Recent advances in gene therapy for cancer theranostics

There is great interest in developing gene therapies for many disease indications, including cancer. However, successful delivery of nucleic acids to tumor cells is a major challenge, and in vivo efficacy is difficult to predict. Cancer theranostics is an approach combining antitumor therapy with imaging or diagnostic capabilities, with the goal of monitoring successful delivery and efficacy of a therapeutic agent in a tumor. Successful theranostics must maintain a high degree of anticancer targeting and efficacy while incorporating high-contrast imaging agents that are nontoxic and compatible with clinical imaging modalities. This review highlights recent advancements in theranostic strategies, including imaging technologies and genetic engineering approaches. [Display omitted] •There is a need for bioengineered technologies for real-time, noninvasive monitoring of therapeutic gene delivery to tumors.•Multifunctional nanoparticles can coencapsulate therapeutic nucleic acids and diagnostic agents.•Genetically encoded imaging agents express proteins that create contrast with clinical imaging modalities.•Gene-directed enzyme prodrug therapy often involves the expression of an enzyme with multiple substrates.