Immuno-gene Therapy for Metastatic Prostate Cancer

It has long been appreciated that a significant number of prostate cancers will not progress to clinical significance, yet some prostate cancers disseminate rapidly leading to lethal metastatic disease. Therefore, a reasonable goal of prostate cancer research is to develop novel alternative interventions and adjuvant therapeutic approaches that would suppress local tumor growth and/or impact pre-existing metastatic disease. This chapter will describe the potential for gene therapy to achieve this goal. We will review both pre-clinical and clinical studies using in situ gene therapy to generate a systemic immune response. These therapeutic strategies include a cytotoxic approach using the HSV-tk gene combined with the prodrug ganciclovir, the immune modulator gene for interleukin-12, and a novel gene that is both cytotoxic and immunomodulatory, Related to Testes-specific, Vespid and Pathogenesis proteins-1 (RTVP-1).