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Clinical applications of oligonucleotides for cancer therapy
Vittorio DeFranciscis1, Giovanni Amabile2, Marcin Kortylewski3
1National Research Council, Institute of Genetic and Biomedical Research, Milan, Italy.
Abstract:
Oligonucleotide therapeutics (ONTs) represent a rapidly evolving modality for cancer treatment, capitalizing on their ability to modulate gene expression with high specificity. With more than 20 nucleic acid-based therapies that gained regulatory approval, advances in chemical modifications, sequence optimization, and novel delivery systems have propelled ONTs from research tools to clinical realities. ONTs, including siRNAs, antisense oligonucleotides, saRNA, miRNA, aptamers, and decoys, offer promising solutions for targeting previously "undruggable" molecules, such as transcription factors, and enhancing cancer immunotherapy by overcoming tumor immune evasion. The promise of ONT application in cancer treatment is exemplified by the recent FDA approval of the first oligonucleotide-based treatment to myeloproliferative disease. At the same time, there are challenges in delivering ONTs to specific tissues, mitigating off-target effects, and improving cellular uptake and endosomal release. This review provides a comprehensive overview of ONTs in clinical trials, emerging delivery strategies, and innovative therapeutic approaches, emphasizing the role of ONTs in immunotherapy and addressing hurdles that hinder their clinical translation. By examining advances and remaining challenges, we highlight opportunities for ONTs to revolutionize oncology and enhance patient outcomes.
Insights
Oligonucleotide therapeutics (ONTs) are revolutionizing cancer treatment by precisely modulating gene expression. Despite delivery challenges, ONTs offer new hope for targeting difficult molecules and enhancing immunotherapy.
Area of Science:
- Biotechnology
- Molecular Biology
- Oncology
Background:
- Oligonucleotide therapeutics (ONTs) are a rapidly advancing class of drugs for cancer treatment.
- Over 20 nucleic acid-based therapies are approved, showcasing significant progress in chemical modifications, sequence optimization, and delivery systems.
- ONTs offer novel strategies for targeting previously undruggable molecules and enhancing cancer immunotherapy.
Purpose of the Study:
- To provide a comprehensive review of oligonucleotide therapeutics in clinical trials for cancer.
- To highlight emerging delivery strategies and innovative therapeutic approaches.
- To emphasize the role of ONTs in cancer immunotherapy and address challenges to clinical translation.
Main Methods:
- Review of current literature on oligonucleotide therapeutics in oncology.
- Analysis of clinical trial data and regulatory approvals.
- Examination of advancements in delivery systems and therapeutic strategies.
Main Results:
- Oligonucleotide therapeutics have shown promise in targeting specific genes and enhancing cancer immunotherapy.
- Recent FDA approval for a myeloproliferative disease highlights the clinical potential of ONTs.
- Key challenges include tissue-specific delivery, off-target effects, cellular uptake, and endosomal release.
Conclusions:
- Oligonucleotide therapeutics hold significant potential to revolutionize oncology and improve patient outcomes.
- Addressing current challenges in delivery and efficacy is crucial for broader clinical translation.
- ONTs represent a powerful tool for personalized cancer medicine and overcoming treatment resistance.
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