The Timeline highlights some of the most important advances across
cancer care and research. Many of these milestones were supported by
federal research funding, and nearly all of them are the result of
rigorously conducted clinical trials, made possible by the participation
of thousands of individuals with cancer. ASCO’s federally funded
research badge is featured on milestones that stemmed from research
funded at least in part by the National Cancer Institute or other
federal agencies.
The Cancer Progress Timeline is a historical overview of
ground-breaking advances in cancer research and care that have improved
the outlook for patients and led to a better quality of life. With more
than 400 milestones, the Timeline spans 170 years, including advances
such as the advent of general anesthesia and its use for cancer surgery
in the mid-1800s, the signing of the National Cancer Act into law in
1971, and recent breakthroughs in immunotherapy.
The Timeline features a chronology of Major Milestones of
ground-breaking advances across cancer care and research. In addition,
there are timelines that detail practice-changing advances for common
cancer types and types of care. Many of the advances in the Cancer
Progress Timeline have also been featured in ASCO’s Clinical Cancer
Advances report, which tells the story of each year’s most influential
research.
Logo for National Cancer Act’s 50th anniversary2021 marked the 50th
anniversary of the National Cancer Act, which opened a new era of cancer
research in the United States. It led to a major expansion of funding
for cancer research and paved the way for the next five decades of
progress and advances in cancer prevention, screening, and treatment.
Many of the advances in the Progress Timeline are directly attributable
or can trace their development, to federal research funding. These
advances are marked by ASCO’s federally funded research badge.
2020
First-In-Class Drug Reduces Need for Transfusion in Patients With
Lower-Risk MDS
One of the most common features of myelodysplastic syndromes (MDS) is
anemia. Patients with lower risk MDS who are anemic are typically
treated with red blood cell transfusions and erythropoietin-stimulating
agents and can require transfusions for long periods of time. However,
not all patients are able to tolerate these treatments. Luspatercept is
a new type of drug that helps red blood cell precursors become mature
red blood cells, increasing the red blood cell count. More patients in
the phase III MEDALIST trial (ClinicalTrials.gov identifier:
NCT02631070) who received luspatercept (38%) no longer required
transfusions for 8 weeks compared with those in the placebo arm (13%).
The findings of this trial led to the approval of luspatercept by the
FDA for patients with lower-risk myelodysplastic syndromes with ringed
sideroblasts. This class of drugs fills a significant need among
patients with MDS.
More Information:
Lancet.
383:2239-2252, 2014
N
Engl J Med 2020; 382:140-151
FDA
Approval
2019
Long-term Data Proves HPV Vaccine Is Effective Against Infection and
Cervical Intraepithelial Neoplasia
The first vaccine for human papillomavirus (HPV) was licensed in 2006
with the aim of preventing infections that can lead to cervical cancer
and anogenital warts later in life. Today nearly 100 countries have
instituted HPV vaccination programs. In a 2019 analysis of real-world
data, researchers found that the prevalence of two high-risk HPV strains
(16 and 18) dropped by 83% among females age 13-19 years and by 66% in
young women age 20-24 years in the 5-8 years after the introduction of
HPV vaccination. The analysis included 40 trials in high-income
countries between 2014 and 2018. Decreases in prevalence of HPV 16 and
18 were also seen for women age 25-29 years (most of whom are
unvaccinated in the general population), as well as decreases for HPV
31, 33, and 45 for females age 13-24 years. In addition, after 5-9 years
of vaccination, grade 2+ cervical intraepithelial neoplasia (CIN2+)
decreased by 51% among screened girls aged 15–19 years and by 31% among
women aged 20–24 years.
More Information:
The
Lancet 2019;394:497-509
Targeted Therapy Ribociclib Added to Endocrine Therapy Improves
Survival in Young Women with Certain Types of Breast Cancer
The combination of the CDK4/6 inhibitor ribociclib with endocrine
therapy provided an overall survival advantage for pre- and
perimenopausal women with advanced HR+, HER2- breast cancer, compared to
standard endocrine therapy plus placebo. Results from the MONALEESA-7
trial showed 42-month survival with ribociclib of 70.2%, compared with
46% for women who received placebo plus standard endocrine treatment.
The treatment combination is an important step forward for the treatment
of younger women with this disease, who tend to have more aggressive
disease with worse survival than those who are postmenopausal.
More Information:
N Engl
J Med 2019; 381: 307-16
2018
Maintenance Olaparib Extends Progression Free Survival in Patients
With Advanced BRCA-Mutated Ovarian Cancer
Poly (ADP-ribose) polymerase, or PARP inhibitors, represent a major
treatment advance in ovarian cancer. These enzymes promote cancer cell
death by interfering with DNA replication in cancers that have faulty
DNA damage-repair genes, such as BRCA1/2. In this phase-III trial, women
with newly diagnosed advanced-stage BRCA-mutated ovarian cancer received
maintenance therapy with the PARP inhibitor olaparib following surgery
and chemotherapy. Women treated with olaparib had a 70% lower risk of
disease progression or death compared to no maintenance treatment. Not
only did these results lead to FDA approval of olaparib for this
indication, they represent a big step forward in treating patients with
this type of cancer.
