The efficacy and safety of oncolytic viruses in the treatment of intermediate to advanced solid tumors: a systematic review and meta-analysis

Abstract

Background: Cancer treatment remains one of the most formidable challenges worldwide. Some novel treatment strategies, including molecularly targeted therapy, gene therapy, and cellular immunotherapy, have also been investigated to improve therapeutic effects for cancer patients and have demonstrated unexpected positive effects. This systematic review and meta-analysis evaluated the efficacy and safety of oncolytic virus (OV) monotherapy or combination therapy for intermediate to advanced solid tumors. Methods: We retrieved articles from PubMed, Embase, Web of Science, CNKI, Wanfang and VIP. The quality of the included studies was assessed by Review Manager Software version 5.3. STATA software was used to perform meta-analyses of efficacy, overall survival (OS) and adverse reactions.Results: A total of 22 studies involving 3,996 patients were included in this analysis, including 13 H101 studies, 5 T-VEC studies, 2 Pexa-Vec studies, 1 HF10 study and 1 Reolysin study. Regarding oncolytic adenovirus H101, meta-analysis showed that patients treated with H101 monotherapy or H101 combined with chemotherapy had a significantly higher objective response rate (ORR) than those treated with chemotherapy. Patients in the H101 and T-VEC groups had significantly longer effect size (ES) than the control group patients. The odds ratio (OR) and ES of patients with hepatocellular carcinoma, lung cancer and melanoma treated with OV were analyzed. For the safety profile, the total incidence of adverse reactions was similar in both groups. In terms of the other OVs, according to a systematic review, we found that after Reolysin treatment, the ORR was 26.9% in patients with head and neck cancer. The phase I study of HF10 exhibited some therapeutic potential. The adverse events (AEs) associated with the other OVs mainly included fever, nausea and vomiting, leukopenia, and hypotension. Discussion: OVs are effective and well tolerated for the treatment of intermediate to advanced solid cancer and represent a promising therapeutic approach for solid cancers.

Advances in cell-based delivery of oncolytic viruses as therapy for lung cancer

“…Moreover, systematic reviews and meta-analyses evaluated the efficacy and safety of OV in lung cancer and showed that the objective response rate was significantly higher in patients receiving oncolytic adenovirus H101 monotherapy or combination with chemotherapy than in patients only receiving chemotherapy. 159 There still is a long way to go before the use of optimized OVs will be sophisticated enough to become a standard part of a likely combined (immuno)therapy against lung cancer. For this, the pitfall of systemic OV application must be overcome.…”

The Influence of Oncogenic Viruses in Renal Carcinogenesis: Pros and Cons

“…These viruses, which have been studied in many research settings, are known to have minimal human toxicity and to destroy tumoral cells specifically and they have a wide spectrum of anticancer activity. In a systematic review and meta-analysis, the authors studied 4000 patients treated for different cancers with oncolytic viruses (OVs) and concluded that this therapy was effective and well-tolerated as a treatment for advanced solid cancers and that it represents a promising therapeutic approach for solid cancers [ 84 ].…”

Oncolytic Viruses: Immunotherapy Drugs for Gastrointestinal Malignant Tumors

“…Therefore, changing the suppressed state of the tumor immune microenvironment has an essential role in clearing tumor cells. Oncolytic viruses can alter the cytokine milieu and enhance immune cell maturation and activation, restoring and increasing the body's function in tumor cell clearance (Raja et al, 2018;Galon and Bruni, 2019) (Figure 3).…”