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Despite impressive advances in the understanding of the disease\u2019s pathological mechanism, classical pharmacological clinical trials failed to provide an efficient cure for ALS over the past twenty years. Two different gene therapy approaches were recently approved for the monogenic disease Spinal muscular atrophy, characterized by degeneration of lower MNs. This milestone suggests that gene therapy-based therapeutic solutions could be effective for the treatment of ALS. This review summarizes the possible reasons for the failure of traditional clinical trials for ALS. It provides then a focus on the advent of gene therapy approaches for hereditary forms of ALS. Specifically, it describes clinical use of antisense oligonucleotides in three familial forms of ALS, caused by mutations in SOD1, C9orf72 and FUS genes, respectively.. Clinical and pre-clinical studies based on AAV-mediated gene therapy approaches for both familial and sporadic ALS cases are presented as well. Overall, this overview highlights the potential of gene therapy as a transforming technology that will have a huge impact on treatment perspective for ALS patients and on the design of future clinical trials.<\/jats:p>","DOI":"10.3233\/jnd-200531","type":"journal-article","created":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T13:28:00Z","timestamp":1602595680000},"page":"25-38","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Beyond the Traditional Clinical Trials for Amyotrophic Lateral Sclerosis and The Future Impact of Gene Therapy"],"prefix":"10.1177","volume":"8","author":[{"given":"Marisa","family":"Cappella","sequence":"first","affiliation":[{"name":"INSERM, Institute of Myology, Centre of Research in Myology, Sorbonne Universit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Fran\u00e7ois","family":"Pradat","sequence":"additional","affiliation":[{"name":"INSERM, CNRS, Laboratoire d\u2019Imagerie Biom\u00e9dicale, Sorbonne Universit\u00e9, Paris, France"},{"name":"APHP, D\u00e9partement de Neurologie, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, Centre r\u00e9f\u00e9rent SLA, Paris, France"},{"name":"Northern Ireland Centre for Stratified Medicine, Biomedical Sciences Research Institute Ulster University, C-TRIC, Altnagelvin Hospital, Derry\/Londonderry, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Querin","sequence":"additional","affiliation":[{"name":"INSERM, Institute of Myology, Centre of Research in Myology, Sorbonne Universit\u00e9, Paris, France"},{"name":"Association Institut de Myologie, Plateforme Essais Cliniques Adultes, Paris, France"},{"name":"APHP, Service de Neuromyologie, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Grazia","family":"Biferi","sequence":"additional","affiliation":[{"name":"INSERM, Institute of Myology, Centre of Research in Myology, Sorbonne Universit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,10,13]]},"reference":[{"key":"ref001","doi-asserted-by":"publisher","DOI":"10.1038\/nrn3430"},{"key":"ref002","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200105313442207"},{"key":"ref003","doi-asserted-by":"crossref","unstructured":"PetrovD, MansfieldC, MoussyA, HermineO. 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