TREATMENT OF CANCER HARBORING MUTATIONS IN THE TP53 GENE AND/OR POST-TRANSLATIONAL MODIFICATIONS IN THE P53 PROTEIN WITH PARVOVIRUSES

Abstract

Treatment of cancer harboring mutations in the TP53 gene and/or post-translational modifications in the p53 protein. The present invention relates to the use of viruses belonging to the family Parvoviridae, genus Protoparvovirus, or combinations of such viruses with chemotherapy drugs, in the treatment of cancer. In particular the cancer is characterized by showing mutations in the TP53 gene and/or post-translational modifications in the p53 protein.

Claims

1. A method for treatment of cancer, comprising administering a viral particle comprising a nucleotide sequence consisting essentially of: SEQ ID NO: 1 or SEQ ID NO: 2 to a subject in need thereof, wherein the cancer presents at least one mutation in the gene TP53 or p53 protein selected from the group consisting of: R273H, P72R, E258K, G245S, V173L and phosphorylation of the p53 protein.

2. The method according to claim 1, wherein the phosphorylation of p53 protein is constitutive, or it has been previously induced by genotoxic chemotherapy drugs or by oncogenic viruses.

3. The method according to claim 1, wherein the phosphorylation of p53 protein consists of the phosphorylation of the Ser15 residue.

4. (canceled)

5. (canceled)

6. The method according to claim 1, wherein the cancer is selected from the group consisting of glioma, glioblastoma, acute myeloid leukemia, lung adenocarcinoma, bladder carcinoma and rectal adenocarcinoma.

7. (canceled)

8. (canceled)

9. (canceled)

10. A pharmaceutical composition comprising a viral particle which in turn comprises a nucleotide sequence consisting essentially of: SEQ ID NO: 1 or SEQ ID NO: 2 in combination with a genotoxic chemotherapy drug.

11. The pharmaceutical composition according to claim 10, wherein the genotoxic chemotherapy drug is selected from the group consisting of: cisplatin, hydroxyurea, 5-fluorouracil, gemcitabine and cytosine arabinoside.

12. The method of claim 1, further comprising administering a genotoxic chemotherapy drug to the subject, wherein the cancer presents at least one mutation in the gene TP53 or p53 protein selected from the group consisting of: R273H and phosphorylation of the p53 protein.

13. The method of claim 12, wherein the genotoxic chemotherapy drug is selected from the group comprising: cisplatin, hydroxyurea, 5-fluorouracil, gemcitabine or cytosine arabinoside.

14. The method of claim 12, wherein the nucleotide sequence consists essentially of SEQ ID NO: 1.

15. The method of claim 14, wherein the genotoxic chemotherapy drug is selected from the group comprising: cisplatin, hydroxyurea, 5-fluorouracil, gemcitabine or cytosine arabinoside.

16. The method of claim 12, wherein the nucleotide sequence consists essentially of SEQ ID NO: 2, and the cancer presents phosphorylation of the p53 protein.

17. The method of claim 16, wherein the genotoxic chemotherapy drug is selected from the group comprising: cisplatin, hydroxyurea, 5-fluorouracil, gemcitabine or cytosine arabinoside.

18. The method of claim 1, wherein the nucleotide sequence consists essentially of: SEQ ID NO: 1.

19. The method of claim 1, wherein the nucleotide sequence consists essentially of: SEQ ID NO: 2, and the cancer presents phosphorylation of the p53 protein.

Description

DESCRIPTION OF THE FIGURES

[0052] FIG. 1. The parvovirus minute virus of mice (MVM) induces p53 in human glioblastoma stem cells (GS, or hGS). Stem cells obtained from glioblastoma patients were infected with the MVMp (prototypic strain) and MVMi (immunosuppressive strain) viruses and analyzed for p53 protein expression. Left: analysis by immunofluorescence (IF) in confocal microscopy for the expression of the viral protein NS1 and the cellular p53 in GS cells of patients #5, 7 and 8 growing as neurospheres. Mock, uninfected cells. Right: analysis of the induction of the same proteins by western-blot in GSs of the four patients. Nestin: loading control. The molecular masses (kDa) are indicated on the right.

[0053] FIG. 2. Post-translational modification of p53 and genetic alterations of TP53 in GS cells permissive to the cytotoxic infection and replication of the parvovirus MVM. A. Analysis by IF in confocal microscopy of the correlation between the expression of NS1, the induction of p53 phosphorylated in Ser15, and the replication of the MVMp genome, in glioblastoma stem cells (GS) from four patients (#5, 7, 8, 9). B. Cytometric analysis, in GS of two patients, of the correlation between the level of MVMp genome replication and the phosphorylation of p53 in Ser15. C. Cytometry of A9 mouse fibroblasts infected by MVMp and analyzed for correlation between the levels of: NS1 expression and virus DNA replication (upper), modification of p53 in S15 and virus DNA replication (medium), and NS1 expression and p53 induction (bottom). D. Illustration of some mutations in TP53 detected by massive sequencing (NGS) in GS of two patients previously infected and drawn by the expression of NS1 (+)/p53-S15 (+). E. Frequency of appearance of TP53 mutations detected by NGS in GS of three patients infected and drawn by the expression of NS1(+)/p53-S15 (+). F. Representation of the four mutations detected by NGS in the p53 protein domains in GS cells of four patients infected with MVMp and drawn by expression of NS1 (+)/p53-S15 (+). The positions of the V173L (present in mouse A9 fibroblasts as V170L) and R273H (present in the U373MG and U251MG human glioblastoma cell lines) are also indicated. The type and number of accumulated absolute cases of all described mutations in the TP53 domains (TAD, transactivation domain; PRD, proline-rich domain; DBD, DNA-binding domain; OD, oligomerization domain) as reported by the consortiums TCGA (the Cancer Genome Atlas, NIH USA; https://portal.gdc.cancer.gov) and Cosmic (Sanger Institute of the UK; https://cancer.sanger.ac.uk/cosmic) in human GBM samples are illustrated.

[0054] FIG. 3. Post-translational modification in p53 and genetic alterations of TP53 in established cell lines of human cancer and GS infected with the parvovirus MVM strains. A. Confocal IF panels of established human and primate cell lines infected with two strains (i, p) of parvovirus MVM and stained for p53, p53 phosphorylated at Ser15 (pp53), and parvovirus DNA (vDNA). B. Confocal IF estimation of the p53-S15 frequency and expression level in different uninfected (mock) or infected cells with the MVM strains. C, D. Western blot analysis of the induction of NS1, p53 and p53-S15 in GS (C) and different established lines of mouse (A9) and human glioblastoma (D). E. Purification by sorting of A9 and GS cells based on the expression of NS1+ and p53-S15+. The indicated populations were used for the genetic analysis of TP53. The percentage of cells positive for the markers in the selected windows is indicated. F. Western blot analysis of p53 recognition by specific antibodies against two regions of the protein in different cell lines. Note the lack of recognition of p53 in the U87MG cell line by the antibody specific for the approx-20 domain. G. wtTP53 prevents the expression of the virus NS1 protein. Confocal IF analysis of the expression of p53 and NS1 in A9 and NB324K cells transfected with a plasmid expressing wtp53 or with carrier DNA. H, I. Chromatograms showing Sanger sequencing of p53 regions in the established cells and indicated pooled populations (H) or in GS (I). J. Representation of the TP53 mutations detected in this study in relation to all those described in the TP53 domains (TAD, transactivation domain, PRD, proline-rich domain, DBD, DNA-binding domain, OD, oligomerization domain) by the TCGA (The Cancer Genome Atlas, NIH USA; https://portal.gdc.cancer.gov) and Cosmic (Sanger Institute of the UK; https://cancer.sanger.ac.uk cosmic) consortium in the indicated types of human cancers. The scheme shows how most mutations in different types of cancer occur in the DBD domain of the TP53 gene, although the frequency of a particular mutation can be very high in a certain type of cancer.

