|
|
||||
|
|
||||
|
||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Basic and Translational Investigations |
Department of Neurosurgery, VU University Medical Center, 1007 MB Amsterdam, The Netherlands (W.J.V.H., M.L.L, C.M.D.); Division of Human Gene Therapy, Departments of Medicine, Obstetrics and Gynecology, Pathology, and Surgery (H.W., J.N.G., D.T.C.), Gene Therapy Center (H.W., J.N.G., D.T.C.), Division of Cardiovascular Disease (J.N.G.), and Department of Neurosurgery (G.Y.G.), University of Alabama at Birmingham, Birmingham, AL 35294-2172, USA; and Department of Medicine and Gene Therapy Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel, 91120 (Y.S.H.)
Address correspondence to Yosef S. Haviv, Department of Medicine and the Gene Therapy Institute, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem, Israel, 91120 (yhaviv{at}hadassah.org.il).
| Abstract |
|---|
|
|
|---|
Key Words: adenovirus coxsackie-adenovirus receptor gene therapy glioma infectivity enhancement
| Introduction |
|---|
|
|
|---|
Genetic modification of Ad capsid for CAR-independent infection may involve either replacement of the entire Ad fiber or the fiber knob, or the insertion of heterologous ligands into the fiber knob of Ad5.16-20 Recent genetic approaches developed by our group for CAR-independent Ad infection include insertion of a polysine (pK7) motif into the C-terminal end of the Ad5 fiber gene, or insertion of an RGD4C (RGD) motif into the HI loop of the fiber knob, or both.21 Another CAR-independent approach employed display of a xeno-fiber knob on a human Ad capsid fiber.22 These genetic approaches to alter vector tropism all proved highly efficient in cancer cells grown in monolayer culture. In this study, we investigated whether the utility of tropism modification of Ad vectors attained in vitro is maintained in solid glioma tumor xenografts. This issue is critical for cancer gene therapy endeavors because tumor components may impose several levels of blockage on vector distribution and gene delivery. In addition to cancer cells, tumors consist of stroma comprising reactive fibroblasts and extracellular matrix, basement membranes, abnormal blood vessels, necrotic regions, and infiltrating cells of the immune system. Standard cancer therapy may further accentuate necrosis, apoptosis, and fibrosis within the tumor, thereby potentially confounding the potential distribution of viral vectors. Our results indicate that while tropism-modified Ad vectors could dramatically enhance infectivity in low-CAR glioma cells in vitro, Ad capsid modification was not the sole determinant of in vivo gene delivery in glioma xenografts.
| Materials and Methods |
|---|
|
|
|---|
Adenoviral Vectors
All Ad vectors used in this study were replication deficient (E1 deleted) and based on the serotype-5 Ad genome. The construction of Ad5, Ad5.pK7, Ad5.RGD, and Ad5.RGD.pK7 has been described previously.21 Ad5 is an untargeted Ad vector, used as an isogenic control for Ad5.pK7, Ad5.RGD, and Ad5.RGD.pK7. Ad5. pK7 and Ad5.RGD differ from Ad5 by the respective insertion of a polysine (pK7) or an RGD motif into the C-terminal end of the Ad5 fiber gene or the HI loop of the fiber knob. Ad5.RGD.pK7 contains an RGD motif in the HI loop of the fiber knob in addition to the pK7 motif at the C-terminal end. These Ad vectors all include two identical bicistronic reporter gene cassettesfirefly luciferase and green fluorescent protein (GFP)each driven by a separate cytomegalovirus promoter.
A different approach for Ad capsid modification used Ad5Luc1-CK (also termed AdCK-2)22 displaying genetic xeno-fiber knob replacement via the fiber knob of the canine Ad serotype 2. The cell entry mechanism of Ad5Luc1-CK involves both the putative cellular receptor(s) of the canine Ad serotype 222 and CAR. The control Ad vector for Ad5Luc1-CK was the isogenic, capsid-unmodified Ad5Luc1. Thus, we used two groups of viral vectors, whereby a distinct untargeted Ad5 vector served as an isogenic control to the corresponding retargeted Ad vectors (Fig. 1). All viruses were rescued on 293 cells and purified by using a standard CsCl gradient protocol. The number of viral particles was determined using a conversion factor of 1.1 x 1012 viral particles (vp) per absorbance unit at 260 nm. The titers of these viruses were as follows: Ad5, 3.1 x 1012 vp/ml; Ad5.RGD, 2.1 x 1012 vp/ml; Ad5.RGD.pK7, 7.8 x 1011 vp/ml; Ad.pK7, 1.0 x 1012 vp/ml; Ad5Luc1, 3.7 x 1012 vp/ml; Ad5Luc1-CK, 9.7 x 1011 vp/ml.
|
Relative mean fluorescence intensity was calculated as the ratio of the mean fluorescence intensity of the sample of interest to that of the corresponding negative control. The FITC-positive cell population for each cell line was determined by gating cells incubated with 1% buffer only (negative control).
