This study determined the effect of Ad -E1A gene therapy in vivo. TC71 cells ( 2Â10 6 ) injected subcutaneously into nude mice resulted in tumor development ( 1 -3 mm ) 6 days later. Animals were then treated with Ad -E1A or Ad --gal ( 5Â10 9 plaque -forming units ) by intratumoral injection twice weekly for 2 weeks. Animals received 8 mg / kg VP -16 given by intraperitoneal injection daily for 5 days following the first week of treatment with Ad -E1A or Ad --gal. Control animals received no therapy or VP -16 only after tumor cells were injected. When tumors exceeded 2Â2 cm, the mice were sacrificed and the tumors underwent histologic and immunohistochemical analysis. Tumors from mice treated with Ad -E1A plus VP -16 were 9.6 -fold smaller than those treated with VP -16 alone and 6.3 -fold smaller than those treated with Ad -E1A alone. HER2 / neu p185 protein expression decreased in all tumors that received Ad -E1A therapy. TUNEL fluorescence staining revealed more apoptosis in the tumors from animals treated with Ad -E1A plus VP -16 than in those from animals treated with Ad -E1A alone, Ad --gal plus VP -16, or VP -16 alone. These data demonstrated that Ad -E1A gene therapy down -regulated HER2 / neu expression, increased tumor cell apoptosis induced by VP -16, and enhanced tumor cell sensitivity to VP -16. Ad -E1A may have potential in the treatment of relapsed drug -resistant Ewing's sarcoma. Cancer Gene Therapy ( 2002 ) 9, 407 -413 DOI: 10.1038 / sj / cgt / 7700449Keywords: Ewing's sarcoma; Ad -E1A; gene therapy; VP -16 E wing's sarcoma is the second most common primary malignant bone tumor in children and young adults and has a high potential for metastasizing to the lungs, bones, and bone marrow. Most patients with Ewing's sarcoma die from lung and bone metastases. The overall 5-year survival rate is 41.2%. 1,2 Moreover, the prognosis is poor for patients who have had a relapse and for patients with large primary tumors or metastatic disease at presentation. Therefore, new strategies are needed to improve the survival rates. The HER2/neu oncogene encodes a 185 -kDa human epidermal growth factor receptor-2 transmembrane protein ( p185 ) with intrinsic tyrosine kinase activity. Overexpression of HER2 /neu was found in approximately 30% of human breast and ovarian cancers. 3,4 Enhanced expression of HER2 /neu increased the tumorigenicity and metastatic potential of human ovarian and lung cancer cells. Clinical studies indicated that overexpression of HER2/neu correlated with poor prognosis, shorter patient survival, and chemoresistance. 5,6 We previously demonstrated that TC71 human Ewing's sarcoma cells overexpress HER2/neu. Thus, HER2/ neu may also play a role in the poor disease-free survival rate associated with multiagent chemotherapy in this disease. The adenovirus type 5 early region 1A (E1A ) gene is a wellknown transcriptional factor. This gene inhibits HER2 /neu expression in both rodent and human breast cancer and ovarian cancer cells through the HER2 /neu promoter and with the involvement of the H...