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Coxsackievirus A21 (CVA21) is a naturally occurring, nonenveloped RNA enterovirus developed as an oncolytic virus therapy for cancer. It selectively infects and lyses tumor cells by targeting the intercellular adhesion molecule 1 (ICAM-1) and decay-accelerating factor (DAF/CD55), which are overexpressed in several cancers including metastatic melanoma. Upon administration, the virus replicates within tumor cells leading to direct cell lysis and induction of antitumor immune responses. The most clinically advanced formulation is known as V937 or CAVATAK. Developed from the wild-type Kuykendall strain, it has been evaluated in clinical trials for unresectable melanoma and other solid tumors. The main mode of action involves viral infiltration and replication within tumors resulting in destruction of malignant tissue[1][3][5][6].
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