[0055] FIG. 4. Parvovirus MVMp and MVMi infections of mouse and human cell lines, and GS of patients, transfected with adenovirus oncogenes that alter p53. A. Confocal IF analysis of NIH3T3 cells, or (B) GS8 cells, transfected with plasmids expressing oncogenes showing increased replication of the MVMp genome. C. Similar study in GS8 cells showing accumulation levels of the main replicative intermediate (mRF) of the MVM genome analyzed by southern-blot. D. Effect of transfection with plasmids expressing oncogenes on the replication of the MVMp genome in GS8 cells, or (E) of the MVMi genome in U87MG measured by IF-confocal (left) or cytometry (right).

[0056] FIG. 5. Effects of chemotherapy drugs (CD) on the infection of U373MG glioblastoma cells with parvovirus MVMp. A. Analysis by cytometry and by confocal IF (B) of the effect of three CD on the levels of NS1 and p53-S15 expression. C. IF-confocal analysis of dose effect of Cisplatin in the levels of NS1, p53-S15, and virus genome replication. D. Analysis under similar conditions measuring levels of NS1 and p53 signaling proteins by SDS-blot, or (E) cell viability by colony formation.

[0057] FIG. 6. CD effects on the infection of U87 MG glioblastoma cells with the parvovirus MVMi. A, B. IF-confocal analysis of the dose effect of 5FU and hydroxyurea (HU) on the p53-S15 levels in uninfected U87 cells. C. Dose effect of these CD on the levels of the main replicative intermediate (mRF) of the viral genome analyzed by Southern-blot. D. IF-confocal analysis of the effect of these CD on the levels of NS1, p53-S15 and virus genome replication. Dose effect of 5FU on the levels of NS1 and p53 signaling proteins measured in blot (E), and on cell viability determined by colony formation (F). Dose effect of HU on the levels of NS1 and p53 signaling proteins measured by blot (G), and on cell viability determined by colony formation (H).

[0058] FIG. 7. CDs effects on the infection of U87MG cells with parvovirus MVMp. A. IF-confocal analysis of Cisplatin dose effect on the levels of NS1, p53-S15 and parvovirus genome replication. B. Western blot analysis of equivalent samples by measuring NS1 levels and several p53 signaling cellular proteins. C, D and E. Cell survival (measured by colony formation) in infections at different multiplicities (PFU/cell) with MVMp combined with the indicated doses of diverse CDs.

DETAILED DESCRIPTION OF THE INVENTION

Example 1. Materials and Methods

Example 1.1. Cells and Cell Cultures

[0059] The human glioblastoma stem cells were obtained from tumor explants provided by the Neurosurgery service of the Ramón y Cajal Hospital in Madrid. Explants were diagnosed as glioblastoma grade IV by histochemistry performed by the Pathology service of the same hospital. In all cases, the informed consent of the patients was obtained and the approval of the Institutional Ethics Committee of the Ram6n y Cajal Hospital in Madrid. Further research in tissue culture was authorized by the respective Ethics Committee of the Universidad de Madrid, and Centro de Biologiá Molecular Severo Ochoa (CSIC-UAM). The biopsies, collected at the foot of the operating room, were mechanically and enzymatically disintegrated, and finally the cell suspension was filtered to be cultivated in the DMEM medium: F12 (1:1) supplemented with various factors.

[0060] On the other hand, the established cell lines of mouse, human cancers and other mammals were cultured in Dulbecco's Modified Eagle medium (DMEM) buffered with 0.3% NaHCO, and in atmosphere of 5% CO.sub.2. The medium was supplemented with antibiotics (75 U/ml streptomycin, 75 μg/ml penicillin G), 2 mM L-Glutamine and 5% of fetal bovine serum (FCS) des-complemented at 56° C. for 30 minutes. The following cell lines have been used: [0061] Human Glioblastoma: [0062] U87-MG: glioblastoma-human astrocytoma (ATCC: HTB 14). [0063] U373-MG: glioblastoma-human astrocytoma (RRID: CVCL_2219) [0064] U251-MG: glioblastoma-human astrocytoma (RRID:CVCL_0021) (ECACC09063001). [0065] Other human cancers: [0066] Hela, human cervical carcinoma (ATCC-CCl-2) [0067] NB324K: human kidney fibroblasts of newborn transformed with the large T antigen 1 Polyomavirus SV40 (RRID: CVCL_U409). [0068] Carcinogenic cell lines of other mammals: [0069] COS-1, primate liver fibroblasts transformed by the Polyomavirus SV40 (ATCC CRL-1650) [0070] A9: line derived from mouse L fibroblasts selected by the HGPRT phenotype. It shows a certain carcinogenic capacity when injected into mice (ATCC CCL-1.4).

Example 1.2. Flow Cytometry

[0071] In all the experiments, a minimum of 30,000 events per sample were acquired in a FACSCantoII cytometer (BD Biosciences), which were pre-selected by a region based on their size and complexity (FSC and SSC parameters, respectively) in order to exclude cellular debris and other contaminating particles. The CellQuest software (BD Biosciences) was used to acquire the events and the FlowJo software (Tree Star) was used to analyze the data. The cell cycle analysis was in accordance to [Gil-Ranedo, J., Hernando, E., Riolobos, L., Dominguez, C., Kann, M, and José M Almendral. 2015. The mammalian cell cycle regulates nuclear parvovirus capsid assembly. PlosPathogens, 11; 11 (6): e1004920]. For staining, cells were permeabilized with PBS+0.1% triton X-100 for 10 minutes at room temperature, then blocked with the same buffer supplemented with 1% FCS for 20 minutes. Cells were re-suspended in PBS (pH 7.2)+0.5% BSA and the primary antibodies indicated in the figures were added followed by 1 h stirring at 37° C. Cells were washed in PBS and the secondary antibodies were added and incubated similarly. Two further washes in PBS were made before analyzing the samples in the flow cytometer.

[0072] In the purification of cells by flow cytometry (FACS) for the genetic analysis of TP53 (as shown in the FIG. 3E), all solutions were prepared with Diethyl Pyrocarbonate (DPC) using distilled water free of nucleases (Gifco, distilled water DNase/RNase free 10977-035). Cells were permeabilized and incubated with antibodies as indicated above, but PBS buffers were supplemented with vanadate (RNase inhibitor), gelatin instead of BSA (allowing autoclave), and filtered. Before sorting, the cytometry equipment (Aria, BD) was extensively washed with autoclaved PBS-DEP pre-cooled at 4° C., the circumvented cells were collected on sterile tubes (F15, Falcon) on ice, and Trizol was immediately added to inhibit degradation and next proceed with RNA purification.

Example 1.3. Clonogenic Analysis of Cell Viability

[0073] The clonogenic capacity and cell viability were estimated by a colony formation assay based on [Rubio, M P, Guerra, S., and Almendral, J M 2001. Genome replication and postencapsidation functions mapping to the nonstructural gene restrict the host range of a murine parvovirus in human cells. J Virol 75 (23): 11573-11582].

