Toca 511 is a modified retroviral replicating vector based on Moloney c-retrovirus with an amphotropic envelope. As an investigational cancer treatment, Toca 511 preferentially infects cancer cells without direct cell lysis and encodes an enhanced yeast cytosine deaminase that converts the antifungal drug 5-fluorocytosine to the anticancer drug, 5-fluorouracil. A panel of established human cancer cell lines, derived from glioblastoma, colon, and breast cancer tissue, was used to evaluate parameters critical for effective anticancer activity. Gene transfer, cytosine deaminase production, conversion of 5-fluorocytosine to 5-fluorouracil, and subsequent cell killing occurred in all lines tested. We observed >50% infection within 25 days in all lines and 5-fluorocytosine LD 50 values between 0.02 and 6 lg/ml. Although we did not identify a small number of key criteria, these studies do provide a straightforward approach to rapidly gauge the probability of a Toca 511 and 5-fluorocytosine treatment effect in various cancer indications: a single MTS assay of maximally infected cancer cell lines to determine 5-fluorocytosine LD 50 . The data suggest that, although there can be variation in susceptibility to Toca 511 and 5-fluorocytosine because of multiple mechanistic factors, this therapy may be applicable to a broad range of cancer types and individuals.INTRODUCTION THE IDEA OF USING replication-competent viruses as a direct therapy for the treatment of cancer emerged more than a century ago.1 The c-retrovirus murine leukemia virus (MLV) is an attractive tool for tumor gene therapy, as its nonlytic life cycle and requirement for host cell division allow for tumor-selective enhanced gene transfer 2 and spread throughout the tumor. This MLV-based approach to gene therapy has been used to deliver and express the cytosine deaminase (CD) gene into tumor cells, providing a specific conversion of the well-tolerated antifungal prodrug, 5-fluorocytosine (5-FC), into the potent chemotherapeutic 5-fluorouracil (5-FU), which has been well established in preclinical studies. [2][3][4][5][6] Building on this concept, Tocagen's retroviral replicating vector (RRV) named Toca 511 7 (vocimagene amiretrorepvec) preferentially infects tumors without immediate cell killing and encodes an optimized yeast cytosine deaminase (yCD) that converts 5-FC into 5-FU within infected tumors. 3,4,7,8 We are currently investigating the clinical utility, in recurrent high-grade glioma, of Toca 511 in combination with Toca FC, an investigational orally administered extended-release formulation of 5-FC (NCT01470794, NCT01156584, NCT01985256, and NCT02414165).CD is lacking or poorly expressed in most human cells but is often expressed in yeast and bacteria as part of the pyrimidine salvage pathway and is responsible for converting cytosine to uracil and ammonia. CD also catalyzes, by means of a deamination step, the conversion of the prodrug 5-FC to the chemotherapeutic drug 5-FU 9,10 within cancer cells expressing gene therapy-delivered CD. CDbased prodru...