Fluorescence Microscopy
U118 glioma cells were plated in six-well plates (105 cells/well). Two days later, cells were infected for 1 h with either the control Ad5 vector or the retargeted vector Ad5.pK7 or Ad5.RGD.pK7, at a multiplicity of infection (MOI) of 1,000 vp/cell. Fluorescence microscopy was performed two days later with an Olympus IX70 inverted epifluorescence microscope. All samples were photographed and processed under the same conditions.
Luciferase Assays
Cells were seeded in 24-well plates (50,000 cells/well, 25,000 cells/well for VU-28), with each well containing 0.5 ml of growth medium. After 24 h, cells were infected at an MOI of 40, 200, and 1,000 in 500 µl of infection medium. After 1 h, the infection medium was replaced with growth medium. Twenty-four hours later, the growth medium was aspirated, and the cells were washed and lysed with 100 µl of lysis buffer (Promega, Madison, WI, USA) and mechanically harvested. Ten microliters of each sample was then mixed with 50 µl of luciferase assay reagent (Promega) and measured for relative light units (RLU) with a Berthold Lumat LB9501 luminometer. Standardization between cell lines and MOIs was accomplished by setting the values obtained with the relevant Ad5 control vector as 100%.
Competitive Inhibition Assays
U118 cells were plated in 12-well plates at a density of 105 cells/well the day before infection. An MOI of 200 was used for each infection. Ad5.pK7 and Ad5.RGD.pK7 were preincubated with unfractionated heparin (heparin sodium salt from porcine in intestinal mucosa [Sigma], 0.1, 1, or 10 µg/ml), to block the heparan sulfate proteoglycan (HSPG) cellular entry mechanism, as described previously.21
To block the putative cellular receptor for canine Ad vector, U87 cells were preincubated with recombinant canine knob (0.5, 5, or 50 µg/ml) and then infected with Ad5Luc1-CK at an MOI of 200. Luciferase assays were used to evaluate the efficiency of infection.
In Vivo Glioma Xenograft Model and Luciferase Imaging
All animal experiments were approved by the Institutional Animal Care and Use Committee of the University of Alabama at Birmingham and performed according to their guidelines. The glioma xenograft models were established in female athymic nude mice (National Cancer Institute-Frederick Animal Production Area, Frederick, MD, USA) by stereotactical injection of glioma cells into the mouse brain at the region of the caudate-putamen nucleus. Glioma cells that stably express firefly luciferase (Luc+ U87MG), and regular glioma cells, including high-CAR D54MG cells and low-CAR U87MG cells, were used in the experiments. For each mouse, 5 x 105 glioma cells in a 5-µl volume were injected into the brain. Two weeks later, 1010 vp of each Ad vector was injected into the brain tumors that were established with regular U87MG or D54MG cells. Noninvasive, live luciferase imaging was performed at different days after viral injection to follow the transgene (luciferase reporter) expression. The experimental design of the in vivo glioma xenograft model is depicted in Table 1. Luciferase imaging was performed using a custom-built noninvasive optical imaging system similar to the ChemiPro imaging system (Roper Scientific, Tucson, AZ, USA). For live imaging, the mice were anesthetized with isoflurane inhalation. Following intraperitoneal injection of D-luciferin (2.5 mg/100 µl per mouse), the bioluminescent signals in live mice were captured with a highly sensitive back-illuminated VersArray:1KB charge-coupled device (CCD) camera (Princeton Instruments, Trenton, NJ, USA) that was equipped with a Nikkor f/1.2 lens. Images were acquired with WinView/32 (Roper Scientific) and analyzed with ImageTool 3.0 (University of Texas Health Science Center, San Antonio, TX, USA) and Photoshop 7.0 (Adobe Systems Incorporated, San Jose, CA, USA).
|
Statistical Methods
Student's t-test was used to compare the efficiency of gene delivery by the various Ad vectors in glioma cells in vitro or in the in vivo glioma tumor models; p < 0.05 was considered significant. The Wilcoxon two-sample test was used to confirm statistical significance.