More Information:
N
Engl J Med 2018;379:2495-2505
Treatment targets BRCA mutations in breast cancer
Findings from a large clinical trial of women with advanced, germline
BRCA mutation-related breast cancer show that the PARP inhibitor
olaparib (Lynparza) lowers the risk of cancer progression, with fewer
side effects, compared to standard chemotherapy. Based on these data,
olaparib is approved for this use by FDA, marking the first time any
drug has been approved to treat certain patients with a BRCA gene
mutation who have metastatic breast cancer. Up to 3% of all breast
cancers are related to inherited changes in the BRCA1 and BRCA2 genes,
which affect a cell’s ability to repair damaged DNA. PARP inhibitors
further block DNA repair in cancer cells, which helps slow or stall
tumor growth.
More Information:
N Engl
J Med 2017;377:523-533
FDA
Approval
Combination therapy offers first effective treatment for Anaplastic
Thyroid Cancer in nearly 50 years
The combination of trametinib (Mekinist) and dabrafenib (Tafinlar)
shows a strong and durable response in a single-arm phase II study of
patients with anaplastic thyroid cancer (ATC) with BRAF V600E mutation
and no satisfactory locoregional treatment options. Based on the
results, the therapy is approved for the treatment of patients with
locally advanced or metastatic ATC. The combination is the first therapy
approved for ATC in nearly 50 years. Combination treatment with
trametinib and dabrafenib become the standard of care for patients with
ATC with tumors that have a BRAF mutation.
More Information:
J Clin
Oncol 2018;36:7-13
FDA
Approval
Immunotherapy Combination Extends Survival for Renal Cell
Carcinoma
Nivolumab (Opdivo) is a programmed death 1 (PD-1) immune checkpoint
inhibitor antibody; ipilimumab (Yervoy) is an anti–cytotoxic
T-lymphocyte-associated antigen 4 (CTLA-4) antibody. While both
treatments are checkpoint inhibitors, they work in different but
complementary ways. Results from the phase III CheckMate 214 trial shows
that the combination of these two treatments provides a survival benefit
for patients who were previously untreated for advanced renal cell
carcinoma with intermediate- and poor-risk disease, when compared with
standard treatment. The findings lead to the approval of this
combination therapy — the first immunotherapy regimen — for kidney
cancer.
More Information:
N Engl
J Med 2018;378:1277-1290
FDA
Approval
21-Gene Expression Assay Guides Choice of Adjuvant Therapy for
Certain Patients with Breast Cancer
A 21-gene-basedtest (Oncotype DX) predicts risk of recurrence and
guides adjuvant therapy for women with low and high risk of recurrence
of hormone receptor-positive, human epidermal growth factor receptor 2
(HER2) negative, lymph node-negative breast cancer. Women at low
risk for recurrence can receive endocrine therapy alone, while
those at high risk receive chemoendocrine therapy. However,
it is unclear how to treat women with intermediate risk.
The TAILORx trial shows that for women with test results indicating
an intermediate risk of recurrence, chemotherapy is no
longer needed as endocrine therapy alone
results in comparable survival.
More Information:
N Engl
J Med 2018;379:111-121
Sodium Thiosulfate Helps Reduce Risk of Cisplatin-Induced Hearing
Loss
While cisplatin chemotherapy and surgery are effective treatments for
children with standard-risk hepatoblastoma, cisplatin treatment can
result in serious and irreversible hearing loss. The use of sodium
thiosulfate following cisplatin treatment roughly halves the risk of
hearing loss in a study of more than 100 patients with hepatoblastoma
from 1 month to 18 years of age. Event-free and overall survival at 3
years are comparable with and without the addition of sodium
thiosulfate.
More Information:
N Engl
J Med 2018;378:2376-2385
Lower Intensity Methotrexate Produces Highest Cure Rates for
Pediatric Patients with T-ALL
A less toxic treatment regimen of the anti-cancer drug methotrexate
resulted in the best outcomes ever reported for children and adolescents
with T-cell acute lymphoblastic leukemia (T-ALL). In a federally-funded
trial, the regimen showed a 5-year disease-free survival rate of 91.5%
and overall survival rate of 93.7%. In comparison, the historical
overall survival rate for T-ALL was approximately 81% based on earlier
clinical trials in this patient population.
More Information:
J
Clin Oncol 2018;36:2926-34
Immunotherapy/Chemotherapy Combination Approved for Extensive
SCLC
The 2019 FDA approval of the immunotherapy atezolizumab in
combination with chemotherapy represents a major advance in the
treatment of extensive small cell lung cancer. The approval was based on
the results of the IMpower 133 study, which showed significantly longer
survival with the addition of atezolizumab to carboplatin and etoposide
chemotherapy. The combination therapy has become the standard of care
for extensive-stage small cell lung cancer in the United States.
