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Abstract
Prostate cancer remains the leading cause of cancer-related morbidity and mortality for men in the Western
world. Conventional anti-cancer therapies like chemotherapy, irradiation, and hormone ablation often slow tumor
growth but do not engender long term benefits on patient survival. These therapies are limited by the fact that
tumor re-growth and spread to distal sites usually occurs following the conclusion of treatment. Therefore, there is
an increasing demand for the development of alternative therapeutic regiments. The use of oncolytic viruses for
the treatment of prostate cancer is an attractive option due to the natural ability of viruses to target and kill cancer
cells. Furthermore, oncolytic viruses may be genetically manipulated to transfer exogenous genes into cancer cells
in order to provide new generations of biological controls. This brief review highlights the potential of select
oncolytic viruses as promising modalities for prostate cancer treatments and presents the advantages and
practicalities of such viruses as therapeutic agents.
Keywords: Oncolytic viruses; Prostate cancer; Cancer therapies; One of the most widely studied oncolytic viruses is adenovirus.
Adenovirus; Herpes simplex virus; Vaccinia virus; Newcastle disease This virus was initially isolated in the early 1950s from adenoid-
virus; Vesicular stomatitis virus infected
Oncolytic Viruses
Viruses are commonly thought of as opportunistic organisms that
hijack cellular machinery with the ultimate goal of replicating and
causing destruction in the host. However, viruses are increasingly
being explored as therapeutic agents for a variety of disorders and
diseases, including cancers, due to their natural ability to spread to
various cell types. Oncolytic viruses are replication-competent viruses
that have the ability to selectively target cancerous growths, either
naturally through adaptation or through genetic manipulation. The
field of oncolytic virus development has spanned approximately
twenty years, with numerous viruses currently in clinical trials and in
various stages of development as anti-cancer agents. Although
oncolytic viruses exhibit diversity in their biologics and host range,
oncolytic viruses share common features of selective replication in
tumors, effective lysis of tumor cells, either directly or through
activation of anti-tumor immunity, and dispersion within tumor
masses. Strategies employed by viruses to target cancer cells include
exploiting the defective antiviral responses in cancer cells, the use of
cancer-specific surface markers as viral entry receptors, as well as
the use of cancer-specific promoters to activate viral gene products.
Many viruses that are currently being developed as agents against
prostate cancers have taken advantage of these strategies.
Depending on the disease state, the current treatments for prostate
cancer include radiotherapy, surgery, and hormone-deprivation
therapy [1]. Prostate cancer is particularly well-suited for oncolytic
therapies due to the fact that prostate removal or ablation is not life-
threatening. Furthermore, the major cause of death from prostate
cancers results from metastatic spread. Therefore, the natural ability
of viruses to spread to distal sites and seek out susceptible cancerous
tissues makes them attractive therapeutic agents for this disease. The
response to oncolytic therapies may also be monitored by serum
prostate-specific antigen (PSA) levels. This review will focus on
select oncolytic viruses and the advances that have been made in
developing them as therapeutic agents for the treatment of prostate
cancer.
Adenovirus
Adv Tech Biol Med
ISSN: ATBM, an open access journal Volume 1 • Issue 2 • 1000107
cell cultures, thus leading to the name adenovirus. It is recognized
as the etiological agent for diverse syndromes due to the presence of
approximately 50 serotypes. Not only does adenovirus possess
inherent oncolytic activity, it is widely being developed as a vaccine
and gene therapy agent.
Adenoviruses are attractive therapeutic vectors due to their wide
host range and the ease by which they may be manipulated
genetically [2]. Furthermore, a decade worth of clinical trials have
tested the safety and efficacy of various adenoviral vectors, thus
providing a framework from which to engineer novel agents. As an
oncolytic virus, much research has revealed that unmodified
adenovirus is insufficient to effectively treat neoplastic tissue due to
a variety of factors, including clearance from the immune system,
hepatic virus sequestration and down regulation of the coxsackie-
adenovirus receptor (CAR) in tumor cells [3-5], thus leading to the
engineering of second- and third- generation viruses with greater
therapeutic efficacy.
