EXTH-51. HSV-PTENΑ TREATMENT TARGETS GLIOMA STEM CELLS TO REDUCE STEMNESS AND SENSITIZES GLIOBLASTOMA TO IRRADIATION

Glioblastoma is one of the most lethal and treatment-resistant tumors of the central nervous system. Despite maximal surgical and medical therapy, survival remains dismal with a median of 21 months. Despite advances in treatment, this has only led to modest survival benefit. A significant challenge in treatment of glioblastoma is targeting glioma stem cells (GSCs) which are a source of therapy resistance. Oncolytic viral (OV) therapy is a promising therapy for solid tumors that preferentially targets tumor cells for lysis and an anti-tumor immune response while sparing normal cells. Among all OVs, oncolytic Herpes Simplex Virus (oHSV) is substantially ahead in the clinic, with an oHSV T-VEC approved by the FDA for metastatic melanoma treatment and G47∆ which received conditional approval for the treatment of GBM in Japan. In prior work, our group has demonstrated that PTENα expression by an oHSV (HSV-P10) results in improved long-term survivors in intracranial tumor-bearing mice compared to HSVQ treatment. We aim to elucidate the mechanism of improved therapeutic efficacy of HSV-P10 against GBM and evaluate if HSV-P10 may overcome radio-resistance. RNA sequencing and GSEA analysis of primary human GBM cells infected with control HSVQ or HSV-P10 reveals that while HSVQ virus infection leads to an increase in genes regulating IL6-STAT3 pathway, pivotal in maintaining stemness properties, HSV-P10 infection leads to a reduction. HSV-P10 reduces CD133+/CD44+ stem cells, induces DNA damage and sensitizes the GBM cells to irradiation. Our findings reveal a novel mechanism induced by HSV-P10 in combination with irradiation where HSV-P10 modulates IL6-STAT3 signaling downregulating genes associated with stemness (Nestin, Sox2). HSV-P10 infection in combination with irradiation reduces GSC tumor sphere formation in vitro and sensitizes GBMs to radiotherapy in an intracranial mouse xenograft model. Our findings uncover a possible mechanism to overcome GSC-mediated therapy resistance to improve the therapeutic efficacy for GBM.