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Aglatimagene besadenovec + insulin human (CAN-2409) is an investigational gene-mediated cytotoxic immunotherapy (GMCI) being developed by Candel Therapeutics for the treatment of localized prostate cancer and other solid tumors. The therapy utilizes a replication-deficient adenoviral vector (Ad5) to deliver the Herpes Simplex Virus thymidine kinase (HSV-tk) gene directly into tumor cells. Once expressed, the HSV-tk enzyme converts co-administered prodrugs, such as valacyclovir, into cytotoxic metabolites that inhibit DNA synthesis, leading to tumor cell death and the induction of a systemic anti-tumor immune response. In clinical trial protocols, such as the Phase 3 trial for intermediate-high risk localized prostate cancer, the viral vector is diluted with Humulin R (regular human insulin). The insulin serves as a surfactant to prevent the viral particles from adhering to the surfaces of syringes and needles, ensuring the delivery of the intended therapeutic dose.
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