The first oncolytic adenovirus used to treat human cancers is
ONYX-15, containing a deletion of the viral EIB 55 KD gene. The lack
of EIB 55 KD expression restricts ONYX-15 replication and killing in
cells infected in the G1 phase of the cell cycle [6-8]. This poses a
limitation to cancer therapies because a significant number of cells
within tumors exist in the G1 phase. Because of this, ONYX-15
therapies have been more successful when combined with
chemotherapy or radiation therapies [7,9]. Additional adenoviruses
with mutations in the E1A gene product have been generated. E1A
stimulates S phase entry and serves to transactivate both cellular and
viral genes essential for a productive viral infection [10]. For
targeting prostate cancers, investigators have taken advantage of
prostate specific promoters and inserted them upstream of the EIA
gene of adenovirus type 5 (Ad5), thus restricting viral replication to
prostate cancer cells. An example of such a virus is
Received April 16, 2013; Accepted May 24, 2013; Published May 27, 2013
Page 2 of 7
Citation: Ahmed M (2013) Oncolytic Viruses as Therapeutic Agents for Prostate Cancer. Adv Tech Biol Med 1: 107. doi:10.4172/atbm.1000107
CN706 which was created by engineered to express other studies highlight the include immune and suicide
inserting the prostate specific sTGFβRIIFc, a protein which success of combination gene therapies. Adenoviruses
enhancer (PSE) derived from directly targets and inhibits the approaches in cancer have been developed to express
the 5’ end of the PSA gene TGF-β pathway. TGF-β has treatments. cytokines, chemokines, tumor-
into Ad5 [11]. In treatments been shown to play an associated antigens or other
Further therapeutic
with CN706, virus replication important role in the control of immunomodulatory factors. For
regiments employed for
correlates with the level of bone metastases [21,22] and example, adenoviruses armed
prostate cancers
PSA expression within given high levels of this factor in the with immune-therapeutic genes
prostate cancer cells. Studies blood circulation are poor such as IL-12 and IL-24 have
show that this virus is effective prognostic markers of prostate shown some efficacy in
at restricting growth of PSA- cancer [23,24]. This virus preclinical studies for the
producing LNCaP prostate induces significant reduction treatment of prostate cancers
tumors in cell culture and of tumor burden, osteoclast [16,33]. Immune cells including
animal model studies. number and bone destruction macrophages have also been
Numerous studies have also in a bone metastasis mouse utilized to deliver adenoviruses
shown efficacy by targeting model [19], thus displaying its to hypoxic areas of prostate
prostate cell surface markers potential as a therapeutic for tumors [31]. In terms of suicide
that are shown to be up- prostate cancer metastases. gene therapy, the two most
regulated during widely used prodrug therapies
Combination approaches
tumorigenesis. Prime candidates for prostate cancers include
have also been explored as HSV thymidine kinase (HSV-
include prostate-specific
membrane antigen (PMSA), means to promote adenovirus tk) together with ganciclovirir
whose increased expression replication and killing at tumor (GCV) or acyclovir, cytosine
correlates with aggressive sites. Numerous studies have deaminase (CD) and
tumors, prostate stem cell reported synergistic interaction 5-fluorocytosine (5-FC)
antigen (PSCA), the urokinase- of adenovirus with cytotoxic [34,35]. Each of these
type plasminogen activator drugs such as cisplatin, therapeutic regiments
receptor (uPAR), which is gemcitabine, docetaxel and represents a targeted approach
involved in tumor angiogenesis mitoxantrone for the treatment for prostate cancers that have
[12-15], and differential display of prostate cancers [25-27]. acquired resistance to
code 3 (DD3 or DD3(PCA)) While exact mechanisms are conventional treatments.
