
- Georgetown Brain Tumor Center and Department of Neurosurgery, Georgetown University Medical Center, Washington, DC 20007, USA
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