Last week I had a post on winning the war on cancer and I think the tone was rather depressing. Well, I am not sure if this post will get much better. In fact, this is going to be a post which will make some people uncomfortable and others very happy. For, in this post, I will discuss some conclusions that were made several years ago concerning the new drugs that came out of Europe over a five-year period that were intended to have anti-cancer properties.
There was a publication in August of 2005 that looked at anti cancer agents or new drugs that came out (were approved by the European Union) from 1995 to 2000. Actually, to be more fair and accurate, the publication in the British journal of cancer looked at the 12 new anti cancer drugs that were approved during that five-year period. When looking that those 12 drugs that were approved for cancer for the European market, those new drugs did no better (and in some cases worse) than the drugs that were already out there for use/sale. What does this tell you? Well, for one it tells you that despite the millions (less but still a lot than the US) that the European market has spent on researching and developing drugs for cancer during that five-year period (and since 200 as well), the drugs are not very effective. The drugs were not even more safe than the existing ones. It also tells us that perhaps the pharmaceutical approach of screening new drugs and testing those drugs in what are called drug screen and in mouse models of cancer is perhaps not the way to go. In fact, some would argue (but I am not sure that I would) that drugs are not the way to proceed at all for curing cancer.
Besides the basic science that goes behind every drug that is being developed for clinical purposes, there must be clinical trials where the drug is tested in humans. Usually there are four different types of trials that are needed to be carried out for every single drug. The first set of trials is usually done to look at safety and make sure the drug does not do more harm than benefit and the last set of trials is where the drug is tested in the real disease setting with as many people as possible and where some are treated with a placebo and others are tested with the drug (in a blinded fashion). Don’t worry if you don’t understand all of this, but this just illustrates one very important point….these trials are VERY very expensive!!! In fact, as of 2005 the estimated total cost of bringing a drug from the chemists bench to human use is about $804 million and takes 12-14 years to develop. Now you see why drugs cost so much…the companies spend so much to develop them that they are looking to recover the costs and of course make a profit…not so easy to do these days. Anyhow, to make a long story short, with such few successes anyway, it is amazing that drug companies even bother in the first place. Well, one reason they do is that if they do get a blockbuster drug that patients need to take for a life time can early them several billion dollars in revenue or more before the patent expires.
One example of a blockbuster anti-cancer drug that has earned Novartis billions of dollars is called Gleevec (TM). This drug is used to treating patients with a cancer called chronic myelogenous leukemia or CML. This drug works well and does act as a miracle cure in some ways (prevents the disease from coming back), but the patient must take this drug for the rest of their lives. The minute the patient stops taking this drug, the cancer returns. Since the drug was first used in 2000, we will see if the patients will start to develop mutations in their cancer cells that make the drug useless. We now know that some patients (about 20%) already have mutations in their cancer cells that make the cells resistant to the cancer. So, only time will tell if people with CML can tolerate this drug for their entire lives.
So, back to the question….are drugs doing the trick…are they helping us advance in the war against cancer. It seems as perhaps no. It is so hard right now to get any drugs approved by the FDA in the USA now. The drugs in general are not that effective once they are used in the general public and that is due to many reason, but primarily due to the fact that people are complex and so are their cancers. The drugs simply don’t work as well as the research usually show they do in the real world. The models that are used to test the drugs in the lab are not that good and so on and so forth.
Is it time to turn to other treatments or other approaches. Well, yes probably. We know that early detection saves live. Now prostate cancer can be picked up fairly easily with very simple and non invasive screening. That early detection is now saving lives….not the drugs against prostate cancer. Drugs do help, but if the cancer is detected late the drugs are fairly useless. Early detection of breast cancer, vaccination against the virus that can cause cervical cancer (the human papilloma virus), and other non ‘chemical based’ approaches are working better right now at saving lives than the new drugs are. Of course, surgeries and transplants save hundreds of thousands of lives for those who can afford them. There is a renewed wave of natural remedies against cancer, but I think it is too early to see if these are helping us to win the war on cancer. Some are complete rubbish and some may actually work, but good luck differentiating the two kinds.
Anyhow, it is not all doom and gloom but at the moment cancer does have the upper hand. It will be interesting to see what the next ten years in development bring to cancer!
For more information about this and other cancer topics, feel free to visit cancer made simple!