Example 1.4. Indirect Immunofluorescence (IF)

[0074] Immunofluorescence analyses were performed on neurospheres of hGSCs (human glioblastoma stem cells) and established adherent cell lines as follows: [0075] Neurosphere staining. The cell spheres were fixed for 30 minutes with paraformaldehyde (PFA) 4%, then permeabilized for 10 minutes at room temperature with 0.1% Triton X-100 (Merck) in PBS, and blocked by incubating 20 minutes with 0.1% Triton X-100 and 10% fetal bovine serum (Sigma) in PBS. Neurospheres were incubated in the same buffer with the primary antibodies indicated in the figures for 1 h at 37° C., and finished by four five-minute PBS washes. Then neurospheres were incubated with the secondary antibodies at appropriate concentrations in the same buffer and conditions, and finally stained with DAPI for half an hour and mounted embedding at 37° C. in 0.8% agarose-LGT prepared in PBS. Embedded neurospheres were applied as 200 microliters drops on pre-cooled large (2×3 cm) coverslips and stored at 4° C. in the dark until confocal analysis. [0076] Adherent cells. The cell lines were seeded on coverslips, treated as indicated in the figures and fixed for 10 minutes with 4% paraformaldehyde. Staining with antibodies was carried out essentially as described above for the neurospheres. Cells were mounted with Fluoromount G (Southern Biotech). Preparations were kept at least 16 h at room temperature in the dark before observation under a microscope. [0077] Analysis of virus replication by FISH. This method was used to determine the degree of replication of the parvovirus MVM genome. The probe used was a mixture of three DNA oligonucleotides labeled at the 3′ terminal end with the Cy5 fluorophore, and complementary to different sequences of the MVM genome. Cells adhered and fixed in 4% paraformaldehyde were permeabilized for 10 minutes with 0.2% Triton X-100 (Merck) in PBS and equilibrated for 5 minutes at room temperature in 2×SSC (0.3 M NaCl; 30 mM Na.sub.2C.sub.6H.sub.5O.sub.7, pH 7) supplemented with 15% formamide. Hybridization was with 500 ng/ml of each oligonucleotide in FISH buffer (5×SSC, 0.5% SDS, 10% dextran sulfate, 50% formamide) for 2.5 hours at 37° C. The preparations were washed twice with 2×SSC, 15% formamide for 30 minutes. Finally, samples were blocked in 0.1% Triton X-100 and 1% FCS in PBS for 20 minutes at room temperature, and the immunofluorescence protocol described above was continued. [0078] Image captures. In neurosphere preparations, a confocal laser scanning microscope LSM510 META coupled to an inverted Axiovert200 microscope (Zeiss), or a multiphoton confocal laser scanning microscope LSM710 coupled to an inverted microscope AxioObserver (Zeiss) were used. For the analysis of preparations with dispersed cells, an Axiovert200 (Zeiss) inverted microscope coupled to a monochrome and color ccd camera was used. Whenever indicated, the multiphoton confocal laser scanning microscope LSM710 was used. The images were processed with Adobe Photoshop CS5 programs (Adobe Systems Incorporated) and ImageJ/FIJI (http://rsb.info.nih.gov/ij/) taking the same samples as a zero-signal reference without antibodies (auto-fluorescence control), or only with secondary antibodies.

Example 1.5. Parvovirus MVM

[0079] MVM belongs to the family Parvoviridae, genus Protoparvovirus. The prototypic strain of this virus (MVMp) was originally isolated from fibroblasts [Crawford, L. (1966) A minute virus of mice, Virology, 29, p. 605-612] and the so-called immunosuppressive strain (MVMi) from mouse lymphocytes [Bonnard, G D, Manders, E K, Campbell, D A, Herberman, R B and Collins, M J (1976) Immunosuppressive activity of a subline of the mouse EL-4 Lymphoma, J Exp Med, 143 (1), pp. 187-205. DOI: 10.1084 jem.143.1.187]. Only the MVMi strain is pathogenic in mice.

Example 1.6. Production of Parvovirus MVM in Culture

[0080] The preparations of the parvovirus MVM (p, i) were obtained in NB324K cells following established protocols [Segovia, J C, Gallego, J M, Bueren, J A and Almendral, J M (1999) Severe leukopenia and dysregulated erythropoiesis in SCID mice persistently infected with the parvovirus minute virus of mice., Journal of Virology, 73 (3), pp. 1774-84], [Sánchez-Martínez, C., Grueso, E., Carroll, M, Rommelaere, J. and Almendral, J M (2012) Essential role of the unordered VP2 n-terminal domain of the parvovirus MVM capsid in nuclear assembly and endosomal enlargement of the virion fivefold channel for cell entry. Virology, 432 (1), pp. 45-56], [Gil-Ranedo, J., Hernando, E., Valle, N., Riolobos, L., Maroto, B. and Almendral, J M (2018) Differential phosphorylation and n-terminal configuration of capsid subunits in parvovirus assembly and viral trafficking, Virology, 518, pp. 184-194]. For this, we used plasmids containing the complete genome of MVMp and MVMi strains, including the palindromic sequences of the [Gardiner, M S and Tattersall, P. 1988. Mapping of the fibrotropic and lymphotropic host range determinants of the parvovirus minute virus of mice. J Virol 62 (8): 2605-2613] [Hirt, B., Colomar, M C and Beard, P. (1998) Two segments in the genome of the immunosuppressive minute virus of mice determine the host-cell specificity, viral control DNA replication and affect viral RNA metabolism, Journal of General Virology, 79, 581-586] which allows obtaining viral particles by transfection of cells [Sánchez-Martínez, C., Grueso, E., Carroll, M., Rommelaere, J. and Almendral, J M (2012) Essential role of the unordered VP2 n-terminal domain of the parvovirus MVM capsid in nuclear assembly and endosomal enlargement of the virion fivefold channel for cell entry. Virology, 432 (1), pp. 45-56]. Using virus directly produced by transfection (48 h post-transfection), NB324K cells grown to confluence in ten P100 plates (a total of 5×10.sup.7 cells) were infected at a multiplicity of infection (MOI) of 0.005 plaque-forming units/cell (PFU/cell) in 1 ml of complete PBS (PBSc; PBS) with 0.9 mM CaCl.sub.2 and 0.5 mM MgCl.sub.2) with 0.1% FCS. After 1 h at 37° C., the inoculum was removed and incubated in DMEM with 5% FCS for 5 h to allow internalization of the virus. Subsequently the adhered cells were detached with trypsin-EDTA, diluted in 400 ml of DMEM with 5% FCS and seeded onto fifty P100 plates. Cells were incubated until the appearance of cytopathic effect (approximately 5 days).

