Editor’s Note: Amit Kumar, Ph.D, is an expert in cancer diagnostics with over 20 years of experience in cancer research. He is the Vice Chairman of ITUS Corporation and Executive Chairman of Anixa Diagnostics Corporation, which is developing a blood test (Cchek ™), for the early detection of tumor-based cancers. This article first appeared in The Journal of Antibody Drug Conjugates and has been republished with permission.
A seemingly healthy patient walks into the doctor’s office for a routine checkup. The doctor says: “I have good news and bad news. The bad news is that based upon the latest statistics from the American Cancer Society, one out of two men and one out of three women will get some type of cancer during their lifetimes. If we wait until you have symptoms of cancer and the cancer is likely advanced, you will have a 25% chance of survival. The good news is that if we detect the cancer early, you would have a 95% chance of surviving and we now have a simple blood test for the early detection of the most common types of cancers. Do you want me to order the test?”
For nearly 45 years, the national dialogue, when it comes to cancers, has remained essentially the same. We have been racing for the cure, praying for the cure, searching for the cure, researching for the cure, raising money for the cure, funding the cure, and developing treatments for the cure. Curing cancer has become the “national cancer objective”. In the recent State of the Union address, President Obama announced a renewed national effort towards finding “a cure” for cancer. Each year, there are approximately 1.7 million new cancer diagnoses in the U.S., so finding a cure for cancer certainly sounds like a noble objective. [1]
However, with all of the time, money, and effort that has been spent in search of a cure, the number of overall cancer deaths has continued to increase. This year, 8 million people worldwide [2] will die from cancer related illnesses, including 600,000 people in the United States. [1] Some would argue that our national cancer objective, has become our national cancer obsession, diverting resources away from the development of alternative technologies that may be more effective in reducing cancer related deaths. In essence, we may have been blinded by our own ambition of curing advanced cancers. New technological advances are on the way that will result in a paradigm shift in how we think about and approach cancers. The time has come to take the blinders off and to change the national cancer dialogue.
National Cancer Act
To fully understand how our obsession with curing advanced cancers got started, we need to go back to 1971 and the signing of the The National Cancer Act (P.L. 92–218). That bill officially started what is commonly referred to as the “war against cancer.” Two and one half billion dollars was allocated towards what President Nixon described as “a total national commitment towards the conquest of cancer” with a stated goal of “finding a cure.” [3] Somewhat ironically, the President marked the occasion by predicting that the signing of the National Cancer Act may be remembered in history as the most significant action taken by his administration. Regardless, the national cancer objective was born. Forty-five years later, the U. S. government alone has spent more than $100 billion funding cancer research in both the public and private sectors. Though we are nowhere close to a comprehensive understanding of cancers, such government spending has been tremendously beneficial, providing funding for basic cancer research which is the foundation for new cancer treatments.
To say that the war on cancer has been a failure is a bit disingenuous. While often thought of as a single disease, researchers and doctors know that cancer is over 120 different diseases, each with its own subtypes . So the concept of “curing cancer” as if it is a single disease, was flawed from the start. We have made significant progress in many cancer areas, and certain cancers such as childhood leukemia, are almost completely curable. However, for much of the past 100 years we have relied upon the same 3 treatment options in our approaches to cancer: surgery,chemotherapy and radiation. Over the years, surgeries have become more refined and less invasive and disfiguring, drugs have been developed to make chemotherapy more tolerable, and radiation has become more precise. We have developed better ways to use and combine the three basic treatments, but all too often, the side effects from the treatments continue to be as bad or worse than the disease itself.
Over the last four decades, with the emergence of the biotechnology industry, drugs such as antibodies and related antibody-drug conjugates have been developed for many cancers. However, these biological drugs are enormously expensive and are effective only for a small number of patients. New immunotherapy approaches, which focus on boosting the body’s immune system to fight cancer, have started to be approved in the last couple of years. Early results look promising, but overall effectiveness is yet to be determined, and again, affordability remains an issue.
The Next Breakthrough
Nearly a trillion dollars (in 2016 dollars) has been spent by the private sector in attempts to develop cancer therapeutics over the last 45 years.[5] Drug companies are often the darlings of Wall Street, with the lure of the “next big cancer drug” fueling stock prices and enormous valuations. We continually read about new cancer drug “breakthroughs” that took billions of dollars to develop and that “dramatically” increase life expectancies for patients with a particular type or subtype of cancer. Associated with all of these stories are anecdotes of one or a small number of individuals that have beaten their once, terminal disease. While all of these drug therapies are beneficial, increases in average life expectancies from many of these drugs are measured in weeks or months, as opposed to years. Such drug therapies can hardly be considered successful. Although new classes of drug therapies such as those noted above show promise, and are reasons for guarded optimism, the results from cancer drug therapies as a whole, in terms of significantly increasing life expectancies and reducing cancer related deaths, are disappointing at best.
