Gene therapy in surgical oncology.

BACKGROUND

Surgery remains the only potentially curative treatment modality for the majority of patients with solid tumors. Conventional chemotherapy and radiotherapy only have roles as adjuvant or palliative therapies for most common cancers. Two decades of research have led to the first attempts at producing and introducing clinically useful genetically modified cells into humans.

METHODS

Modern molecular methods have been developed that allow the stable transfer of foreign DNA sequences into human and other mammalian somatic cells. At the present time, gene therapy predominantly involves gene insertion either directly into a target cell in situ or into an appropriate cell in vitro that is then introduced to a physiologically relevant site. We present an overview of the potential applications of molecular biology for practicing surgeons, particularly in the field of surgical oncology, to show how genes are harnessed and inserted into target somatic cells.

CONCLUSIONS

Although significant clinical therapies have and will continue to emerge from these initial experiments, only the future will provide evidence of whether the present technical skills are sufficient to have an impact on the long-term benefits for patients with cancer and genetic defects.