[16]. ONYX15 and the poorly understood, studies have
prostate-specific adenoviruses implicated the early viral EIA H
illustrate the two main gene in chemosensitization e
strategies employed to restrict [28]. By screening a panel of r
oncolytic adenovirus replication replicating mutants with EIA p
to tumor tissues: deletions, Miranda et al. [27]
e
1) By inactivating viral genes showed that adenovirus-
whose functions can be mediated sensitization to
s
compensated in cancer cells, cytotoxic drugs is dependent on
and 2) By placing essential regulatory domains in the S
viral genes under control of EIA conserved region 1 i
cancer or tissue-specific domain, which may have m
promoters [17]. functions favoring viral p
In addition to the success amplification [29]. There is also
l
of engineered adenoviruses interest in enhancing the
effects of oncolytic e
utilizing targetable prostate
cancer specific receptors, virotherapies with dietary x
prostate cancers have been phytochemicals with known
targeted with viruses containing anti-cancer properties. Natural V
the promoter for human dietary compounds with low i
telomerase reverse transcriptase toxicity, such as curcumin,
r
(hTERT), the catalytic genistein and resveratrol, have
componenent of the telomerase shown efficacy at killing
u
ribonucleoprotein complex prostate cancer cells in s
found in cancer cells. An combination with an oncolytic
example of such a virus is adenoviral mutant both in T
OBP-301, which shows strong vitro and in vivo [30]. y
anticancer effects by inducing Additional therapies include
the lysis of human prostate
p
the delivery of oncolytic
cancer cells and also adenoviruses to cancer cells or
e
demonstrates antimetastatic tumor tissue following
effects by eradicating sensitization with irradiation, I
detectable contralateral LNCaP which is linked to DNA
tumors in vivo [18]. More Herpes simplex virus type I
damage recognition and repair (HSV-1) is a natural human
recently, Hu et al. [19,20] [31,32]. The results of these
developed an hTERT promoter- pathogen which has been
studies, as well as numerous studied as an oncolytic agent
containing adenovirus
Citation: Ahmed M (2013) Oncolytic Viruses as Therapeutic Agents for Prostate Cancer. Adv Tech Biol Med 1: 107. doi:10.4172/atbm.1000107
for over two decades. During human primates [45]. NV1020
this time, increased strides is a multimutant HSV-1 strain
have been made in that contains several genetic
developing HSV for the modifications including deletion
treatment of a variety of of the UL24 gene and one copy
different cancers. This progress of the γ34.5 gene [46]. This
is highlighted by the translation virus has also shown efficacy in
of at least six oncolytic HSV reducing prostate tumor growth
vectors to the clinic, some in vivo and significantly
having progressed to Phase decreasing serum PSA levels
II/III clinical trials [36]. A [47]. Additional attenuated,
benefit to oncolytic HSV-1 replication competent viruses
therapies is the availability of derived from first generation
anti-HSV specific drugs oncolytic HSV-1, such as
(acyclovir) that may be NV1023 and G47Δ, are being
administered upon detection of evaluated for their ability to
a life threatening infection.
promote greater antitumor
Early studies of oncolytic HSV
activity against prostate cancers
focused on developing safe
[43,48].
anti-cancer agents by deleting
the γ34.5 gene, which governs In addition to testing the
neuropathogenicity [37,38]. ability of oncolytic HSV-1
Further vectors were strains to induce tumor cell
developed by introducing killing, they have also been
mutations or deletions in used as a platform to deliver
specific genes to prevent transgenes of interest. The
reversions to wild-type strains. integration of membrane-
However, these changes led to fusion activity into these
limited success due to viruses has been shown to
attenuation of replication in promote anti-tumor effects in
susceptible tissues including prostate cancer cells [29,49].
prostate carcinoma cells [39], Furthermore, viruses have been
indicating that greater potency armed with agents commonly
was necessary to promote used for prostate cancer
oncolytic efficacy. Current
vaccinations such as prostatic
studies are focusing on
acid phosphatase (PAP) [50]
synergizing the effects of
immune modulators
oncolytic HSV with a variety of
agents.
Several oncolytic HSV-1
strains have shown promise at
treatment of prostate cancers.
G207 is one of the first
onoclytic HSV-1 strains taken
into clinical trials. This virus,
derived from strain F, contains
deletions in both copies of the
γ34.5 gene and has an
inactivated ICP6 gene, which
encodes a viral ribonucleotide
reductase function [40]. The
double mutations permit viral
replication within quiescent
tumor cells carrying specific
oncogene deletions but not in
normal cells [41]. G207 has
been shown to be effective at
killing human prostate cancer
cells in vitro, as well as in vivo
in both subcutaneous xenograft
and transgenic mouse models
[42-44]. Additionally, it
displayed no evidence of
clinical disease and virus spread
into other organs when injected
into the prostates of HSV-1
susceptible mice and non-
Citation: Ahmed M (2013) Oncolytic Viruses as Therapeutic Agents for Prostate Cancer. Adv Tech Biol Med 1: 107. doi:10.4172/atbm.1000107
Page 3 of 7
Citation: Ahmed M (2013) Oncolytic Viruses as Therapeutic Agents for Prostate Cancer. Adv Tech Biol Med 1: 107. doi:10.4172/atbm.1000107
such as IL-12 [51], as well as to express large genes. cause of cancer-related deaths. N
factors that enhance virus Furthermore, studies have e
In addition to GLV-1h68, a
replication such as Ing4 shown that it is able to enter recombinant vaccinia virus w
(inhibitor of growth 4) [52,53]. and replicate efficiently within expressing PSA (rV-PSA) was c
numerous cell types without constructed by inserting the
Studies have focused on a
enhancing virus replication at causing natural disease in PSA gene into the viral
humans [55]. However, to s
prostate cancer tissues as well genome of the Wyeth strain
as exploring combination promote safety, attenuated, of vaccinia. rV-PSA has t
approaches. Lee et al. [54] avirulent versions of vaccinia shown some success in Phase I l
have developed recombinant viruses, including those clinical trials as indicated by e
viruses whose expression is lacking replication capacity, limited toxicity and evidence of
regulated by the presence of have been utilized as delivery immunological activity in
vectors for gene therapies or as D
the prostate specific promoter patients with rising PSA levels
(AAR(2) PB) and the 5’UTR vaccine vectors for the i
after local therapy, and in
of rFGF-2, thus promoting expression of immunizing patients with metastatic
s
tumor specificity. G47Δ, a antigens. More recently, androgen- independent prostate e
multimutated, replication vaccinia virus has also gained cancer [60,61]. a
competent HSV-1 vector popularity as an anti-cancer s
derived from G207, was agent. Beginning in 2007,
engineered by creating an Zhang et al. [56] described the
e
additional deletion within the oncolytic potential of the
non-essential α47gene [54]. The attenuated recombinant V
combination of androgen vaccinia virus GLV-1h68 in i
ablation with G47D therapy breast tumors. Since then, the r
resulted in greater tumor oncolytic effect of this virus u
growth suppression than either has been demonstrated in
therapy alone in the TRAMP- s
numerous cancer models,
C2 subcutaneous model. These including in the treatment of Newcastle disease virus
are a few of the many lymph node metastases (NDV) is a negative-sense
examples of approaches to originating from prostate single-stranded virus that causes
enhance the oncolytic potential carcinoma cells [57]. deadly infection in various
of HSV-1 vectors, similar to species of birds but is non-
those outlined for adenoviruses. Current studies are pathogenic to humans and
interested in determining the domestic animals. NDV has
V mechanisms by which GLV- been applied for the treatment
a 1h68 promotes anti-cancer of human cancers since the
c activity. GLV-1h68 was early 1960s with studies on
c engineered by inserting three uterine carcinoma [62]. Since
expression cassettes into then, it has been reported to
i
different loci of the viral possess oncolytic activity
n genome. Further genomic against a range of cancer types
i analysis confirmed that these and various strains have been
a insertions reduced the tested in clinical trials in
virulence of this virus and different human cancers
V promoted cancer cell tropism including glioblastoma
[58]. Recent studies have multiforme and colorectal
i
attributed the ability of GLV- cancer [63-65]. Studies have
r shown that NDV exhibits
1h68 to effectively treat lymph
u node metastases of prostate inherent selectivity for a
s carcinoma cells to the elevated diverse group of tumors over
vascular permeability in normal cells due to defects in
Vaccinia virus is a large,
metastases leading to greater antiviral responses, such as the
enveloped virus belonging to
release of virus particles and type I interferon (IFN)
the poxvirus family. The study
spread to susceptible tissues response, in certain cancer cells
of vaccinia virus began with its [66,67]. However, it has also
popularity as the choice for [59]. Furthermore, the presence
of increased number of been proposed that tumor
smallpox vaccination and in its specificity may be dependent
role in the successful global immune cells and the
proliferation of cancer cells at upon tumor cell resistance to
eradication of smallpox by apoptosis [68]. These tumor-
1979. Since then, there has metastatic areas are thought
specific defects serve to enhance
been great interest in to provide favourable conditions
replication of NDV in cancer
developing vaccinia virus a for virus infection and
cells to promote virus-induced
vector for the expression of replication. Taken together,
cytotoxicity.
