gemcitabine + valproic acid + valganciclovir

Gemcitabine + valproic acid + valganciclovir is a combination regimen known as Cytolytic Viral Activation Therapy (CVAT), currently under investigation by Chang Gung Memorial Hospital for the treatment of recurrent or metastatic nasopharyngeal carcinoma (NPC). This therapeutic strategy leverages the association of NPC with the Epstein-Barr virus (EBV). The regimen uses valproic acid (a histone deacetylase inhibitor) and gemcitabine (a nucleoside metabolic inhibitor) to induce EBV from its latent phase into the lytic phase within tumor cells. This induction leads to the expression of viral enzymes, such as thymidine kinase, which then activate the antiviral prodrug valganciclovir into its active, cytotoxic form. This mechanism results in selective cell death of EBV-infected cancer cells, while gemcitabine provides additional direct antineoplastic activity by inhibiting DNA synthesis and ribonucleotide reductase.

Other names

Cytolytic Viral Activation TherapyGEM + VPA + VGCGemcitabine + Valproic acid + Valganciclovir