Example 1.7. Purification of Parvovirus MVM

[0081] We followed protocols described by [Santarén, J F, Ramírez, J C and Almendral, J M (1993) Protein species of the parvovirus minute virus of MVMp strain: involvement of phosphorylated VP-2 subtypes in viral morphogenesis., Journal of Virology, 67 (9), pp. 5126-38], [Hernando, E., Llamas-Saiz, A L, Foces-Foces, C., McKenna, R., Portman, L, Agbandje-McKenna, M. and Almendral, J M (2000) Biochemical and Physical Characterization of Parvovirus Minute Virus of Mice Virus-like Particles, Virology, 267 (2), pp. 299-309], [Sánchez-Martínez, C., Grueso, E., Carroll, M., Rommelaere, J. and Almendral, J M (2012) Essential role of the unordered VP2 n-terminal domain of the parvovirus MVM capsid in nuclear assembly and endosomal enlargement of the virion fivefold channel for cell entry. Virology, 432 (1), pp. 45-56] and [Gil-Ranedo, J., Hernando, E., Riolobos, L., Dominguez, C., Kann, M., and José M. Almendral. 2015. The mammalian cell cycle regulates nuclear parvovirus capsid assembly. PlosPathogens, 11; 11 (6): e1004920]. In short, the virus present in the medium was recovered by precipitation with 3.4% polyethylene glycol 6000 and 0.5 M NaCl overnight at 4° C. and subsequently centrifuged at 5000 rpm for 30 minutes in an angular Sorvall GSA rotor. To recover the intracellular virus, the cell pellet was resuspended in 50 mM Tris-HCl pH 7.5, 1 mM EDTA (TE) and subjected to three consecutive freeze/thaw cycles, after which 0.2% SDS was added and clarified at 8000 rpm, 10 min at 4° C. in a Sorvall HB4 swinging rotor. The virus recovered from the medium and the intracellular virus were pooled and centrifuged through a 20% sucrose cushion (Merck) in 50 mM Tris-HCl pH 8.0, 1 mM EDTA, 0.1 M NaCl and 0.2% SDS for 18 h at 16000 rpm in a TST 28.38 rotor. The pellet was resuspended in TE with 0.2% Sarkosyl (Sigma) and banded to equilibrium in a CsCl gradient (ni=1.371) run for 24 h at 50000 rpm and 15° C. in a TFT 80.13 rotor. Fractions of 0.5 ml were collected by syringe from the top of the gradients and the presence of empty capsids and DNA-filled viruses was determined by hemagglutination with mouse erythrocytes. Finally, the fractions containing the viruses were pooled and dialyzed against PBS. Purified virus was stored in aliquots at −70° C.

Example 1.8. Hemagglutination

[0082] This method was used to estimate the amount of virus particles and follow up purifications. It was based on [Sánchez-Martínez, C., Grueso, E., Carroll, M, Rommelaere, J. and Almendral, J M (2012) Essential role of the unordered VP2 n-terminal domain of the parvovirus MVM capsid in nuclear assembly and endosomal enlargement of the virion fivefold channel for cell entry. Virology, 432 (1), pp. 45-56] and [Hernando, E., Llamas-Saiz, A L, Foces-Foces, C., McKenna, R., Portman, L, Agbandje-McKenna, M. and Almendral, J M (2000) Biochemical and Physical Characterization of Parvovirus Minute Virus of Mice Virus-like Particles, Virology, 267 (2), pp. 299-309]. For the hemagglutination (HA) assay, adult mouse blood was washed three times with phosphate saline (PBS), collecting the erythrocytes by centrifugation in a tabletop centrifuge at 1500 rpm for 5 min. After several washes the erythrocyte sediment was resuspended as 50% (v/v) in PBS and kept at 4° C. until use. The HA was carried out in U-profile microtest plates (Nunc). The samples to be evaluated were applied in a final volume of 100 μl in PBS and serial dilutions 1:2 in PBS were made. Finally, 50 μl of 2% erythrocytes in PBS was added to each well, the plate was gently shaken and kept at 4° C. in darkness for at least two hours. The title was obtained from the inverse of the highest dilution that maintains the hemagglutinating capacity.

Example 1.9. Parvovirus MVM Titration by Plaques Formation

[0083] Based on [Gil-Ranedo, J., Hernando, E., Valle, N., Riolobos, L., Maroto, B. and Almendral, J M (2018) Differential phosphorylation and n-terminal configuration of capsid subunits in parvovirus assembly and viral trafficking, Virology, 518, pp. 184-194]. NB324K cells seeded 24 h before in P60 plates at a density of 2.2×10e5 cells/plate were used. The culture medium was removed, cells washed in PBS with Ca++ and Mg++(complete or PBSc), and the viral inoculum was added in 400 l per P60 diluted in PBSc supplemented with 0.1% FCS. After one-hour adsorption at 37° C. with gentle agitation, the inoculum was removed and 7 ml of plating medium (DMEM, 10% FCS, and 0.6% agarose LM-GQT Pronadisa) equilibrated at 37° C. was added. After a 6-days incubation, the plates were fixed in 10% formaldehyde (Panreac) in PBS and stained with 0.2% violet crystal (Panreac) in 10% formaldehyde prepared in PBS. The count of the number of lysis plaques multiplied by the dilution allows to obtain the infectious titer of the virus in plaque forming units per milliliter (PFU/ml).

Example 1.10. Obtaining Viral DNA

[0084] The low molecular weight DNA from cells electroporated with plasmids, or infected with MVM, was obtained by a modified Hirt's method [Segovia, J C, Gallego, J M, Bueren, J A and Almendral, J M (1999) Severe leukopenia and dysregulated erythropoiesis in SCID mice persistently infected with the parvovirus minute virus of mice., Journal of Virology, 73 (3), pp. 1774-1784]. Briefly, the transfected cells were lysed in Hirt's solution (50 mM Tris pH 7.5, 0.5% SDS, 10 mM EDTA) supplemented with 20 μg/ml tRNA carrier to ensure recovery, and digested with proteinase K (100 μg/ml) (Merck) for 2 hours at 37° C. The reaction was adjusted to 1M NaCl and the genomic DNA was precipitated overnight at 4° C. The enriched fraction of low molecular weight viral DNA was obtained from the supernatant after centrifuging the samples at 4° C. and 14 K rpm for 30 minutes in a microfuge (Eppendorff). This DNA was precipitated with 0.3 M NaCl and 2.5 volumes of absolute ethanol at −20° C., washed with 70% ethanol to remove salts, and resuspended in water or in 50 mM Tris pH 7.5 and 1 mM EDTA.

Example 1.11. DNA Electrophoresis and Transfer to Membranes

[0085] Samples were electrophoresed 2-3 h at 60V on a 0.8% agarose gel (Gibco) in Tris-Borate-EDTA buffer (45 mM Tris-borate, 1 mM EDTA) with 5 μg/ml ethidium bromide (Boehringer) together with molecular weight markers (HindIII digest of phage 029 DNA) and controls of replicative forms and ssDNA of MVM. The transfer was made to a Nylon membrane (Hybond-N+, Amersham, Pharmacia) in 0.4 M NaOH overnight. Finally, the membrane was washed in a 2×SSC solution for 10 minutes at room temperature (20×SSC is: 3 M NaCl, 0.3 M sodium citrate) and dried 2 hours at 78° C.

Example 1.12. Hybridization with Specific MVM Probe

[0086] The membrane was incubated in pre-hybridization solution (5×SSC, 5×Denhardts' solution [Ficoll (Ty400), Polyvinylpyrrolidone, BSA], 10 mM Tris-HCl pH 7.5, 0.5% SDS, 50% Formamide), to eliminate possible nonspecific binding, for four hours at 42° C. Next, the solution was replaced by the hybridization solution, which is formed by the same components of the pre-hybridization solution together with the denatured probe. The probe was the full-length the MVM genome labeled in vitro to high specific activity with .sup.32P by “random priming” generally using dCTP-alpha .sup.32P and purified by a Sephadex G-50 spin-column. Hybridization was allowed at 42° C. for one or two days, and finally membranes were washed with a solution of 0.1×SSC and 0.5% SDS at 50° C. for three hours, before exposure to X-ray films.

