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Adeno-Associated Virus Vector-Mediated Systemic Delivery of IFN-ß Combined with Low-Dose Cyclophosphamide Affects Tumor Regression in Murine Neuroblastoma Models

Author's Affiliations: ¹ Departments of Surgery and ² Division of Experimental Hematology, St. Jude Children's Research Hospital; ³ Department of Surgery, University of Tennessee College of Medicine, Memphis, Tennessee; and ⁴ Department of Hematology/Oncology, University College London, London, United Kingdom

Requests for reprints: Andrew Davidoff, Department of Surgery, St. Jude Children's Research Hospital, 332 North Lauderdale, Memphis, TN. Phone: 901-495-4060; Fax: 901-495-2176; E-mail: andrew.davidoff{at}stjude.org.

Purpose: Type I IFNs (IFN-/ß) have shown significant antitumor activity in preclinical models but limited efficacy and significant toxicity in clinical trials. We hypothesized that the antitumor activity of type I IFNs could be enhanced by chronic, low-dose systemic delivery and sought to test this in murine neuroblastoma models.

Experimental Design: Continuous liver-generated expression of human IFN-ß (hINF-ß) was achieved through a gene therapy–mediated approach using adeno-associated virus vectors encoding hIFN-ß (AAV hINF-ß). Orthotopic localized retroperitoneal and disseminated models of neuroblastoma were established using three different xenografts. Immunohistochemical analysis and ELISA were used to evaluate the antiangiogenic effect of therapy.

Results: The development of both localized orthotopic (retroperitoneal) and disseminated neuroblastoma was prevented in all mice expressing hINF-ß. Continued growth of established retroperitoneal tumors, treated with AAV hINF-ß as monotherapy, was significantly restricted, and survival for mice with established, disseminated disease was significantly prolonged following administration of AAV hINF-ß. Analysis of treated tumors revealed a significant antiangiogenic effect. Mean intratumoral vessel density was diminished and expression of the angiogenic factors vascular endothelial growth factor and basic fibroblast growth factor were both decreased. Finally, combination therapy in which AAV hIFN-ß was used together with low-dose cyclophosphamide resulted in regression of both established retroperitoneal and disseminated disease.

Conclusions: AAV-mediated delivery of hIFN-ß when used as monotherapy was able to restrict neuroblastoma growth due in part to inhibition of angiogenesis. When used in combination with conventional chemotherapy, AAV hIFN-ß was able to effect complete tumor regression.

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