View source for Vocimagene amiretrorepvec/flucytosine

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{{Infobox drug
| drug_name         =
| type              = combo
<!-- Combo data -->
| component1        = Vocimagene amiretrorepvec
| class1            = [[Gene therapy]]
| component2        = Flucytosine
| class2            = [[Cancer drug]]
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| legal_AU          = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled -->
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| legal_UK          = <!-- GSL, P, POM, CD, CD Lic, CD POM, CD No Reg POM, CD (Benz) POM, CD (Anab) POM or CD Inv POM / Class A, B, C -->
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<!-- Identifiers -->
| synonyms          = Toca 511 and Toca FC
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}}
'''Vocimagene amiretrorepvec/flucytosine''' is an experimental [[combination drug]] involving a [[gene therapy]] agent and a [[prodrug]].  It is a candidate drug to treat brain cancers.
Vocimagene amiretrorepvec (also known as Toca 511) is a gene therapy agent, wherein the payload is a gene encoding [[cytosine deaminase]] (CD) in a replicating, non-lytic [[Viral vector#Retroviruses|retroviral vector]].<ref name=Strebe2016kindofreview>{{cite journal | vauthors = Strebe JK, Lubin JA, Kuo JS | title = "Tag Team" Glioblastoma Therapy: Results From a Phase 1 Trial of Toca 511 and 5-Fluorocytosine for Recurrent High-Grade Glioma | journal = Neurosurgery | volume = 79 | issue = 6 | pages = N18–N20 | date = December 2016 | pmid = 27861411 | doi = 10.1227/01.neu.0000508605.38694.fd | doi-access = free }}</ref>
[[Flucytosine]] (also known as 5-fluorocytosine, 5-FC, and Toca FC) is an [[antifungal]] drug.  It is used in an extended-release [[Pharmaceutical formulation|formulation]].  Flucytosine is a prodrug of [[5-fluorouracil]] (5-FU), a cancer drug.  5-Fluorouracil does not cross the [[blood–brain barrier]] well, but flucytosine does.<ref name=Strebe2016kindofreview/>
The combination drug was designed to be used after a brain tumor is [[Segmental resection|removed surgically]]; vocimagene amiretrorepvec is intended to be injected into the tissues lining the hole where the tumor was (this region is called the [[Resection margin|margin]]), where the virus replicates only in cells that are dividing - in other words, cancer cells left over in the margin and immune cells that are present.  Flucytosine is then administered to the person, and is converted to 5-fluorouracil in those cells by CD expressed by cells that had been infected with the gene therapy vector.<ref name=Strebe2016kindofreview/>
By July 2017, the EMA had granted the combination priority review status, and the FDA had granted it [[Breakthrough Therapy Designation]] and [[FDA Fast Track]] designation for recurrent HGG, and an orphan designation for the treatment of glioblastoma.<ref name=Adis>{{cite web|title=Vocimagene amiretrorepvec-flucytosine gene therapy - Tocagen|url=http://adisinsight.springer.com/drugs/800032273|work = AdisInsight | publisher =  Springer Nature Switzerland AG |access-date=29 August 2017|language=en}}</ref>
The combination is under development by [[Tocagen]] and as of July 2017 phase 2/3 trials were underway for recurrent [[astrocytoma]] and recurrent high grade [[glioblastoma]].<ref name=Adis/>
== References ==
{{reflist}}
[[Category:Experimental cancer drugs]]