More Information:
N Engl
J Med 2018; 379:2220-9
2017
First therapy introduced to treat cancer based on tumor genomics
alone
Researchers demonstrate the efficacy of the immune checkpoint
inhibitor pembrolizumab (Keytruda) for the treatment of patients with 12
different solid tumor types with high microsatellite instability, a
signature of DNA mismatch repair deficiency. Pembrolizumab results in
long-lasting tumor shrinkage in a significant portion of patients with
these tumor types. Based in part on these results, the FDA grants
accelerated approval to pembrolizumab (KEYTRUDA) for the treatment of
adult and pediatric patients with unresectable or metastatic,
microsatellite instability-high or mismatch repair deficient solid
tumors that have progressed following prior treatment and who have no
satisfactory alternative treatment options. This approval marks a
milestone in precision oncology, when for the first time a patient can
be treated on the basis of the tumor’s genomics, instead of its location
in the body.
More Information:
Science
2017; 357(6349):409-413
FDA
Approval
Integrating patient-reported outcomes into routine cancer care
improves survival
A large, randomized trial demonstrates for the first time that
capturing patient-reported outcomes on an ongoing basis using a
web-based tool helps patients with advanced cancer live several months
longer, compared to standard care. The web-based tool enables patients
to report common symptoms in real time and triggers alerts to clinicians
if symptoms worsen. When appropriate, clinicians take action to relieve
symptoms, such as lowering chemotherapy dosing or changing supportive
care plans. The study demonstrates how newer technologies aimed at
improving communications between patients and their health care teams
can have a meaningful impact on survival and quality of life. This
development spurs greater focus on integrating similar tools into
routine cancer care.
More Information:
JAMA
2017;318:197-198
Lu 177 Dotatate Delivers Targeted Radiation to Somatostatin
Receptor-positive Midgut Neuroendocrine Tumors
Lutetium 177 dotatate is a compound that combines a radioactive
isotope with a somatostatin (growth hormone-inhibiting hormone) analog.
This combination makes it possible to deliver radiation directly to
tumor cells in patients with advanced, progressive, somatostatin
receptor-positive midgut neuroendocrine tumors. The results of the
NETTER-1 trial demonstrate improved response and longer progression-free
survival with Lu 177 dotatate compared with standard treatment. Based on
this data, the FDA approvedLu 177 Dotatate (Lutathera) for the treatment
of adults with this type of tumor in the midgut, foregut, or
hindgut.
More Information:
N Engl
J Med 2017;376:125-135
FDA
Approval
2016
Pembrolizumab extends NSCLC survival, with fewer side effects
Studies find that pembrolizumab (Keytruda) improves survival and
causes fewer side effects than standard chemotherapy for patients with
advanced non-small cell lung cancer (NSCLC) and high levels of PD-L1
protein in the tumor. These trials include patients who were newly
diagnosed and previously treated with other therapies, leading the FDA
to approve the drug for both populations of patients. These approvals
establish a new treatment paradigm for this type of lung cancer, with
immunotherapy becoming the preferred treatment over chemotherapy
regimens for PD-L1-positive cancers.
More Information:
N Engl J
Med 2016; 375:1823-1833
Lancet
2016; 387(10027): 1540–1550
FDA;
Pembrolizumab (KEYTRUDA) Checkpoint Inhibitor
First new treatment for bladder cancer in three decades
The FDA approves atezolizumab (Tecentriq) for treatment of advanced
urothelial carcinoma, the most common form of bladder cancer. With this
approval, atezolizumab becomes the first new bladder cancer treatment in
30 years and the first PD-L1 immune checkpoint inhibitor approved for
any use. The approval follows an early clinical trial in which
atezolizumab rapidly shrank tumors in patients with previously treated
advanced urothelial cancer, particularly those with high levels of PD-L1
in the tumor and immune cells.
More Information:
FDA
News Release; FDA Approves New, Targeted Treatment for Bladder
Cancer
Lancet 2016;
387(10031):1909-1920
Childhood cancer survivors living longer and healthier
A federally funded analysis of over 34,000 five-year childhood cancer
survivors shows significant gains in long-term survival over three
decades, owing to steady refinements in treatment. The rate of death
from any cause within 15 years of childhood cancer diagnosis declined by
half (from 12% to 6%) among survivors treated in the 1990s compared to
those treated in the 1970s. While treatment advances played a major
role, reductions in treatment-related health complications likely had
the greatest impact on long-term survival. This includes lower dose of
radiation for certain cancers and less use of anthracycline
chemotherapy. These advances helped make it possible for more than
400,000 childhood cancer survivors to be alive today in the United
States.
