Gene Therapy for Prostate Cancer

Prostate cancer is the second most common cancer, and the second most common form of cancer-related death in men. The principal treatments for advanced disease have been based on androgen ablation strategies, which result in cell death for responsive populations of cancer cells. Unfortunately, few patients achieve a sustained complete response, and the mean survival for patients with androgen-resistant disease is generally less than 1 year. It has also become more evident that treatment for localized disease can often be unsuccessful when measured by surrogate end points such as serum prostate specific antigen (PSA) levels. The development of effective gene-based therapies for this disease is therefore welcome and would fill a void in the availability of suitable therapies in the adjuvant and advanced setting. Although significant preclinical work is underway in this field, clinical gene therapy for prostate cancer is in its earliest stages. In this article the general considerations for any genetic approach to the treatment of prostate cancer are reviewed. Furthermore, discussion of the clinical trials in progress and of recent preclinical research in prostate gene therapy will provide a sense of the direction in which this field is moving and where the major obstacles to the implementation of effective therapy still exist.