Oncolytic adenoviruses for the treatment of human cancer: focus on translational and clinical data.

Although results of cancer treatment have improved steadily, metastatic solid tumors can be cured only rarely and therefore new modalities are needed. Tumors often become apoptosis-resistant and capable of excluding drugs during therapy. Similar mechanisms of resistance apply to many treatment regimens, and cross-resistance between different chemotherapeutics often limits the treatment options. Therefore, loss of efficacy may occur simultaneously for different chemotherapeutics. One experimental strategy with an increasing amount of clinical evidence is oncolytic viruses, which replicate preferentially in tumor cells by taking advantage of cancer-specific cellular changes. Adenoviruses are the most widely clinically used oncolytic agents. Replication of oncolytic virus per se kills tumor cells, but oncolysis can also activate the immune system, which may play a role in tumor control. Viruses can be modified in a variety of ways to improve their selectivity and efficacy. The adenovirus genome can be easily engineered to incorporate different tumor targeting mechanisms and therapeutic transgenes for improved antitumor properties. Here we review the available preclinical and clinical data on use of oncolytic adenoviruses in humans.