Foreman Paul M, Friedman Gregory K, Cassady Kevin A, Markert James M
Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Neurotherapeutics. 2017 Apr;14(2):333-344. doi: 10.1007/s13311-017-0516-0.
Malignant glioma is the most common primary brain tumor and carries a grim prognosis, with a median survival of just over 14 months. Given the poor outcomes with standard-of-care treatments, novel treatment strategies are needed. The concept of virotherapy for the treatment of malignant tumors dates back more than a century and can be divided into replication-competent oncolytic viruses and replication-deficient viral vectors. Oncolytic viruses are designed to selectively target, infect, and replicate in tumor cells, while sparing surrounding normal brain. A host of oncolytic viruses has been evaluated in early phase human trials with promising safety results, but none has progressed to phase III trials. Despite the 25 years that has passed since the initial publication of genetically engineered oncolytic viruses for the treatment of glioma, much remains to be learned about the use of this therapy, including its mechanism of action, optimal treatment paradigm, appropriate targets, and integration with adjuvant agents. Oncolytic viral therapy for glioma remains promising and will undoubtedly impact the future of patient care.
恶性胶质瘤是最常见的原发性脑肿瘤，预后不佳，中位生存期仅略超过14个月。鉴于标准治疗的效果不佳，需要新的治疗策略。肿瘤病毒疗法治疗恶性肿瘤的概念可追溯到一个多世纪以前，可分为具有复制能力的溶瘤病毒和复制缺陷型病毒载体。溶瘤病毒旨在选择性地靶向、感染肿瘤细胞并在其中复制，同时不损害周围正常脑组织。许多溶瘤病毒已在早期人体试验中进行了评估，安全性结果令人鼓舞，但尚无一种进入III期试验。尽管自最初发表关于基因工程溶瘤病毒治疗胶质瘤的文章以来已经过去了25年，但关于这种疗法的使用仍有许多有待了解的地方，包括其作用机制、最佳治疗模式、合适的靶点以及与辅助药物的联合使用。溶瘤病毒疗法治疗胶质瘤仍然很有前景，无疑将影响患者护理的未来。
