Gene Therapy for Pancreatic Cancer

Abstract

Core tip: This paper tries to present a full picture of gene therapy in pancreatic cancer, providing an unambiguous classification and comprehensive analysis, especially in therapeutic targets and clinical trials worldwide. From our work, you may find the hotspots in related research and the reason why they get there.Liu SX, Xia ZS, Zhong YQ. Gene therapy in pancreatic cancer. World J Gastroenterol 2014; 20(37): 13343-13368 Available from: URL: http://www.wjgnet.com/1007-9327/full/v20/i37/13343.htm DOI: http://dx.doi.org/10.3748/wjg.v20.i37.13343 INTRODUCTIONPancreatic cancer (PC) is an aggressive and highly lethal malignant disease. The incidence of PC is lower than that of many other types of cancer, but it is the fourth most common cause of death from cancer [1] . PC is highly malignant and invasive, owing to nonspecific incipient symptoms and early metastasis. Most patients have local or metastatic spread at the time of presentation, and less than 15% of patients are candidates for surgery. Therefore, the prognosis of the disease remains poor. Recent statistics from the US National Cancer Institute showed that the overall 5-year relative survival rate for [2002][2003][2004][2005][2006][2007][2008] was 5.8%, and nearly 90% of all patients were dead in 1 TOPIC HIGHLIGHT Gene therapy in pancreatic cancer WJG 20 th Anniversary Special Issues (14): Pancreatic cancerSi-Xue Liu, Zhong-Sheng Xia, Ying-Qiang Zhong year from diagnosis, with a median survival less than 6 mo [2,3] . Surgery is still the first line treatment for PC, because it provides the only curable option. Other adjuvant treatments are chemotherapy, radiotherapy, physiotherapy and biotherapy. However, PC is highly resistant to the currently available chemotherapy and radiotherapy, and it is one of the cancers for which survival rate has not been substantially improved during the past 30 years. Therefore, new effective modalities for the treatment of this disease are urgently required. In recent years, with the outstanding progress of modern molecular biology, tumor immunology and gene engineering technology, tumor biotherapy is becoming a perspective and rapidly developing field of modern medicine, which is expected to improve state of or even cure patients who are not curable by classical methods of therapy.Generally, tumor biotherapy includes immunotherapy and gene therapy, but there is no explicit boundary between them. Gene therapy can be used to transfer genes into tumor cells to render them more highly immunogenic, while cancer immunotherapy utilizes gene engineering technology to produce immunomodulating agents, such as tumor vaccines.Since the first gene therapy clinical trial was approved by the National Institutes of Health in May 1990, significant progress in gene therapy technology has been achieved. In September 2006, a successful immunogene therapy of two patients with metastatic melanoma was reported. Up to July 2013, we have entries for 1970 trials undertaken in 31 countries, and most of them had been aimed at the treatment of cancer...