Fig. 9: Control of viral replication in the combination therapy with oncolytic adenovirus and CDK4/6 inhibitors.

Adenovirus E1A and E2 expression is controlled by the well-balanced E2F/RB protein complex through E2F-binding sites in their promoter region (black bars). Both promoter regions compete for binding of the E2F/RB protein complex indicating a novel level of regulatory mechanism in viral life cycle. Excess level of this protein complex suppresses efficient transcription at early time points in the replication life cycle. Inhibition of RB and E2F1 protein level by CDK4/6-inhibitors might cause a shift towards low level of active E2F1 and thus facilitate early viral gene expression and replication.