How Cancer Could be Cured by 2015

Abstract

As announced by Andrew von Eschenbach, NCI has set the goal of eliminating suffering and death due to cancer by 2015. Supporting this prediction, I discuss that cancer might be controlled and even cured by combining three potential therapeutic strategies aimed at (i) cancer-specific targets, (ii) universally-vital targets with selective protection of normal cells (the selective combinations) and (iii) tissue-specific targets. Although (i) targeting cancer-specific pathways (e.g., by imatinib and gefitinib) is probable, it alone will not be sufficient to control cancer. This strategy is limited to oncogene (kinase)-dependent cancers and is further limited by therapy-induced resistance and tumor progression. Thus, targeting cancer-specific pathways needs to be complemented by two divergent therapeutic strategies: (ii) selective combinations and (iii) tissue-selective therapy. With selective protection of normal cells (based on cell cycle and apoptosis manipulation), combinations of selective and chemotherapeutic drugs can be effective in most common cancers. Alternatively, tissue-selective therapy can suppress cancer cells in a tissue-selective manner, sparing other tissues. While alone, each therapeutic strategy may cause drug resistance and even tumor progression; these obstacles can be overcome and even exploited by using all three strategies in sequence. And finally, these strategies will benefit from molecular diagnostics and can be used for chemoprevention.