foreign genes. This virus is these data indicate that vaccinia
attractive as a delivery vehicle virus GLV-1h68 may be used for The mechanisms underlying
because of its ability to stably the preferential destruction of the antitumor activity of NDV
accept as much as 25 kb of metastatic prostate carcinoma have been investigated in
cells, which represent a major numerous studies. Multiple
foreign DNA, thus enabling it
Citation: Ahmed M (2013) Oncolytic Viruses as Therapeutic Agents for Prostate Cancer. Adv Tech Biol Med 1: 107. doi:10.4172/atbm.1000107
studies have revealed the role of determinant of virulence is the
apoptosis in cell death by NDV, cleavage site in the F protein,
including both the intrinsic and which becomes fusogenic only
extrinsic pathways. The exact upon proteolytic cleavage into
mechanisms of apoptotic death two disulfide- linked
are dependent on the strain of polypeptides by host cellular
NDV, the cell lines and the proteases [80]. In an attempt to
detection assays [69-74]. In improve antitumor efficacy,
addition to direct killing Shobana et al. [81] have
induced by the virus, NDV engineered the F protein
also stimulates robust innate cleavage site to target the serine
and adaptive immunity. Various protease, PSA, such that F
strains of NDV are capable of protein is cleavable exclusively
stimulating macrophage by PSA in prostate cancer
activity as indicated by the cells. This strategy enhanced
detection of macrophage pathogenicity of oncolytic NDV
enzymes such as iNOS,
in prostate cancer cells as a
lysozyme and acid phosphatase
result of restricted viral
as well as the production of
replication and fusogenicity
nitric oxide and TNF-α [75-77].
[82].
Natural killer (NK) cells have
also been shown to mediate V
cytotoxicity against multiple
e
tumor cell lines following
infection of peripheral blood s
mononuclear cells (PBMCs) i
with NDV strain 73-T, one of c
the most well-characterized u
oncolytic strain of NDV [78]. l
NDV as an oncolytic agent a
for the treatment of prostate r
cancer is currently in the early
stages of development. Studies
S
with NDV
73-T have demonstrated t
antitumor effects in prostate o
carcinoma (PC3) xenografts m
upon systemic administration a
[79]. Furthermore, significant t
inhibition of tumor growth i
(77-96%) was also observed in
t
epidermoid, colon, large cell
lung, breast and low passage i
colon carcinoma xenograft s
models. Although phase I
clinical trials using naturally V
attenuated NDV strains such as i
PV701 have been conducted,
r
they have not included patients
with prostate cancers.
u
Nevertheless, clinical trials s
have revealed that PV701 was Vesicular stomatitis virus
well tolerated by patients when (VSV), a negative-strand RNA
administered intravenously virus of the Rhabdovirus
[35]. Side effects, including flu- family, has been studied as an
like symptoms, localized anti-cancer agent
adverse effects at the tumor
site and infusion reactions,
were observed. However, there
was no toxicity from the
oncolytic virus treatment.
Infection with NDV is
dependent on two viral
glycoproteins;
hemagglutininneuraminidase
(HN) and fusion (F). A major
Citation: Ahmed M (2013) Oncolytic Viruses as Therapeutic Agents for Prostate Cancer. Adv Tech Biol Med 1: 107. doi:10.4172/atbm.1000107
Page 4 of 7
Citation: Ahmed M (2013) Oncolytic Viruses as Therapeutic Agents for Prostate Cancer. Adv Tech Biol Med 1: 107. doi:10.4172/atbm.1000107
for several years. VSV exhibits numerous properties of an effective PC3 cells, Nguyen et al. [92] pretreated prostate cancer cells with
oncolytic agent including its well-defined biology, ability to induce histone deacetylase inhibitors (HDIs) known to suppress the type I IFN
apoptosis in a wide array of cancer cells and the lack of preexisting response [93]. Using the HDIs, HDI-MS-275 and SAHA (Vorinostat),
immunity in humans [67,82-85]. Similar to Newcastle disease virus, which have shown promising anti-cancer results in preclinical or
it has been proposed that the susceptibility of tumors to VSV is due clinical trials, they were able to augment the oncolytic activity of VSV-
to development of defects in antiviral responses during tumorigenesis Δ51-GFP both in vitro and in vivo xenograft models. Another approach
[67,82,85-87]. While normal cells may be infected by VSV, they
involved engineering the recombinant (VSV)-MΔ51 virus to express
respond to the virus by enhancing the type I IFN response, leading
the cytosine deaminase/uracil phosphoribosyltransferase (CD::UPRT)
to the attenuation of virus replication. However, wt strains of VSV
suicide gene and 5-fluorocytosine (5FC) prodrug [93]. This virus had
have the ability to suppress the antiviral response, induce systemic