Example 1.13. Antibodies

[0087] The primary and secondary antibodies used in immunological techniques were:

TABLE-US-00002 IF/ Antibody m/pAc Dilution Incubation WB Origin Reference Primary B7 mAc 1:50  1 h RT IF No commercial C R Parrish Antibodies BAX pAb  1:10000 1 h RT WB Proteintech 50599-2-Ig Beta-Actin pAc 1:5000 1 h RT WB Invitrogen PA1-183 MDM2 mAB  1:10000 1 h RT WB Proteintech 66511-1-Ig Nestin mAc 1:500  1 h RT IF Chemicon MAB5326  1:100000 4° C. on WB NS1-Mouse pAc 1:2000 1 h RT IF No commercial J M Almendral NS1-S7 pAc 1:2000 1 h RT IF No commercial J.  1:100000 4° C. on WB Rommelaere p21 mAc  1:10000 4° C. on WB Santa Cruz sc-53870 Biotechnology PCNA mAc 1:2000 4° C. on WB Cell Signaling # 2586 p53 (~20) mAb 1:200  1 h RT IF Cell signalling # 2524 1:2000 4° C. on WB p53 (212-217) mAb 1:20  1 h RT IF Invitrogen AHO0112 1:2000 4° C. on WB Pp53 (S15) mAb 1:2000 1 h RT IF Cell Signaling # 9286 1:2000 4° C. on WB VP (VPB pAc 1:100  1 h RT IF No commercial J M  1:10000 4° C. on WB Almendral Secondary Anti-rabbit pAc 1:500  1 h RT IF Invitrogen A-31572 antibodies IgG-Alexa 555 Anti-rabbit pAc 1:500  1 h RT IF Invitrogen IgG-Alexa 647 Anti-rabbit pAc 1:500  1 h RT IF Invitrogen A-31570 IgG-Alexa 488 Anti-mouse pAc  1:10000 1 h RT WB DAKO P0161 Ig-HRP Anti-rabbit pAc  1:10000 1 h RT WB Cell signalling # 7074 Ig-HRP

Example 1.14. Chemical Reagents

[0088] Hydroxyurea was obtained from Calbiochem (Hydroxyurea cat 400046-5 gm). 5-Fluoruracil (5FU) was obtained from Sigma (Ref F-6627-1G). Cisplatin from EMC Millipore (232120-50 mg).

Example 1.15. Protein Analyses: SDS-PAGE and Transfer to Membranes. Protein

[0089] samples, once denatured by boiling for five minutes in loading buffer (10% glycerol (Merck), 5% β-mercaptoethanol (Merck), 0.002% bromophenol blue (Merck), 0.5M Tris-HCl pH 6.3, 0.4% SDS), were resolved by denaturing gel electrophoresis of 8% polyacrylamide. Electrophoresis was carried out in a Tris-Glycine buffer (25 mM Tri-HCl (Serva), 192 mM Glycine (Gibco), 0.1% SDS) for two-four hours at 100 V in minigels (10×10×0.1 cm), with molecular mass markers run in parallel (“Prestained SDS-PAGE Standards, Broad Range” (Biorad), or “Protein Molecular Weight Standards, Broad Range”, Amersham). The samples were transferred to nitrocellulose memebrane (Schleicher and Schuell) in transfer buffer (25 mM Tris base, 192 mM glycine, 0.1% SDS, 20% methanol) for one hour at 100 V (Trans-blot electrophoretic transfer Cell, Biorad).

Example 1.16. Detection of Proteins Blotted to Membrane (“Western Blot”)

[0090] The membrane was hydrated in TBS-T buffer (20 mM Tris pH 7.5, 140 mM NaCl, 0.1% Tween 20) and incubated under shaking for one hour at 4° C. in TBS-T with 10% fetal bovine serum (FBS). After washing with TBS-T it was incubated with the primary antibody diluted in TBS-T with 1% FBS and 1% NP40, for 24 h at 4° C. After thorough washing, the secondary antibody was added at incubated for 1 h at RT. Finally, the membrane was washed with TBS-T and TBS (without Tween 20), revealed with the ECL system (“Enhanced Chemiluminiscence”, Amersham) and exposed to autoradiograpy (Kodak).

Example 1.17. Plasmids

[0091] To express the p53 protein in cell cultures the pCMV-neo-p53 plasmid was used [Baker S J, Markowitz S, Fearon E R, Willson J K, and Vogelstein B. Suppression of human colorectal carcinoma cell growth by wild-type p53. Science 1990, 249 (4971): 912-5], kindly provided by J. Paramio (Ciemat, Madrid). The plasmid named “Helper” and the plasmid to express the E4orf6 oncogene of Adenovirus [Winter, K., von Kietzell, K., Heilbronn, R., Pozzuto, T., Fechner, H., and S. Weger. (2012). Roles of E4orf6 and VA I RNA inadenovirus-mediesated stimulation of human parvovirus B19 DNA 30 replication and structural gene expression. J. Virol. 86, 5099-5109] were kindly donated by S. Weger (Charité, Berlin). Plasmids were transfected into cells by a chemical (Jetpaid) or physical (electroporation) method depending on cell type.

Example 1.18. Sequencing of the TP53 Gene

[0092] Cell samples were processed to obtain total RNA using Trizol and conventional protocols. The RNA was then copied to cDNA using Reverse Transcriptase and random primers. The thus obtained cDNA was used to sequence the human or mouse TP53 gene using the TP53 sequence and primers listed in the Annex. Methods followed were the conventional Sanger sequencing, or massive sequencing (NGS) for the RNA samples obtained from FACS-sorted GSs (see FIGS. 2 and 3). Both methods of sequencing were performed by the Parque Cientifico de Madrid (PCM) using the equipment and protocols available in this facility.

Example 2. Results

Example 2.1. The Expression of the Parvovirus MVM Major NS1 Cytotoxic Protein in Human Glioblastoma Stem Cells (GS) Correlates with p53 Induction

[0093] FIG. 1 (left) shows the p53 response in GS from three patients (#5, 7 and 8) infected by the MVMp or MVMi strains. In uninfected neurospheres, p53 staining is weak and homogeneous. After infection the expression of NS1, the major nonstructural cytotoxic virus protein, was detected in a variable % of GS depending on the patient, but in all three cases p53 is induced strongly and specifically in the NS1+ cells. When infections of GS from four patients were analyzed in western blot (FIG. 1, right), the p53 induction of p53 is not evident by the signal background coming from most cells not expressing NS1. Only in GS7, more permissive to MVM, this induction is patent. Therefore, GS cells induce a genuine DNA damage response (DDR) involving p53, in response to MVM infection.

Example 2.2. Those GS Permissive to the Parvovirus MVM Genome Replication Induce p53 Modified by Phosphorylation at the Serine 15 Residue

[0094] We next studied whether the DDR mounted by the GS in response to the parvovirus MVM involves, in a cell-type and/or virus-strain dependent, the modification at the Serine 15 residue of p53 by phosphorylation (Pp53-S15). In uninfected GS neurospheres, a basal expression of Pp53-S15 was observed, with some prominent cells in GS5 and GS7, but when infected by MVMp the Pp53-S15 is clearly induced in a significant fraction of the cells expressing NS1 (FIG. 2A). An estimate of the basal expression percentages, and of the Pp53-S15 induction in response to MVM strains infection—in GS as well as in various established lines—are shown in FIG. 3B. However, the virus genome replication in the neurospheres occurs preferentially in those Pp53-S15+GS cells (FIG. 2A, below). This correlation NS1+/Pp53-S15+ was quantitatively confirmed by flow cytometry (FIG. 2B), since in the NS1+ populations of GS from two patients infected by MVMp, the synthesis of viral DNA (vDNA+) is preferably carried out in cells expressing high levels of Pp53-S15.