| Results |
|---|
|
|
|---|
|
When low-CAR glioma cell lines were tested for susceptibility to Ad infection, the three retargeting strategies proved superior to regular Ad5 vectors with no capsid modification (Fig. 3A-C). Specifically, in the low-CAR U118 and U87 cells, substantially higher levels of gene delivery could be achieved by all three retargeted vectors. In the medium-CAR glioma cell lines D65 and M59K, the infectivity enhancement of the retargeted Ad vectors was lower than in the low-CAR cells. In high-CAR cells, there was no consistent advantage for CAR-independent infection. Of note, the degree of infectivity enhancement of the retargeted Ad vectors varied in the D65 and M59K cell lines, in accordance with the two distinct cell populations in regard to CAR expression, as shown in Fig. 2. While the double-modified Ad5.RGD.pK7 showed more efficient CAR-independent cell entry in the low-CAR primary glioma cells and in U118 cells, Ad5.pK7 infection was more efficient in the low-CAR U87 cells, possibly indicating variable HSPG and integrin cell-surface expression in different glioma cell lines. In low-CAR cells, Ad5.RGD.pK7 was superior to Ad5.RGD vector (Fig. 3C), which was previously shown to enhance infectivity in glioma cells.23,25 Thus, the novel retargeted Ad vectors Ad5Luc1-CK, Ad5.pK7, and Ad5. RGD.pK7 augment Ad-based gene delivery into established low-CAR glioma cell lines.
|
|
Retargeting Ad Vectors Enhances Infectivity in Primary, Low-Passage Glioma Cells
Glioma cells derived before the eighth passage from tumor samples of patients (referred to here as primary glioma cells) are often considered to better reflect the true nature of tumor cells. Therefore, we further evaluated the utility of the three retargeting strategies in four low-passage, primary glioma cell lines. First, we classified the primary glioma cells on the basis of their CAR expression (Fig. 5A). Next, we evaluated the utility of the various retargeted Ad vectors as gene delivery vehicles into the primary glioma cells. Our findings indicate that in low-CAR primary glioma cells, all three retargeting strategies could augment gene delivery. Of note, the efficiency of Ad5.RGD.pK7 was substantially higher than that of the other vectors (Fig. 5B). In parallel with the established glioma cell lines, infectivity enhancement correlated inversely with the level of CAR expression in primary glioma cell lines.
|
Infectivity Enhancement of Ad Vectors Is Compromised In Vivo in Glioma Xenografts
We next examined whether the CAR-independent Ad infection attained in vitro may predict in vivo gene delivery. To this end, we preestablished orthotopic human glioma xenografts in mice, followed by direct intracranial injection of the various Ad vectors. To directly evaluate gene delivery in real time, we studied live animals in which luciferase activity in the tumors was imaged using a CCD camera to quantitatively measure light emission. To validate transcranial measurement of gene expression, we first confirmed intracranial light signaling from glioma xenograft tumors consisting of glioma cells constitutively expressing luciferase (Fig. 6A). The increasing luciferase signals at day 15 compared with day 10 after tumor inoculation were compatible with active tumor growth, thereby confirming the establishment of the glioma xenograft model. Next, we preimplanted two different types of orthotopic human glioma xenografts (Luc-) in nude mice, followed by intratumoral injection of either the three retargeted Ad vectors or the unmodified Ad5 isogenic control vector (Table 1). The in vivo gene delivery efficiency was evaluated by noninvasive luciferase imaging since the vectors contained the firefly luciferase reporter. Of note, the two xenograft types were composed of human glioma cells with either low (U87) or high (D54) levels of CAR expression.
|
As also found under the in vitro conditions, in high-CAR glioma tumors we observed no infectivity enhancement: the capsid-modified Ad5.pK7 and Ad5.RGD.pK7 vectors showed no significant difference from the control Ad5 vector with regard to in vivo gene delivery efficiency (p = 0.657 and p = 0.372, respectively), whereas the Ad5Luc1-CK vector appeared significantly less efficient than the isogenic control vector (p = 0.020; Fig. 6B). Unlike in the two-dimensional glioma cell monolayers, however, in low-CAR glioma tumors in vivo, the unmodified Ad vectors were not inferior to the capsid-modified Ad (p = 0.239 for Ad5.pK7, p = 0.208 for Ad5.RGD.pK7, and p = 0.447 for Ad5Luc1-CK; Fig. 6C). Thus, in human glioma xenografts, in vitro CAR independence does not necessarily predict enhanced gene delivery in vivo.