immunity and replicate in the central nervous system [86,88,89], thus an enhanced ability to kill PC3 cells as compared to viruses lacking
leading to safety concerns. Over the last decade, increasing strides the suicide gene. Furthermore, it was effective at killing additional
have been made in the understanding of the interaction between the tumor cell lines derived from the breast. These, and similar studies
virus, cancers, and the immune response. This has led to the with other oncolytic viruses demonstrate the concept that in order
development of a number of recombinant attenuated VSVs with the to promote oncolysis, synergistic combination approaches must be
goal of enhancing the oncolytic potential of the virus, either directly investigated. Immunocompetent transgenic mice have served as
or indirectly through stimulation of the immune response, while useful model systems for measuring the safety and efficacy of VSV
maintaining safety. VSV has been tested as a candidate oncolytic treatment of prostate tumors. Moussavi et al. [94] demonstrated that
virus for prostate cancer by several groups. Early studies with prostate an IFN- sensitive VSV (AV3 strain) expressing luciferase effectively
cancers tested the ability of a matrix (M) protein mutant of VSV spreads in tumor-bearing prostate-specific PTEN(-/-) mice to
(rM51R-M virus) to kill LNCaP and PC3 prostate cancer cells in cell selectively infect and kill prostate tumor cells while sparing normal
culture and xenograft model systems [86]. The M51R M protein cells in control mice [95]. In these studies the virus was injected at
mutation disrupts the ability of VSV to shut- off the host antiviral the prostate site, thus demonstrating the utility of this administration
response in infected cells [85,86,90]. Xenograft studies showed that route. More recently, this same group showed that AV3 effectively
rM51R-M virus exhibits enhanced selectivity for tumor over normal targets metastatic lesions arising in the transgenic adenocarcinoma of
cells as compared to wt VSV strains, as indicated by the ability of
the mouse prostate (TRAMP) model [95]. The TRAMP C2 cell line
the virus to effectively kill tumor cells with limited signs of disease
derived from TRAMP mice was also utilized to demonstrate the
[86]. However, the efficacy of the virus depends on the cell type.
enhanced oncolytic properties of a recombinant VSV encoding
LNCaP cells are extremely sensitive to the effects of the virus while
PC3 cells remain resistant to infection and killing by rM51R-M virus SV5-F able to induce syncytial formation [96]. The SV5-F
perhaps due to the constitutive expression of numerous antiviral gene recombinant virus was constructed by replacing VSV glycoprotein
products in this cell line [91] (Figure 1). Several M51 protein (G) with that of the SV5-F to generate rVSV-DeltaG-SV5-F. rVSV-
mutants of VSV have been used to explore combination approaches DeltaG-SV5-F virus replication was restricted to TRAMP-C2 tumors
for the treatment of a variety of cancers, including prostate cancers. where it showed enhanced apoptotic and cytotoxic effects relative to a
In an attempt to augment the ability of VSV-Δ51-GFP to kill VSV- control virus lacking SV5-F.
resistant
Antiviral
A. Normal Cell -Viral replication inhibited
response -Type I IFN response
- Surrounding cells protected
Antiviral
response -Viral replication
-Cell killing
B. Cancer Cell - virus spread
(i.e. LNCaP)
Cancer-specific genetic
alterations in antiviral
pathways
Antiviral
response -Viral replication inhibited
-Type I IFN response
C. Cancer Cell - Surronding cells protected
(i.e. PC3)
Cancer-specific genetic
alterations but antiviral
pathways intact
Figure 1: Selective killing of cancer cells by oncolytic M protein mutant strains of VSV. Oncolytic M protein mutant VSVs act as selective anti-cancer agents due to
their inability to inhibit host gene expression in infected cells. As a result, infected cells produce type I IFN and other antiviral cytokines in response to virus infection.
A. Normal cells contain intact antiviral response pathways that are induced by M protein mutant VSV leading to the attenuation of viral replication and prevention of
spread to surrounding tissue. B. Some cancer cells acquire genetic defects in antiviral pathways that render them susceptible to the oncolytic activity of M protein
mutant viruses. C. Other cancers retain intact antiviral pathways that protect them from the oncolytic activity of VSV. The resistance of these cancer cells to VSV
may be due to the constitutive expression of antiviral factors or their ability to mount an antiviral response upon infection with VSV, similar to that observed in
normal cells.
Page 5 of 7
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