CURRENT ISSUES IN CANCER .8. GENES, DREAMS, AND CANCER

There have been tremendous advances in our understanding of cancer fro m the application of molecular biology over the past decade. The disea se is caused by a series of defects in the genes that accelerate growt h-oncogenes-and those that slow down cellular turnover-tumour suppress or genes. The proteins they encode provide a promising hunting ground in which to design and test new anticancer drugs. Several treatment st rategies are now under clinical trial entailing direct gene transfer. These include the use of gene marking to detect minimal residual disea se, the production of novel cancer vaccines by the insertion of genes which uncloak cancer cells so making them visible to the host's immune system, the isolation and coupling of cancer specific molecular switc hes upstream of drug activating genes, and the correction of aberrant oncogenes or tumour suppressor genes. The issues in these approaches a re likely to have a profound impact on the management of cancer patien ts as we enter the next century.