More Information:
N
Engl J Med 2016; 374:833-842
NCI;
Childhood Cancer Survivor Study: An Overview
2015
A new class of breast cancer treatment introduced
2015-2016
Palbociclib (Ibrance) becomes the first in a new class of medicines
called cyclin-dependent kinase (CDK) inhibitors, which block key
proteins that control cell division. In clinical trials, addition of
palbociclib to standard hormone therapy extended the time until the
cancer worsened by a median of 11 months when given as initial therapy
and by about 5 months for women with previously treated cancer. In 2015,
the FDA grants accelerated approval to palbociclib in combination with
letrozole (Femara) as initial hormone-based therapy in post-menopausal
women with hormone receptor-positive, human epidermal growth factor
receptor 2 (HER2)-negative advanced breast cancer. In 2016, the FDA
grants accelerated approval to palbociclib with fulvestrant (Faslodex)
to treat advanced breast cancer that worsens following initial hormone
therapy.
More Information:
Lancet
Oncology 2016; 17(4): 425-439
N Engl J
Med 2016; 375:1925-1936
FDA;
Palbociclib (IBRANCE Capsules)
2014
FDA approves two immunotherapies for melanoma
FDA grants accelerated approval to pembrolizumab (Keytruda) and
nivolumab (Opdivo) for patients with advanced melanoma that cannot be
removed with surgery who no longer respond to other treatments.
These therapies, known as “immune checkpoint inhibitors,” work by
blocking a pathway called PD-1, that prevents the body’s immune system
from attacking cancer cells.
Approval comes following research showing that the therapies shrank
tumors in up to 40% of patients. In one clinical trial, nivolumab
extended survival compared to targeted therapy for patients with
BRAF mutations.
More Information:
Lancet
2014; 384(9948): 1109–1117
Lancet
Oncology 2015; 16(4): 375–384
JCO
2014; 32(10): 1020-1030
N Engl J
Med 2015; 372: 320-330
2011
Aromatase inhibitors cut breast cancer risk in postmenopausal
women
2011-2014
A large Phase III trial shows for the first time that exemestane
(Aromasin) – part of a group of drugs called aromatase inhibitors –
greatly lowers the chance of developing invasive breast cancer in
postmenopausal women who are at a high risk for breast cancer. This
includes women with BRCA gene mutations, as well as other risk
factors. In 2014, another aromatase inhibitor, anastrozole (Arimidex),
was shown to lower the risk of breast cancer by nearly 50% over five
years.
Two other drugs, tamoxifen (Nolvadex) and raloxifene (Evista), are
also FDA-approved for breast cancer prevention in women at high risk for
the disease Aromatase inhibitors work differently, however, and tend to
carry milder side effects.
More Information:
N
Engl J Med 2011; 364:2381-2391
Lancet
2014; 383(9922): 1041–1048
2010
Record number of Americans surviving cancer – nearly 14 million
The National Cancer Institute and the American Cancer Society report
that the number of cancer survivors in the U.S. increased to an all-time
high of 13.7 million. This represents a more than four-fold increase
since 1971 (when just 3 million survivors were alive). By 2022, the
number of survivors is expected to reach 18 million. The report
highlights major progress in treatment that has led to improved survival
rates, as well as the need to address the long-term health effects of
cancer, and cancer treatment, among survivors.
More Information:
CDC
MMWR: Cancer Survivors
New prohibitions on indoor tanning after it’s declared
carcinogenic
2009-2017
In 2009, the International Agency for Research on Cancer, a working
group of the World Health Organization, declared that UV-emitting
tanning devices are “carcinogenic to humans.”
Between 2011 and 2017, several new pieces of legislation are enacted
to restrict the use of indoor tanning, starting with a new California
law prohibiting indoor tanning to people under the age of 18. Fourteen
other states and the District of Columbia subsequently follow suit. In
2014, the U.S. Food & Drug Administration issues an order requiring
all indoor tanning devices to carry a visible black-box warning against
use before age 18, and it reclassifies indoor tanning devices from a low
to a moderate risk, allowing the agency greater control over the
devices. Policy changes continue in Australia, where nearly all states
enact bans on indoor tanning in 2015.
More Information:
International
Agency for Research on Cancer; Sunbeds and UV Radiation
NCSL;
Indoor Tanning Restrictions for Minors
FDA
Code of Regulations Title 21 2017
Queensland
Government Statement on Indoor Tanning
Lancet
Oncology 2009; 10:751-752
Adding palliative care to standard chemotherapy improves survival
for advanced lung cancer patients
A head-to-head trial shows that patients who received standard
chemotherapy along with palliative care (specialized treatment to
address the symptoms of cancer, but not treat the disease) immediately
after their diagnosis with advanced lung cancer lived three months
longer and had a higher quality of life than patients who had
chemotherapy alone. Patients who received the combination approach were
also less likely to undergo aggressive therapy at the end of life, such
as resuscitation. The results demonstrate the potential for palliative
care to no only improve quality of life, but to extend patients’ lives
as well.
