Abstract PO089: Comparison of Two oHSV Vectors for the Treatment of Glioblastoma

Abstract
Glioblastoma multiforme (GBM) is the most common human brain cancer. Despite a well-established standard of care, the 5-year mortality rate of GBM patients is 95%, highlighting the need for innovative therapeutic interventions. A variety of oncolytic viruses, including those derived from herpes simplex virus (oHSV), have been designed for GBM therapy, but early-phase clinical trials have reported few complete responses without evidence of durable anti-tumor immunity. Potential reasons for the lack of efficacy are limited vector potency (i.e., virulence) and the presence of a highly immunosuppressive tumor microenvironment (TME) comprised of few activated lymphocytes, large numbers of immunosuppressive myeloid cells (macrophages, myeloid derived suppressor cells [MDSCs], microglia), and an agglomerate of immunosuppressive cytokines (IL-10, VEGF, MIF, etc.). Herein we explore these obstacles by comparing the anti-tumor activity of two different oHSV designs and by arming oHSV with an immunomodulatory payload designed to encourage the development of anti-tumor immunity. We first compared the activities of an HSV-1 KOS strain derivative designated KG4:T124 or colloquially, 2A5B, and an F strain derivative designated rQNestin34.5v.1 (a similar oHSV, rQNestin34.5v.2, is currently in a phase I clinical trial for GBM). We evaluated viral entry, replication capacity, and cytotoxicity using both murine and human glioma cell lines in vitro. Viral entry was relatively similar between both vectors, but rQNestin34.5v.1 replicated more effectively and generally induced greater viral mediated cytotoxicity. In syngeneic mice, rQNestin34.5v.1 reduced orthotopic GL261N4 tumor burden compared to 2A5B, but neither virus impeded disease progression in the more pernicious CT2A model. Evaluation of either the GL261N4 or CT2A TME revealed that both viruses induced a high influx of tumor associated macrophages, a transient polymorphonuclear (PMN) cell population, but did not alter the frequency of monocytic MDSCs. As a strategy to enhance oHSV efficacy, we sought to differentiate the highly immunosuppressive MDSC population into pro-inflammatory macrophages using oHSV armed with IL-12, a cytokine that has been shown to provide this activity. We show that oHSV:IL-12 induced a significant increase in tumor-associated macrophages and increased the survival of animals bearing either tumor type. Although we observed a low percentage of complete responses with the presence of anti-tumor CTLs demonstrated by tumor rechallenge experiments, IL-12 alone was not sufficient to significantly improve overall long-term animal survival, suggesting that additional arming genes should be considered in combination with IL-12. Citation Format: Joseph W. Jackson, Bonnie L. Hall, Lisa Bailey, Christophe Quéva, E. Antonio Chiocca, Justus B. Cohen, Joseph C. Glorioso. Comparison of Two oHSV Vectors for the Treatment of Glioblastoma [abstract]. In: Abstracts: AACR Virtual Special Conference: Tumor Immunology and Immunotherapy; 2020 Oct 19-20. Philadelphia (PA): AACR; Cancer Immunol Res 2021;9(2 Suppl):Abstract nr PO089.