Progress in nonviral gene therapy for breast cancer and what comes next?

ABSTRACT

Introduction: The possibility of correcting defective genes and modulating gene expression through gene therapy has emerged as a promising treatment strategy for breast cancer. Furthermore, the relevance of tumor immune microenvironment in supporting the oncogenic process has paved the way for novel immunomodulatory applications of gene therapy.

Areas covered: In this review, the authors describe the most relevant delivery systems, focusing on nonviral vectors, along with the description of the major approaches used to modify target cells, including gene transfer, RNA interference (RNAi), and epigenetic regulation. Furthermore, they highlight innovative therapeutic strategies and the application of gene therapy in clinical trials for breast cancer.

Expert opinion: Gene therapy has the potential to impact breast cancer research. Further efforts are required to increase the clinical application of RNAi-based therapeutics, especially in combination with conventional treatments. Innovative strategies, including genome editing and stem cell-based systems, may contribute to translate gene therapy into clinical practice. Immune-based approaches have emerged as an attractive therapeutic opportunity for selected breast cancer patients. However, several challenges need to be addressed before considering gene therapy as an actual option for the treatment of breast cancer.

KEYWORDS:

• Breast cancer
• gene therapy
• nonviral nanovectors
• immunotherapy
• vaccine
• clinical trials

Article highlights

• Gene therapy has a great potential to improve the clinical management of breast cancer patients.

• Further efforts are required to increase the clinical application of RNAi-based therapeutics.

• Genome editing and stem cell-based systems may contribute to translate gene therapy into clinical practice.

• Immune-based strategies are emerging as an attractive therapeutic opportunity for specific breast cancer patients.

• Several challenges need to be addressed before considering gene therapy as a concrete option for the treatment of breast cancer patients.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This work was supported by Associazione Italiana Ricerca sul Cancro [AIRC Grant 6251 to L Santarpia] and Fondazione Italiana Ricerca sul Cancro [FIRC fellowship 18328 to G Bottai]. Furthermore, F Corsi and M Truffi are supported by the Fondazione Regionale per la Ricerca Biomedica (NANODRUG platform project).