Radbill Andrew E, Reddy Alyssa T, Markert James M, Wyss J Michael, Pike Martin M, Akella N Shastry, Bharara Niteesh, Gillespie G Yancey
Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
J Neurovirol. 2007 Apr;13(2):118-29. doi: 10.1080/13550280601187177.
Viral oncolytic therapy for malignant brain tumors involves local intratumoral delivery of a genetically engineered virus with tumor cell-specific lytic activity. Promising preliminary results have been achieved in preclinical models with G207, a replication-competent herpes simplex virus type 1 constructed with multiple directed mutations. Although the safety of G207 has been demonstrated in adults, application of viral oncolytic therapy to children with brain tumors has been delayed because of previous lack of data concerning the impact of a replication-competent oncolytic virus on the developing mammalian brain. In this study there was no significant difference in long-term physical development, cognitive performance, or exploratory behaviors between mice that received intracerebral inoculation of G207 or control saline at 4 days of age. However, histological examination and magnetic resonance imaging revealed frequent unilateral ventriculomegaly ipsilateral to the site of injection in only the G207 group. These results suggest that although it is unlikely that G207 will have significant adverse effects on neurodevelopmental outcomes of pediatric patients with brain tumors, an initial study of G207 in children should exclude those patients with tumors in or near the ventricular system as well as patients less than 2 years of age. Furthermore, patients in such a study will need to be closely monitored for the development of hydrocephalus.
用于恶性脑肿瘤的病毒溶瘤疗法涉及在肿瘤内局部递送具有肿瘤细胞特异性裂解活性的基因工程病毒。在临床前模型中,使用G207(一种构建有多个定向突变的具有复制能力的1型单纯疱疹病毒)已取得了有前景的初步结果。尽管G207在成人中的安全性已得到证实,但由于先前缺乏关于具有复制能力的溶瘤病毒对发育中的哺乳动物脑影响的数据,病毒溶瘤疗法在儿童脑肿瘤患者中的应用一直被推迟。在本研究中,4日龄时接受脑内接种G207或对照盐水的小鼠在长期身体发育、认知表现或探索行为方面没有显著差异。然而,组织学检查和磁共振成像显示,仅在G207组中,注射部位同侧频繁出现单侧脑室扩大。这些结果表明,尽管G207不太可能对患有脑肿瘤的儿科患者的神经发育结果产生显著不良影响,但在儿童中对G207进行的初步研究应排除那些肿瘤位于脑室系统内或附近的患者以及年龄小于2岁的患者。此外,在这样的研究中,患者需要密切监测是否发生脑积水。