| Discussion |
|---|
|
|
|---|
Previously, genetic strategies to modify the Ad fiber have been reported to augment infectivity in glioma cells.23,24 In this study, we revisited the hypothesis that Ad-based gene delivery into gliomas could be enhanced by genetic retargeting of the vectors to alternative cellular Ad receptors. To address this issue, we performed in vitro and in vivo studies with three distinct approaches for Ad retargeting. In vitro, we first showed that CAR expression varies considerably among glioma cell lines. CAR expression was quantified as low, medium, or high. We next demonstrated that in established and primary low-CAR glioma cell lines, all three genetic approaches could enhance Ad infection, independently of CAR.
Of note, in the low-CAR U118 glioma cell line and in primary low-CAR glioma cells, double targeting of HSPG and integrins could augment Ad infectivity (Figs. 3A, 5B), whereas in the low-CAR U87 glioma cell line, double targeting of HSPG and integrins was less efficient than HSPG-based cell entry alone. Furthermore, as shown in Fig. 4A, competitive inhibition of HSPG-mediated cell entry with heparin in U118 cells could efficiently block Ad5.pK7 infection but not Ad5.RGD.pK7 infection. These results indicate that, in U118 glioma cells, integrins may play an important role as mediators of cell entry for Ad5.RGD.pK7 but not for Ad5. pK7. Because Ad5.RGD.pK7 can potentially utilize both HSPG and integrins for cell entry, variable expression of these cell-surface receptors in distinct cell lines may account for the different capacity to achieve CAR-independent infectivity enhancement. In this regard, it has been suggested that double modification of the Ad fiber may cause conformational ligand changes21 that may affect Ad cell entry differentially in different cell lines.
A major finding of our in vivo studies in glioma xenografts was the lack of infectivity enhancement of Ad5. RGD.pK7 (Fig. 6C), in contrast to results under monolayer conditions. This observation is compatible with results of previous in vivo studies in which, in an intraperitoneal ovarian cancer model, Ad5.RGD.pK7 was less efficient than Ad5.pK7 and did not enhance infectivity over Ad5. In contrast, in a subcutaneous ovarian tumor xenograft, Ad5.RGD.pK7, but not Ad5.pK7 or Ad5.RGD, enhanced infectivity.27 The variable nature of tumors was also demonstrated in vivo in a syngeneic melanoma tumor model in which another capsid-modified Ad vector incorporating both RGD and pK7 ligands could confer infectivity enhancement in vitro but not in vivo.28 Thus, in addition to the levels of CAR expression, other factors clearly play significant roles in the susceptibility of glioma tumors to Ad vectors.
These other factors may include intratumoral restriction of vector distribution within the tumor mass by (1) high tumor-cell density and intratumoral connective tissue29; (2) limited availability of vectors within the "infection zone," corresponding to up to five layers of tumor cells around the needle track30; (3) size of virions29; (4) host immune response, augmented by display of charged ligands31; (5) tumor inactivation of viral DNA after inoculation32; (6) charged ligands promoting binding to extracellular matrix proteins, for example, integrins and HSPGs33,34; (7) a gradient of viral infection that results in a high MOI primarily around the needle track; and (8) attenuation of vectors for safety reasons. Altogether, inefficient intratumoral diffusion probably accounts for the limited distribution of Ad-mediated gene delivery in human glioma tumors, as observed in previous human clinical trials.35 Some of these obstacles may be addressed by replication-competent oncolytic viruses or via combined therapeutic modalities.36,37
In conclusion, although novel strategies for CAR-independent Ad-mediated cell entry could confer infectivity enhancement of primary and established low-CAR glioma cell lines in vitro, these approaches were less efficient in vivo. Thus, gene delivery into glioma cell monolayers, inclusive of primary glioma cells, cannot predict gene delivery in complex, heterogenic three-dimensional tumors. Further research is required to characterize and overcome the factors impeding gene delivery into glioma tumors.
| Acknowledgments |
|---|
Received for publication May 29, 2006. Accepted for publication October 12, 2006.
| References |
|---|
|
|
|---|
Elliott WL, Roberts BJ, Howard CT, Leopold WR. Chemotherapy with [Sp-4-3-(R)]-[1,1-cyclobutanedicarboxylato(2-)](2-methyl-1, 4-butanediamine-N,N')platinum (Ci-973, Nk121) in combination with standard agents against murine tumors in-vivo. Cancer Res. 1994;54: 4412-4418.
