Last year, Dr. James Watson, the noble prize winner, part of a team responsible for the discovery of the structure of DNA declared that beating cancer was possible by 2020. His argument in the NY Times was that if we really focused money into basic science cancer research rather than clinical cancer treatment centers, this recommendation turned out to be politically unacceptable and he was kicked out of the cancer advisory center.
What seems to really connect with Dr. Watson’s statement is that our most cutting edge cancer therapeutics are often based on ancient hypothesises or assumptions.
Take Angiogenesis as an example(the need for tumors to create their own blood supply to sustain themselves), this mechanism of action was proposed by Dr. Judah Folkman back in the early 70’s and after much resistance in the scientific community accepted decades later. As a result of Dr. Folkman’s work and the the development of drugs that choked off the creation of new blood supplies to cancer cells our latest generation of Cancer therapeutics have emerged (Erbitux, Herceptin, Velcade and Tarceva). One seemingly important point here should be the glacial pace of Cancer development over the last couple of decades and our need to innovate out of this deadly lethargic pace of innovation.
Understanding how to differentiate between cancers
The good news is that biotech’s and pharma companies are heavily investing in new experimental therapies (arguably the number 1 target for therapeutic development) through the use of newer genomic technologies and an increased understanding of how to really separate out different variations of cancer. Herceptin (Trastuzumab) only works well for certain types of breast cancer, typically on those breast cancers that over express HER2 but when it’s appropriately used it can have a substantial effect, further reducing relapse risk in some women by 50%.
Future Cancer treatments
Increasingly, there’s a consensus that not only do cancers have to be specifically targeted based on their specific genomic mutations (which can be a daunting task based on the latest findings of 23,000 mutations in a sequenced lung cancer cell) but it seems likely that cancers will also have to be treated with a combination of therapeutics to reduce the risk of resistance developing (a similar concept to treating bacterial infections). As a result many current studies are ongoing to identify effective combination therapies and over time will likely be a combination of better and better biologic therapies (protein,RNAi and cellular) as well as through the use of targeted radiotherapy and surgery.