Gene therapy of ovarian cancer.

For the treatment of ovarian cancer, gene therapy is increasingly viewed as the fourth therapeutic concept (in addition to surgery, chemotherapy, and irradiation). Many approaches that use viral and nonviral delivery systems have been employed to introduce genes into tumor cells, thus changing their malignant phenotype. The development of tissue-specific promoters has enhanced the specificity of adenoviral transduction, the most commonly used transfer method. Phase I clinical trials (targeting p53, BRCA1, Her2/neu, Bcl-2, MDR, EIA, and HSV-TK genes) have been performed to test the relative safety of different strategies. Further studies are needed to evaluate the effectiveness of these treatments. New studies must evaluate gene therapy alone and in combination with cytostatic regimens because preclinical studies have shown the chemosensitizing effects of several target genes. The increasing knowledge about the genetic background of ovarian cancer will provide many targets for novel gene therapy approaches.