Gene Therapy of Bladder Cancer.
BACKGROUND: The incidence of bladder cancer has been steadily increasing and, despite improvements in treatment, many patients will not survive five years. Gene therapy is a promising approach that may improve the management of this disease. METHODS: Gene therapy involves two steps: (1) selection of an appropriate gene and (2) transfer of that gene to the target cells. RESULTS: Five broad categories of cancer gene therapy are undergoing clinical evaluation: (1) immunological augmentation by cytokine or (2) foreign gene transfer into tumor cells, (3) insertion of a suicide gene into tumor cells, (4) tumor suppressor gene reconstitution, and (5) bone marrow protection by insertion of a multidrug resistance gene. CONCLUSIONS: Although many gene transfer approaches have great intuitive appeal, several constraints, including problems with methods of gene transfer, must be overcome before this biologic approach can reach its potential.
Seigne
JD
Department of Urology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA.