Abstract. Renal cell carcinoma is the most frequent kidney malignancy and patients with metastatic disease have a poor prognosis. Suppressed apoptosis and marked invasiveness are distinctive features of renal cell carcinoma. In the present study, a dual-regulated oncolytic adenovirus expressing the interluekin (IL)-24 gene (Ki67-ZD55-IL-24) was constructed utilizing the Ki67 promoter to replace the native viral promoter of the E1A gene. Whether the combination of Ki67-ZD55-IL-24-mediated gene virotherapy and radiotherapy produced increased cytotoxicity in renal cell carcinoma cells via mitochondrial apoptotic cell death was investigated. The data indicated that this novel strategy has the potential to be further developed into an effective approach to treat renal cell carcinoma. The results showed that the combination of Ki67-ZD55-IL-24 and radiotherapy significantly enhanced anti-tumour activity via increasing the induction of apoptosis in melanoma cells compared with the other agents.
IntroductionRenal cell carcinoma (RCC) is the most frequent kidney malignancy and patients with metastatic RCC have a poor prognosis (1). In the United States, RCC is diagnosed in ~51,000 patients each year (2). If the disease is detected at an early stage, a large portion of the kidney or the entire organ may be removed, and prolonged patient survival may be achieved (3). However, if the disease has spread beyond the capsule of the kidney into the adrenal gland or surrounding fascia with nodal involvement, the prognosis is poor with rapid progression. In addition, RCC is frequently characterized as highly refractory to multiple established cytotoxic radiotherapy and chemotherapy regimens.Previous data have suggested that interleukin 24 (IL-24) is a promising candidate for cancer gene therapy (4). IL-24 has been demonstrated to suppress growth and induce apoptosis in a wide range of human cancer types without apparent cytotoxicity to normal cells (4). Recent studies have shown that IL-24 radiosensitizes various cancer cells, including non-small cell lung carcinoma, renal carcinoma and malignant glioma cells (5).Ki-67 is an established proliferation mediator and is used extensively to estimate the proliferation fraction of tumors (6). The Ki67 labeling index is an independent predictor of disease progression and recurrence in carcinomas, and also is used as a grade index and prognostic marker. The Ki-67 gene promoter is a tumor-selective promoter with the desired specificity and efficiency to further restrict transgene expression in tumor cells and improve the targeting of gene therapy (7).Oncolytic adenoviruses are a novel class of therapeutic agent in cancer treatment. A previous study observed that the E1B 55-kDa gene-defective oncolytic adenovirus ZD55 not only efficiently infected, replicated in and lysed tumor cells, but also amplified IL-24 gene expression levels. Furthermore, the increased expression levels of IL-24 in the tumor microenvironment did not affect adjacent normal cells (8).One strategy to achieve the desired t...