Abstract
Since the discovery of DNA and the subsequent recognition that genetic defects (either inherited or acquired) can be responsible for various disease states, the concept of gene therapy has been extremely appealing. However, despite intensive work in this field of medicine, gene therapy has yet to make a major impact on the treatment of patients. Many technical challenges exist that must be overcome before gene therapy can be put into widespread practice. The gene delivery system (vector) encounters extracellular and intracellular barriers, must be nontoxic and nonimmunogenic, and must allow sufficient expression of the gene of interest. Many vectors have been created in attempts to overcome these problems; however, the ideal expression vector for use in humans has yet to be identified. Both inherited and acquired diseases may potentially benefit from gene therapy. X-linked severe combined immunodeficiency-X1 is an inherited disease in which gene therapy is not only being actively pursued as a potentially curative treatment, but some exciting progress has been made in recent years. In addition, acquired diseases, such as cancer, often have defined genetic alterations and, thus, are potential candidates for treatment with gene therapy. For example, malignant melanoma, a tumor that is notoriously chemoresistant, may avoid immune recognition by progressive loss of cell surface MHC class I molecules. Allovectin-7® is a DNA plasmid containing the gene encoding human MHC class I HLA-B7. Early phase I/II studies of Allovectin-7® in patients with metastatic melanoma have shown some encouraging results. It is one of many examples of how gene therapy may affect cancer treatment in the near future.
Similar content being viewed by others
References
Watson JD, Crick FH. A structure for deoxyribose nucleic acid. Nature 1953Apr 25; 171(4356): 737–8
Friedmann T, Roblin R. Gene therapy for human genetic disease? Science 1972; 75: 949–55
Balicki D, Beutler E. Gene therapy of human disease. Medicine 2002; 81(1): 69–86
Verma IM, Somia N. Gene therapy: promises, problems and prospects. Nature 1997Sep 18; 389: 239–42
US National Institutes of Health [online]. Available from URL: http://http://www.chnicaltrials.gov/ct/action/GetStudy [Accessed 2005 Jun 2]
Kouraklis G. Gene therapy for cancer: from the laboratory to the patient. Dig Dis Sci 2000Jun; 45(6): 1045–52
Galanis E, Vile R, Russell SJ. Delivery systems intended for in vivo gene therapy of cancer: targeting and replication competent viral vectors. Crit Rev Oncol Hematol 2001; 38: 177–9
Morsy MA, Kohnosuke M, Clemens P, et al. Progress toward human gene therapy. JAMA 1993Nov 17; 270(19): 2238–45
Kouraklis G. Progress in cancer gene therapy. Acta Oncol 1999; 38(6): 675–83
Purcell DF, Broscius CM, Vanin EF, et al. An array of murine leukemia virus-related elements is transmitted and expressed in primate recipient of retroviral gene transfer. J Virol 1996; 70: 887–97
Li Z, Dullmann J, Schiedlmeier B, et al. Murine leukemia induced by retroviral gene marking. Science 2002Apr 19; 296(5567): 497
Fisher KJ, Choi H, Burda J, et al. Recombinant adenovirus deleted of all viral genes for gene therapy of cystic fibrosis. Virology 1996; 217: 11–22
Kochanek S, Clemens PR, Mitani K, et al. A new adenoviral vector: replacement of all viral coding sequences with 28 kb of DNA independently expressing both full-length dystrophin and b-galactosidase. Proc Natl Acad Sci U S A 1996; 93: 5731–6
