Oncolytic Viruses in Fallopian Tube Cancer Treatment
Fallopian tube cancer is a rare gynecological malignant tumor that occurs in the fallopian tube that connects the ovary and uterus. Its incidence only accounts for 1% to 2% of all gynecological cancers. In the United States, approximately 300 to 400 women are diagnosed with this disease each year. The mortality rate of fallopian tube cancer is very high.
The origin of fallopian tube cancer is generally due to the spread or metastasis of tumors in other parts (such as ovaries or endometrium), and some of them belong to primary fallopian tube cancer. Because this cancer is very rare, little is known about its cause. However, researchers are studying whether genetic factors play a role. There is evidence that women who have inherited the BRCA1 gene associated with breast and ovarian cancer have an increased risk of fallopian tube cancer, and a family history of the fallopian tube or ovarian cancer may also increase the risk of fallopian tube cancer.
Fig.1 Female reproductive system.
Diagnosis and Treatment of Fallopian Tube Cancer
The most common symptoms of fallopian tube cancer are abnormal vaginal bleeding, leucorrhea and/or abdominal pain. If the discharge cannot be resolved, it may indicate the presence of cancer. The pelvic pain associated with fallopian tube cancer occurs because the entrapped fluid blocks and enlarges the fallopian tubes. Pain is often called colic or dull pain. Since it is difficult to see abnormalities inside the fallopian tube, fallopian tube cancer is generally difficult to diagnose. One of the most important steps in evaluating patients with gynecological diseases is to perform a correct pelvic examination, but usually an ultrasound imaging system should be added for the diagnosis of fallopian tube cancer.
In order to help to treat diseases and provide some guidance information for prognosis and convalescence, the International Federation of Obstetricians and Gynecologists use the FIGO system to stage fallopian tube cancer and describe the size and local invasiveness of the tumor (T) - if there is a lymph node, the lymph node (N) is involved, if it has spread to other areas of the body (M). Then interpret it as a stage from I (indicating a more limited disease) to IV (indicating a more advanced disease). Generally, the higher the stage, the more severe cancer.
Oncolytic Virus Treatment of Fallopian Tube Cancer
The emerging oncolytic virus therapy represents a unique strategy with broad prospects in cancer treatment. Oncolytic virus therapy is defined as the use of a class of non-pathogenic or low-pathogenic viruses that can replicate in cancer cells and eliminate in situ. The OVs therapeutic agents currently under development are mostly derived from naturally-occurring viruses, and generally have little natural pathogenicity in humans, and can be given greater targeting and anti-cancer efficacy through genetic engineering. At present, the most commonly used in gynecological cancer is the adenovirus vector, which has been genetically modified into various recombinant conditions to replicate adenovirus (CRAd) for the treatment of cancer. The main objective of the current early anti-fallopian tube clinical trials is to test the safety of the virus. All participating patients received OV administration via IP catheter. All these clinical studies showed that OVs were well tolerated, the maximum tolerated dose was not reached in any trial, and encouraging anti-tumor responses were observed in all trials.