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Background
Tumour resistance to a wide range of drugs (multiple drug resistant, MDR) acquired after intensive chemotherapy is considered to be the main obstacle of the curative treatment of cancer patients. Recent work has shown that oncolytic viruses demonstrated prominent potential for effective treatment of diverse cancers. Here, we evaluated whether genetically modified vaccinia virus (LIVP-GFP) may be effective in treatment of cancers displaying MDR phenotype.
Methods
LIVP-GFP replication, transgene expression and cytopathic effects were analysed in human cervical carcinomas KB-3-1 (MDR−), KB-8-5 (MDR+) and in murine melanoma B-16 (MDR−), murine lymphosarcomas RLS and RLS-40 (MDR+). To investigate the efficacy of this therapy in vivo, we treated immunocompetent mice bearing murine lymphosarcoma RLS-40 (MDR+) (6- to 8-week-old female CBA mice; n = 10/group) or melanoma B-16 (MDR−) (6- to 8-week-old female C57Bl mice; n = 6/group) with LIVP-GFP (5 × 107 PFU of virus in 0.1 mL of IMDM immediately and 4 days after tumour implantation).
Results
We demonstrated that LIVP-GFP replication was effective in human cervical carcinomas KB-3-1 (MDR−) and KB-8-5 (MDR+) and in murine melanoma B-16 (MDR−), whereas active viral production was not detected in murine lymphosarcomas RLS and RLS-40 (MDR+). Additionally, it was found that in tumour models in immunocompetent mice under the optimized regimen intratumoural injections of LIVP-GFP significantly inhibited melanoma B16 (33 % of mice were with complete response after 90 days) and RLS-40 tumour growth (fourfold increase in tumour doubling time) as well as metastasis.
Conclusion
The anti-tumour activity of LIVP-GFP is a result of direct oncolysis of tumour cells in case of melanoma B-16 because the virus effectively replicates and destroys these cells, and virus-mediated activation of the host immune system followed by immunologically mediated destruction of of tumour cells in case of lymphosarcoma RLS-40. Thus, the recombinant vaccinia virus LIVP-GFP is able to inhibit the growth of malignant cells with the MDR phenotype and tumour metastasis when administered in the early stages of tumour development.
Interleukin 2 (IL-2) was the first cytokine applied for cancer treatment in human history. It has been approved as monotherapy for renal cell carcinoma and melanoma by the FDA and does mediate the regression of the tumors in patients. One of the possible mechanisms is that the administration of IL-2 led to T lymphocytes expansion, including CD4+ and CD8+ T cells. In addition, a recent study demonstrated that antigen-specific T cells could also be expanded through the induction of IL-2, which plays a crucial role in mediating tumor regression. However, despite the long-term and extensive use of IL-2 in the clinic, the ratio of patients who get a complete response was still low, and only about one-fifth of patients showed objective tumor regression. Therefore, the function of IL-2 in cancer treatment should continue to be optimized and investigated. A study by Franz O. Smith et al. has shown that the combination treatment of IL-2 and tumor-associated antigen vaccine has a strong trend to increased objective responses compared to patients with melanoma receiving IL-2 alone. Peptide vaccines are anti-cancer vaccines able to induce a powerful tumor antigenspecific immune response capable of eradicating the tumors. According to the type of antigens, peptide vaccines can be classified into two distinct categories: Tumor-associated antigens (TAA) vaccine and tumor-specific neoantigens (TSA) vaccine. Currently, Peptide vaccines are mainly investigated in phase I and phase II clinical trials of human cancer patients with various advanced cancers such as lung cancer, gastrointestinal tumors, and breast cancers. Vaccinia virus (VACV) is one of the safest viral vectors, which has been wildly used in cancer treatment and pathogen prevention. As an oncolytic vector, VACV can carry multiple large foreign genes, which enable the virus to introduce diagnostic and therapeutic agents without dramatically reducing the viral replication. Meanwhile, the recombinant vaccinia virus (rVACV) can be easily generated by homologous recombination. Here, we used the vaccinia virus as the therapeutic cancer vector, expressing mouse Interleukin 2 (IL-2) and tumor-associated antigens simultaneously to investigate the combined effect of anti-tumor immune response in the 4T1 mouse tumor model. As expected, the VACV driven mIL-2 expression remarkably increased both CD4+ and CD8+ populations in vivo, and the virus-expressed tumor-associated peptides successfully elicited theantigen-specific T cell response to inhibit the growth of tumors. Furthermore, the experiments with tumor-bearing animals showed that the mIL-2 plus tumor antigens expressing VACV vector gave a better anti-cancer response than the mIL-2 alone expressing vector. The combinations did significantly more inhibit tumor growth than mIL-2 treatment alone. Moreover, the results confirmed our previous unpublished data that the mIL-2 expression driven by synthetic early/late promoter in the Lister strain VACV could enhance the tumor regression in the 4T1 mouse model.
