Choi Eugene A, Lei Hanqin, Maron David J, Mick Rosemarie, Barsoum James, Yu Qian-Chun, Fraker Douglas L, Wilson James M, Spitz Francis R
Department of Surgery, Institute of Human Gene Therapy, The University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19404, USA.
Clin Cancer Res. 2004 Feb 15;10(4):1535-44. doi: 10.1158/1078-0432.ccr-0040-03.
Preclinical in vitro and in vivo studies have demonstrated synergistic interactions between 5-fluorouracil (5-FU) and type I and II IFNs against human colorectal cancer cells. Despite these activities, randomized human trials have failed to identify a clinical benefit for this combination treatment. These limited clinical results may be secondary to the short half-life of recombinant IFN protein and the increased systemic toxicities of 5-FU/IFN combinations. We have previously reported an adenoviral-mediated IFN-beta gene therapy strategy, which may circumvent the pitfalls of recombinant IFN therapy. However, a dose-dependent toxicity and acute inflammatory response to systemically administered adenovirus vectors may limit the clinical application of this therapy. The combination of adenoviral-mediated IFN-beta gene therapy and 5-FU resulted in tumor regression, apoptosis, and improved survival in an established liver metastases model. These therapeutic effects were observed at a significantly lower vector dose than we had previously reported and with limited toxicity. This approach may allow for an effective clinical application of this therapy and warrants additional investigation.
临床前的体外和体内研究已证明5-氟尿嘧啶(5-FU)与I型和II型干扰素之间对人结肠癌细胞存在协同相互作用。尽管有这些活性,但随机人体试验未能确定这种联合治疗的临床益处。这些有限的临床结果可能是由于重组干扰素蛋白的半衰期短以及5-FU/干扰素联合用药导致全身毒性增加。我们之前报道过一种腺病毒介导的干扰素-β基因治疗策略,该策略可能规避重组干扰素治疗的缺陷。然而,全身给药的腺病毒载体的剂量依赖性毒性和急性炎症反应可能会限制这种治疗方法的临床应用。在已建立的肝转移模型中,腺病毒介导的干扰素-β基因治疗与5-FU联合使用导致肿瘤消退、细胞凋亡并提高了生存率。观察到这些治疗效果时所用的载体剂量明显低于我们之前报道的剂量,且毒性有限。这种方法可能使该治疗方法得以有效应用于临床,值得进一步研究。