Glioma Therapy Using Targeted Oncolytic HSV Vectors

多形性胶质母细胞瘤（GBM）是一种毁灭性的疾病，尽管尽了最大努力，但几乎总是导致患者死亡 使用标准疗法，包括手术、放疗和化疗。需要新的治疗干预需要新的治疗干预 其可以与标准医疗实践结合使用。在这些治疗方法中，基因治疗可能 对GBM的治疗有希望，然而有效基因递送的障碍仍然存在。高度减毒 复制能力HSV-1载体提供了一个强大的机会，提供有效的基因传递，除了 自然溶解特征（溶瘤）和早期人体试验支持该方法的安全性。在这一提议中， 通过对载体的改良，探索提高HSV溶瘤载体效力的方法 在肿瘤块内的分布，测试其性能可能是 通过增强和更特异的肿瘤内复制以及通过使用额外的转基因来改善， 更有效地破坏肿瘤块，包括局部浸润肿瘤细胞进入正常脑组织。 在整个研究过程中，将结合放射外科手术评估载体性能和肿瘤杀伤。 我们将使用G207的性能作为基准来比较任何矢量改进。 在四个相关的具体目标中，我们将：（i）利用胶原酶来增强肿瘤内载体分布 通过先进的活体显微镜观察;（ii）检查HSV基因组中新的遗传变异，以寻找更多 活性突变体溶瘤载体具有与目前用于早期患者的载体相同或更好的安全性 研究（例如G207）;（iii）开发重靶向策略，通过识别肿瘤特异性HSV感染， 肿瘤细胞受体;和（iv）将新的抗肿瘤转基因引入载体骨架，其包括（a）嘌呤 核苷磷酸化酶（PNP）与6-甲基嘌呤（MeP）联合处理，（B）氯毒素（CltX），肽 抑制肿瘤细胞迁移并可诱导肿瘤细胞凋亡的肿瘤坏死因子（TNF α）， 使肿瘤细胞和肿瘤脉管系统对放射外科方法敏感。 这些研究的结果旨在发现新的载体，更有效的转基因和交付策略 这两种方法一起可以提供基因治疗作为一种有效的方法， 复发性GBM优于目前可用的治疗方法。

Glioblastoma multiforme(GBM) is a devastating disease that almost invariably leads to patient death despite best efforts using standard therapies that include surgery, radiation and chemotherapy. New therapeutic interventionsare needed which may be used in combination with standard medical practice. Among these treatments, gene therapy potentially holds promise for treatment of GBM however impediments to effective gene delivery remain. Highly attenuated replication competent HSV-1 vectors providea powerful opportunityto provide effective gene delivery in additionto the natural lytic features (oncolysis) and early phase human trials support the safety of this approach. In this proposal, experiments are outlinedto explore methodsto enhancethe potency of HSV oncolyticvectors through improvedvector distribution within the tumor mass, the testing of additional mutant vector backbones whose performance may be improved by enhanced and more specific intra-tumoralreplicationand through the use of additionaltransgenes that may be more effective in destruction of the tumor mass including locally infiltrating tumor cells into normal brain tissue. Throughout this investigationvector performanceand tumor killing will be evaluated in combinationwith radiosurgery. We will use the performance of G207 as a benchmark with which to compare any vector improvements. In four related specific aims we will: (i) Exploit the use of collagenases to enhance intra-tumoral vector distribution as visualized by advanced vital microscopy; (ii) Examine new genetic alterations in the HSV genome in a search for more active mutant oncolytic vectors that have the same or better safety profiles as vectors currently used in early phasepatient studies (e.g. G207); (iii) Develop retargeting strategies to enable tumor-specific HSV infection through recognition of tumor-cell receptors; and (iv) Introduce novel anti-tumor transgenes into the vector backbone that include (a) purine nucleoside phosphorylase (PNP) in combination with 6-methylpurine(MeP) treatment, (b) chlorotoxin (CltX), a peptide that inhibits tumor cell migration and may induce tumor cell apoptosis (c) tumor necrosis factor (TNFoc)that acts to sensitize tumor cells and the tumor vasculature to radiosurgical methods. The outcome of these studies are intended to discover new vectors, more effective transgenes and delivery strategies which together may provide gene therapy as an effective approach to at least prolong the survival of patients with recurrent GBM over currently available treatment methods.