A promising new approach for the treatment of human cancer is the use of oncolytic viruses, which exhibit tumor tropism. One of the top candidates in this area is the oncolytic vaccinia virus (VACV), which has already shown promising results in animal studies and in clinical trials. However, due to discrepancies in both innate and adaptive immunity between mice and men the evaluation of the vaccinia virus’ interactions with the host immune system in mice are not fully conclusive of what is actually happening in human cancer patients after systemic administration of vaccinia virus. Also, ethical and legal concerns as well as risk of potential toxicity limit research involving human patients. Therefore, a good in vivo model for testing interactions between vaccinia virus and human immune cells, avoiding the numerous limitations and risks associated with human studies, could be a humanized mouse model.
LIVP-1.1.1, GLV-2b372, GLV-1h68, GLV-1h375, GLV-1h376 and GLV-1h377 VACVs were provided by Genelux Corporation. GLV-2b372 was constructed by inserting TurboFP635 expression cassette into the J2R locus of the parental LIVP-1.1.1. GLV-1h375, -1h376 and -1h377 VACVs encode the human CTLA4-blocking single-chain antibody (CTLA4 scAb). Performed replication and cytotoxicity assays demonstrated that all six viruses were able to infect, replicate in and kill human tumor cells in virus-dose- and time-dependent fashion. CTLA4 scAb and β-glucuronidase (GusA) expression as well as viral titers in GLV-1h376-infected cells were analyzed by ELISA, β-glucuronidase assay and standard plaque assay, respectively, and compared. An excellent correlation with correlation coefficients R2>0.9806 were observed. GLV-1h376-encoded CTLA4 scAb was successfully purified from supernatants of infected CV-1 cells and demonstrated in vitro affinity to its human CTLA4 target and lack of cross-reactivity to mouse CTLA4. CTLA4 scAb functionality was confirmed in Jurkat cells. LIVP-1.1.1, GLV-2b372, GLV-1h68 and GLV-1h376 were next studied in non-tumorous and/or tumor-bearing humanized mice.
It was demonstrated that injection of human CD34+ stem cells into the liver of preconditioned newborn NSG mice let to a successful systemic reconstitution with human immune cells. CD19+ B cells, CD4 and CD8 single positive CD3+ T cell, NKp46+CD56- and NKp46+CD56+ NK cells as well as CD33+ myeloid cells developed. At early time points after engraftment, majority of the human hematopoietic cells detected in the mouse blood were CD19+ B cells and only a small portion were CD3+ T cells. With time a significant change in CD19+/CD3+ ratio was reported with a decrease of B cells and an increase of T cells. Implantation of A549 cells under the skin of those humanized NSG mice resulted in a progressive tumor growth, described for the first time in this thesis. Successful colonization of subcutaneous A549 tumors with VACVs was visualized and demonstrated by detection of virus-mediated TurboFP635 and GFP expression as well as by standard plaque assay and immunohistochemistry. The human CD45+ cell population in tumors was represented mainly by NKp46+CD56bright NK cells and a large portion of activated CD4+ and cytotoxic CD8+ T cells. However, no significant differences were observed between control and LIVP-1.1.1-infected tumors, suggesting that the recruitment of NK and activated T cells were more tumor tissue specific than virus-dependent. Unfortunately, virus-mediated CTLA4 scAb expression in the GLV-1h376-infected tumors was also not able to significantly increase activation of T cells compared to control and GLV-1h68-treated mice. Importantly, ELISA, β-glucuronidase and standard plaque assays showed an excellent correlation with correlation coefficients R2>0.9454 between CTLA4 scAb, GusA concentrations and viral titers in tumor samples from those GLV-1h376 treated mice.
T cells isolated from the spleens of such control or GLV-1h68- or -1h376-treated A549 tumor-bearing mice were functional and could successfully be activated with human T cells activation beads. However, although no significant difference was observed between the three mouse groups, a slightly higher percentage of the GLV-1h376-treated mice-derived T cells were expressing CD25 and producing IFN-ɣ after ex vivo activation, probably due to the CTLA4 blockade by the virus-encoded CTLA4 scAb in the GLV-1h376-treated mice. Also, slightly higher levels of IL-2 were detected in the culture supernatant of those splenocytes compared to control samples. In contrast, T cells from all three mouse groups were not able be activated by A549 tumor cells ex vivo.
Our model has the specific advantage that tumors develop under the skin of the humanized mice, which allows accurate monitoring of the tumor growth and evaluation of the oncolytic virotherapy. Therefore it is important to choose the right approaches for its further improvement.