Example 2.3. Transformed Cell Lines of Distinct Origins, Including Various Types of Human Cancers, which are Permissive to NS1 Expression and Sometimes to MVM Genome Replication, Harbor p53 Mutated and/or Altered Phenotypically, Usually by Phosphorylation at Ser15

[0095] To extend the previous study to other types of cancers, as well as to the cells used to grow these viruses, several human and other mammals cell lines were infected with the two virus strains (MVMp, MVMi) and analyzed for the NS1 expression and virus genome replications, in relation to the presence of mutations in the TP53 gene and to post-translational modifications of the p53 protein. The results obtained in these analyses were: [0096] The A9 cell line of immortal mouse fibroblasts, commonly used to grow MVMp virus [Gardiner, E M and Tattersall, P. 1988. Mapping of the fibrotropic and lymphotropic host range determinants of the parvovirus minute virus of mice. J Virol 62 (8): 2605-2613] [Gil-Ranedo, J., Hernando, E., Riolobos, L., Dominguez, C., Kann, M., and José M. Almendral. 2015. The mammalian cell cycle regulates nuclear parvovirus capsid assembly. PlosPathogens, 11; 11 (6): e1004920] infected with MVMp and synchronized with thymidine, were analyzed at 9 h post-release of this arrest, when the synthesis of macromolecules of the virus reaches its maximum values [Gil-Ranedo, J., Hernando, E., Riolobos, L., Dominguez, C., Kann, M., and Jose M. Almond tree 2015. The mammalian cell cycle regulates nuclear parvovirus capsid assembly. PlosPathogens, 11; 11 (6): e1004920]. It was observed that while the cell cycle of uninfected A9 cells accumulated under these conditions at G2 (FIG. 2C, upper), a significant fraction of the infected cells was retained before G2. Although close to 40% of the cell population did not express NS1, all cells expressing NS1 had progressed to G2. More importantly, only half of those NS1 expressing cells are permissive to the synthesis of the virus DNA (vDNA). P53 was induced in response to infection, and level of synthesis corresponded to that of NS1 (FIG. 2C, below). In these cells the Pp53-S15 constitutive levels were undetectable (see also FIG. 3C), but were strongly induced in response to infection, and those vDNA+ cells have higher p53-S15 induction levels (FIG. 2C, middle panel).

[0097] To analyze the marked difference between the NS1+ cells allowing or not vDNA synthesis, we proceeded to sort these two cell populations and to characterize their TP53 genetic. Sorted A9 NS1+ cells behaved again distributed in two populations vDNA+/− of similar size (FIG. 3 E, left). Remarkably, the TP53-G665 C mutation (which determines the amino acid change V170 L) was detected in the expressed mRNA in the two A9 populations, as well as in the initial unsorted A9 population, but not in control non-transformed mouse fibroblasts non-permissive to MVM infection (FIG. 3H). Therefore, A9 cells have the nonsense V170L mutation (corresponding to V173L in the human TP53 gene), which may be required for the expression of NS1 (see more below). The MVMp genome replication is mainly confined to a A9 cell subpopulation in which infection induces p53 phosphorylated at Ser15. [0098] Human and Primate cell lines transformed by oncogenic viruses (FIG. 3A, upper), expressing oncogenes that inactivate or functionally alter p53. These were three: NB324K, human newborn kidney cells transformed by the oncogenic polyomavirus SV40 T antigen [Shein, H M, Enders, J F and Levinthal, J D (1962). Transformation induced by simian virus 40 in human renal cell cultures. II. Cell-virus relationships. Proceedings of the National Academy of Sciences of the United States of America, 48, pp. 1350-7]. The sequence of the TP53 gene in these cells determined from cDNA had no mutations (data not shown), but they did show Pp53-S15 constitutive alteration, p53 induction correlating with NS1 expression, and virus genome replication at high levels in most cells (FIG. 3A and FIG. 3D), although the Pp53-S15 expressing levels in virus replicating cells varied. The results were similar in COS-1 cells (primate fibroblasts also transformed by SV40), and Hela (obtained from human cervical cancer induced by Papillomavirus infection), although the virus genome replication and Pp53-S15 constitutive levels were generally lower (FIG. 3A). [0099] Cell lines established from glioblastoma patients. [0100] U373-MG and U251-MG. These cells harbor the TP53-g849a mutation that encodes the R273H amino acid change in p53, a mutation well documented in the literature that we confirmed by Sanger sequencing of their mRNA (data not shown). These cells are poorly permissive to the two MVM (p, i) strains, as only a small fraction of the population induces NS1 at low levels, coinciding with a p53 rise (FIG. 3A and FIG. 3D). These glioblastoma cell lines show constitutive Pp53-S15 alteration, though at basal levels, and they sustain MVM (p, i) strains genome replication exclusively in those low number of Pp53-S15+ cells (FIG. 3A). [0101] U87-MG. Genetic alterations in the TP53 mRNA could not found in this cell line (data not shown), as described earlier in the literature, nor they showed the Pp53-S15 modification constitutively (see FIGS. 4, 6 and 7). However, the U87-MG expressed p53 protein must have other type(s) of post-translational modification(s) since a commercial antibody (Invitrogen) raised against the 212-217 amino acids domain did recognize it (as well as other p53 species in other cell types), whereas other commercial antibody of different specificity (Cell Signaling) obtained against a peptide from the environment of residue 20, did not recognize p53 (FIG. 3F). Notably U87-MG cells were mostly permissive to the expression of the NS1 protein of MVMi, but not that protein of MVMp, although MVMi did not replicate its genome nor induced Pp53-S15+(FIGS. 4 and 6).

Example 2.4. Expression of the Cytotoxic NS1 Protein of Parvovirus MVM Requires TP53 Mutations or p53 Protein Modifications

[0102] Although the correlation between genetic alterations in TP53 and/or modifications in the p53 protein with the expression of the NS1 protein of MVM was consistent in several transformed cell lines (FIGS. 1-3), this evidence did not demonstrate a causal relationship between both phenomena. To address this important issue, we proceeded to overexpress the p53 protein from the pCMV-neo-p53 plasmid [Baker S J, Markowitz S, Fearon E R, Willson J K, Vogelstein B. Suppression of human colorectal carcinoma cell growth by wild-type p53. Science 1990, 249 (4971): 912-5] both in mouse A9 cells that possess the TP53-V173L mutation (actually the equivalent V170L mouse mutation) and NB324K cells that lack mutations in TP52 but show highly phosphorylated p53-S15 (FIGS. 3A and C). As shown in FIG. 3G, NS1 expression upon transfection with carrier DNA (prepared from salmon sperm) was very high in both cell types, while p53 levels were basal or undetectable. However, when p53 was over-expressed by the pCMV-neo-p53 transfection, an absolute inhibition of NS1 expression was caused. Those mouse A9 and human NB324K cells overexpressing transfected wtp53 above the characteristic constitutive levels, completely exclude the accumulation of the viral NS1 protein (see pTP53 panels in FIG. 3G). Therefore, the expression of NS1 requires functional alterations of p53 induced by genetic mutations in TP53 or post-translational modifications in the p53 protein.