More Information:
Cancer.Net;
Lung Cancer - Non-Small Cell: Treatment Options
N Engl J
Med 2010; 363: 733-42
First drug shown to improve survival for patients with advanced
melanoma
In a Phase III study, the targeted drug ipilimumab (Yervoy) – which
boosts a specific component of the immune system – is found to improve
survival and delay disease progression in patients whose advanced
melanoma progresses despite other therapies. The drug is approved for
this use in early 2011.
Soon after, a second trial finds that treatment using a combination
of ipilimumab and dacarbazine (a chemotherapy drug commonly used in
melanoma) extends survival compared to dacarbazine treatment alone.
More Information:
Cancer.Net;
Melanoma: Treatment Options
N Engl J
Med 2010; 363: 711-23
N Engl J
Med 2011; 364: 2517-26
CT scanning reduces lung cancer deaths among heavy smokers
Results from a large clinical trial show that annual screening with
low-dose spiral CT (LDCT) scans reduces the risk of lung cancer death by
20 percent, compared to annual chest X-rays, in current and former heavy
smokers.
The National Lung Screening Trial, funded by the National Cancer
Institute, compared LDCT scanning to standard chest X-rays in this group
of people at high risk for developing lung cancer. This finding marks
the first-ever lung cancer screening approach that has been shown to
reduce lung cancer mortality. The debate about the appropriate use of
LDCT screening for lung cancer among the general population, however,
continues.
More Information:
Cancer.Net;
Expert Perspective from ASCO on the Results of the National Lung
Screening Trial
Radiology
2011; 258(1)
N Engl J
Med 2011; 365: 395-409
2009
Major studies report conflicting results about benefits of PSA
testing
The proper role of PSA testing remains uncertain after large,
randomized trials provide conflicting results on whether routine testing
reduces deaths from prostate cancer. Initial results from two studies
indicate that PSA testing has minimal, if any, effect on overall
survival and leads to the over-diagnosis and treatment of slow-growing
cancers that are unlikely to be life-threatening. A third study finds
that PSA testing reduces the risk of prostate cancer death in some men
by 40 percent. Given the conflicting evidence, leading medical societies
urge men to discuss the risks and benefits of screening with their
doctors.
More Information:
Cancer.Net;
Prostate Cancer: Risk Factors and Prevention
N Engl J
Med 2009; 360: 1310-19
N Engl J
Med 2009; 360: 1320-28
2006
First vaccine approved to prevent cervical cancer
The FDA approves the first vaccine to prevent infection with two
high-risk strains of the human papillomavirus (HPV16 and HPV18) that are
known to cause about 70 percent of all cervical cancers. The vaccine,
called Gardasil, is approved for girls and young women aged 9 to 26,
based on a clinical trial showing that the vaccine was safe and was 100
percent effective against these types of HPV, and those that cause
genital warts, for at least four and a half years after vaccination. A
second vaccine, Cervarix, is approved in 2009 to prevent infection
against the cancer-causing HPV strains in young women aged 10 to 25.
Gardasil is later approved to prevent additional HPV-related diseases in
children and young adults aged 9 to 26, including vaginal, vulvar and
anal cancers in females, and anal cancer and genital warts in males.
Studies have also linked HPV infection to head and neck cancers,
suggesting that the vaccine may help prevent these cancers as well.
More Information:
Cancer.Net;
HPV and Cancer
Lancet
Oncology 2005; 6(5): 271-78
N Engl J
Med 2007; 356: 1928-43
2005
Two targeted drugs approved for advanced colon cancer
The drugs cetuximab (Erbitux) and panitumumab (Vectibix) are approved
to treat colon cancer that has spread to other parts of the body
(metastatic disease). These drugs attack tumors that express the
epidermal growth factor receptor (EGFR) protein, which is involved in
cancer cell growth. Later, a coordinated analysis of multiple studies
shows that cetuximab and panitumumab are effective only in patients with
the normal form of a gene known as KRAS. This discovery helps physicians
ensure that the drugs are used only for patients who stand to benefit,
while eliminating unnecessary treatment and costs for patients who will
not.
More Information:
N Engl J
Med 2008; 359: 1757-1765
Journal of
Oncology Practice 2009; 5(2): 71-72
Research sheds light on long-term health problems of cancer
survivors
In the 1990s, researchers begin a major study of the long-term
effects of cancer and its treatment, focusing on survivors of childhood
cancer. In 2005, the Childhood Cancer Survivors Study reports that
survivors’ risk of long-term health problems – including heart problems,
second cancers and scarring of the lungs – was five times greater than
that of their healthy siblings. Similar results have been found for
survivors of other cancers with high cure rates, such as testicular
cancer.
The results are helping oncologists and primary care providers
monitor and better manage the long-term health of the millions of cancer
survivors alive today.
