The “hallmarks of cancer” provide a framework for thinking about what capabilities cancers have in common, and there are lots of them: proliferation, apoptosis resistance, angiogenesis, metastasis, etc.
It seems to me like the paper focus on foreground of the issue with the cancer while ignoring the background of what else is wrong with the system for the cancer to proliferate. Whenever cancer grows it’s because the immune system failed to kill it.
The NCI’s preclinical research narrowed things down amazingly well; only 150 out of 700,000 potential chemotherapies (about 0.02%) were deemed promising enough to enter the clinic, and of those, 40 showed some anti-cancer efficacy (27%, much higher than the 3.6% of modern clinical-stage cancer drug candidates that receive FDA approval.)15
It’s worth noting that the FDA approval criteria for cancer have been loosened in the Food and Drug Administration Modernization Act (FDAMA) of 1997 which allowed surrogate endpoints and only a single clinical trial. The 21st Century Cures Act of 2016 further made it easier to get cancer drugs approved.
AP: The new study found that between 2013 and 2017, there were 46 cancer drugs granted accelerated approval. Of those, 63% were converted to regular approval even though only 43% demonstrated a clinical benefit in confirmatory trials.
The situation is more dire than it would be if all the FDA approved drugs would provide a clear benefit.
It seems to me like the paper focus on foreground of the issue with the cancer while ignoring the background of what else is wrong with the system for the cancer to proliferate. Whenever cancer grows it’s because the immune system failed to kill it.
It’s worth noting that the FDA approval criteria for cancer have been loosened in the Food and Drug Administration Modernization Act (FDAMA) of 1997 which allowed surrogate endpoints and only a single clinical trial. The 21st Century Cures Act of 2016 further made it easier to get cancer drugs approved.
The situation is more dire than it would be if all the FDA approved drugs would provide a clear benefit.