We have far to go before gene therapy of malignancy can truly be said to have made a major impact on these diseases.
Figure 1 Chimeric anti-EBV T lymphocyte transduced with the gene encoding for the chimeric GD2 specific-zeta chain + scFv. See the color insert for a color version of this figure.
Nonetheless, over the past decade, new techniques including gene transfer and immunotherapy have produced unequivocal tumor responses even in advanced disease. Improvement of gene transfer for the treatment of cancer certainly relies on 4 major steps: (1) simplification of gene transfer protocols, still too complex to implement in a clinical environment; (2) controllable, tissue-specific regulation of transgene expression; (3) progress in the understanding of carcinogenesis mechanisms to improve therapeutic strategies; (4) improvement in the methodology of clinical trials, including optimal choice of the patient population, and monitoring of tumor and immune responses, within the tight frame of regulatory and cost-related issues. As we continue to make incremental advances in the application of these approaches, we can expect to see gene therapy increasingly supplement probably long before they can eventually supplant conventional cancer therapeutics.
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