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Reovirus in cancer therapy: an evidence-based review

Authors Clements D, Helson E, Gujar S, Lee P

Received 5 April 2014

Accepted for publication 29 April 2014

Published 9 July 2014 Volume 2014:3 Pages 69—82


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 6

Derek Clements,1,* Erin Helson,2,* Shashi A Gujar,2,3 Patrick WK Lee1,2
1Department of Pathology, 2Department of Microbiology and Immunology, Dalhousie University, 3Strategy and Organizational Performance, IWK Health Center, Halifax, Nova Scotia, Canada

*These authors contributed equally to this work, and are joint first authors

Abstract: Reovirus, a double-stranded ribonucleic acid virus and benign human pathogen, preferentially infects and kills cancer cells in its unmodified form, and is one of the leading oncolytic viruses currently undergoing clinical trials internationally. With 32 clinical trials completed or ongoing thus far, reovirus has demonstrated clinical therapeutic applicability against a multitude of cancers, including but not limited to breast cancer, prostate cancer, pancreatic cancer, malignant gliomas, advanced head and neck cancers, and metastatic ovarian cancers. Phase I trials have demonstrated that reovirus is safe to use via both intralesional/intratumoral and systemic routes of administration, with the most common adverse reactions being grade I/II toxicities, such as flu-like illness (fatigue, nausea, vomiting, headache, fever/chills, dizziness), diarrhea, and lymphopenia. In subsequent Phase II trials, reovirus administration was demonstrated to successfully decrease tumor size and promote tumor necrosis, thereby complementing compelling preclinical evidence of tumor destruction by the virus. Importantly, reovirus has been shown to be effective as a monotherapy, as well as in combination with other anticancer options, including radiation and chemotherapeutic agents, such as gemcitabine, docetaxel, paclitaxel, and carboplatin. Of note, the first Phase III clinical trial using reovirus in combination with paclitaxel and carboplatin for the treatment of head and neck cancers is under way. Based on the evidence from clinical trials, we comprehensively review the use of reovirus as an anticancer agent, acknowledge key obstacles, and suggest future directions to ultimately potentiate the efficacy of reovirus oncotherapy.

Keywords: virotherapy, reovirus, oncotherapy

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