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Table 1

A comparison of three oncolytic viruses: strength and pitfalls

VirusVVHerpes simplex virus (HSV)Coxsackievirus A21, B3 (CVA21 and CVB3)
GenomedsDNA (~ 180-Kb, 200 genes)dsDNA (~ 152-kb, 80 genes)(+) ssRNA (~ 7.4-Kb, one polyprotein)
Capacity of inserted DNA25–40 Kb30–40 Kb300 bases for stable recombinant
Tumor selectivity (once inside the cells)Pexa-Vec: selectively replicates in and destroys cancer cells driven by genetic pathways commonly activated in cancers.T-VEC: two mutations make up cancer selectivity with activated Ras and high endogenous ribonucleotide reductaseAberrant signaling pathways within tumor cells
On cell surface: CVA21: ICAM-1 dependent. CVB3: CAR dependent
Life cycleCytoplasm (no risk of integration)Nucleus (more risk of integration)Cytoplasm
Mechanisms of cell deathApoptosis and necroptosis (ICD)aApoptosis, necrosis, and pyroptosis (ICD)Immunogenic apoptosis, autophagy (ICD)
ImmunogenicityHighHighHigh
Transgene expressionHighHighHigh
Clinical trial stagePhase III for liver cancerT-VEC approved for melanomaPhase II study in advanced melanoma (CVA21)

aICD immunogenic cell death

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