What Progress Has Been Made in Cancer Research Over the Last 250 Years?

Corry

Marketing Manager

Cancer research is the key to finding a cure for cancer.  The month of May has been designated as cancer research month and is a time to pause and reflect on the work the cancer research community does day in and day out and to pay tribute to those raising funds to support cancer research.  Without these efforts, advancements in diagnosing and treating cancer for the expected 1.7 million new cancer cases this year would not be possible.  

A Look Back on the past 250 years of Cancer Research and a Bright Future for Finding a Cure:

There have been many milestones achieved over the last 250 years of cancer research.  The National Cancer Institute and the American Society of Clinical Oncology have shared the following timelines to highlight achievements and progress made in the world of oncology and cancer care.  It was truly stunning to see how far we have come in the diagnosis and treatment of cancer. Take a look at some of the milestones below …  more research is needed in order to combat this disease for good but it is very promising to see how far we have come!

In 1775 – the first environmental link to cancer was made by Percivall Pott who discovered a correlation between the exposure to chimney soot and squamous cell carcinoma in those working as chimney sweeps.  

In 1895X-ray was discovered by Wilhelm Roentgen

In 1902 – Theodor Boveri recognized cancerous tumors arise from single cells that have experienced chromosome damage.  

In 1903 – the first radiation therapy treatment was administered to two patients with basal cell carcinoma of the skin by S.W. Goldberg and Efim London.  

In 1909 – Paul Ehrlich discovered the immune system usually suppresses tumor formation.

In 1928 – the pap smear was introduced to help detect cervical cancer by George Papanicolaou.  

In 1932 – David H. Patey developed the modified radical mastectomy for breast cancer. This surgical procedure was less disfiguring than the radical mastectomy which was developed in 1882 by William Halsted.  

In 1937 – President Franklin D. Roosevelt established the National Cancer Institute (NCI) and Sir Geoffrey Keynes introduced breast-sparing surgery followed by radiation therapy as a treatment advancement for breast cancer.

In 1941hormonal therapy was discovered by Charles Huggins.

In 1947 – Sidney Farber showed that antimetabolite drugs which are a derivative of folic acid achieved temporary remissions in children with leukemia.  

In 1949 – the FDA approved nitrogen mustard, an alkylating agent, which helps kill cancer cells by modifying their DNA.  

In 1950 – Ernst Wynder, Evarts Graham, and Richard Doll identify cigarette smoking as a risk factor in developing lung cancer.  

In 1953 – Roy Hertz and Min Chiu Li achieved the first complete cure of a solid tumor by chemotherapy using methotrexate to treat choriocarcinoma (a rare reproductive tissue cancer).  

In 1958 – Emil Frei, Emil Freireich, and James Holland discovered administration of combination chemotherapy induced partial and complete remissions to prolong survival in adults and children with acute leukemia.  

In 1964 – The Epstein-Barr virus was linked to Burkitt lymphoma and was later shown to cause other cancers such as nasopharyngeal carcinoma, Hodgkin lymphoma, and some stomach cancers.

In 1971 – President Richard Nixon signed the National Cancer Act to establish national cancer research centers and national cancer control programs.  

In 1978 – the FDA approves Tamoxifen, a hormonal treatment for breast cancer.  Later in 1998 the NCI-sponsored Breast Cancer Prevention Trial showed tamoxifen can reduce the incidence of breast cancer among women who are at increased risk of the disease by about 50% and the drug was approved by the FDA for this use.  

In 1979 – the TP53 gene was discovered as the most commonly mutated gene in human cancer.  It is a suppressor gene which means it helps control cell proliferation and suppresses tumor growth.

In 1984 – the Her2-Neu oncogene was identified and discovered that in 20-25% of breast cancers overexpression of this gene can occur. Her2 positive breast cancers are more aggressive with a poor prognosis.   

In 1993 – an NCI clinical trial showed annual screening with fecal occult blood testing (FOBT) can reduce colorectal cancer mortality by approximately 33%.  

In 1994 & 1995 – the BRCA1 and BRCA2 tumor suppressor genes were cloned. Mutations of these genes greatly increase the risks of breast and ovarian cancer in women and the risks of several other cancers in both men and women.  

In 1996 – the FDA approves Anastrozole for the treatment of estrogen receptor positive advanced breast cancer in postmenopausal women. This is the first aromatase inhibitor (blocks the production of estrogen in the body) to be approved for cancer therapy.  

In 1997 – the FDA approved Rituximab which is a monoclonal antibody for patients with treatment-resistant, low grade or follicular B-cell non-Hodgkin lymphoma. It was also later approved for initial treatment of non-Hodgkin lymphoma, diffuse large B-cell lymphoma, and for chronic lymphocytic leukemia.  

In 1998 – the FDA approved Trastuzumab, a monoclonal antibody targeting cancer cells that overproduce Her2 for treatment in women with Her2 positive metastatic breast cancer. It was also later approved for adjuvant (post-op) treatment of women with Her2 positive early-stage breast cancer.  