Schmitt CA, Fridman JS, Yang M, et al. A senescence program controlled by p53 and p16(INK4a) contributes to the outcome of cancer therapy. Cell. 2002;109: 335-346.[CrossRef][ISI][Medline]
Eck SL, Alavi JB, Alavi A, et al. Clinical protocoltreatment of advanced CNS malignancies with the recombinant adenovirus H5.010RSVTK: a phase I trial. Hum Gene Ther. 1996;7: 1465-1482.[ISI][Medline]
Puumalainen AM, Vapalahti M, Agrawal RS, et al. Beta-galactosidase gene transfer to human malignant glioma in vivo using replication-deficient retroviruses and adenoviruses. Hum Gene Ther. 1998;9: 1769-1774.[ISI][Medline]
Trask TW, Trask RP, Aguilar-Cordova E, et al. Phase I study of adenoviral delivery of the HSV-tk gene and ganciclovir administration in patients with recurrent malignant brain tumors. Mol Ther. 2000;1: 195-203.[CrossRef][ISI][Medline]
Sandmair AM, Vapalahti M, Yla-Herttuala S. Adenovirus-mediated herpes simplex thymidine kinase gene therapy for brain tumors. Cancer Gene Ther. 2000;465: 163-170.[ISI]
Miller CR, Buchsbaum DJ, Reynolds PN, et al. Differential susceptibility of primary and established human glioma cells to adenovirus infection: targeting via the epidermal growth factor receptor achieves fiber receptor-independent gene transfer. Cancer Res. 1998;58: 5738-5748.
Asaoka K, Tada M, Sawamura Y, Ikeda J, Abe H. Dependence of efficient adenoviral gene delivery in malignant glioma cells on the expression levels of the coxsackievirus and adenovirus receptor. J Neurosurg. 2000;92: 1002-1008.[ISI][Medline]
Staba MJ, Wickham TJ, Kovesdi I, Hallahan DE. Modifications of the fiber in adenovirus vectors increase tropism for malignant glioma models. Cancer Gene Ther. 2000;7: 13-19.[CrossRef][ISI][Medline]
Douglas JT, Kim M, Sumerel LA, Carey DE, Curiel DT. Efficient oncolysis by a replicating adenovirus (Ad) in vivo is critically dependent on tumor expression of primary Ad receptors. Cancer Res. 2001;61: 813-817.
Fueyo J, Gomez-Manzano C, Alemany R, et al. A mutant oncolytic adenovirus targeting the Rb pathway produces anti-glioma effect in vivo. Oncogene. 2000;19: 2-12.[CrossRef][ISI][Medline]
Tsugawa T, Kuwashima N, Sato H, et al. Sequential delivery of interferon-alpha gene and DCs to intracranial gliomas promotes an effective antitumor response. Gene Ther. 2004;11: 1551-1558.[CrossRef][ISI][Medline]
Immonen A, Vapalahti M, Tyynela K, et al. AdvHSV-tk gene therapy with intravenous ganciclovir improves survival in human malignant glioma: a randomised, controlled study. Mol Ther. 2004;10: 967-972.[CrossRef][ISI][Medline]
Parr MJ, Manome Y, Tanaka T, et al. Tumor-selective transgene expression in vivo mediated by an E2F-responsive adenoviral vector. Nat Med. 1997;3: 1145-1149.[CrossRef][ISI][Medline]
Franklin RJM, Quick MM, Haase G. Adenoviral vectors for in vivo gene delivery to oligodendrocytes: transgene expression and cytopathic consequences. Gene Ther. 1999;6: 1360-1367.[CrossRef][ISI][Medline]
Krasnykh VN, Mikheeva GV, Douglas JT, Curiel DT. Generation of recombinant adenovirus vectors with modified fibers for altering viral tropism. J Virol. 1996;70: 6839-6846.
Krasnykh V, Dmitriev I, Mikheeva G, Miller CR, Belousova N, Curiel DT. Characterization of an adenovirus vector containing heterologous peptide epitope in the HI loop of the fiber knob. J Virol. 1998;72: 1844-1852.
Dmitriev I, Krasnykh V, Miller CR, et al. An adenovirus vector with genetically modified fibers demonstrates expanded tropism via utilization of a coxsackievirus and adenovirus receptor-independent cell entry mechanism. J Virol. 1998;72: 9706-9713.
