Combining Vascular Normalization with an Oncolytic Virus Enhances Immunotherapy in Advanced Stage Ovarian Cancer

Purpose: Intravenous delivery of oncolytic viruses often leads to tumor vascular shutdown, resulting in decreased tumor perfusion and elevated tumor hypoxia. We hypothesized that using 3TSR to normalize tumor vasculature prior to administration of an oncolytic Newcastle disease virus (NDV) would enhance virus delivery and trafficking of immunological cell subsets to the tumor core, resulting in systemically enhanced immunotherapy and regression of advanced stage Epithelial Ovarian Cancer (EOC). Experimental Design: Using an orthotopic, syngeneic mouse model of advanced stage EOC, mice were pre-treated with 3TSR (4mg/kg per day) alone or followed by combination with fusogenic NDV(F3aa) (1.0x10 8PFU). Results: Treatment with 3TSR normalized tumor vasculature, enhanced blood perfusion of primary EOC tumors and induced disease regression. Animals treated with combination therapy had the greatest reduction in primary tumor mass, ascites accumulation and secondary lesions (50% of mice were completely devoid of peritoneal metastases). Combining 3TSR+NDV(F3aa) led to enhanced trafficking of immunological cells into the primary tumor core. Conclusions: We have shown, for the first time that NDV, like other oncolytic viruses, is a potent mediator of acute vascular shutdown and that preventing this through vascular normalization can promote regression in a preclinical model of advanced stage ovarian cancer. This challenges the current focus on induction of intravascular thrombosis as a requisite for successful oncolytic virotherapy.

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