Table 2.

Clinical trials featuring oncolytic viruses against pancreatic cancer.

Oncolytic Virus Backbone	Oncolytic Virus Name	Brief Description of the Clinical Trial
Adenovirus	ONYX-015 (dl1520)	ONYX-015 injection via EUS into pancreatic carcinomas by the transgastric route with prophylactic antibiotics is feasible and generally well tolerated either alone or in combination with gemcitabine [167].
	ONYX-015 (dl1520)	Intratumoral injection of an E1B-55 kDa region-deleted adenovirus into primary pancreatic tumors was feasible and well-tolerated at doses up to 10(11) PFU (2 x 10(12) particles), but viral replication was not detectable [168].
	Ad5-yCD/mutTKSR39rep-ADP	A combination of intratumoral Ad5-DS and gemcitabine is safe and well tolerated in patients with LAPC [169].
	Ad5-yCD/mutTKSR39rep-hIL12	Ongoing clinical trial, no results posted to date. NCT03281382.
	LOAd703	Ongoing clinical trial, no results posted to date. NCT02705196.
	VCN-01	Ongoing clinical trial, no results posted to date. NCT02045589.
	VCN-01	Ongoing clinical trial, no results posted to date. NCT02045602.
Herpesvirus	T-VEC	EUS-guided FNI of T-VEC in advanced pancreatic ca, at initial doses of 104 to 106 PFU/mL followed by up to 107 PFU/mL, was feasible and tolerable. Evidence of biologic activity was observed [170].
	T-VEC	Ongoing clinical trial, no results posted to date. NCT03086642.
	HF10	HF10 direct injection under EUS-guidance in combination with erlotinib and gemcitabine was a safe treatment for locally advanced pancreatic cancer [171].
	HF10	Ongoing clinical trial, no results posted to date. NCT03252808.
	OrienX010	Ongoing clinical trial, no results posted to date. NCT01935453.
Reovirus	Reolysin	Pelareorep was safe but ineffective when administered with carboplatin/paclitaxel, regardless of KRAS mutational status. Immunologic studies suggest that chemotherapy backbone improves immune reconstitution and that targeting remaining immunosuppressive mediators may improve oncolytic virotherapy [172].
	Reolysin	PD analysis revealed reovirus replication within pancreatic tumor and associated apoptosis. Upregulation of immune checkpoint marker PD-L1 suggests future consideration of combining oncolytic virus therapy with anti-PD-L1 inhibitors [173].
	Reolysin	Pelareorep and pembrolizumab added to chemotherapy did not add significant toxicity and showed encouraging efficacy [174].
	Reolysin	Ongoing clinical trial, no results posted to date. NCT01280058.
Parvovirus	ParvOryx	The drug was safe and well-tolerated and showed a promising profile of anti-tumor effects and signs of clinical efficacy, i.e., prolonged survival. However, the optimum dose as well as the most appropriate route and schedule of administration have to be further investigated [175].

PFU = plaque-forming unit.