Retroviral-mediated gene transfer of the IL-4 gene into experimental gliomas can cause tumor rejection, supporting the clinical use of this form of gene therapy for glioblastomas (GBM). In a clinical setting, the administration of dexamethasone (dex) is a standard procedure for GBM patients. This led us to examine the effects of dex on IL-4 gene therapy. We injected intracranially Fischer 344 rats with phosphatebuffered saline, 9L gliosarcoma cells mixed with E86.L4SN 200 cells (retroviral producer cells, RPC, transducing IL-4 cDNA) and 9L cells mixed with PA317.STK.SBA cells (control RPC expressing the HSV-tk gene). The rats from each group were treated with 0, 50, 100 or 250 mg dex/ kg/day released by osmotic pumps implanted subcutaneously. While 80-100% of rats receiving 9L cells mixed with IL-4 RPC and not treated by dex survived for at least 2 months following tumor injection, only 50% and 17% of rats receiving 50 or 100 mg/kg/day of dex, respectively, reached this time point. These results indicate that dex significantly diminished the anti-tumor effect of IL-4. Thus, in a clinical setting, IL-4 gene transfer should be performed when low levels of dex are administered or in the absence of dex. Gene Therapy (2003) 10, 188-192. doi:10.1038/sj.gt.3301863 Keywords: IL-4; glioma; dexamethasone Glucocorticosteroids (GC) play an important role in the management of malignant brain tumors, either primary or secondary and perioperatively in brain surgery. 1 Dexamethasone (dex) is the GC given in the majority of neuro-oncologic patients, at an empirically chosen dosage of 4 mg qid. Dex has a dramatic effect on symptoms in patients with brain tumors by decreasing the blood-tumor barrier permeability and the regional cerebral blood volume. 2 Furthermore, dex may decrease brain-tumor-associated edema by counteracting the action of VEGF. 3 Steroid medications, including dex, also have immunosuppressive functions. Studies based on flow cytometry to quantify the extent of inflammatory cell infiltration in the immunogenic rat C6 glioma model showed that a 7-day course of dex (100 mg/kg/day) resulted in a greater than 50% inhibition of microglia and lymphocyte (but not macrophage) infiltration into tumors. 4 Dex may specifically inhibit the action of IL-4 by decreasing the expression of the IL-4 receptor alpha. 5 These findings should be considered when experimental immunotherapeutic strategies are evaluated for clinical application. We and others previously found that viral-mediated transfer of the interleukin-4 (IL-4) gene may significantly inhibit the growth of C6, 9L and GL261 experimental gliomas. [6][7][8][9][10][11] In these experiments IL-4 gene transfer was associated with tumor infiltration by inflammatory cells and particularly T-lymphocytes and macrophages. Thus, in view of future clinical trials based on IL-4 gene transfer in gliomas we have evaluated the effects of dex administration on IL-4 gene therapy of 9L malignant gliomas.In experiment A, we tested the effects of 250 mg/kg/ day of dex administered for ...