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TG4023 (also known as MVA-FCU1) is a cancer gene therapy product that utilizes a recombinant modified vaccinia Ankara (MVA) viral vector to deliver the yeast-derived suicide gene FCU1 into tumor cells. The FCU1 gene encodes a bifunctional enzyme with cytosine deaminase and uracil phosphoribosyltransferase activities. When administered in combination with the prodrug flucytosine (5-FC), FCU1 converts 5-FC into cytotoxic agents—5-fluorouracil (5-FU) and 5-fluorouridine-5′-monophosphate—within infected tumor cells. These metabolites induce cell death locally and can diffuse to kill neighboring tumor cells via a bystander effect. This approach is being investigated primarily for unresectable primary or metastatic liver tumors.
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