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Some viruses can be modified to attack cancer cells, whilst leaving healthy cells unharmed. However, it can be hard for the viruses to reach the tumours to attack, without the body’s immune system attacking the viruses. This project is looking at combining cancer-killing viruses with a technique that allows for to get them straight to the affected limb. This will give the virus the helping hand it needs to reach the tumour without being destroyed by body’s immune system.

Trans-TITAN: Translational analysis of samples from the TITAN (Tumoural Injection of T-VEC and Isolated Limb Perfusion) study

Isolated limb perfusion (ILP) is a surgical technique used to treat patients with limb sarcomas unsuitable for standard surgery. ILP delivers high-dose anti-cancer drugs to an affected limb whilst avoiding life-threatening side effects throughout the body. The cancer shrinks in 60% of patients following ILP, although the response can be short-lived.  Furthermore, ILP cannot prevent the cancer from spreading throughout the body (known as metastases).

Laboratory work has found that the addition of cancer-killing viruses to ILP improved how the long the treatment worked for. These viruses have been modified so they only attack cancer cells, leaving healthy cells unharmed. They can either directly destroy cancer cells they infect or stimulate the body’s immune system to recognise and attack cancer cells throughout the body. Therefore, combining viruses with ILP may both improve the length the treatment works for and promote the immune system to prevent or treat metastases elsewhere.

This project is a clinical study to determine if T-VEC, a virus that is being used in similar research, can be safely combined with ILP. This will be both the first time T-VEC has been given to sarcoma patients and combined with ILP. The study will also collect tissue samples to investigate whether this combination therapy provokes the immune system to recognise and attack cancer cells. This research will provide crucial insight into the potential role of cancer-killing viruses, not only in combination with ILP, but also as a treatment for metastatic sarcoma.



  • Presentation given at The Society of Surgical Oncology Congress. March 2019. Chicago, USA
  • Presentation given at the European Association for Cancer Research. June 2018. Amsterdam, Netherlands
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