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**Adenoviral HSV-tk gene therapy** is an investigational, replication-deficient adenoviral suicide-gene therapy that delivers the *Herpes simplex virus* thymidine kinase gene to prostate tumor cells by intratumoral injection. Expression of HSV-tk renders transduced proliferating cells susceptible to subsequently administered systemic ganciclovir, which is phosphorylated into cytotoxic nucleotide metabolites that inhibit DNA synthesis and cause cell death; local killing may extend to neighboring non-transduced cells through a bystander effect. In the Erasmus MC neoadjuvant Phase I study, the vector was injected into localized poor-risk prostate cancer three weeks before radical prostatectomy, followed by systemic ganciclovir. ([onderzoekmetmensen.nl](https://onderzoekmetmensen.nl/en/node/21955/pdf))
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