Example 2.5. The Parvovirus MVM Expresses Cytotoxic Proteins and Replicates its Genome Preferably in Human Glioblastoma Stem Cells (GS) Harboring Genetic Alterations in TP53

[0103] The analyses with established lines supported the association found between the Pp53-S15 modification and the permissiveness to MVM infection in GS cells (FIG. 2A), and further suggested that this relationship could stand from a genetic basis. Therefore, to address this issue in depth, the genetic status of TP53 was analyzed in the GS of the four patients. For this, samples from control uninfected, MVMp or MVMi infected, as well as GS infected by MVMp and further sorted (FACS, see Material and Methods) for the NS1 and Pp53-S15 expression, were obtained. FIG. 3E illustrates the restrictive windows (gates) chosen (to ensure purity) of the NS1+/Pp53-S15+ and NS1+/Pp53-S15 cell populations submitted to genetic analysis. From all these samples polyA+ mRNA was purified, copied to cDNA and amplified by PCR across the TP53 gene. These amplicons were sequenced by new generation sequencing (NGS, FIGS. 2D and E) and confirmed by the conventional Sanger sequencing method (FIG. 3I). The various mutations in TP53 that were detected are described below (discussed in the N to C direction of the p53 protein): [0104] The P72R Mutation. The c215g mutation that involves the amino acid residue P72R change (nonsense mutation) in the proline rich domain (PRD) of p53 (see FIGS. 2F and 3J), is clearly apparent in the infected and FACS-sorted (+/+ and +/−) GS7 populations, as well as in a significant proportion of both equivalent GS8 sorted populations, and in a very low proportion of GS5 cells allowing NS1 expression (+/−). Therefore, the p53-P72R change benefits the MVMp transcription and replication, although to a different degree depending on the GS context GBM patient. It is interesting that this mutation has been described in a single sample of GBM by the Cosmic database (FIG. 2F), but it is a common mutation in hematopoietic and lymphoid tumors, in particular P72R is by far the most frequent TP53 mutation in Acute Myeloid Leukemia (AML) (FIG. 3J). [0105] The V173L mutation corresponds to the V170L change that we have identified in the A9 mouse fibroblast cell line. This mutation has been described in two GBM samples (FIG. 2F), and it is localized in the “hotspot” region of the DBD domain of p53 where more mutations have been found (FIG. 3J). The V173L change is implicated in diverse cancers but particularly at high frequency in rectal adenocarcinoma and lung adenocarcinoma (FIG. 3J). [0106] The G245S mutation. It was found by NGS that the GS from patients 8 and 9 have the TP53 gene mutated in the position g733a, what entails the amino acid change G245S (nonsense mutation) in all cells and all samples (sorted and total populations regardless of MVM infection) of these patients (FIG. 2 D, E). The mutation was confirmed in the same samples by Sanger sequencing (FIG. 3I). The general presence of the mutation suggests that does not benefit the virus gene expression by itself. However, this TP53-g733a mutation also appears in a low proportion of the GS5 cells (FIG. 2E), exclusively in those infected and sorted (+/+ and +/−), which point out that the p53-G245S change may contribute to MVM transcription and replication in these GS5 cells. It is important to note that this mutation has already been described at high frequency in the updated GBM genetic databases (FIG. 2F), in consistency with its location within the “hot spot” region of p53, the DBD domain. Furthermore, the p53-G245S change is one of the most frequent mutations in the multiple types of human cancer analyzed for TP53 genetics (FIG. 3J), as for example bladder cancer, rectal and lung adenocarcinomas (FIG. 3J). [0107] The E258K mutation. The g772a mutation, which entails the E258K amino acid change (missense mutation), was observed by NGS in the low percentage of the infected and sorted GS7 population expressing NS1, strongly suggesting that it contributes to viral transcription in these GBM stem cells. This mutation was not previously described in the current GBM genetic databases (FIG. 2F), although it is also localized in the “hotspot” p53 DBD domain, where more mutations have been found. Indeed the E258K mutation is common in many types of cancers (FIG. 2F, lower), and it stands out as a very common mutation in bladder carcinoma (FIG. 3J). [0108] The R273H mutation. This nonsense mutation was not found in the primary GS of the four patients that we have analyzed (FIGS. 2 and 3), although it is very common in GBM genetic databases (FIG. 2F). Noteworthy, the p53-R273H mutation is currently highlighted as the most frequent in the overall thousands of human cancers studied (see examples in FIG. 3J). Although the failure to identify the R273H mutation in the four GS could be due to the limited number of samples, our study rather suggests that this mutation per se poorly benefits the MVM infection. This hypothesis is endorsed by the fact that the U373MG and U251MG glioblastoma cell lines harboring this mutation, are poorly permissive to MVMp as well as to MVMi infections (FIGS. 3A, and 5). However, MVMp makes very good synergy with chemotherapeutic drugs in the cytotoxic infection of the U373MG glioblastoma line (FIG. 5, see below), strongly suggesting that genotoxic chemotherapy treatments of GBM and other cancers bearing the p53-R273H mutation in combination with MVM may bring very important clinical benefits. [0109] The S366A mutation. The t1096g mutation, which entails the S366A amino acid change (a nonsense mutation), was observed by NGS in the global and sorted GS5 and GS7 populations independently of MVM infection. This suggests that this mutation by itself neither benefits nor inhibits parvovirus MVM infection. It is unlikely that this mutation contributes to some extent with others in the GS7 and GS5 permissiveness to MVM infection, although this possibility cannot be ruled out with the available data. The mutation S366A resides at the p53 carboxy-terminus, and it has not been described in GBM samples (FIG. 2F). Indeed, its overall role in human cancer seems poorly relevant (FIG. 3J, below).

[0110] In summary, the following relevant conclusions can be drawn from this analysis: [0111] All GS populations expressing the NS1 cytotoxic protein, which may replicate the MVMp genome to different levels, harbor in a certain percentage some TP53 mutation, either individually or accompanied by other(s). [0112] The G245S and the R273H mutations favoring MVM infection in GS and glioblastoma cell lines respectively, are the most frequent p53 mutations found in GBM and other genetically characterized human cancers, which underscores the importance of our analysis. [0113] The P72R, V173 L, and E258K mutations, were previously undescribed or found at very low frequency in GBM. However, they do appear at high frequency in other cancer types, which may allow extending the MVM-based therapy other cancers. [0114] The P72R (except one case) and E258K mutations have not been previously described in GBM, yet they become detected in GS by NGS upon MVMp infection, which could allow the use of MVM for diagnosis of minor though clinically relevant p53 mutations in tumors. [0115] GS harboring TP53 mutations that correlate with NS1 expression also induce Pp53-S15 phosphorylation, which should promote virus transcription and replication. [0116] Therefore, among the large genetic heterogeneity of the GS populations, even being most cells wtTP53, the MVM specifically targets in the cytotoxic infection, and sometimes also in the virus genome replication, the low GS proportion harboring genetically altered TP53. [0117] The most frequent TP53 mutation in human cancer, R273H, does not make cells permissive to MVM by itself, but it does promote however an important synergistic cytotoxicity of the virus with chemotherapy (see more below).

Example 2.6. The Exogenous Expression of Oncogenes that Alter p53 Increases the Permissiveness of GS and Glioblastoma Cell Lines to MVM Infection

[0118] The high permissiveness to NS1 expression and MVM genome replication in cancer lines with constitutive Pp53-S15 staining and expressing viral oncogenes (FIG. 3A, upper), prompted us to investigate a possible causal connection between both features, if wtTP53 cells could be made susceptible to MVM by exogenously altering functionally p53. FIG. 4A shows that NIH3T3 mouse fibroblasts not permissive to MVMp infection substantially increase NS1 expression and virus genome replication upon transfection by a so called “helper” plasmid, which inactivates p53 by a degradation mediated by the expression of the E1A, E1B, and E4 orf6 adenovirus oncogenes, and inactivate PKR by the VA-RNA I [Winter, K., von Kietzell, K., Heilbronn, R., Pozzuto, T. Fechner, H., and S. Weger. (2012). Roles of E4orf6 and VA I RNA inadenovirus-mediesated stimulation of human parvovirus B19 DNA replication and structural gene expression. J. Virol. 86, 5099-5109]. In parallel (FIG. 4D), MVMp infected GS5 cells, mounting a high DDR in response to NS1 expression, substantially increase the viral genome replication if they are transfected with the “helper” plasmid or another plasmid only expressing the E4orf6 oncogene [Winter, K., von Kietzell, K., Heilbronn, R., Pozzuto, T., Fechner, H., and S. Weger. (2012). Roles of E4orf6 and VA I RNA in adenovirus-mediated stimulation of human parvovirus B19 DNA replication and structural gene expression. J. Virol. 86, 5099-5109]. The results were confirmed in GS8 cells, which are very restrictive to MVMp replication although induce p53 in NS1 expressing cells (FIG. 4B), but a significant increase in MVM replication is observed when oncogenes are expressed by transfection (FIG. 4C). This experimental strategy was translated to the MVMi infection of U87-MG glioblastoma cells, which possess a wtTP53 sequence but express a post-translational modified p53 protein (FIG. 3). Consistently, oncogenes expression also resulted in a significant increase in virus genome replication measured by IF-confocal (FIG. 4E, left) and cytometry (FIG. 4E, right). Therefore adenovirus oncogenes functionally inactivating p53 increase MVM replication in GSs and glioblastoma cell lines with wtTP53.