Dirven CMF, Grill J, Lamfers MLM, et al. Gene therapy for meningioma: improved gene delivery with targeted adenoviruses. J Neurosurg. 2002;97: 441-449.[ISI][Medline]
Lamfers MLM, Grill J, Dirven CMF, et al. Potential of the conditionally replicative adenovirus Ad5-delta 24RGD in the treatment of malignant gliomas and its enhanced effect with radiotherapy. Cancer Res. 2002;62: 5736-5742.
Wu HJ, Seki T, Dmitriev I, et al. Double modification of adenovirus fiber with RGD and polylysine motifs improves coxsackievirus-adenovirus receptor-independent gene transfer efficiency. Hum Gene Ther. 2002;13: 1647-1653.[CrossRef][ISI][Medline]
Glasgow JN, Kremer EJ, Hemminki A, Siegal GP, Douglas JT, Curiel DT. An adenovirus vector with a chimeric fiber derived from canine adenovirus type 2 displays novel tropism. Virology. 2004;324: 103-116.[CrossRef][ISI][Medline]
Yoshida Y, Sadata A, Zhang WP, Saito K, Shinoura N, Hamada H. Generation of fiber-mutant recombinant adenoviruses for gene therapy of malignant glioma. Hum Gene Ther. 1998;9: 2503-2515.[CrossRef][ISI][Medline]
Shinoura N, Yoshida Y, Tsunoda R, et al. Highly augmented cytopathic effect of a fiber-mutant E1B-defective adenovirus for gene therapy of gliomas. Cancer Res. 1999;59: 3411-3416.
Grill J, Van Beusechem VW, Van de Valk P, et al. Combined targeting of adenoviruses to integrins and epidermal growth factor receptors increases gene transfer into primary glioma cells and spheroids. Clin Cancer Res. 2001;7: 641-650.
Alemany R, Gomez-Manzano C, et al. Gene therapy for gliomas: molecular targets, adenoviral vectors, and oncolytic adenoviruses. Exp Cell Res. 1999;252: 1-12.[CrossRef][ISI][Medline]
Wu H, Han T, Lam JT, et al. Preclinical evaluation of a class of infectivity-enhanced adenoviral vectors in ovarian cancer gene therapy. Gene Ther. 2004;11: 874-878.[CrossRef][ISI][Medline]
Koizumi N, Mizuguchi H, Utoguchi N, Watanabe Y, Hayakawa T. Generation of fiber-modified adenovirus vectors containing heterologous peptides in both the HI loop and C terminus of the fiber knob. J Gene Med. 2003;5: 267-276.[CrossRef][ISI][Medline]
Sauthoff H, Hu J, Maca C, et al. Intratumoral spread of wild-type adenovirus is limited after local injection of human xenograft tumors: virus persists and spreads systemically at late time points. Hum Gene Ther. 2003;14: 425-433.[CrossRef][ISI][Medline]
Jia W, Zhou Q. Viral vectors for cancer gene therapy: viral dissemination and tumor targeting. Curr Gene Ther. 2005;5: 133-142.[ISI][Medline]
Liu Q, Muruve DA. Molecular basis of the inflammatory response to adenovirus vectors. Gene Ther. 2003;10: 935-940.[CrossRef][ISI][Medline]
Nemunaitis J, Khuri F, Ganly I, et al. Phase II trial of intratumoral administration of ONYX-015, a replication-selective adenovirus, in patients with refractory head and neck cancer. J Clin Oncol. 2001;19: 289-298.
Haviv YS, Curiel DT. Conditional gene targeting for cancer gene therapy. Adv Drug Deliv Rev. 2001;53: 135-154.[CrossRef][ISI][Medline]
Thomas CE, Edwards P, Wickham TJ, Castro MG, Lowenstein PR. Adenovirus binding to the coxsackievirus and adenovirus receptor or integrins is not required to elicit brain inflammation but is necessary to transduce specific neural cell types. J Virol. 2002;76: 3452-3460.
Pulkkanen KJ, Yla-Herttuala S. Gene therapy for malignant glioma: current clinical status. Mol Ther. 2005;12: 585-598.[CrossRef][ISI][Medline]
Haviv YS, Blackwell JL, Kanerva A, et al. Adenoviral gene therapy for renal cancer requires retargeting to alternative cellular receptors. Cancer Res. 2002;62: 4273-4281.
Lam JT, Kanerva A, Bauerschmitz GJ, et al. Inter-patient variation in efficacy of five oncolytic adenovirus candidates for ovarian cancer therapy. J Gene Med. 2004;6: 1333-1342.[CrossRef][ISI][Medline]
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|