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This combination therapy consists of aglatimagene besadenovec, temozolomide, and valacyclovir. Aglatimagene besadenovec is an investigational oncolytic viral immunotherapy based on a replication-defective adenoviral vector encoding the herpes simplex virus thymidine kinase (HSV-tk) gene. When injected into tumors, it transduces tumor cells to express HSV-tk. Subsequent administration of the prodrug valacyclovir leads to its conversion by HSV-tk into a toxic nucleotide analogue within these cells, resulting in selective tumor cell death and release of tumor antigens that stimulate an anti-tumor immune response[3][6][7]. Temozolomide is an oral alkylating agent that induces DNA damage in cancer cells and is commonly used for glioblastoma treatment. The combination aims to enhance cytotoxicity against tumor cells through both direct killing (via temozolomide and HSV-tk/valacyclovir-mediated mechanisms) and immune activation.
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