Conquering Cancer in Our Lifetime: New Diagnostic and Therapeutic Trends

Cancer has now surpassed cardiovascular disease as the number 1 killer of both men and women (1). Approximately 1 of 3 of us will develop cancer during our lifetime. Despite the war on cancer declared more than 40 years ago by President Richard Nixon, the battle has not yet been won, despite a substantial investment in resources. The US National Cancer Institute has an annual budget of approximately $5 billion and since 1971 has spent >$90 billion on the science, treatment, and prevention of cancer (2). The pharmaceutical industry has invested several times that sum in developing anticancer drugs and antibodies. Small-molecule inhibitors such as imatinib have changed the natural history of chronic myelogenous leukemia and gastrointestinal stromal tumor. Antibodies that include rituximab and trastuzumab have improved overall and long-term survival for patients with lymphoma and breast cancer, but many new targeted agents approved by the US Food and Drug Administration have extended progression-free survival times by only a few months. Of greater concern is that only 1 in 20 new oncologic agents entering clinical trials proves to be sufficiently safe and effective to achieve approval. Progress has been slow and sometimes inefficient.Robert C. Bast, Jr.Some scientists have claimed that the cancer incidence and mortality rates have not changed over the last 15 years. The fact is, however, that the overall cancer mortality rate has declined significantly in the US since 1990, despite the aging of the population. For example, the incidence for the major killer, lung cancer, began to decline in the early 1980s, owing to the antismoking campaigns, and the overall 5-year mortality rate decreased by 1.6% by 2010. …