Effects of stem cell transcription factor-expressing vaccinia viruses in oncolytic virotherapy
(2012)
Cancer remains the second leading cause of death in the industrialized. The data from many different studies investigating the nature of cancer-initiating cells coined the description ‘cancer stem cells’ and has major implications on conventional cancer therapy. Thus, to improve the outcome of cancer treatment and to lower negative side effects, the development of novel therapeutic regimens is indispensable. It has been demonstrated in many preclinical studies that oncolytic virotherapy using vaccinia virus may provide a powerful and well-tolerable new tool in cancer therapy which is currently investigated in several clinical trials (Phase I & II) as stand-alone treatment or in combination with conventional cancer therapy. Cancer-initiating cells and stem cells share a variety of characteristics like the ability to self-renew, differentiation potential, quiescence, drug and radiation resistance, activation and inhibition of similar signaling pathways as well as expression of cell surface markers and stem cell-related genes. In this work, two new recombinant vaccinia viruses expressing the transcription factors Nanog (GLV-1h205) and Oct4 (GLV-1h208) were engineered to provide deeper insight of these stem cell master regulators in their significance of cancer-initiation and their impact on oncolytic virotherapy. Both viruses were analyzed for their replication potential in A549 and PC-3 human cancer cells. Marker gene expression was assessed by RT-PCR, SDS-PAGE and Western blotting, ELISA or immunocytochemistry.Furthermore, the effect of GLV-1h205 infection on the cell cycle in A549 cells was analyzed. Next, the effects of virus-mediated expression of stem cell transcription factors on therapeutic efficacy and survival rates in A549 xenograft mouse models was analyzed. A non-functional Nanog mutant-expressing virus strain (GLV-1h321) was engineered to analyze whether the observed therapeutic benefits were promoter- or payload-driven. Furthermore, this study analyzed the potential of GLV-1h68 to infect, replicate in, and lyse colorectal cancer cell lines to study whether oncolytic vaccinia viruses can be potential new and less invasive treatment regimens for late stage colorectal cancer. Marker gene expression was assessed by fluorescence microscopy and FACS. The transcription factor Klf4 is highly expressed in quiescent, terminally differentiated cells in the colonic epithelium whereas it is dramatically downregulated in colon cancers. Klf4 expression leads to cell growth arrest and inhibits Wnt signaling by binding to beta-catenin. To further improve the treatment of colorectal cancers, new recombinant vaccinia viruses (GLV-1h290-292) mediating the expression of differing amounts of the tumor suppressor Klf4 by using different promoter strengths were engineered. Initial characterization of recombinant vaccinia viruses expressing Klf4 by replication assay, cell viability assay, SDS-PAGE and Western blotting, immuncytochemistry and analysis of protein functionality by qPCR and ELISA analysis for cellular beta-catenin expression, demonstrated promoter strength-dependent expression of and impact of Klf4. To further boost the effects of tumor suppressor Klf4, a vaccinia virus strain expressing Klf4 with a C-terminal fusion of the TAT transduction domain (GLV-1h391) was engineered. Treatment of HT-29 non-responder tumors in vivo with GLV-1h291 and GLV-1h391 led to significant tumor growth inhibition and improved overall survival compared to GLV-1h68. This makes the Klf4-TAT expressing GLV-1h391 a promising candidate for the treatment of colorectal cancer in man.
Background
The capacity of the recombinant Vaccinia virus GLV-1h68 as a single agent to efficiently treat different human or canine cancers has been shown in several preclinical studies. Currently, its human safety and efficacy are investigated in phase I/II clinical trials. In this study we set out to evaluate the oncolytic activity of GLV-1h68 in the human lung adenocarcinoma cell line PC14PE6-RFP in cell cultures and analyzed the antitumor potency of a combined treatment strategy consisting of GLV-1h68 and cyclophosphamide (CPA) in a mouse model of PC14PE6-RFP lung adenocarcinoma.
Methods
PC14PE6-RFP cells were treated in cell culture with GLV-1h68. Viral replication and cell survival were determined by plaque assays and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays, respectively. Subcutaneously implanted PC14PE6-RFP xenografts were treated by systemic injection of GLV-1h68, CPA or a combination of both. Tumor growth and viral biodistribution were monitored and immune-related antigen profiling of tumor lysates was performed.
Results
GLV-1h68 efficiently infected, replicated in and lysed human PC14PE6-RFP cells in cell cultures. PC14PE6-RFP tumors were efficiently colonized by GLV-1h68 leading to much delayed tumor growth in PC14PE6-RFP tumor-bearing nude mice. Combination treatment with GLV-1h68 and CPA significantly improved the antitumor efficacy of GLV-1h68 and led to an increased viral distribution within the tumors. Pro-inflammatory cytokines and chemokines were distinctly elevated in tumors of GLV-1h68-treated mice. Factors expressed by endothelial cells or present in the blood were decreased after combination treatment. A complete loss in the hemorrhagic phenotype of the PC14PE6-RFP tumors and a decrease in the number of blood vessels after combination treatment could be observed.
Conclusions
CPA and GLV-1h68 have synergistic antitumor effects on PC14PE6-RFP xenografts. We strongly suppose that in the PC14PE6-RFP model the enhanced tumor growth inhibition achieved by combining GLV-1h68 with CPA is due to an effect on the vasculature rather than an immunosuppressive action of CPA. These results provide evidence to support further preclinical studies of combining GLV-1h68 and CPA in other highly angiogenic tumor models. Moreover, data presented here demonstrate that CPA can be combined successfully with GLV-1h68 based oncolytic virus therapy and therefore might be promising as combination therapy in human clinical trials.