In 2001 – a clinical trial studying a drug called Imatinib Mesylate, which targets a unique protein produced by the Philadelphia chromosome, is found effective against chronic myelogenous leukemia (CML) and gastrointestinal stromal tumors (GIST).  

In 2003 – the NCI sponsored Prostate Cancer Prevention Trial (PCPT) showed the drug Finasteride reduced the production of male hormones in the body and lowered a man’s prostate cancer risk by about 25%.

In 2006 – the NCI STAR Study (Study of Tamoxifen and Raloxifene) delineated that postmenopausal women at an increased risk of breast cancer can reduce their risk by taking the antiestrogen drug, Raloxifene. The side effect risk is lower with Raloxifene than Tamoxifen.  Additionally, the FDA approved Gardasil vaccine which protects against the development of the human papillomavirus (HPV), an infection that causes 70% of cervical cancers.

In 2009 – a second drug was approved by the FDA for protection against the human papillomavirus (HPV) called Cervarix. HPV causes approximately 70% of all cervical cancers.

In 2010 – the NCI sponsored Lung Cancer Screening Trial (NLST) showed that screening with low-dose CT scans reduced lung cancer deaths by about 20% in a large group of current and heavy smokers.   

In 2011 – the FDA approved the use of Ipilimumab, a monoclonal antibody for the treatment of inoperable metastatic melanoma.  This drug stimulates the immune system to attack cancer cells by removing a “brake” that normally controls the intensity of immune responses.  

In 2012 – the NCI sponsored PLCO Cancer Screening Trial confirmed that screening people 55 years and older for colorectal cancer using flexible sigmoidoscopy reduces colorectal cancer incidence and mortality resulting in a 21% lower risk of developing colorectal cancer and a 26% lower risk of dying from the disease.

In 2013 – the FDA approved Ado-Trastuzumab Emtansine (T-DM1) for the treatment of Her2 positive breast cancer that was previously treated with trastuzumab and/or a taxane drug.  T-DM1 is considered a immunotoxin made by chemically linking the monoclonal antibody trastuzumab to the cytotoxic agent mertansine which in turn inhibits cell proliferation by blocking the formation of microtubules.

In 2014The Cancer Genome Atlas project (TCGA) which is a joint effort between the NCI and National Human Genome Research Institute, analyzed DNA and other molecular changes in more than 30 types of cancer.  One finding was related to stomach cancer being 4 different diseases based on differing tumor make-up. This could potentially lead to cancer being classified by their molecular abnormalities as well as organ or tissue of origin.   Additionally, in 2014 the FDA approved Pembrolizumab for the treatment of advanced melanoma.  A monoclonal antibody blocks the activity of a protein called PD-1 on immune cells increasing the strength of immune response against cancer. 

In 2015 – the FDA approved a new class of drugs called cyclin-dependent kinase (CDK) inhibitors, which block proteins that control cell division, specifically a drug called Palbociclib to be used with Letrozole (Femara) as initial hormone-based therapy in post-menopausal women with hormone-receptor-positive, Her2 negative advanced breast cancer. Additionally, in 2015, three new immunotherapies for the treatment of non-small cell lung cancer were approved by the FDA for patients who worsened during or following chemotherapy.  Nivolumab (Opdivo), Atezolizumab (Tecentriq), and Pembrolizumab (Keytruda) each showed extended survival and resulted in fewer side effects than chemo.  All three help the immune system fight cancer by targeting proteins PD-1 and PD-L1.

In 2016 – the first new treatment for bladder cancer in three decades was approved by the FDA.  Atezolizumab (Tecentriq) was approved for advanced bladder cancer after a clinical trial showed rapid shrinkage of tumors in patients who had been previously treated for advanced bladder cancer.

In 2017 – the FDA approved the first gene therapy called Tisagenlecleucel.  The chimeric antigen receptor-modified T cell (CAR-T) therapy tisagenlecleucel (Kymriah) caused completed remissions in a majority of young patients with B-cell acute lymphoblastic leukemia (ALL) that had progressed despite previous treatment with standard therapy.  CAR-T therapy genetically modifies a person’s immune T cells to target a specific cancer protein and trigger the destruction of cancer cells.  This therapy only has to be administered once because the CAR-T cells continue to multiply and the anti-cancer effects persist and can even increase over time.  

Although the above timeline does not highlight each and every milestone achieved over the last 250 years, it represents highlights of the incredible progress that has been made and shows a tremendous shift in focus and research efforts surrounding immunotherapies.  Technology has allowed scientists and researchers the ability to evaluate and study the human body and genetics with great precision but also with great promise. There have been many studies showing remarkable success using the body’s natural immune response to help find and destroy cancer cells.  It is a very exciting time in the world of cancer research as strategy, technology, and innovation lead a future of hope in finding a cure for cancer.

If you are interested in learning more about ways you can help cancer researchers, please visit the American Association for Cancer Research Foundation website and review the Take Action and Support Us tabs for more information.  

Resources:

AACR

ASCO

https://www.cancer.gov/research/progress/250-years-milestones

https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2018/cancer-facts-and-figures-2018.pdf 

Photo by Pixabay on Pexels