Department of Neurosurgery, Atenas University Center, Passos, Minas Gerais, Brazil.
Hospital Israelita Albert Einstein, University of Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil.
Oncotarget. 2024 Sep 30;15:662-673. doi: 10.18632/oncotarget.28647.
Many studies have highlighted the use of oncolytic viruses as a new class of therapeutic agents for central nervous system (CNS) tumors, especially glioblastomas (GMB). Zika Virus (ZIKV) proteins targeted to specific stem cells have been studied and animal models with promising results.
A systematic review was evaluated the efficacy and safety of the ZIKV use for CNS tumors treatment. Data were extracted and the studies were evaluated using the Robins-I tool. We assessed bias in each study using criteria such as selection bias, performance bias, detection bias, attrition bias, reporting bias, and others. According to Cochrane guidelines, bias was classified as high, low, or uncertain. High bias occurred when studies did not meet the criteria. Low bias was assigned when criteria were clearly met. Uncertain bias reflected insufficient information for a clear classification.
The 14 included studies shown that ZIKV reduced cell viability or inhibited the growth, proliferation of glioma stem cells (GSCs), and Bcl2 expression - which could potentially enhance the effect of chemotherapy/radiotherapy; caused cytopathic effects, induced tumor cell damage, manifested oncolytic properties, and even selectively safely killed GSCs; ultimately, it led to significant tumor remission and enhanced long-term survival through enhanced T-cell response.
Although current evidence suggests ZIKV as a promising treatment for CNS tumors and may improve survival when combined with surgery and radiotherapy. Despite limited human evidence, it shows potential benefits. Further research is needed to confirm safety, efficacy, and optimize treatment in humans.
许多研究强调了溶瘤病毒作为一种新的中枢神经系统(CNS)肿瘤治疗药物的应用,特别是胶质母细胞瘤(GMB)。针对特定干细胞的寨卡病毒(ZIKV)蛋白已被研究过,并在动物模型中取得了有前景的结果。
我们系统地评估了 ZIKV 用于 CNS 肿瘤治疗的疗效和安全性。提取数据,并使用 Robins-I 工具评估研究。我们使用选择偏倚、表现偏倚、检测偏倚、失访偏倚、报告偏倚等标准评估每项研究中的偏倚。根据 Cochrane 指南,偏倚分为高、低或不确定。当研究不符合标准时,出现高偏倚。当标准明显符合时,分配低偏倚。不确定的偏倚反映了缺乏明确分类的信息。
14 项纳入的研究表明,ZIKV 降低了细胞活力或抑制了神经胶质瘤干细胞(GSCs)的生长和增殖,以及 Bcl2 的表达,这可能增强化疗/放疗的效果;引起细胞病变效应,诱导肿瘤细胞损伤,表现出溶瘤特性,甚至选择性地安全杀死 GSCs;最终,通过增强 T 细胞反应,导致肿瘤明显缓解并提高长期生存率。
尽管目前的证据表明 ZIKV 作为 CNS 肿瘤的一种有前途的治疗方法,并且可能与手术和放疗结合使用时提高生存率,但由于人类证据有限,它显示出了潜在的益处。需要进一步的研究来确认安全性、疗效,并优化人类的治疗方案。