Purpose: To test the effects of a new combination, cytosine deaminase (CD) + uracil phosphoribosyltransferase (UPRT)^mediated gene-directed enzyme prodrug therapy (GDEPT) with interleukin (IL)-12 and IL-18, on (a) growth of murine prostate and remote tumor deposits, (b) mouse survival, and (c) T helper (Th) 1/Th2 serum cytokine balance with a special focus to assess correlation with tumor burden/survival. Experimental Design: Efficacy of intraprostatic administration of adenovirally delivered murine IL-12 and IL-18 against orthotopic RM1 tumors and lung pseudometastases was assessed in C57BL/6 mice. At necropsy, tumor growth, lung colony counts, effects on immune cell infiltration, vasculature, apoptosis, and proliferation were estimated. Next, CDUPRT-GDEPT + cytokines were tested at suboptimal doses in mice with RM1CDUPRT prostate tumors/RM1 lung deposits and analyzed as above. Effects on mouse survival were also assessed. Host immune responses to different treatments were assessed by monitoring 11serum cytokines using Luminex technology. Results: Our data show that IL-12 and IL-18, when combined with CDUPRT-GDEPT, caused significant reduction in local RM1 tumors and lung colonies with enhanced long-term survival versus individual treatments. A dramatic enhancement of tumor infiltration by a wider repertoire of immune cells and disruption of vasculature implied the combination to be more immunostimulatory and antiangiogenic. Remarkably, lowering of serum IL-4 and monocyte chemoattractant protein-1 (MCP-1) was consistently associated with lower tumor burden (local and systemic), and this, rather than an increase inTh1cytokines, better predicted treatment efficacy. In addition, mouse survival correlated with substantially higher cytokine (Th1/Th2) levels after treatment. Conclusion: Locoregional application of CDUPRT-GDEPTand IL-12/IL-18 was effective against local and systemic prostate cancer and improved survival. Monitoring serum levels of IL-4 and MCP-1may accurately reflect tumor burden and, hence, host response to therapy.Heterogeneity of clinical prostate cancer has culminated in inadequacy of single-treatment regimens and inefficient patient management. An urgent need has emerged for (a) new combination regimens that can be given into the primary tumor with systemic effects and without toxicities and (b) design of preclinical screening to generate clinically relevant data.Immunostimulatory strategies have the potential to combat cancer and generate long-term anticancer effects. However, poorly immunogenic tumors and immunocompromised patients pose a challenge. The in situ amplification of cytotoxicity via local and distant bystander effects by locally delivered gene-directed enzyme prodrug therapies (GDEPT) is shown to be inflammatory [T cells, macrophages, and natural killer (NK) cells], and several studies support the concept that further enhancement is possible using cytokines (1). This was first shown when IL-2 combined with thymidine kinasebased GDEPT (HSV-tk) was found to be more potent aga...