More Information:
Cancer.Net;
Survivorship
NCI:
Late Effects of Childhood Cancer
JNCI
2005; 97(18): 1354-65
U.S. launches effort to map cancer genomes
The National Cancer Institute and the National Human Genome Research
Institute team up to launch The Cancer Genome Atlas project. In its
initial phase, the project aims to develop a comprehensive atlas of the
genomes of three common cancers – lung, ovarian, and glioblastoma, a
form of brain cancer. By gaining a deeper understanding of the genetic
pathways involved in the development and growth of these cancers,
researchers hope to identify molecular targets that can guide
development of effective new treatment.
More Information:
The
Cancer Genome Atlas; Pilot Project
Nature
2008; 455: 1069-75
2004
Adjuvant therapy proven effective in lung cancer
In findings that quickly change the standard of care, clinical trials
show that giving chemotherapy after surgery dramatically improves
survival for patients with early-stage non-small cell lung cancer, the
most common form of the disease. Previously, chemotherapy was considered
to be largely ineffective for lung cancer. These study results
demonstrate that adjuvant chemotherapy could have an equal or greater
impact on survival in lung cancer as it does in breast or colon
cancer.
More Information:
Cancer.Net;
Lung Cancer - Non-Small Cell: Treatment Options
N Engl J
Med 2004; 350: 351-60
N Engl J
Med 2005; 352: 2589-97
FDA approves first “anti-angiogenic” drug, bevacizumab
Bevacizumab (Avastin) is the first of a new generation of targeted
drugs, called anti-angiogenics, that attack cancer by blocking the
growth of blood vessels that tumors needs to grow. First approved to
treat colorectal cancer, in 2004, the drug has since become an important
treatment for patients with advanced lung, ovarian and kidney cancers,
and for certain brain tumors, who have few other effective options.
More Information:
N Engl J
Med 2004; 350: 2335-42
Lancet
2007; 370(9605): 2103-11
2003
First targeted drugs for lung cancer attack “EGFR” receptor
The FDA approves two new targeted treatments for advanced, non-small
cell lung cancer, gefitinib (Iressa) and erlotinib (Tarceva). Both drugs
target the epidermal growth factor receptor (EGFR), a protein on cell
surfaces that is involved in driving lung cancer growth and spread.
Approval is based on data showing that erlotinib extends survival in
patients with advanced lung cancer – a rare finding for any treatment –
and that gefitinib delays the time before a patient’s cancer progresses.
Around the same time, studies show that the drugs only work for patients
with specific mutations in the EGFR protein. These mutations are found
most often in lung cancer patients who never smoked.
To date, the two drugs are approved only for certain patients whose
cancer no longer responds to other therapies. But recent studies
indicate that for people with the relevant EGFR mutations, the drugs
could also be valuable first-line treatment options.
More Information:
Lancet
2005; 366(9496): 1527-37
N Engl J
Med 2010; 362: 2380-88
N Engl J
Med 2009; 361: 947-957
Obesity pinpointed as cause of many cancer deaths
An important prospective analysis involving nearly 1 million
Americans reports that obesity could account for up to 20 percent of
U.S. cancer deaths. Obesity is linked to a higher risk of death from
liver cancer, along with several other cancer types. The researchers
also estimate that 90,000 cancer-related deaths could be prevented
annually if Americans maintained a healthy weight.
As obesity becomes more prevalent, researchers project that deaths
from liver cancer and other forms of the disease will rise as well.
More Information:
N
Engl J Med 2003; 348: 1625-38
Scientists decode the human genome
Scientists announce that they have successfully mapped the 3 billion
DNA letters in the human genome. This marks the completion of the Human
Genome Project, an unprecedented international collaboration between
researchers in the U.S. in and six other countries, funded primarily by
the U.S. government. Results of the 13-year effort are made freely
available to scientists around the world, paving the way for research to
identify the genetic defects that fuel cancer, and for new ways of
screening for and treating the disease.
More Information:
Nature
2003; 422: 835-47
Human
Genome Project Informative Archive 1990-2003
2002
Doubling of U.S. biomedical research budget expands cancer
research
Beginning in 1998, President Bill Clinton and Congressional leaders
enact a series of large, annual budget increases for the National
Institutes of Health, doubling the agency’s biomedical research efforts
over the next five years. The new investments accelerate the pace of
cancer research in the lab and in the clinic, leading to important
advances over the next decade. More recently, however, federal support
for cancer research has declined in real terms, potentially slowing the
pace of progress against the disease.
More Information:
Office
of Legislative Policy and Analysis: Legislative Chronology
New
York Times; Government Ready to Boost Spending for Biomedicine
2001
Imatinib found highly effective against rare gastrointestinal
tumor
Just weeks after being approved to treat chronic myelogenous
leukemia, the targeted drug imatinib is shown to be effective against a
rare abdominal tumor called GIST (gastrointestinal stromal tumor). Prior
to imatinib, available drug treatments had little effect on GIST tumors.
