Evaluation of Topical Polyinosinic Acid-Polycytidylic Acid in Treatment of Localized Herpes Zoster in Children with Cancer: a Randomized, Double-Blind Controlled Study

Abstract

Twenty-four children with cancer and localized herpes zoster were randomized to receive either topical polyinosinic acid-polycytidylic acid [poly(I:C)] or a saline placebo. Solutions containing 1.0 or 2.5 mg of drug per ml were applied to the lesions every 3 h, seven times a day for 7 consecutive days. Serial, standardized color photographs were used to evaluate the progression of lesions and maximum percentage of dermatome involvement. In patients receiving poly(I:C), the median days of new lesions after therapy was 2.0 days as opposed to 3.5 days in placebo-treated patients. This difference was not statistically significant. Moreover, the total median days of lesions and percentage of dermatome involvement were similar in both groups, as were complications. Neither the concentration nor the total dose of drug was related to the outcome of infection. We conclude that topical poly(I:C), as used in this study, was of no benefit in treatment of localized herpes zoster.

Systemic adenoviral gene delivery to orthotopic murine breast tumors with ablation of coagulation factors, thrombocytes and Kupffer cells

“…This finding supports the feasibility of using co‐administration of poly(i) and adenovirus in cancer patients. Poly(i) has also previously been used in clinical trials 50, 51.…”

“…The depletion of Kupffer cells may also be appealing because these cells have an important role in directing the immune response towards adenoviruses. Treatment of cancer patients with poly(i) may be feasible in the context of clinical trials because this agent has already been tested in herpes and cancer trials, amongst other studies 50, 51. Thrombocytopenia is quite common in advanced cancer patients 53, and adenovirus injection results in further thrombocyte reduction 34 and therefore there may be no need for additional platelet depletion.…”

The role of interferon in viral infections

“…Preliminary studies suggested that interferon administration could be safely tolerated by cancer patients with varicella zoster infections [67,121]. Treatment of cancer patients with topical application of the interferon inducer polyriboinosinicpolyribocytidylic acid at the site of local infections did not prevent the spread of herpes zoster [61]. However, the course of herpes zoster infections in cancer patients can be moderated by treatment with human leukocyte interferon [55,163,220].…”

TLR3 agonism augments CD47 inhibition in acute myeloid leukemia

“…Additionally, poly(I:C) has synergized previously with CD47 blockade in colorectal cancer models 33 . As variations of poly(I:C) are in use in over 13 clinical trials currently as an immunoadjuvant, we adapted use of this TLR3 agonist in our murine models [34][35][36][37] . Administering poly(I:C) over a twoweek period revealed significant shifts in macrophage phenotype, most notably the additional presence or increase in M1 macrophage populations.…”