The romantics wearing rose tinted glasses might well think of successful cancer drug development much like the famous poem by Lord Byron;

“She walks in beauty, like the night
Of cloudless climes and starry skies”

Yet the reality is much more opaque with endless cloudy or wet days and foggy nights much more typical than the exception.

There are often unexpected glitches in the form of serious adverse events, drug interactions, biomarker crashes, narrower therapeutic indexes and poor activity.

None of this stops a raft of companies rushing into a niche when it is suddenly declared ‘hot’ and everyone wants a piece of the action.  This creates an entirely different series of issues to tackle such as acquired resistance and cross resistance.

Some of the numbers in this latest research surprised me and left me pondering a series of provocative questions such as who’s going to stand out from the crowd, who is going finesse things in the clinic – and most importantly – who’s going to break the mould with a different approach?

In this article we explain some of the nuances at play and offer some pointers of new directions the field is taking, not all of them, I’m sorry to say, are for the better…

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