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Clinical experiences with systemically administered siRNA-based therapeutics in cancer
Clinical experiences with systemically administered siRNA-based therapeutics in cancer
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Clinical experiences with systemically administered siRNA-based therapeutics in cancer
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Clinical experiences with systemically administered siRNA-based therapeutics in cancer
Clinical experiences with systemically administered siRNA-based therapeutics in cancer

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Clinical experiences with systemically administered siRNA-based therapeutics in cancer
Clinical experiences with systemically administered siRNA-based therapeutics in cancer
Journal Article

Clinical experiences with systemically administered siRNA-based therapeutics in cancer

2015
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Overview
Key Points Several Phase I trials evaluating the use of siRNA for the treatment of solid cancers have now been completed. All trials to date have used nanoparticle-based delivery systems to transport therapeutic siRNA to tumours following systemic administration. Despite concerns about potential overwhelming immunostimulation following systemic siRNA administration in humans, the data reported to date for clinically evaluated siRNA therapeutics (both naked and chemically modified siRNA) have shown these therapeutics to be well tolerated, with only modest and treatable immunostimulatory reactions. Successful delivery of functional siRNA to human tumours has been demonstrated in multiple trials, providing proof-of-principle for RNAi- based therapeutics in humans. Results from these trials show that safe target gene inhibition can be achieved in patients, when systemically treated twice per week with either lipid- or polymer-based nanoparticle formulations containing siRNAs at doses in the 0.5–1.0 mg siRNA per kg range. Several Phase I trials evaluating systemically administered siRNA-based therapeutics for cancer have recently been completed. Here, Zuckerman and Davis critically assess these studies and discuss key lessons learnt and implications for the future development of siRNA-based therapeutics and clinical trial design. Small interfering RNA (siRNA)-based therapies are emerging as a promising new anticancer approach, and a small number of Phase I clinical trials involving patients with solid tumours have now been completed. Encouraging results from these pioneering clinical studies show that these new therapeutics can successfully and safely inhibit targeted gene products in patients with cancer, and have taught us important lessons regarding appropriate dosages and schedules. In this Review, we critically assess these Phase I studies and discuss their implications for future clinical trial design. Key challenges and future directions in the development of siRNA-containing anticancer therapeutics are also considered.