Imatinib works like a “circuit breaker” to block enzymes that can send
faulty signals to trigger tumor cell growth. In GIST, it blocks the
growth signal of a gene called c-Kit.
More Information:
N Engl J
Med 2002; 347: 472-80
1999
First targeted anti-breast cancer drug, trastuzumab (Herceptin), has
major impact on care
The FDA approves the groundbreaking drug trastuzumab (Herceptin)
after research shows that adding the monoclonal antibody to chemotherapy
dramatically increases survival for women with advanced breast cancer
that over-produces a protein called HER2. In 2006, the drug is also
approved as part of adjuvant therapy (after surgery) for women with
early-stage HER2-positive breast cancer, after two major trials show
that it reduces the risk of recurrence by more than 50 percent, an
unprecedented result.
About 25 percent of breast cancer patients have HER2-positive
disease, and prior to the introduction of trastuzumab, there were no
effective treatments for these cancers, which were considered some of
the most aggressive, deadly forms of the disease. Recently, trastuzumab
was also FDA-approved to treat patients with stomach cancers that have a
similar over-production of the HER2 protein.
More Information:
Cancer.Net;
Breast Cancer: Treatment Options
N
Engl J Med 2001; 344: 783-92
N Engl J
Med 2005; 353: 1673-84
1998
Chemotherapy before surgery helps more women benefit from
breast-conserving treatment
A major trial reports that an approach called neoadjuvant
chemotherapy – providing chemotherapy before surgery – allows more than
two-thirds of women with large breast tumors to undergo
breast-conserving surgery, called lumpectomy, instead of full
mastectomy. The goal of neoadjuvant therapy is to shrink tumors so they
can be removed surgically. Breast-conserving surgery, also called
lumpectomy, is easier to recover from and results in far better cosmetic
outcomes – without compromising survival – compared with mastectomy.
Neoadjuvant therapy is later shown to benefit patients with rectal and
other cancers.
More Information:
Cancer.Net
Journal
of Clinical Oncology 1998; 16(8): 2672-78
Journal
of Clinical Oncology 2008; 26(5): 778-85
Treatment guidelines highlight obesity-cancer link
Major studies linking obesity to an increased risk of common cancers
prompt the National Institutes of Health to publish clinical guidelines
on managing obesity in adults. The guidelines point specifically to the
increased risk for endometrial, breast, prostate and colon cancers, in
addition to other serious health problems.
More Information:
Obesity
Education Initiative; The Evidence Report 1998; 98(4083)
Drug therapy can reduce breast cancer risk in women at high
risk
The FDA approves tamoxifen (Novaldex), a hormonal drug already used
to prevent recurrence of breast cancer, to reduce the risk of developing
breast cancer in women who are at high risk for the disease. The
approval is based on a large trial showing that tamoxifen reduced breast
cancer risk by more than 40 percent in women with a strong family
history of breast cancer or with mutations in the BRCA1 and BRCA2 genes.
Later research shows that a different drug used to treat osteoporosis,
raloxifene (Evista), is as effective as tamoxifen at preventing invasive
breast cancer, but with a lower risk of certain side effects.
More Information:
Cancer.Net;
Drugs to Lower Breast Cancer Risk
Journal
of the National Cancer Institute 1998; 90(18)
JAMA
2006; 295(23): 2727-41
New radiotherapy technique enables precise targeting of tumors near
sensitive tissue
Doctors begin using intensity modulated radiation therapy (IMRT), a
highly advanced radiation technique, to precisely target tumors that lie
close to vital organs and other sensitive tissue that must be protected
from radiation. IMRT uses sophisticated software and complex new
machinery to vary both the shape and intensity of radiation. One of the
clearest benefits has been in the treatment of head and neck cancers;
IMRT allows doctors to minimize radiation exposure to the spinal cord,
optic nerve and salivary glands, reducing side effects without
compromising tumor control.
More Information:
Seminars
in Radiation Oncology 1999; 9(1): 60-77
International
Journal of Radiation Oncology, Biology, Physics 2001; 50(3):
695–704
1997
Prophylactic surgery helps prevent breast and ovarian cancers in
women at high risk
In the mid-1990s, researchers discover that women who have mutations
in the genes known as BRCA1 and BRCA2 have a significantly increased
risk of developing breast and ovarian cancers. Soon after, studies find
that women with the mutations, or with a strong family history of these
cancers, may be able to reduce their cancer risk by 90 percent or more
by undergoing surgical removal of their breasts (mastectomy), ovaries
(oophorectomy), or both. A decade later, a major review of published
studies confirms that removal of the ovaries and fallopian tubes in
premenopausal women with BRCA mutations reduces the risk of breast
cancer by 51 percent and the risk of ovarian and fallopian tube cancers
by 79 percent.
