The Top Advances in Oncology in the Last 50 Years
The American Society of Clinical Oncology as part of the 50th anniversary published the 5 top advances in clinical oncology as voted by physicians/patients and the public:
- Cure for Hodgkin’s Lymphoma: the four drug chemotherapy ABVD (doxorubicin/bleomycin/vinblastine/dacarbazine) developed in the 70’s by Giovanni Bonadonna achieved a 90% cure rate and remains first line treatment to this date for the disease.
- The HPV vaccine which was FDA approved in 2006 (Gardasil): the vaccine targets HPV 16 & 18 which are the known cause of 70% of cervical cancers. It also prevents other HPV related disease like anal cancer, vaginal, vulvar cancer and genital warts and more recent studies suggest also head and neck cancers.
- Targeted agents for CML (chronic myelogenous leukemia): there are now numerous oral agents that target the phyladelphia chromosome, the molecular defect at the root of the disease. The first agent FDA approved in 2001 was Gleevec. This drug has transformed a disease that was lethal within 6 years, even with bone marrow transplant, into a chronic disease with a median survival rate of 30 years.
- Cure for testicular cancer: back in the 70’s Dr. Lawrence Einhorn combined the chemotherapeutic agents cisplatin/vinblastine and bleomycin together achieving a cure rate of 70% - nowadays with combined modality the cure rate for testicular cancer exceeds 90%. (See Lance Armstrong who had brain metastasis.)
- Antinausea development: the most frightening thing about chemotherapy for most patients is the thought of nausea and vomiting. Finally in the 90’s different receptors were discovered to have a major role in nausea/vomiting and were targeted with new drugs. The 5HT3 receptor (Zofran/kytril/anzemet/aloxi) and the NKI receptor (emend).
I would add to this incredible list the “growth factors” that boost the immune system (neupogen/granix/neulasta) since I remember the times when patients were hospitalized with fever/neutropenia for days on end, needed dose delays and reductions in their chemotherapy, compromising cure rates and at times we lost patients from fever and neutropenia.Erythropoietin(Procrit/Aranesp) is the growth factor that promotes red blood cell production making possible to avoid blood transfusions in most cases.