Kochanek S. High-capacity adenoviral vectors for gene transfer and somatic gene therapy. Hum Gene Ther 1999; 7: 527–33
Yang Y, Nunes FA, Berencsi K, et al. Cellular immunity to viral antigens limits El-deleted adenoviruses for gene therapy. Proc Natl Acad Sci U S A 1994; 91: 4408–11
Marshall E. Gene therapy on trial. Science 2000May 12; 288(5468): 951–7
StGeorge JA. Gene therapy progress and prospects: adenoviral vectors. Gene Ther 2003; 10: 1135–41
Niidome T, Huang L. Gene therapy progress and prospects: nonviral vectors. Gene Ther 2002; 9: 1647–52
Schatzlein AG. Non-viral vectors in cancer gene therapy: principles and progress. Anticancer Drugs 2001; 12: 275–304
Mannucci PM, Tuddenham GD. The hemophilias: from royal genes to gene therapy. N Engl J Med 2001Jun 7; 344(23): 1173–9
Kay MA, Manno CS, Ragni V, et al. Evidence for gene transfer and expression of factor IX in haemophilia B patients treated with an AAV vector. Nat Genet 2000; 24: 257–61
Roth DA, Tawa NE, O’Brien JM, et al. Nonviral transfer of the gene encoding coagulation factor VIII in patients with severe hemophilia A. N Engl J Med 2001Jun 7; 344(23): 1735–42
Powell JS, Ragni MV, White GC, et al. Phase I trial of FVIII gene transfer for severe hemophilia A using a retroviral construct administered by peripheral intravenous infusion. Blood 2003Sep 15; 102(6): 2038–45
Van denDriessche T. Challenges and progress in gene therapy for hemophilia A. Blood 2003Sep 15; 102(6): 1938–9
Ohashi T, Boggs S, Robbins P, et al. Efficient transfer and sustained high expression of the human glucocerebrosidase gene in mice and their functional macrophages following transplantation of bone marrow transduced by a retroviral vector. Proc Natl Acad Sci U S A 1992; 89: 11332–6
Sorge J, Kuhl W, West C, et al. Complete correction of the enzymatic defect of type I Gaucher disease fibroblasts by retroviral mediated gene transfer. Proc Natl Acad Sci U S A 1987; 84: 906–9
Dunbar CE, Kohn DB, Schiffmann R, et al. Retroviral transfer of the glucocerebrosidase gene into CD34+ cells from patients with Gaucher disease: in vivo detection of transduced cells without myeloablation. Hum Gene Ther 1998; 9: 2629–40
Cavazzana-Calvo M, Hacein-Bey S, de SaintBasile G, et al. Gene therapy of human severe combined immunodeficiency (SCID)-Xl disease. Science 2000; 288: 669–72
Hacein-Bey-Abina S, Le Deist F, Carrier F, et al. Sustained correction of x-linked severe combined immunodeficiency by ex vivo gene therapy. N Engl J Med 2002; 346: 1185–93
Hacein-Bey-Abina S, vonKalle C, Schmidt M, et al. A serious adverse event after successful gene therapy for x-linked severe combined immunodeficiency. N Engl J Med 2003; 348: 255–6
Dave UP, Jenkins NA, Copeland NG. Gene therapy insertional mutagenesis insights. Science 2004; 303: 333
Hacein-Bey-Abina S, vonKalle C, Schmidt M, et al. LMO2-associated clonal T cell proliferation in two patients after gene therapy for SCID-X1. Science 2003; 302: 415–9
Jemal A, Murray T, Ward E, et al. Cancer statistics, 2005. CA Cancer J Clin 2005; 55: 10–30
Delves PJ, Roitt IM. The immune system: first of two parts [published erratum appears in N Engl J Med 2000; 343 (15): 1132]. N Engl J Med 2000Jul 6; 343: 37–49
Tanaka K, Isselbacher KJ, Khoury G, et al. Reversal of oncogenesis by expression of a major histocompatibility complex class I gene. Science 1985; 228(4695): 26–30