Example 2.7. Chemotherapy Drugs Altering p53 Phosphorylation Increase MVMp Gene Expression, Replication, and Ability to Kill U373-MG Glioblastoma Cells Harboring the TP53-R273H Mutation, Very Frequent in Multiple Types of Human Cancers

[0119] As MVM infection correlated with Pp53-S15 expression (FIGS. 2 and 3), we studied whether the virus infection can benefit from a combination therapy with chemotherapeutic drugs (CD) of common use in clinical regimes (5FU, HU and Cis-Pt). For example, CisPt is a commonly used drug in clinical regimes against multiple human cancers (Dasari, S., and Tchounwou, PB. Cisplatin in cancer therapy: Molecular Mechanisms of action. Eur J Pharmacol. 2014 Oct. 5; 0: 364-378). For this study, we used human glioblastoma cell lines with two genetic backgrounds. In the first study, U373MG carrying the R273H mutation frequently present in many types of human cancers [Muller, P A, and Vousden, K H 2013. P53 mutations in cancer. Nat. Cell Biol. 13, 2-8] [Brennan, C W et al. The somatic genomic landscape of glioblastoma. Cell 155, 462-477], moreover in a deep search in current databases performed by us it appears as the most frequent in GBM (FIG. 2F) and cancer in general (FIG. 3J). The FIG. 5A shows by flow cytometric analysis of MVMp infected U373MG (that allows to quantitatively determine the levels of protein expression in cells), an increase in the percentage of cells expressing the NS1 protein, as well as in the level of expression, in combined treatments with a single dose of the CDs with respect to the simple infection. The CisPt treatment determines the highest increase in both parameters of NS1 expression. This benefit is most likely linked to the generalized Pp53-S15 induction in all cells caused by CisPt, which is also observed in treated and non-infected cells. This effect was confirmed by IF-confocal (FIG. 5B).

[0120] Consequently, the CisPt dose effect on different MVMp life cycle parameters, and on p53 phosphorylation and functional signaling in U373-MG cells, was analyzed. For this, the U373-MG cells treated with Cis-Platinum doses (10-120 microM) for 1 hour at 37° C. were inoculated with MVMp to allow adsorption, and then of the infection was allowed to progress for 24 hours. Cells were sampled and processed for virus macromolecular markers and Pp53-S15 determinations. A significant increase in the Pp53-S15 levels was observed by IF-confocal across all the assayed 5-20 microM range of Cis-Pt doses (FIG. 5C), in a coordinated manner to the increase (%) of the NS1 expression and virus genome (vDNA) replication with respect to the basal infection. Of note, the virus genome replication levels benefitted from 10 microM CisPt but not from higher doses, which seems to damage the vDNA synthesis machinery. The increasing NS1 levels across the 5 to 20 microM CisPt doses was confirmed by western blot (FIG. 5D), which also reflected alterations in the levels of the p21 and MDM2 factors related to p53 functional signaling.

[0121] We finally analyzed whether these MVM/CisPt cooperative effects impact cancer cells viability, and therefore whether they imply a therapeutic significance. As seen in FIG. 5E, the simple 1-hour treatment with CisPt progressively decreased the viability (clonogenic assay) of U373-MG cells, in correspondence with its common use as chemotherapy drug in the oncology clinic. Moreover, MVMp singly inoculated at two MOI also decreased cell viability to some extent. However, when CisPt and MVMp were applied in combination, the cell viability decreased very significantly in an additive manner (FIG. 5E, 5 and 10 microM CisPt). This joint cooperation between the drug and the virus in killing human U373-MG glioblastoma cells, which harbor the TP53-R273H mutation, can lead to important therapeutic benefits in the treatments against the multiple human cancers carrying this mutation (see FIG. 3J).

Example 2. 8. The Two MVMp and MVMi Parvovirus Strains, in Combined Therapy with CDs, Increase their Gene Expression and Replication, and their Ability to Kill U87-MG Human Glioblastoma Cells Harboring p53 Post-Translational Modifications

[0122] In a second study, this analysis of CD/MVM combined therapy was extended to the U87-MG human glioblastoma cell line, which lacks TP53 mutations but expressed post-translationally modified p53 protein forms (FIG. 3F). In the first analysis, a possible CD/MVMi cooperation was studied. At basal state the U87-MG cells did not show significant Pp53-S15 signal, MVMi expressed high NS1 levels but failed to replicate its genome (FIG. 6D). However, HU and 5FU treatments of uninfected U87-MG cells substantially increased per se p53 phosphorylation at the Ser15 residue (FIG. 6A,B). Consistent with this effect, when these CDs were administered at selected doses they proportionally increased the replication levels of the virus genome in these cells (FIG. 6C, D). As shown in FIGS. 6F and H, this vDNA synthesis increase corresponded to a greater capacity of the MVMi to kill U87-MG cells in combination with 5FU (whose effects reached synergy levels) and with OH-U (additive effects). FIGS. 6E and G show as the increased Pp53-S15 phosphorylation that accompanies the infection (in respect to uninfected cells) is higher at the CD doses bringing best benefit for the virus, which also determine a more patent decrease in the p21 levels (a functional marker of p53).

[0123] In a second analysis the CD/MVMp cooperation was analyzed. MVMp infection of U87-MG (FIG. 7A) yields a very low proportion of NS1+ cells even at high multiplicity (MOI 10). However, when cells were treated with different Cis-Pt doses prior infection, a very significant increase in the percentage of NS1+ cells were observed (FIG. 7A). This increase was consistent with that of the Pp53-S15 levels correlating with the CisPt doses used. The NS1/Pp53-S15 coordinated increase was also demonstrated by western-blot (FIG. 7B), which also reflected p21 alterations. As described above for U373MG, the MVMp genome replication (vDNA) also benefitted from the 10 or 20 microM Cis-Pt treatment, but not from higher doses, suggesting an increased sensitiveness of the replicative over the transcriptional virus machineries to CisPt (FIG. 7A). The increase in the % of NS1+ cells corresponded to the greater capacity of MVMp to kill U87-MG cells in combination with CisPt, which reached levels of synergy at the 10 and 20 microM doses (FIG. 7C). Interestingly, the decrease in p21 levels (a functional marker of p53) in the infected cells was more patent at these doses (FIG. 7B). Finally, combining MVMp with 5FU (FIG. 7D) and HU (FIG. 7E) also yielded consistent additive effects in U87-MG cells killing at the doses at which these CD induce higher Pp53-S15 levels in uninfected cells (see FIGS. 6A and B respectively).