A Predictive Model for Synergistic Oncolytic Virotherapy: Unveiling the Ping-Pong Mechanism and Optimal Timing of Combined Vesicular Stomatitis and Vaccinia Viruses

Abstract

We present a mathematical model that describes the synergistic mechanism of combined Vesicular Stomatitis Virus (VSV) and Vaccinia Virus (VV). The model captures the dynamic interplay between tumor cells, viral replication, and the interferon-mediated immune response, revealing a `ping-pong' synergy where VV-infected cells produce B18R protein that neutralizes interferon-$\alpha$, thereby enhancing VSV replication within the tumor. Numerical simulations demonstrate that this combination achieves complete tumor clearance in approximately 50 days, representing an 11\% acceleration compared to VV monotherapy (56 days), while VSV alone fails to eradicate tumors. Through bifurcation analysis, we identify critical thresholds for viral burst size and B18R inhibition, while sensitivity analysis highlights infection rates and burst sizes as the most influential parameters for treatment efficacy. Temporal optimization reveals that therapeutic outcomes are maximized through immediate VSV administration followed by delayed VV injection within a 1-19 day window, offering a strategic approach to overcome the timing and dosing challenges inherent in OVT.