A surgical delivery system for targeted cancer gene therapy : the potential therapeutic role of genetically modified microvascular free flaps in the management of primary tumours

Abstract

Gene therapy has generated interest for the treatment of soft tissue malignancies. It offers the theoretical promise of delivering cytotoxic, immunomodulatory, or anti- angiogenic genes to produce proteins targeting tumour cells. The initial excitement generated by gene therapy has been tempered by the disappointing results of clinical trials. Some of the major barriers preventing gene therapy from achieving clinical use include the inability to accurately target the viral vector, insufficient levels of transgene expression, transient expression of the desired gene, and systemic host toxicity. This aim of this study was to address some of these issues by using a novel technique to transduce microvascular free tissue ex vivo. This approach limits systemic toxicity while also allowing a more targeted method of gene therapy delivery and would be useful after oncologic surgery for soft tissue cancers because many of these patients require microvascular reconstructions to repair the ablative defect.