Glioblastoma multiforme (GBM) is the most frequent and devastating primary brain tumor in adults. Despite current\ntreatment modalities, such as surgical resection followed by chemotherapy and radiotherapy, only modest\nimprovements in median survival have been achieved. Frequent recurrence and invasiveness of GBM are likely due\nto the resistance of glioma stem cells to conventional treatments; therefore, novel alternative treatment strategies\nare desperately needed. Recent advancements in molecular biology and gene technology have provided attractive\nnovel treatment possibilities for patients with GBM. Gene therapy is defined as a technology that aims to modify\nthe genetic complement of cells to obtain therapeutic benefit. To date, gene therapy for the treatment of GBM has\ndemonstrated anti-tumor efficacy in pre-clinical studies and promising safety profiles in clinical studies. However,\nwhile this approach is obviously promising, concerns still exist regarding issues associated with transduction\nefficiency, viral delivery, the pathologic response of the brain, and treatment efficacy. Tumor development and\nprogression involve alterations in a wide spectrum of genes, therefore a variety of gene therapy approaches for\nGBM have been proposed. Improved viral vectors are being evaluated, and the potential use of gene therapy alone\nor in synergy with other treatments against GBM are being studied. In this review, we will discuss the most\ncommonly studied gene therapy approaches for the treatment of GBM in preclinical and clinical studies including:\nprodrug/suicide gene therapy; oncolytic gene therapy; cytokine mediated gene therapy; and tumor suppressor\ngene therapy. In addition, we review the principles and mechanisms of current gene therapy strategies as well as\nadvantages and disadvantages of each.
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