Cancer suicide gene therapy The ultimate goal of cancer therapy is the complete elimination of all cancer cells, while leaving all healthy cells unharmed. One of the most promising therapeutic strategies in this regard is cancer suicide gene therapy (CSGT), which is rapidly progressing into new frontiers. The therapeutic success, in CSGT, is primarily contingent upon precision in delivery of the therapeutic transgenes to the cancer cells only. This is addressed by discovering and targeting unique or / and over-expressed biomarkers displayed on the cancer cells and cancer stem cells. Specificity of cancer therapeutic effects is further enhanced by designing the DNA constructs, which put the therapeutic genes under the control of the cancer cell specific promoters. The delivery of the suicidal genes to the cancer cells involves viral, as well as synthetic vectors, which are guided by cancer specific antibodies and ligands. The delivery options also include engineered stem cells with tropisms towards cancers. Main mechanisms inducing cancer cells' deaths include: transgenic expression of
thymidine kinases,
cytosine deaminases, intracellular antibodies, telomeraseses, caspases, DNases. Precautions are undertaken to eliminate the risks associated with transgenesis. Progress in genomics and proteomics should help us in identifying the cancer specific biomarkers and metabolic pathways for developing new strategies towards clinical trials of targeted and personalized gene therapy of cancer. By introducing the gene into a malignant tumor, the tumor would reduce in size and possibly disappear completely, provided all the individual cells have received a copy of the gene. When the DNA sample in the virus is taken from the patient's own healthy cells, the virus does not need to be able to differentiate between cancer cells and healthy ones. In addition, the advantage is that it is also able to prevent metastasis upon the death of a tumor.
As a cancer treatment One of the challenges of cancer treatment is how to destroy malignant tumors without damaging healthy cells. A new method that shows great promise for accomplishing this employs the use of a suicide gene. A suicide gene is a gene which will cause a cell to kill itself through apoptosis. Suicide gene therapy involves delivery of a gene which codes for a cytotoxic product into tumor cells. This can be achieved by two approaches, indirect gene therapy and direct gene therapy. Indirect gene therapy employs enzyme-activated
prodrug, in which the enzyme converts the prodrug to a toxic substance and the gene coding for this enzyme is delivered to the tumor cells. For example, a commonly studied strategy based on transfection of
herpes simplex virus thymidine kinase (HSV-TK) along with administration of ganciclovir (GSV), in which HSK-TK assists in converting GCV to a toxic compound that inhibits DNA synthesis and causes cell death. Whereas, direct gene therapy employs a toxin gene or a gene which has the ability to correct mutated proapoptotic genes, which can in turn induce cell death via apoptosis. For instance, the most researched immunotoxin for cancer therapy is the diphtheria toxin as it inhibits protein synthesis by inactivating elongation factor 2 (EF-2) which in turn inhibits protein
translation, Moreover,
p53 is identified to be frequently abnormal in human tumors and studies show that restoring function of p53 can cause apoptosis of cancer cells. Lastly, cell-based vectors employ stem cells as carriers of suicide genes. In the last few years, cell-mediated gene therapy for cancer using mesenchymal stem cells (MSCs) was patented.
Bystander effect The bystander effect (BE) is phenomenon as a result of which it is possible to kill untransfected tumor cells located adjacent to transduced cells in suicide gene therapy. As hundred percent transduction of all tumor cells is very difficult to achieve, BE is critical feature of suicide gene therapy.
Limitations The drug is supposed to show high specificity towards cancer in order to effective, but studies have shown this to be rarely achieved. Moreover, expression of suicide gene was under control of tumor-specific promoters like
human telomerase (hTERT),
osteocalcin,
carcinoembryonic antigen; however, only hTERT promoter was found to enter clinic trials. This is majorly because of the low transcriptional power of these tumor-specific promoters for suicide gene expression. Additionally, poor accessibility to target cells is an important limitation of suicide gene therapy. Another major hurdle of suicide gene therapy is partial vector specificity to target affected cells. Finally, lack of specific animal models to predict the clinical outcome and other effects of SGT.
Biotechnology Suicide genes are often utilized in biotechnology to assist in molecular cloning. Vectors incorporate suicide genes for an organism (such as
E. coli). The cloning project focuses on replacing the suicide gene by the desired fragment. Selection of vectors carrying the desired fragment is improved since vectors retaining the suicide gene result in cell death. == References ==