Gene therapy of lung cancer.

It is estimated that there will be 157,200 deaths from lung cancer in 2003. Current regimens of surgery, chemotherapy and radiation have not significantly changed overall 5-year survival rates for this disease. Thanks to intensive molecular studies over the last three decades, new targets for treatment have been identified, including replacement of tumor suppressor genes, prevention of angiogenesis and tumor growth, and regulation of programmed cell death. Promising advances have been made but obstacles still abound before effective use of these strategies at the patient bedside can occur. One area of concentration lies in developing more accurate and complete delivery of the therapeutic constructs. In the evolution of gene therapy approaches, from beginning theory to translational research, investigators in thoracic malignancies have played a leading role, utilizing a number of methods and delivery vehicles. The objective of this review is to discuss some of the major molecular targets available for manipulation in lung cancer, describe vectors and techniques currently used by thoracic researchers to deliver therapy, and provide the p53 model as an example of progression from bench research to clinical treatment.