Conditionally replicative adenoviruses for cancer therapy

Local sustained delivery of oncolytic adenovirus with injectable alginate gel for cancer virotherapy

Adenoviruses (Ad) have been investigated for their efficacy in reducing primary tumors after local intratumoral administration. Despite high Ad concentrations and repetitive administration, the therapeutic efficacy of Ad has been limited because of rapid dissemination of the Ad into the surrounding normal tissues and short maintenance of Ad biological activity in vivo. To maximize the therapeutic potential of Ad-mediated gene therapeutics, we investigated the efficacy of local, sustained Ad delivery, using an injectable alginate gel matrix system. The biological activity of Ad loaded in alginate gel was prolonged compared with naked Ad, as evidenced by the high green fluorescent protein gene transduction efficiency over an extended time period. Moreover, oncolytic Ad encapsulated in alginate gel elicited 1.9- to 2.4-fold greater antitumor activity than naked Ad in both C33A and U343 human tumor xenograft models. Histological and quantitative PCR analysis confirmed that the oncolytic Ad/alginate gel matrix system significantly increased preferential replication and dissemination of oncolytic Ad in a larger area of tumor tissue in vivo. Taken together, these results show that local sustained delivery of oncolytic Ad in alginate gel augments therapeutic effect through selective infection of tumor cells, sustained release and prolonged maintenance of Ad activity.

A novel CRAd in combination with cisplatin enhanced the antitumor efficacy in ovarian cancer

OBJECTIVES

The aim of this study was to investigate the combined effects of a novel survivin promoter-based conditionally replicating adenovirus (CRAd-S.RGD) plus cis-diamminedichloroplatinum (cisplatin, CDDP) in ovarian cancer in vitro and in vivo.

METHODS

The viability of human ovarian cancer cell line SKOV3 was determined by MTT assay following the infection with different doses of CRAd-S.RGD, either alone or in combination with CDDP. The antitumor efficacies and survival curves were evaluated at the end of the treatment regimens with the subcutaneous administration of CRAd-S.RGD, CDDP, combined therapy of CRAd-S.RGD plus CDDP, or phosphate-buffered saline in a SKOV3 xenograft animal model. Furthermore, the apoptosis rate of tumor tissues in mice was determined subsequent to the treatments.

RESULTS

In vitro, the CRAd-S.RGD destroyed SKOV3 cells by oncolysis in a dose-dependent manner, and the viability of SKOV3 cells was significantly lower in the combined-therapy group than that in the individual-therapy groups. In vivo, enhanced tumor inhibition and animal survival rates were obtained in a synergistic manner with CRAd-S.RGD plus CDDP, as compared with the treatment with CRAd-S.RGD or CDDP alone. There was an increase in the apoptosis rate of the cells following the combined therapy. The results clearly demonstrated that there was a synergistic effect in the combination of CRAd-S.RGD and CDDP in increased therapeutic efficacy. Similar therapeutic efficacy could be obtained with CRAd-S.RGD plus CDDP at 2 lower doses that minimized the drug toxicity to host tissues.

CONCLUSIONS

The strategy of CRAd-S.RGD in combination with CDDP was a potential therapeutic modality for the therapy in ovarian cancer.

ABBREVIATIONS

CDDP - cisplatin, cis-diamminedichloroplatinum, CRAd - conditionally replicating adenovirus, CRAd-survivin - the survivin promoter-based conditionally replicating adenovirus, CRAd-S.RGD - CRAd-survivin-RGD4C, MOI - multiplicity of infection, PBS - phosphate-buffered saline, PI - propidium iodide.

