DEVELOPMENT AND INNOVATION IN CANCER MEDICINE - Innovation in the Biopharmaceutical Industry - page 49

high CR high CR low CR

high cure low cure low cure

5% 40% 55%

HD AML NSCLC

ALL breast colon

testis ovary stomach

chorio SCLC prostate

childhood sarcoma pancreas

BL myeloma glioma

Fig. 1. Chemotherapy for advanced cancer. There are three groups of cancer. The first group represents
cancer which is frequently cured by drugs that have a high complete response (CR). In the second
group, although there is a high CR, most patients relapse with resistant disease. In the third group,
CR is rare; 5% of cancer patients are in the first group, 40% in the second and 55% in the third.

little more than palliative benefit (Fig. 1). The advent of molecularly targeted drugs
promises to dramatically change all of this.

The future
Within the next 20 years, cancer will be considered a chronic disease, just like
conditions such as diabetes, heart disease and asthma. These conditions impact the
way people live but do not inevitably lead to death. The model of prostate cancer
will become more usual: men die with it, not from it. Progress will be made in
cancer prevention, and also in enhancement of our understanding of the causes of
cancer. Our concepts then will be different than they are today. New types of cancer
detection, diagnosis and treatment will be crucial to understand the future.
When cancer develops, it will be controllable due to refinements of current
technologies and techniques (imaging, radiotherapy and surgery), and availability
of targeted drugs. A cure will still be sought, but will not be the only satisfactory
outcome. Patients will still be closely monitored after treatment but the fear that
is prevalent even in the beginning of the 21st century, that cancer inevitably kills,
will be replaced by an acceptance that many forms of cancer are a consequence of
old age.
Making predictions about the future is fraught with difficulties. In the 1980s,
who could have imagined the impact that mobile phones, the internet and low-cost
airlines would have on global communication? Medicine will progress by similar
unexpected, incremental changes in innovation.
Therefore, it is difficult to analyse the economic impact of developments in can-
cer care. The greatest benefit will simply be the assurance that the best possible care
is offered to the most patients, irrespective of their socio-economic circumstances