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Blood, 1 December 2004, Vol. 104, No. 12, pp. 3543-3549.
Prepublished online as a Blood First Edition Paper on August 12, 2004; DOI 10.1182/blood-2004-03-0852.


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Submitted March 8, 2004
Accepted June 2, 2004

Tumor cells escape suicide gene therapy by genetic and epigenetic instability

Oliver Frank, Cornelia Rudolph, Christoph Heberlein, Nils von Neuhoff, Evelin Schroeck, Axel Schambach, Brigitte Schlegelberger, Boris Fehse, Wolfram Ostertag, Carol Stocking, and Christopher Baum*

Department of Cell and Virus Genetics, Heinrich Pette Institute, Hamburg, Germany
Institute for Cell and Molecular Pathology, Hannover Medical School, Hannover, Germany
Biotechnologie, Celltec GmbH, Hamburg, Germany
Institute of Clinical Genetics, Medical Faculty Carl Gustav Carus, Dresden, Germany
Department of Bone Marrow Transplantation, University Hospital Eppendorf, Hamburg, Germany
Division of Experimental Hematology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
Department of Hematology, Hemostaseology, Hemostaseology and Oncology, Hannover Medical School, Hannover, Germany

* Corresponding author; email: baum.christopher{at}mh-hannover.de.

Transfer and expression of suicide genes is one cornerstone of cancer gene therapy and is also considered as a proactive tool to enhance the safety of somatic transgenesis. Here we addressed whether retrovirus-mediated suicide gene therapy would result in a predictable anti-tumor efficiency, given that problems related to gene transfer are solved or that the suicide gene is used in a proactive approach. Using retroviral vectors encoding the thymidine kinase gene of herpes simplex virus, we transduced EL-4 lymphoma cells and induced experimental tumors in congeneic C57Bl/6 mice. Systemic administration of ganciclovir (GCV) resulted in remission of transduced clonal and polyclonal tumors in vivo. However, GCV-resistant relapses occurred and were found to be associated with postinsertional alterations of transgene structure or loss of the entire transgene. Complete loss of a retrovirally marked fusion chromosome was confirmed by spectral karyotyping. Transgene silencing occurred in another clone. We conclude that genetic as well as epigenetic instability related to biological features of the tumor, the insertion site and the vector represent relevant limitations of retroviral suicide gene therapy. Considering the mechanisms of escape identified here, the proactive use of suicide genes to prevent complications of insertional mutagenesis may still be efficient.


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