Clinical efforts to modulate angiogenesis in the adult: gene therapy versus conventional approaches

A gene therapy approach towards the modulation of neovascularization provid es important advantages that could be crucial for the success of therapies that target blood vessels. These advantages include sustained local express ion and the ability to supply multiple pro- or anti-angiogenic factors. The re is potential near-term success in the application of this approach for t he treatment of ischemic vascular diseases. Although there is convincing pr oof of concept in animal models that an anti-angiogenesis gene therapy appr oach can be used to treat cancer, this is a highly competitive field with s mall molecules, recombinant proteins and monoclonal antibodies already in c linical trials. The scientific rationale for the use of gene therapy is sou nd, but realization of its full potential for the treatment of a broad arra y of diseases will require several challenging technical hurdles to be over come and safety concerns to be alleviated.