Expert consensus on administering oncolytic viruses for gynecological cancers in China

Oncolytic virus (OV) therapy constitutes a novel advancement in cancer immunotherapy, with a distinctive dual mechanism of action against gynecological malignancies. These viruses, either genetically engineered or naturally occurring, are designed to selectively replicate within and lyse tumor cells, while eliciting a robust systemic antitumor immune response through the release of tumor-associated antigens and danger signals. This therapeutic strategy shows considerable promise for treating recurrent or treatment-resistant ovarian, cervical, and endometrial cancers, conditions for which conventional therapies are often inadequate. To standardize and enhance its clinical implementation, an expert consensus evaluated and endorsed three primary routes of administration. Intratumoral injection administers the virus directly into accessible tumors, thereby maximizing local viral concentration while minimizing systemic exposure. By contrast, intravenous infusion is useful for addressing disseminated or metastatic disease, as it enables the virus to circulate and target tumor sites throughout the body. Intraperitoneal delivery is particularly significant for gynecologic malignancies, such as ovarian cancer, which predominantly metastasizes within the abdominal cavity. This approach exposes peritoneal surfaces to a high concentration of the therapeutic virus, ensuring direct interaction with both primary and metastatic lesions. By delineating these strategic administration pathways, the consensus provides a practical framework to improve efficacy, inform clinical decision-making, and facilitate the broader integration of OV therapy into the oncological treatment repertoire for gynecological cancers.