Efficacy of Oncolytic Viral Therapy in Pediatric Brain Tumors: A Systematic Review of Clinical Trials
Thirumalaivasan Dhasakeerthi1, Praveen Nandha Kumar Pitchan Velammal2, Mansi Agrawal3, Divya Nayar1, Keerthana Veluswami4, Hari Vorappan Manickavelan4
1UAMS, Little Rock, 2Tirunelveli Medical College, India, 3MGM Medical college, India, 4Stanley Medical College, India
Objective:

To assess the efficacy of Oncolytic Virotherapy on Pediatric Brain tumors

Background:
Oncolytic virotherapy has shown effectiveness in treating various cancers, including melanoma, hepatocellular carcinoma, pancreatic cancer, and glioblastoma multiforme. This study aims to evaluate the efficacy of oncolytic virotherapy in pediatric brain tumors.
Design/Methods:

Guided by the PRISMA guidelines, we conducted a systematic review of clinical trials up to December 2023. The terms “clinical trial,” “oncolytic viruses,” “glioma,” “glioblastoma,” “pediatric brain tumors,” “oncolytic virotherapy” were searched amid language restriction to English.

Results:

Three clinical trials of oncolytic viral therapy (OVT) of malignant gliomas were included to this analysis with overall 32 pediatric patients (12.5 years of median age). The virus agents used in studied were HSV G-207, DNX-2401, and ADV-tk. The cohort consisted of 16 cases of glioblastoma, 12 of diffuse intrinsic pontine glioma (DIPG), two of anaplastic astrocytoma, one recurrent ependymoma and one high-grade glioma. The overall survival (OS) ranged between 4.6 and 47.7 months. The progression-free survival (PFS) ranged from 1.7 months to 47.7 months. The most common mutation was unmethylated MGMT, in which the median OS and PFS of these patients was 12.6 months and 4.6 months respectively. Common adverse events regarding OVT that have been noted are fever, headache and nausea. The majority of patients underwent additional treatments, including radiotherapy, surgery and chemotherapy, with temozolomide and lomustine being the most frequently used chemotherapeutic agents. Serological testing showed conversion in most cases, particularly in those with DIPG.

 
Conclusions:
Early-phase trials suggest that oncolytic virotherapy is generally well-tolerated and shows potential efficacy especially if it used as an adjuvant therapy along with chemotherapy, radiotherapy or surgery. However, larger and more advanced clinical trials are required to determine survival rates, adverse effects and make definitive comparisons with conventional therapeutic approach. 
10.1212/WNL.0000000000212357
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.