After gene therapy: issues in long-term clinical follow-up and care

Pharmaceutical perspectives of nonviral gene therapy

The use of nonviral plasmid-based gene medicines represents an attractive in vivo gene transfer strategy that is simple and lacks many risks that are inherent to viral systems. Commercialization of gene medicines requires a thorough analysis of business opportunities, unmet clinical needs, competitive products under development, and issues related to intellectual property. Synthetic gene delivery systems are designed to control the location of a gene within the body by affecting distribution and access of a gene expression system to the target cell, and/or recognition by a cell surface receptor and uptake followed by intracellular and nuclear translocation. Plasmid-based gene expression systems are designed to control the level, fidelity, and duration of in vivo production of a therapeutic gene product. This review will provide insights into the potentials of plasmid-based gene therapy and critical evaluation of gene delivery sciences and clinical applications of gene medicines.

Genetic engineering: moral aspects and control of practice

Present-day scientific advances have made it possible to use somatic cell gene therapy for the treatment of serious human genetic disease. Gene therapy is enormously important for curing some diseases, otherwise untreatable. The technical ability to perform germline gene alteration is also under way. Society must determine its attitude toward germline alteration and toward intervention for the purpose of genetic enhancement. Eugenic genetics is purely theoretical at present and is likely to remain so for a long time. Articles in the press, sometimes influenced by specific pressure groups, generate public fear that is in most cases unfounded, due to the lack of feasibility of performing the claims voiced in them. Still, society must be concerned about the possibility that gene therapy will be misused in the future. Gene therapy should only be used in ways that maintain human dignity. The best insurance against misuse is a public well informed and not unnecessarily frightened. With proper safeguards imposed by society, gene therapy can be ethically used.

Gene therapy: current and future implications for oncology nursing practice

OBJECTIVES

To provide oncology nurses with the basic concepts of gene therapy related to cancer and to outline their practice roles.

DATA SOURCE

Published professional articles, clinical protocols, and textbooks.

CONCLUSION

Oncology nurses will need to become knowledgeable about the methods and applications of gene therapy for cancer to participate in clinical trials and to develop relevant nursing development plans.

IMPLICATIONS FOR NURSING PRACTICE

Advances in genetic testing and gene therapies will extend oncology nursing roles in direct patient care, education, advocacy, provision of genetic services, and nursing research. Oncology nurses will also participate in dialogue and development of social policies with regard to the safety, ethical, and social issues related to cancer gene therapy.