gene therapy, the strategy of replacing a defective gene to treat disease, has been a major promise yet remains unfulfilled. the american society of gene therapy (asgt) meeting in july 2002 highlighted the current state of the field. early optimism in the 1980s and 1990s was tempered by challenges such as poor gene expression and immune complications, requiring further research. despite this, the field continues to grow, with improved gene delivery methods, expression strategies, and targeting techniques. new viral vectors and site-specific integration methods were presented. the meeting also focused on stem cells, highlighting both clinical and basic approaches for future therapies. however, the main challenge remains getting gene therapy to the clinic. the 1999 tragedy of jesse gelsinger led to stricter regulations. the us food and drug administration is establishing a new office to regulate cellular, tissue, and gene therapies. alain fisher presented the only prominent success story, x-linked severe combined immunodeficiency. french anderson predicted FDA approval of the first gene therapy treatment within three years. nature medicine posted the first two articles through its new advance online publication (aop) process, allowing rapid publication of accepted research. these articles go through the same rigorous process as print articles and are assigned a digital object identifier (doi). articles are published online every monday, with press embargoes lifted every sunday. subscribers can access the articles through the nature medicine home page.gene therapy, the strategy of replacing a defective gene to treat disease, has been a major promise yet remains unfulfilled. the american society of gene therapy (asgt) meeting in july 2002 highlighted the current state of the field. early optimism in the 1980s and 1990s was tempered by challenges such as poor gene expression and immune complications, requiring further research. despite this, the field continues to grow, with improved gene delivery methods, expression strategies, and targeting techniques. new viral vectors and site-specific integration methods were presented. the meeting also focused on stem cells, highlighting both clinical and basic approaches for future therapies. however, the main challenge remains getting gene therapy to the clinic. the 1999 tragedy of jesse gelsinger led to stricter regulations. the us food and drug administration is establishing a new office to regulate cellular, tissue, and gene therapies. alain fisher presented the only prominent success story, x-linked severe combined immunodeficiency. french anderson predicted FDA approval of the first gene therapy treatment within three years. nature medicine posted the first two articles through its new advance online publication (aop) process, allowing rapid publication of accepted research. these articles go through the same rigorous process as print articles and are assigned a digital object identifier (doi). articles are published online every monday, with press embargoes lifted every sunday. subscribers can access the articles through the nature medicine home page.