Cancer research: Is now our time?

The following is a rather curious promotional video that was shown at the plenary sessions of the AACR 2010 meeting. I first saw it yesterday, and thought my readers might be interested in it while I’m winding my way home:

It’s basically a compendium of various facts about cancer and cancer research with a rather obnoxious techno soundtrack to make it “hip” in the way that middle-aged white guys think is “hip.” (Believe it or not, the AACR actually played this loud enough to feel the bass.) Annoying music aside, though, the graphics in the video compellingly boil down a large amount of information, both promising and not, packed into less than five minutes. For example, the toll of cancer is listed, but so is the massive improvement in life expectancy of children with acute lymphoblastic leukemia since the 1960s. On the other hand, the video points out that only 3-4% of adults with cancer participate in clinical trials, largely because, although 85% of adults express interest in clinical trials when asked, only around 9% are ever asked. This is a travesty, and we have to do better.

More interesting to me were a couple of other citations. For instance, there are 17,590 citations for articles in the peer-reviewed scientific literature about cancer, but there are zero—yes, zero–FDA approved therapies that target p53-mutant cells. Similar numbers apply to the oncogene ras, which theoretically should be easier to target than p53. One little fact that left me shaking my head was a statement that about half of all scientific papers are about less than 10% of all genes. Well, duh! Those are in general the scientifically interesting genes. On the other hand, it is rather depressing to note in this video something that’s been noted in many places, namely that the average age at which an investigator gets his or her first NIH R01 grant used to be 34 in 1980. Now it’s 42. (I got my first R01 when I was 42, actually.)

One of the coolest tidbits of information was the explosion in cDNA microarray data, with the first one published in 1995. Now there are over 300,000 deposited in a government database to hold such data. In case you’re not familiar with cDNA microarrays, they are a tool for measuring the levels of expression of every gene in the genome simultaneously, and their results are now tools for data mining and identification of potential genes involved in various processes of cancer that are freely available to all investigators through the NCI GEO database. Meanwhile, in 2008 there was only one cancer genome sequenced; now there are 100.

All in all, it’s a rather curious promotional video. It’s not all rah-rah, but it does show enormous progress in some areas, concluding that 2010 AACR Meeting is the time and the place–but for what, I’m not sure. After all, there’s only so much one meeting can do. Overall, this year’s meeting was in general quite good, with a lot of interesting and promising science; certainly it was better than last year’s meeting, which was a disappointment to me. But I don’t know that this meeting will have any more effect on the war on cancer than any previous meeting. After all, progress against cancer is a slow, incremental process, with occasional spurts of progress and often long periods of seemingly no progress. (It’s not unlike punctuated equilibrium in that way.) In any case, if there’s one thing that contributes to disappointment at our progress in cancer therapy thus far, it’s the expectation that there will be a “magic bullet” or huge breakthroughs. One theme of this meeting is that this is the best time ever to make progress in cancer research, given the quantity and sophistication of the tools we now can bring to bear on the problem. That may well be true, but cancer won’t yield its secrets easily. It hasn’t in the past, and there’s no reason to expect that it will in the future.

That is not a pessimistic view, simply a recognition that cancer is not a single disease. It is many, and it is a protean foe. There will be no “cure for cancer,” but that doesn’t mean there won’t be a cure for a cancer or many cures for many different cancers.