Biotech Values

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We're Losing the War on Cancer, reports FORTUNE Magazine

[No commentary needed –I think this article speaks for itself.]

http://biz.yahoo.com/bw/040309/95416_1.html

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Special Investigation Finds Alarming Systemic Faults -- and Suggests Radical Solutions

NEW YORK--(BUSINESS WIRE)--March 9, 2004--America is losing the war on cancer -- and it is time to overhaul the battle plan, reports FORTUNE magazine in a groundbreaking special investigation. FORTUNE executive editor and Hodgkin's disease survivor Clifton Leaf reports that the percentage of Americans dying from cancer is about the same as it was in 1970, and reveals systemic problems that are making cancer so difficult to defeat. "It is like a Greek tragedy," says Intel Chairman and prostate cancer survivor Andy Grove. "Greek Tragedy is the perfect term for it. Heroic figures battling forces greater than themselves. Needless death and destruction -- and it doesn't have to stay this way," writes Leaf, who offers a series of radical changes to turn the battle around. The story appears in the March 22 issue of FORTUNE, on newsstands March 15 and at www.fortune.com as of March 9.

Leaf begins by showing how, in the last three decades, researchers and scientists have amassed an enormous amount of knowledge essential to the war on cancer. But after three months of intensive meetings with leading cancer specialists and top officials throughout the country, Leaf reports that a dysfunctional "cancer culture" has made the search for knowledge "an end unto itself rather than a means to an end." The result is a research and grant culture focused on finding the tiniest improvements to treatment rather than genuine breakthroughs.

Cancer research's focus on shrinking tumors in fatally ill patients is Leaf's most revealing example of this systemwide failure. The bulk of research money and energy is spent on this goal and not on understanding and arresting the process of metastasis -- which kills an incredible 90% of patients. In fact, according to a FORTUNE examination of National Cancer Institute grants going back to 1972, less than 0.5% of study proposals focused on metastasis. Of nearly 8,900 NCI grant proposals awarded last year, 92% didn't even mention metastasis. Consequently, Leaf reports, "Pharma companies don't concentrate on solving the problem of metastasis (the thing that kills people); they focus on devising new drugs that shrink tumors (the things that don't)."

Leaf also points to the preclinical model for drug testing and development, which depends on lab mice, as another major flaw in the war on cancer. According to scientists, these models have very little predictive power for the treatment of human disease. Despite genetic and organ-system similarities, humans and mice have key differences in physiology, tissue architecture, metabolic rate, immune system function and molecular signaling. Tumors in mice can't mimic cancer's most maddening trait in humans, its quick-changing DNA -- a characteristic that leads over time to staggering complexity in the most deadly tumors. And there is a very real possibility that reliance on this flawed model has caused researchers to pass over drugs that would work on humans.

"A fundamental problem which remains to be solved in the whole cancer research effort is that the preclinical models of human cancer, in large part, stink," Robert Weinberg, MIT biology professor and winner of the National Medal of Science tells FORTUNE.

All these failures come to a head, says Leaf, in the clinical trial -- a rigidly controlled, three-phase system for testing new drugs and other procedures in humans. "The process remains the only way to get from research to drug approval -- and yet it is hard to find anyone in the cancer community who isn't maddeningly frustrated by it," he reports.

In the end, Americans have spent -- through taxes, donations and private R&D -- approximately $200 billion to fight cancer since the war on cancer began in 1971. Yet even as research and treatment have intensified, cancer's annual death toll has risen 73% -- over one and a half times the growth of the U.S. population. By contrast, deaths from heart disease and stroke have slowed dramatically.

The FORTUNE report concludes with a proposal for a radical overhaul in how America fights the war on cancer, including a transformation in the way the NCI funds research, a consolidation of the federal war chest into one bureaucracy, from five; and an overhaul of the FDA drug-testing and approval process. "For the nation to finally turn the tide in this brutal war, however, we have to collectively change the culture of the cancer community to one that embraces a coordinated assault on this disease," concludes Leaf. "Science now has the knowledge and the tools; we need to act."
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