Nouri AM, Hussain RF, Dos SA, et al. Intensity of class I antigen expression on human tumour cell lines and its relevance to the efficiency of non-MHC-restricted killing. Br J Cancer 1993; 67: 1223–8
Marincola FM, Shamarnian P, Alexander RB, et al. Loss of HLA haplotype and B locus down-regulation in melanoma cell lines. J Immunol 1994; 153(3): 1225–37
Hicklin DJ, Wang Z, Arienti F, et al. Beta-2-microglobulin mutations, HLA class I antigen loss, and tumor progression in melanoma. J Clin Invest 1998; 101(12): 2720–9
Plautz GE, Yang Z, Wu B, et al. Immunotherapy of malignancy by in vivo gene transfer into tumors. Proc Natl Acad Sci U S A 1993May; 90: 4645–9
Galanis E. Technology evaluation: Allovectin-7®, Vical. Curr Opin Mol Ther 2002; 4(1): 80–7
Bergen M, Chen R, Gonzalez R. Efficacy and safety of HLA-B7/β-2 microglobulin plasmid DNA/lipid complex (Allovectin-7®) in patients with metastatic melanoma. Expert Opin Biol Ther 2003; 3(2): 377–84
D’Urso CM, Wang ZG, Cao Y, et al. Lack of HLA class I antigen expression by cultured melanoma cells FO-1 due to a defect in B2m gene expression. J Clin Invest 1991; 87(1): 284–92
Nabel GJ, Nabel EG, Yang Z, et al. Direct gene transfer with DNA-liposome complexes in melanoma: expression, biologic activity, and lack of toxicity in humans. Proc Natl Acad Sci U S A 1993Dec; 90: 11307–11
Nabel GJ, Gordon D, Bishop DK, et al. Immune response in human melanoma after transfer of an allogeneic class I major histocompatibility complex gene with DNA-liposome complexes. Proc Natl Acad Sci U S A 1996Dec; 93: 15388–93
Silver HKB, Klasa RJ, Bally JB, et al. Phase I gene therapy study of HLA-B7 transduction by direct injection in malignant melanoma [abstract]. Proc Am Assoc Clin Res 1996; 3: 342: 3227
Stopeck AT, Hersh EM, Akporiaye ET, et al. Phase I study of direct gene transfer of an allogeneic histocompatibility antigen, HLA-B7, in patients with metastatic melanoma. J Clin Oncol 1997; 15(1): 341–9
Stopeck AT, Jones A, Hersh EM, et al. Phase II study of direct intralesional gene transfer of Allovectin-7®, an HLA-B7/β2-microglobulin DNA-liposome complex, in patients with metastatic melanoma. Clin Cancer Res 2001Aug; 7: 2285–91
Richards JM, Bedikian A, Gonzalez R, et al. High-dose Allovectin-7® in patients with advanced metastatic melanoma: final phase 2 data and design of phase 3 registration trial [abstract no. 7543]. Proceedings of ASCO 2005, 41st annual meeting; 2005 May 13–17; Orlando (FL)
Gleich LL, Gluckman JL, Armstrong S, et al. Alloantigen gene therapy for squamous cell carcinoma of the head and neck: results of a phase I trial. Arch Otolaryngol Head Neck Surg 1998Oct; 124: 1097–104
Gleich LL, Gluckman JL, Nemunaitis J, et al. Clinical experience with HLA-B7 plasmid DNA/lipid complex in advanced squamous cell carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg 2001Jul; 127: 775–9
Rini BI, Selk LM, Vogelzang NJ. Phase I study of direct intralesional gene transfer of HLA-B7 into metastatic renal carcinoma lesions. Clin Cancer Res 1999Oct; 5: 2766–72
Rubin J, Galanis E, Pitot HC, et al. Phase I study of immunotherapy of hepatic metastases of colorectal carcinoma by direct gene transfer of an allogeneic histocompatibility antigen, HLA-B7. Gene Ther 1997; 4(5): 419–25
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lewis, K.D., Humes, T.N. & Gonzalez, R. Current Status and Future Prospects of Gene Therapy. Am J Cancer 4, 137–144 (2005). https://doi.org/10.2165/00024669-200504030-00001
Published:
Issue Date:
DOI: https://doi.org/10.2165/00024669-200504030-00001