Gene therapy is emerging as a viable option for clinical therapy of monogenic disorders and other genetically defined diseases, with approved gene therapies available in Europe and newly approved gene therapies in the United States. In the past 10 years, gene therapy has moved from a distant possibility, even in the minds of much of the scientific community, to being widely realized as a valuable therapeutic tool with wideāranging potential. The U.S. Food and Drug Administration has recently approved Luxturna (Spark Therapeutics Inc, Philadelphia, PA, USA), a recombinant adenoāassociated virus (rAAV) 2 gene therapy for one type of Leber congenital amaurosis 2 (1, 2). The European Medicines Agency (EMA) has approved 3 recombinant viral vector products: Glybera (UniQure, Amsterdam, The Netherlands), an rAAV vector for lipoprotein lipase deficiency; Strimvelis (Glaxo SmithāKline, Brentford, United Kingdom), an ex vivo gammaretrovirusābased therapy for patients with adenosine deaminaseādeficient severe combined immune deficiency (ADAāSCID); and Kymriah (Novartis, Basel, Switzerland), an ex vivo lentivirusābased therapy to engineer autologous chimeric antigenāreceptor T (CARāT) cells targeting CD19āpositive cells in acute lymphoblastic leukemia. These examples will be followed by the clinical approval of other gene therapy products as this field matures. In this review we provide an overview of the state of gene therapy by discussing where the field stands with respect to the different gene therapy vector platforms and the types of therapies that are available.ā Gruntman, A. M., Flotte, T. R. The rapidly evolving state of gene therapy. FASEB J. 32, 1733ā1740 (2018). http://www.fasebj.org