Targeting mesothelioma using an infectivity enhanced survivin-conditionally replicative adenoviruses

Mesothelioma is a highly malignant neoplasm with no effective treatment. Conditionally replicative adenoviruses (CRAds) represent a promising new modality for the treatment of cancer in general. A key contribution in this regard is the introduction of tumor-selective viral replication for amplification of the initial inoculum in the neoplastic cell population. Under ideal conditions following cellular infection, the viruses replicate selectively in the infected tumor cells and kill the cells by cytolysis, leaving normal cells unaffected. However, to date there have been two limitations to clinical application of these CRAd agents; viral infectivity and tumor specificity have been poor. Herein we report on two CRAd agents, CRAd-S.RGD and CRAd-S.F5/3, in which the tumor specificity is regulated by a tumor-specific promoter, the survivin promoter, and the viral infectivity is enhanced by incorporating a capsid modification (RGD or F5/3) in the adenovirus fiber region. These CRAd agents effectively target human mesothelioma cell lines, induce strong cytoxicity in these cells in vitro, and viral replication in a H226 murine xenograft model in vivo. In addition, the survivin promoter has extremely low activity both in the non-transformed cell line, HMEC, and in human liver tissue. Our results suggest that the survivin-based CRAds are promising agents for targeting mesothelioma with low host toxicity. These agents should provide important insights into the identification of novel therapeutic strategies for mesothelioma.

Developing novel oncolytic adenoviruses through bioselection

Mutants of human adenovirus 5 (Ad5) with enhanced oncolytic activity were isolated by using a procedure termed bioselection. Two mutants, ONYX-201 and ONYX-203, were plaque purified from a pool of randomly mutagenized Ad5 that was repeatedly passaged in the human colorectal cancer cell line HT29, and they were subsequently characterized. ONYX-201 and ONYX-203 replicated more rapidly in HT29 cells than wild-type Ad5, and they lysed HT29 cells up to 1,000-fold more efficiently. The difference was most profound when cells were infected at a relatively low multiplicity of infection, presumably due to the compounding effects of multiple rounds of infection. This enhanced cytolytic activity was observed not only in HT29 cells but also in many other human cancer cell lines tested. In contrast, the cytotoxicity of the bioselected mutants in a number of normal primary human cells was similar to that of wild-type Ad5, thus enhancing the therapeutic index (cytotoxicity in tumor cells versus that in normal cells) of these oncolytic agents. Both ONYX-201 and -203 contain seven single-base-pair mutations when compared with Ad5, four of which were common between ONYX-201 and -203. The mutation at nucleotide 8350, shared by both mutant viruses, was shown to be essential for the observed phenotypes. This mutation was mapped to the i-leader region of the major late transcription unit, resulting in the truncation of 21 amino acids from the C terminus of the i-leader protein. This work demonstrates that bioselection is a powerful tool for developing novel tumor-selective oncolytic viruses. Other potential applications of this technology are discussed.

Wild-type adenovirus decreases tumor xenograft growth, but despite viral persistence complete tumor responses are rarely achieved--deletion of the viral E1b-19-kD gene increases the viral oncolytic effect

Strategies to target viral replication to tumor cells hold great promise for the treatment of cancer, but even with replicating adenoviruses complete tumor responses are rarely achieved. To evaluate replicating adenoviral vectors, we have used A549 human lung cancer nude mouse xenografts as a model system. Intratumoral injection of wild-type adenovirus (Ad309) significantly reduced tumor growth from day 14 (p = 0.04) onward; however, tumor volumes reached a plateau at day 50. At 100 days, high levels of titratable virus were present within persistent viable tumors. In contrast to viral injection into established tumors, when tumor cells were infected in vitro with wild-type virus and then mixed with uninfected tumor cells, 1% of infected cells was sufficient to prevent tumor establishment. An E1b-19kD-deleted viral mutant (Ad337) was more efficient than Ad309 in this cell-mixing model. Just 1 cell in 1000 infected with Ad337 prevented tumor growth. However, although better than wild-type virus, Ad337 was unable to eradicate established flank tumors. These data suggest that although replicating adenoviruses exhibit significant oncolytic activity, barriers within the established tumor, such as connective tissue and tumor matrix, may limit the spread of virus. Strategies to enhance viral spread through established tumors are therefore likely to greatly improve the therapeutic efficacy of replicating adenoviruses.