Record number of medicines for various cancers in clinical trials

A record 887 medicines for various cancers are in clinical trials or awaiting Food and Drug Administration (FDA) review—well over double the number in the pipeline just six years ago, according to a report unveiled today by the Pharmaceutical Research and Manufacturers of America (PhRMA).

“Rapidly advancing technologies and the commitment of researchers to follow new clues are providing hope.”

When PhRMA released its first accounting of medicines in development for cancer in 1988, only 65 were recorded. The numbers over the next decade grew gradually. As recently as 2005, there were fewer than 400 medicines in development for cancer.

"Unprecedented insights into how cancer cells develop, grow and spread are providing new targets and new ways of attacking the disease," said John J. Castellani, PhRMA's president and CEO, explaining the increase. "Rapidly advancing technologies and the commitment of researchers to follow new clues are providing hope."

One promising development is the increased understanding about the many ways a tumor can protect and feed itself by co-opting the body's own mechanisms, for example by reducing the efficacy of the immune system and by proliferating the growth of blood vessels, said Garry Neil, M.D., corporate vice president of science and technology at Johnson & Johnson. Dr. Neil is also chair of PhRMA's Science and Regulatory Affairs Executive Committee.

Other remarkable new developments in cancer research include a better understanding of the key role that cancer stem cells play in resistance to chemotherapy, and the interplay between cancer cells and the supporting tissue that surround them, said Scott Waldman, M.D., Ph.D., of the Kimmel Cancer Center.

Biomarkers, Waldman added, are increasing researchers' ability to predict and to understand the body's response to new therapies. Dr. Waldman was recognized this year by the PhRMA Foundation for his breakthrough work on colorectal cancer.

He and Dr. Neil also pointed to advanced gene sequencing that is revealing the genetic basis of cancer and leading to opportunities for personalized medicine. Not only has genetic sequencing become available to many more researchers, but it has advanced into "next generation" and "multiplexed deep sequencing."

Combination therapies, which were so successful in fighting HIV/AIDS, also represent an important step in cancer treatment, said Dr. Neil.

"As we develop the ability to block, with precision, the drivers of tumor growth, we must also block the escape mechanisms facilely used by these cells," Neil said. Regulatory agencies, he added, are recognizing the need to simplify the testing of multiple medicines in development in order to realize this potential breakthrough.

Although five-year survival rates have increased across cancers since 1975—and have increased dramatically for breast, prostate, colon, rectum and lung cancer—the disease remains a leading cause of death.

Asked where we now stand in the battle against cancer, Dr. Neil quoted Winston Churchill, speaking in the late fall of 1942: "This is not the end. It is not even the beginning of the end…"

However, against a backdrop of new tools and a scientifically-based set of rules, Dr. Neil added, "We are hopefully moving to the beginning of the end for many cancers."