G207 is a multimutated, conditionally replicating herpes simplex virus type 1 (HSV-1) that retains an intact viral thymidine kinase (HSV-tk) gene. The virus exhibits oncolytic activity in various tumors and is being evaluated in patients with recurrent malignant glioma. In view of the potential for ganciclovir (GCV) to either enhance or inhibit the antitumoral activity of HSV-tk-retaining HSV-1 vectors, we evaluated the effect of GCV administration on the antitumoral activity of G207. In culture, addition of GCV either had no effect or inhibited the cytocidal action of G207 at replication-permissive temperatures, while it significantly increased the cell killing in three of the four cell lines studied when virus replication was inhibited at nonpermissive temperatures. Using a G207-permissive immunocompetent mouse tumor model, subcutaneous N18 neuroblastoma in syngeneic A/J mice, we found that GCV treatment did not affect G207-mediated tumor growth inhibition at a variety of viral doses (10 5 , 10 7 , and 10 7 ϫ 2 plaque-forming units). In A/J mice harboring intracerebral N18 tumors, GCV administration had no significant effect on the prolongation of survival by G207 inoculation. These findings suggest that GCV administration may not be beneficial to the efficacy of G207 tumor therapy under conditions that favor active viral replication, because the potential HSV-tk/GCV-mediated enhancement of G207 oncolytic activity may be balanced out by the inhibitory action of GCV on viral replication. Cancer Gene Therapy (2000) 7, 939 -946 Key words: Herpes simplex virus; viral therapy; ganciclovir; bystander effect; thymidine kinase; brain neoplasm.B rain tumors represent 9% of all primary tumors and are the second leading cause of death from neurological disease. 1,2 Gliomas account for 40 -67% of the primary brain tumors, and approximately three-fourths of gliomas are considered malignant. Secondary brain tumors due to metastatic malignancy are also common, and the frequency is increasing because of longer survival of cancer patients in general. Despite progress in microsurgical techniques and adjuvant chemotherapy and radiotherapy, little improvement has been noted in the survival rate of patients with malignant brain tumors. The use of herpes simplex virus thymidine kinase (HSVtk) gene transduction using replication-defective vectors followed by ganciclovir (GCV) administration is a therapeutic design that has been extensively studied in brain tumors. 3-14 GCV, a nucleoside analog, is phosphorylated by HSV-tk, but not by endogenous mammalian tk, and is further anabolized by cellular kinases to GCV triphosphate, which inhibits host cell DNA replication by chain termination. 15 An important, advantageous feature of this strategy is that surrounding nontransduced cells can be killed in the presence of GCV in addition to the cells transduced with HSV-tk gene. 3,7,16 In vitro studies have shown that this so-called bystander effect is associated with gap junctional intercellular communication, through which phosphorylated GCV...