Virotherapy: From single agents to combinatorial treatments

Biochem Pharmacol. 2020 Jul:177:113986. doi: 10.1016/j.bcp.2020.113986. Epub 2020 Apr 21.

Abstract

Virotherpay is emerging as a promising strategy against cancer, and three oncolytic viruses (OVs) have gained approval in different countries for the treatment of several cancer types. Beyond the capability to selectively infect, replicate and lyse cancer cells, OVs act through a multitude of events, including modification of the tumour micro/macro-environment as well as a complex modulation of the anti-tumour immune response by activation of danger signals and immunogenic cell death pathways. Most OVs show limited effects, depending on the viral platform and the interactions with the host. OVs used as monotherapy only in a minority of patients elicited a full response. Better outcomes were obtained using OVs in combination with other treatments, such as immune therapy or chemotherapy, suggesting that the full potential of OVs can be unleashed in combination with other treatment modalities. Here, we report the main described combination of OVs with conventional chemotherapeutic agents: platinum salts, mitotic inhibitors, anthracyclines and other antibiotics, anti-metabolites, alkylating agents and topoisomerase inhibitors. Additionally, our work provides an overview of OV combination with targeted therapies: histone deacetylase inhibitors, kinase inhibitors, monoclonal antibodies, inhibitors of DNA repair, inhibitors of the proteasome complex and statins that demonstrated enhanced OV anti-neoplastic activity. Although further studies are required to assess the best combinations to translate the results in the clinic, it is clear that combined therapies, acting with complementary mechanisms of action might be useful to target cancer lesions resistant to currently available treatments.

Keywords: Immunotherapy; Oncolytic virus.

Publication types

  • Review

MeSH terms

  • Alkylating Agents / therapeutic use
  • Antibiotics, Antineoplastic / therapeutic use
  • Antibodies, Monoclonal / therapeutic use*
  • Antimetabolites, Antineoplastic / therapeutic use
  • Antimitotic Agents / therapeutic use
  • Combined Modality Therapy / methods*
  • Histone Deacetylase Inhibitors / therapeutic use
  • Humans
  • Immunotherapy / methods*
  • Neoplasms / genetics
  • Neoplasms / immunology
  • Neoplasms / pathology
  • Neoplasms / therapy*
  • Oncolytic Virotherapy / methods*
  • Oncolytic Viruses / genetics*
  • Oncolytic Viruses / immunology
  • Platinum Compounds / therapeutic use
  • Protein Kinase Inhibitors / therapeutic use
  • Topoisomerase Inhibitors / therapeutic use
  • Tumor Microenvironment / drug effects
  • Tumor Microenvironment / genetics
  • Tumor Microenvironment / immunology

Substances

  • Alkylating Agents
  • Antibiotics, Antineoplastic
  • Antibodies, Monoclonal
  • Antimetabolites, Antineoplastic
  • Antimitotic Agents
  • Histone Deacetylase Inhibitors
  • Platinum Compounds
  • Protein Kinase Inhibitors
  • Topoisomerase Inhibitors