Comparative safety and efficacy of oncolytic virotherapy for the treatment of individuals with malignancies: a systematic review, meta-analysis, and Bayesian network meta-analysisResearch in context
Summary: Background: Oncolytic virotherapy (OV) is an innovative immunotherapy strategy. A comprehensive understanding of oncolytic viruses is essential for advancing research and clinical practice. This analysis aims to evaluate the clinical outcomes of oncolytic virotherapy in cancer patients. Me...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-08-01
|
| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537025002949 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849717959376764928 |
|---|---|
| author | Poyee Lau Long Liang Xiang Chen Jianglin Zhang Hong Liu |
| author_facet | Poyee Lau Long Liang Xiang Chen Jianglin Zhang Hong Liu |
| author_sort | Poyee Lau |
| collection | DOAJ |
| description | Summary: Background: Oncolytic virotherapy (OV) is an innovative immunotherapy strategy. A comprehensive understanding of oncolytic viruses is essential for advancing research and clinical practice. This analysis aims to evaluate the clinical outcomes of oncolytic virotherapy in cancer patients. Methods: We performed single-arm, pairwise, and Bayesian network meta-analyses, incorporating clinical trials identified through PubMed, Medline, Embase, and the Cochrane Library from database inception to April 30, 2025. Primary endpoints included all-grade and grade ≥3 adverse events (AEs), objective response rate (ORR), and disease control rate (DCR). Effect size measures included risk ratios (RRs) or odds ratios (ORs) with 95% confidence intervals (CIs) or credible intervals (CrIs). Subgroup analyses were conducted to assess outcomes, and meta-regression was applied to evaluate the influence of prognostic variables. This study is registered with PROSPERO, number CRD42022306458. Findings: Of 1976 studies screened, 186 clinical trials with 6979 participants met the inclusion criteria. The most common adverse events associated with oncolytic virotherapy were fatigue (1.98%, 1.71–2.28), pyrexia (2.16%, 1.69–2.69), fever (3.32%, 2.64–4.07), and chills (1.65%, 1.39–1.82), with neutropenia (1.07%, 0.67–1.55) and lymphocytopenia (0.71%, 0.51–0.94) being the predominant severe adverse events. While oncolytic virus monotherapy (OV vs immunotherapy, DCR 2.45, 95% CI 1.60–3.76) and combination regimens (OV plus chemotherapy vs OV, DCR 8.53, 95% CI, 1.97–37.03) enhanced therapeutic efficacy, they presented higher toxicity risks compared to conventional treatments (OV vs immunotherapy, all-grade AE 2.07, 95% CI 1.75–2.44). Notably, combination therapies involving chemotherapy (OV plus chemotherapy vs chemotherapy, all-grade AE 1.10, 95% CI 1.02–1.18) or radiotherapy (OV plus radiotherapy vs radiotherapy, all-grade AE 1.53, 95% CI 1.27–1.84) significantly increase adverse event risks. Conversely, oncolytic virotherapy combined with immunotherapy showed a more favorable safety profile (OV plus immunotherapy vs OV plus chemotherapy, severe AE 0.32, 95% CrI 0.15–0.66) and clinical benefits (OV plus immunotherapy vs OV plus chemotherapy, DCR 0.08, 95% CrI 0.02–0.33). Efficacy varied significantly across treatment strategies (adjusted p = 0.040), virus classifications (adjusted p = 0.0027), administration routes (adjusted p = 0.0080), and patient age groups (adjusted p = 0.00080). Interpretation: This analysis provides robust evidence on the tolerability and efficacy of oncolytic virotherapy in cancer treatment. Oncolytic virotherapy demonstrates significant potential as both monotherapy and in combination regimens, offering a favorable balance of efficacy and safety. Virotherapy paired with immunotherapy exhibits a more favorable safety profile, particularly in regimens involving Reoviridae- or Poxviridae-based strategies. The therapeutic efficacy of oncolytic virotherapy varies notably by multiple factors. Funding: None. |
| format | Article |
| id | doaj-art-c0a6f7681000408b95cf58889bdcbdf5 |
| institution | DOAJ |
| issn | 2589-5370 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj-art-c0a6f7681000408b95cf58889bdcbdf52025-08-20T03:12:31ZengElsevierEClinicalMedicine2589-53702025-08-018610336210.1016/j.eclinm.2025.103362Comparative safety and efficacy of oncolytic virotherapy for the treatment of individuals with malignancies: a systematic review, meta-analysis, and Bayesian network meta-analysisResearch in contextPoyee Lau0Long Liang1Xiang Chen2Jianglin Zhang3Hong Liu4The First Affiliated Hospital (Shenzhen People's Hospital), Southern University of Science and Technology, Shenzhen, 518055, ChinaDepartment of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, China; Medical Genetics & School of Life Sciences, Central South University, Changsha, 410078, ChinaDepartment of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Clinical Research Center for Cancer Immunotherapy, Furong Laboratory, Central South University, Changsha, 410008, ChinaThe First Affiliated Hospital (Shenzhen People's Hospital), Southern University of Science and Technology, Shenzhen, 518055, China; Corresponding author.Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Clinical Research Center for Cancer Immunotherapy, Furong Laboratory, Central South University, Changsha, 410008, China; Corresponding author. Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, China.Summary: Background: Oncolytic virotherapy (OV) is an innovative immunotherapy strategy. A comprehensive understanding of oncolytic viruses is essential for advancing research and clinical practice. This analysis aims to evaluate the clinical outcomes of oncolytic virotherapy in cancer patients. Methods: We performed single-arm, pairwise, and Bayesian network meta-analyses, incorporating clinical trials identified through PubMed, Medline, Embase, and the Cochrane Library from database inception to April 30, 2025. Primary endpoints included all-grade and grade ≥3 adverse events (AEs), objective response rate (ORR), and disease control rate (DCR). Effect size measures included risk ratios (RRs) or odds ratios (ORs) with 95% confidence intervals (CIs) or credible intervals (CrIs). Subgroup analyses were conducted to assess outcomes, and meta-regression was applied to evaluate the influence of prognostic variables. This study is registered with PROSPERO, number CRD42022306458. Findings: Of 1976 studies screened, 186 clinical trials with 6979 participants met the inclusion criteria. The most common adverse events associated with oncolytic virotherapy were fatigue (1.98%, 1.71–2.28), pyrexia (2.16%, 1.69–2.69), fever (3.32%, 2.64–4.07), and chills (1.65%, 1.39–1.82), with neutropenia (1.07%, 0.67–1.55) and lymphocytopenia (0.71%, 0.51–0.94) being the predominant severe adverse events. While oncolytic virus monotherapy (OV vs immunotherapy, DCR 2.45, 95% CI 1.60–3.76) and combination regimens (OV plus chemotherapy vs OV, DCR 8.53, 95% CI, 1.97–37.03) enhanced therapeutic efficacy, they presented higher toxicity risks compared to conventional treatments (OV vs immunotherapy, all-grade AE 2.07, 95% CI 1.75–2.44). Notably, combination therapies involving chemotherapy (OV plus chemotherapy vs chemotherapy, all-grade AE 1.10, 95% CI 1.02–1.18) or radiotherapy (OV plus radiotherapy vs radiotherapy, all-grade AE 1.53, 95% CI 1.27–1.84) significantly increase adverse event risks. Conversely, oncolytic virotherapy combined with immunotherapy showed a more favorable safety profile (OV plus immunotherapy vs OV plus chemotherapy, severe AE 0.32, 95% CrI 0.15–0.66) and clinical benefits (OV plus immunotherapy vs OV plus chemotherapy, DCR 0.08, 95% CrI 0.02–0.33). Efficacy varied significantly across treatment strategies (adjusted p = 0.040), virus classifications (adjusted p = 0.0027), administration routes (adjusted p = 0.0080), and patient age groups (adjusted p = 0.00080). Interpretation: This analysis provides robust evidence on the tolerability and efficacy of oncolytic virotherapy in cancer treatment. Oncolytic virotherapy demonstrates significant potential as both monotherapy and in combination regimens, offering a favorable balance of efficacy and safety. Virotherapy paired with immunotherapy exhibits a more favorable safety profile, particularly in regimens involving Reoviridae- or Poxviridae-based strategies. The therapeutic efficacy of oncolytic virotherapy varies notably by multiple factors. Funding: None.http://www.sciencedirect.com/science/article/pii/S2589537025002949Oncolytic virotherapyOncolytic virusVirotherapyCancerMeta-analysis |
| spellingShingle | Poyee Lau Long Liang Xiang Chen Jianglin Zhang Hong Liu Comparative safety and efficacy of oncolytic virotherapy for the treatment of individuals with malignancies: a systematic review, meta-analysis, and Bayesian network meta-analysisResearch in context EClinicalMedicine Oncolytic virotherapy Oncolytic virus Virotherapy Cancer Meta-analysis |
| title | Comparative safety and efficacy of oncolytic virotherapy for the treatment of individuals with malignancies: a systematic review, meta-analysis, and Bayesian network meta-analysisResearch in context |
| title_full | Comparative safety and efficacy of oncolytic virotherapy for the treatment of individuals with malignancies: a systematic review, meta-analysis, and Bayesian network meta-analysisResearch in context |
| title_fullStr | Comparative safety and efficacy of oncolytic virotherapy for the treatment of individuals with malignancies: a systematic review, meta-analysis, and Bayesian network meta-analysisResearch in context |
| title_full_unstemmed | Comparative safety and efficacy of oncolytic virotherapy for the treatment of individuals with malignancies: a systematic review, meta-analysis, and Bayesian network meta-analysisResearch in context |
| title_short | Comparative safety and efficacy of oncolytic virotherapy for the treatment of individuals with malignancies: a systematic review, meta-analysis, and Bayesian network meta-analysisResearch in context |
| title_sort | comparative safety and efficacy of oncolytic virotherapy for the treatment of individuals with malignancies a systematic review meta analysis and bayesian network meta analysisresearch in context |
| topic | Oncolytic virotherapy Oncolytic virus Virotherapy Cancer Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2589537025002949 |
| work_keys_str_mv | AT poyeelau comparativesafetyandefficacyofoncolyticvirotherapyforthetreatmentofindividualswithmalignanciesasystematicreviewmetaanalysisandbayesiannetworkmetaanalysisresearchincontext AT longliang comparativesafetyandefficacyofoncolyticvirotherapyforthetreatmentofindividualswithmalignanciesasystematicreviewmetaanalysisandbayesiannetworkmetaanalysisresearchincontext AT xiangchen comparativesafetyandefficacyofoncolyticvirotherapyforthetreatmentofindividualswithmalignanciesasystematicreviewmetaanalysisandbayesiannetworkmetaanalysisresearchincontext AT jianglinzhang comparativesafetyandefficacyofoncolyticvirotherapyforthetreatmentofindividualswithmalignanciesasystematicreviewmetaanalysisandbayesiannetworkmetaanalysisresearchincontext AT hongliu comparativesafetyandefficacyofoncolyticvirotherapyforthetreatmentofindividualswithmalignanciesasystematicreviewmetaanalysisandbayesiannetworkmetaanalysisresearchincontext |