It’s all too easy to focus on the here, the now, and what’s hot in the moment, but let’s also remember that while immunotherapy and KRAS might be the hottest topics out there in oncology R&D at the moment, we still need to induce durable and lasting tumour cell killing or the cancer won’t be penned in.
Resistance mechanisms or immune escape will induce relapse, disease recurrence, and off we go again with tumour proliferation, sometimes at a more aggressive rate than before.
Back in the 1970s and earlier all we really had was a bunch of rather nasty and ineffective chemotherapies, often given in sequence, although improvements in dosing, scheduling, and also experimenting with different combinations eventually helped a great deal.
What if we were to look at modern methods of inducing cell death without the nihilistic side effects of old?
After a few false starts and quite a lot of agents condemned to dog drug heaven, we saw the emergence of the CDK4/6 inhibitors in HR+ breast cancer. Since then a number of other targets have started showing up, not just as small molecules but also in quite different modalities.
Is this truly going to be a new revolution to think about or yet another raft of promising agents consigned to the dustbin of screening libraries? The good news is there are some hopeful signs finally peeping out…