Intended for healthcare professionals

Analysis And Comment Controversy

Fighting cancer with oncolytic viruses

BMJ 2006; 332 doi: (Published 19 January 2006) Cite this as: BMJ 2006;332:170
  1. Yuti Chernajovsky (, Arthritis Research Campaign chair of rheumatology,
  2. Lorna Layward, research manager,
  3. Nicholas Lemoine, director
  1. Bone and Joint Research Unit, William Harvey Research Institute, Barts and The London, Queen Mary's School of Medicine and Dentistry, Queen Mary, University of London, London EC1M 6BQ
  2. Research into Ageing, Help the Aged, London
  3. Cancer Research UK Clinical Centre, Institute of Cancer, Barts and The London, Queen Mary's School of Medicine and Dentistry, Queen Mary, University of London
  1. Correspondence to: Y Chernajovsky
  • Accepted 17 November 2005

Although gene therapy has huge potential for modern medicine, our enthusiasm for its powerful potential must not cloud our judgment about the dangers of using increasingly diverse, yet relatively untested, replicating viruses

Gene therapy is currently being studied in both the laboratory and the clinic in relation to many conditions, including cancer, heart disease, and autoimmune diseases. A few thousand patients have received genes in more than a thousand different clinical trials—overwhelmingly patients with cancer (two thirds of the trials), with most receiving non-replicative retroviruses or adenovirus as the vectors for the delivery of the new genes.w1

The use of viral vectors has now expanded from relatively safe, non-replicating viruses to the use of viruses that replicate more selectively in cancer cells than in normal cells (oncolytic viruses).1 The benefit of using these viruses is that as they replicate, they lyse their host cells. Cancer cells are ideal hosts for many viruses because they have the antiviral interferon pathway inactivated or have mutated tumour suppressor genes2 3 that enable viral replication to proceed unhindered. Adenovirus3 4 and herpes simplex virus,5 specifically mutated to replicate faster in cancer cells, are the main replicating human pathogenic viruses used in the clinic.3 To date, more than 250 patients have been treated with ONYX-015, a replicating adenovirus.

Before the Helsinki protocols were approved, only a handful of studies had used live viruses injected into solid tumours. Currently, laboratory (and some clinical) studies are using many different viruses (such as Newcastle disease virus, reovirus, poliovirus, vesicular stomatitis virus, measles,6 and vaccinia7), selected for their ability to actively replicate in cancer cells.8 9 Some of these viruses are pathogens in humans, some also …

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