Abstract
Gene therapy is an innovative therapeutic approach for cancer management, as it offers the possibility of delivering therapeutic genes to cancer cells. However, various obstacles need to be addressed for the safe and effective translation of gene therapy for cancer management. This review is aimed at critically evaluating the obstacles for gene delivery, comparing viral and non-viral vectors for different types of cancer, as well as the logistic and economic issues for both in vivo and ex vivo gene therapies. Heterogeneity of cancer and therapeutic resistance are also emphasized as critical factors that impact the outcome of cancer gene therapy. Current clinical results show promise, with CAR-T cell therapy inducing 81% remission in relapsed refractory acute lymphoblastic leukemia, adenoviral p53 replacement therapy improving response rates to 64% when combined with radiation therapy, compared to 39% with radiation therapy alone, in lung cancer; CRISPR/Cas9-mediated repair of BRCA gene mutations inducing up to 70% reduction in tumor burden in breast cancer; and oncolytic virus T-Vectored inducing 16.3% durable responses, compared to 2.1% with GM-CSF alone, in melanoma. The potential solutions for the obstacles for gene delivery include the development of hybrid vectors, the integration of imaging, as well as the integration of machine learning for the precision of gene therapy for cancer management. Standardization of gene therapy tools, as well as the formulation of effective gene therapy regulations, is recommended as the optimum way for the effective translation of gene therapy for cancer management.