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Cancer-killing viruses can be used to treat limb sarcomas if delivered using a special technique which allows the treatment to be given straight to the affected area. However, although this treatment can prevent a tumour from growing, it cannot prevent it from spreading through the body. This project is looking at ways to combine this technique with drugs which activate the body’s immune system, with the aim of developing a treatment that can prevent both growth and spread of these soft tissue sarcomas.

Combination immunotherapy with immune checkpoint inhibition and oncolytic vaccinia virus delivered by isolated limb perfusion (ILP) to target metastases in extremity soft tissue sarcoma

Soft tissue sarcomas are rare cancers commonly affecting the limbs. In most patients, treatment involves surgical removal of the cancer. Isolated limb perfusion (ILP) is a surgical technique that may be used when patients have a large tumours or had previous surgery. ILP delivers high-dose anti-cancer drugs to an affected limb whilst avoiding life-threatening side effects throughout the body. Research has found that adding cancer-killing viruses to ILP (OV-ILP) improved how long the treatment kept the tumour from growing, neither ILP or OV-ILP treatment prevent tumour spread.  

The immune system plays a major role in the development of cancer, with many tumours able to switch off the immune system from attacking tumour cells.

This project looks at whether standard ILP and OV-ILP alters the number and type of immune cells within a tumour. It will also look at whether combining OV-ILP with other drugs that activate the immune system is an effective strategy to treat or prevent tumour spread in patients with extremity soft tissue sarcoma.



  • Smith, H. G. et al. Vaccinia virus delivered by isolated limb perfusion augments the efficacy of PD-1 blockade in an animal model of extremity soft-tissue sarcoma. Poster presented at the Summit for Cancer Immunotherapy. June, 2017. Ottawa, Canada
  • Poster presented at the European Association of Cancer Research Congress. June, 2018. Amsterdam, Netherlands

Presentations & Workshops

  • Smith, H. G. et al. Viral ILP augments the efficacy of PD-1 blockade in an animal model of extremity soft-tissue sarcoma. Presentation given at the National Cancer Research Institute (NCRI) and British Association of Surgical Oncology (BASO) Congress conference. November, 2017. Liverpool, UK
  • Smith, H. G. et al. Combining oncolytic virotherapy with isolated limb perfusion for advanced extremity sarcomas – from animal model to clinical trial. Presentation given at the Scandinavian Sarcoma Group Congress. September, 2017. Aarhus, Denmark.
  • Smith, H. G. et al. Viral ILP combines with PD-1 Blockade to Improve Local and Distant Disease Control in Extremity Soft Tissue Sarcoma (ESTS). Presentation given at the Society of Surgical Oncology Congress. March, 2018. Chicago, USA.
  • Smith, H. G. et al. Vaccinia virus delivered by isolated limb perfusion combines with PD1 blockade to prevent local and distant relapse in soft-tissue sarcoma. Presentation given at the International Oncolytic Virotherapy Congress. April, 2018. Oxford, UK.
  • Presentation given for the Medical Research Council funded Precision Medicine Doctoral Training Programme by Jiwon Park. 2018.


  • Henry Smith was awarded the 2017 BASO Trainees Oral Prize for his presentation.
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