Favaro Elena, Indraccolo Stefano
Department of Oncology and Surgical Sciences, Oncology Section, University of Padova, 35128 Padova, Italy.
Curr Opin Mol Ther. 2007 Oct;9(5):477-82.
The field of gene therapy offers promising treatment innovations that may prove to be fundamental in helping cancer patients. In this review, recent advances in this field are discussed, with particular emphasis on new trends that have emerged in clinical trials between 2005 and 2006. Notably, among these trials only 5% were phase III trials, reflecting a lack of sound clinical advancement and, possibly, underscoring reduced enthusiasm and financial support by pharmaceutical companies in western countries. Viral vectors continue to be the preferred delivery system, with an increase in exploitation of oncolytic viruses. Nevertheless, the persistent crucial hurdle--the transfer of the therapeutic gene into sufficient numbers of tumor cells--remains. Future clinical trials will aim to identify promising combinations of genetic and conventional medicine. Multicenter trials with a broad patient enrolment will be mandatory to establish definitive proof of efficacy. In this regard, China has recently emerged as a country with growth potential in this sector and it may be the country where evidence of clinical efficacy of cancer gene therapy will first be achieved.
基因治疗领域提供了有前景的治疗创新方法，这些方法可能被证明对帮助癌症患者至关重要。在这篇综述中，将讨论该领域的最新进展，特别强调2005年至2006年期间临床试验中出现的新趋势。值得注意的是，在这些试验中，只有5%是III期试验，这反映出临床进展缺乏坚实基础，并且可能凸显了西方国家制药公司热情降低和资金支持减少的情况。病毒载体仍然是首选的递送系统，溶瘤病毒的应用有所增加。然而，关键障碍依然存在——将治疗性基因转移到足够数量的肿瘤细胞中。未来的临床试验旨在确定基因药物与传统药物的有前景的联合使用方式。必须开展广泛招募患者的多中心试验，以确立疗效的确切证据。在这方面，中国最近已成为该领域具有增长潜力的国家，并且可能是首个取得癌症基因治疗临床疗效证据的国家。
