Abstract

Resistance to therapy is a major obstacle to cancer treatment. It may exist from the beginning, or it may develop during therapy. The review focusses on oncolytic Newcastle disease virus (NDV) as a biological agent with potential to break therapy resistance. This avian virus combines, upon inoculation into non-permissive hosts such as human, 12 described anti-neoplastic effects with 11 described immune stimulatory properties. Fifty years of clinical application of NDV give witness to the high safety profile of this biological agent. In 2015, an important milestone was achieved, namely the successful production of NDV according to Good Manufacturing Practice (GMP). Based on this, IOZK in Cologne, Germany, obtained a GMP certificate for the production of a dendritic cell vaccine loaded with tumor antigens from a lysate of patient-derived tumor cells together with immunological danger signals from NDV for intracutaneous application. This update includes single case reports and retrospective analyses from patients treated at IOZK. The review also presents future perspectives, including the concept of in situ vaccination and the combination of NDV or other oncolytic viruses with checkpoint inhibitors.

Highlights

  • Oncolytic viruses (OVs) provide a new promising way to treat cancer

  • Concluded that the results demonstrated improved disease-free survival (DSF) in comparison with survival data published for similar patients who were treated by surgery alone [134]

  • While there was no significant difference between control and vaccinated rectal cancer, a significant benefit was seen in the colon cancer subgroup with regard to metastasis-free survival and overall survival: In the vaccinated arm, only 30.8% had died, while in the control arm 78.6% had died [142]

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Summary

Introduction

Oncolytic viruses (OVs) provide a new promising way to treat cancer Such biological agents replicate selectively in tumor cells and induce tumor-selective cell death (oncolysis). Oncolytic viral therapy has an initial phase in which the virus mediates direct oncolysis of tumor cells, followed by a second phase of post-oncolytic immune response. This review deals with a native OV from birds, Newcastle disease virus (NDV). This paramyxovirus is not adapted to the human immune system. Since NDV has neither adverse effects on human cells nor any pathology, it can be used as a native OV in cancer patients. The safety profile for NDV includes lack of gene exchange via recombination, lack of interaction with host cell DNA, virus replication independent of cell proliferation and low side effects in cancer patients. This review aims at updating information concerning NDV with regard to basics and application in cancer patients

Evolution and Taxonomy of NDV
Molecular Biology of NDV
The Type I Interferon Response in Birds and Its Inhibition
The Type I Interferon Response in Mammalian Cells and Its Inhibition
Virus Infection of Tumor Cells from Non-Permissive Hosts
Post-Oncolytic Immunity and Direct Activation of Immune Cells by NDV
Potential of NDV to Break Therapy Resistance and Anti-Viral Immunity
Comparison of NDV to other OVs
Over 50 Years of Clinical NDV Application
A New Concept of Multimodal Cancer Immunotherapy
The Two Steps of Multimodal Immunotherapy at IOZK
Patients with firstdiagnosis diagnosisof of primary primary GBM
Side Effects
Limitations and Challenges
OV-Mediated Gene Therapy
Combining NDV with Carrier Cells for Improving Tumor Targeting
Combinatorial Approaches of OVs with Bi- or Tri-specific Antibodies
Combinatorial Approaches with Checkpoint Inhibitors
Modulation of OV Therapy by Pharmacologicals
Summary
Findings
10. Conclusions
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