New Strategies for Cancer Drug Development Urgently Needed

Millions of cancer patients worldwide may soon be able to receive more effective, personalised treatments for their disease thanks to developments in the understanding of cancer biology, experts said at the Cancer Biology for Clinicians Symposium organised by the European Society for Medical Oncology (ESMO).

However, to make the most of this coming transformation, governments, pharmaceutical companies and doctors urgently need to adapt the way drugs are developed, the experts say.

"Cancer therapy is arguably at the most exciting time in its history," said José Baselga, from MGH Cancer Centre in Boston, USA, Co-Chair of the symposium and ESMO Past- President. "It is at the confluence of two new movements, one toward personalised medicine and the other toward the use of new molecularly targeted cancer therapeutics that exploit the tumor’s genetic and molecular signature. These movements provide many challenges, but also the opportunity for making paradigm shifts in the way we think of and treat cancer." Personalised treatment has become increasingly available for cancers over the past decade. This has partly come about as scientists have found that common tumours such as breast cancer are in fact a mixture of several disease types with distinct molecular features. Meanwhile, molecular targeted drugs have also been developed that inhibit particular molecular targets involved in some cancers.

In particular, it is time to rethink whether the standard model of testing drugs in large phase-III trials is an effective way to bring these targeted cancer drugs to patients. This is related to the fact that drug approval usually needs large confirmatory trials that are being done in an unselected population. There is a need for smaller trials done with selected patients to be highly sensitive, a concept that requires the development of molecular selection and relative platforms for doing that.

"In the near future, cancer treatment decisions will be based on biology," said the third meeting Co-Chair Jean-Charles Soria, ESMO spokesperson from Institut Gustave Roussy, France. "It is therefore vital that medical oncologists have the skills and the knowledge to bring these advances to their patients. The future of oncology will be personalised medicine, and the community needs to discuss how this will be implemented."