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Curative anticancer drugs are not discovered yet. The development of new medicines was remarkably slow in recent decades. There are multiple scientific, financial and regulatory problems that have to be solved in order to improve the cancer statistics.

Cancer remains one of the leading causes of mortality worldwide, the second to cardiovascular diseases only. Although the problem was recognized long time ago, and billions of dollars were invested into cancer research and drug development by both governments and pharmaceutical companies worldwide, there is a clear lack of significant progress in treatment of this disease. What we are doing wrong? Why cancer still remains dangerous and often untreatable?

No simple answers to these questions exist. There are many factors contributing to the failure of modern medicine to deliver the cure for this common disease.

Cancer is a very complex problem

Post-genomic era brought a remarkable advance in our understanding of cancer on molecular and cellular level. The picture that emerged is very complex.

Cancer is not a single disease and can be caused by many different genetic alterations. The cancer with the same name, like breast cancer, can have very different molecular mechanism in two different patients.

This means that universal treatment suitable for everyone does not exist. The term “cancer” refers to the huge number of conditions of very different nature that require different drugs to achieve curative effect. All these drugs has to be discovered and development.

Drug discovery and development is very expensive

And here is where the second part of the problem comes. Drug discovery and development is a long and tedious process. It is also very expensive: each successful drug that reaches the patients costs well above US$1 billionby the time it is approved by FDA or any other regulatory body. 

Most of anticancer drugs developed these days provide only some improvement in survival benefits compared to the existing treatments. Almost none provides a cure. This puts into question the ability of these newly developed medicines to bring profits that are sufficient enough to at least cover the development cost.

The question of profits is very important in modern pharmaceutical business.Overwhelming majority of drugs is developed by large multinational corporations. They do deliver good medicines, but like any other companies working in the market economy they have to bring profits to the people who invested into them. Keeping shareholders happy ensures that shareholders invest money needed for work. The structure of business puts incentives on making the drugs that are more likely to bring profits in a relatively short period of time. It is also better to go for safer option and develop a drug with well confirmed proof-of-principle rather than work (and spend money) on the innovative project with unpredictable outcome.  

As a result, most new ideas get generated and developed by the universities, not by pharmaceutical companies. Once idea is convincing enough, industry may pick it up for further development.

Unfortunately, academic research science is chronically underfunded and often relies on charitable donations. Research funding is an easy target for government spending cuts, as has been clearly seen during the last economic crisis.

Continue reading after recommendations

  • Adams, D.J. (2012) The Valley of Death in anticancer drug development: a reassessment. Trends in Pharmacological Sciences 33, 173-180
  • Hait, WN (2010) Anticancer drug development: the grand challenges. Nat. Rev. Drug Discov. 9, 253-254
  • Leaf, C. (2004) Why we’re losing the war on cancer and how to win it. Fortune 149, 76
  • Kola, I and Landis, J. (2004) Can the pharmaceutical industry reduce attrition rates? Nat. Rev. Drug Discov. 3, 711-715
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