The destructive nature of viruses is now being applied to kill cancer cells. A new immuno-oncoloytic virus called pelareorep (Reolysin) is now being tested in a clinical trial in addition to three other drugs for relapsed multiple myeloma. 

The harmless virus has been modified to infect and destroy cancer cells, but not normal cells. It can also release virus particles that can infect close by tumor cells and encourage immune cells to gather to the site. 

This approach is a targeted therapy used in conjunction with standard chemotherapies for both blood and solid tumor cancers. In this case, it is being used with carfilzomib (a proteasome inhibitor), nivolumab (a checkpoint inhibitor), and dexamethasone (a steroid). 

You may have heard that checkpoint inhibitor clinical trials were stopped last year after combinations with immunomodulator drugs like lenalidomide were pulled. The combination of those two classes of drugs were not beneficial and potentially dangerous together. The combination of therapies in this study does not include an immunomodulator. 

The Phase I study goals are to establish a maximum tolerated dose of Reolysin. Researchers will also be looking for time to disease progression, overall survival and levels of inflammation in the bone marrow. 

The study is being performed at Emory University and is open to 62 patients. Craig Hofmeister, MD is the primary investigator for the study said: 

“My hope is this study leads not only to an effective combination dosing schedule but provides quantitative data describing the expression of PD-1, along with correlative studies that reveal the roles of both immune-mediated and direct cytotoxic myeloma cell killing,”

Reolysin is also being tested with another checkpoint inhibitor called pembrolizumab in multiple myeloma and with another checkpoint inhibitor in breast cancer. Reolysin has been granted fast track status for metastatic breast cancer in May of 2017. 

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