Oncolytic Viral Therapy May be Safe and Effective for Patients with Pancreatic Cancer

Oncolytic viral therapy (OVT) demonstrated favorable safety and efficacy results, in addition to standard of care treatment, demonstrating that the therapy may be a promising, innovative approach that can potentially alter the current course of pancreatic treatment and therapy.

The study results were presented at a student poster session during the ASHP (American Society of Health-System Pharmacists) 54th Clinical Meeting & Exhibition in Las Vegas, Nevada.

Pancreatic cancer is the third leading cause of cancer deaths in the United States and is expected to consume another 45,750 lives in the United States in 2019, according to the study. However, surgery and chemotherapy remain the mainstay of treatment and although successful, have a fairly modest impact on survival since most cases are diagnosed during advanced stages of the disease.

The goal of the literature review was to investigate the utility of OVT in the treatment of patients with advanced pancreatic cancer. The review was conducted on PubMed, Medline, and ClinicalTrials.gov to date of September 30, 2019. The literature review included key terms such as: oncolytic virus, pancreatic cancer, clinical trial, review, 5 years, pancreatic neoplasms.

The review included 6 clinical trials:

Hirooka Y et al. HF10 (HSV-1)

This trial was a single arm, open-label, phase I trial, including 9 patients in 3 cohorts. It found that all adverse events were judged as unrelated to the OVT received and an overall effective response, defined as the patients who achieved partial response and stable disease, was 78%.

Nakao A et. al HF10 (HSV-1)

The researchers found no adverse events in OVT through this phase I, dose escalation study that included 6 patients. In addition, 4 patients survived more than 180 days after receiving the HF10 injection, which is longer than the average survival time of patients who received standard of care, ordinary bypass operation.

Mulvihill S et. al ONYX-015 (Adenovirus)

No systemic toxicities and local complications were noted in this phase I, dose escalation study of ONYX-015, but flu-like symptoms (fever and myalgias) were reported by 91% of the included 23 patients. However, 35-45% tumor shrinkage was noted in 6 patients.

Hechet JR et al. ONYX-015 (Adenovirus)

This open label, phase I/II trial included 21 patients examined OXYX-015 plus gemcitabine and found that mild, transient flu-like symptoms such as low-grade fever and chills, were the most common noted toxicities. Furthermore, there was a 6 month survival in 67% of the participants with a median survival time of 7.5 months.

Mahalingam D et al. of Pelareorep: Reolysin

The treatment of pelareorep plus gemcitabine was well tolerated with toxicities that were either self-limiting or manageable with symptomatic therapy in this single arm, open-label, nonrandomized, phase II trial that included 34 patients. Clinical benefit at 12 weeks, defined as partial response and stable disease, was achieved by 17 patients.

Mahalingam D et al. of Reolysin plus Gemcitabine

This case report included a 54-year-old patient with pancreatic adenocarcinoma who was given an intervention of reolysin plus gemcitabine. The patient did not achieve tumor shrinkage but did achieve symptomatic improvement in cancer-related pain and a prolonged stable disease of more than 2 years.

OVT is currently not recognized by treatment guidelines for advanced pancreatic cancer. However, safety and efficacy data from previous studies conducted over the previous 10 years have shown that OVT may be a promising, innovative approach for pancreatic cancer therapy and management.

The study authors note that additional research is still needed to determine the ideal dose and place in therapy to optimize OVT in this challenging disease state.

REFERENCE

Patel Y, Toscani M, Baron J. Use of Oncolytic Viral Therapy in Advanced Pancreatic Cancer. Poster presented at: ASHP (American Society of Health-System Pharmacists) 54th Clinical Meeting & Exhibition; Las Vegas, Nevada: December 9, 2019.