Riga virus is the first oncolytic virotherapy medicine world-wide. It is a native, genetically non-modified, non-pathogenic, melanoma cell-adapted RNA virus of Picornaviridae family, Enterovirus genus, human orphan type 7 (ECHO7) virus. Riga virus is provided as a frozen solution for injection in 2 ml vials and should be transported and kept frozen (-20 ± 2°C) until injection.
The direct anti-tumour effect of Riga virus is due to its oncotropism and oncolytic properties. Riga virus infects only cancer cells while leaving normal cells unaffected and do not cause severe illness or side effects. Riga virus is suitable for repeated treatments.
Riga virus promotes expression of tumour associated differentiation antigen and inhibits the expression of MAGE group antigens that are associated with progressive growth of melanoma on the surface of non-destroyed cancer cells.
Riga virus stimulates humoral immunity – B cell activation, production of antibodies and interferon induction as well as cellular T cell activation – increases the cytotoxic CD8+ cells, helper – CD4+ cells, number of activated CD38 + cells in peripheral blood and apoptosis receptor CD95 + expression on the surface of lymphocytes.
Non-specific immune cells like natural killer cells (NK) and monocytes/macrophages are also activated during Riga virus therapy. The function of the lymph nodes is activated and infiltration of lymphocytes inside the tumour increases, which indicates that local immune activation processes are influenced by Riga virus.
Riga virus may be used either through a systemic administration intramuscularly or locally (intra- or peri-tumourally) to bypass the tumour microenvironment’s barriers. Systemical intramuscular injections of Riga virus are provided either closer to the localization of the primary tumour or – closer to the nearest metastatic foci (lymph collector or distant metastatic site). Usually Riga virus is injected either in the left or right shoulder or in the left or right buttock. Riga virus can also be used before, in-between or after radiotherapy and/or chemotherapy.
Like any other drug, Riga virus may cause side effects. Existing evidence shows that there are very few side effects and no need of disruption of the treatment. So far there has not been registered any serious adverse effect. Generally, Riga virus is very well tolerated and observed side effects were mild and short-termed like temporary sub-febrility for 1-2 days after injection, sleepiness, mild gastrointestinal disturbances and seldom – pain at the site of injection.
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