More Information:
N
Engl J Med 1999; 340(2): 77-84
N
Engl J Med 2002; 346: 1616-22
N
Engl J Med 1997; 336: 1401-08
Surgery found to cure some patients with advanced colon cancer
In general, metastatic cancer is difficult or impossible to treat
with surgery because tumor cells are spread throughout the body. But in
1997, researchers find that some colon cancer patients whose cancer has
metastasized to the liver only can be cured with surgery. In a study of
nearly 300 such patients who underwent surgery between 1960 and 1987,
about one in four were still alive five years later, and nearly of all
of these patients were found to have been essentially cured. A later
study finds that use of positron emission tomography, or PET scanning,
can identify some liver metastases that would have gone unnoticed
before, helping surgeons in the study to achieve a cure rate above 50
percent.
More Information:
Archives
of Surgery 1997; 132(5): 505-11
Annals
of Surgery 2004; 240(3): 438-50
FDA approves first-ever targeted cancer drug, rituximab
The FDA approves the first molecularly targeted cancer drug,
rituximab (Rituxan), to treat patients with B-cell non-Hodgkin lymphoma
that no longer responds to other treatments. Rituximab is in a new class
of drugs called monoclonal antibodies, and targets a protein on the
surface of immune cells known as B cells, interfering with the
development of cancer. It is later combined with other cancer therapies
to boost cure rates and increase survival.
More Information:
Journal
of Clinical Oncology 1998; 16(8): 2825-33
1993
Taxanes emerge as a vital chemotherapy option for ovarian, breast
cancer
A new family of treatments debuts with the FDA approval of paclitaxel
(Taxol) for advanced ovarian cancer. The drug receives one of the
fastest-ever approvals, on the heels of data showing it shrinks ovarian
tumors by more than half in many women who had stopped responding to all
other therapies. Later studies show it extends survival by over a year
when used as an initial therapy for advanced ovarian cancer, along with
the chemotherapy drug cisplatin.
Over the next decade, paclitaxel also proves effective for all stages
of breast cancer – extending lives and delaying disease progression
compared to existing therapies, and delaying recurrence when used as
adjuvant therapy (after surgery). The drug is derived from the bark of a
yew tree, and is the product of a field of research exploring ‘natural’
cures for a range of diseases. Until drugmakers discovered a synthetic
method for producing the drug, there was widespread concern that the
natural resources needed to produce the drug would not meet demand.
More Information:
Cancer.Net;
Treatment Options
Semin Oncol.
1996; 23(5): 40-7
Journal of
Clinical Oncology 2003; 21(17): 3194-3200
Melanoma linked to sun exposure
A growing number of studies indicate that excessive sun exposure,
including a history of severe sunburn, increases the risk of melanoma.
However, researchers caution that some melanomas can occur in areas of
the body without sun exposure, such as on the palms of the hands and
soles of the feet. While researchers continue to seek a better
understanding of melanoma’s risk factors, a number of leading medical
associations have cautioned against excessive sun exposure to reduce the
risk of melanoma and other skin cancers.
More Information:
Cancer.Net;
Melanoma: Risk Factors and Prevention
British
Journal of Cancer 1982; 46: 955
J Am Acad
Dermatol. 1984; 11(1): 674-84
1992
Sentinel lymph node biopsy determines cancer’s spread with fewer
side effects
A surgical technique called sentinel lymph node biopsy becomes a less
invasive way to assess whether cancer has spread in patients with
early-stage melanoma, the most aggressive form of skin cancer. The
procedure involves surgically removing the lymph node closest to the
primary tumor – the “sentinel” node – and examining it under a
microscope for evidence of cancer. If the sentinel node is cancer-free,
no further lymph nodes are removed and the patient is spared the
previous practice of removing a large number of nodes. This allows for
easier recovery and reduces the risk of postoperative side effects such
as lymphedema, a painful swelling of the extremities.
Sentinel lymph node biopsy is later found to be effective for women
with breast cancer.
More Information:
Cancer.Net;
Sentinel Lymph Node Biopsy for Early-Stage Breast Cancer
JAMA.
1996; 276(22): 1818-22
Journal
of Clinical Oncology 2007; 25(24): 3657-3663
1991
Powerful anti-nausea drugs alleviate major side effect of cancer
treatment
Ondansetron (Zofran) is approved by the FDA to prevent vomiting
caused by chemotherapy and/or radiation. The drug works by deactivating
the nervous system’s natural trigger for vomiting. Other, similar drugs
are soon approved, including granisetron (Kytril), dolasetron (Anzemet)
and palonosetron (Aloxi). These and other anti-nausea drugs, like
aprepitant (Emend), make it possible for most cancer patients to receive
chemotherapy in an outpatient setting, with minimal disruption to their
daily routines.
More Information:
Cancer.Net;
Nausea and Vomiting
N
Engl J Med 1990; 322: 810-816
Cancer deaths begin steady decline
For the first time since record-keeping began in the 1930s, cancer
mortality rates begin to decline. The National Cancer Institute, the
Centers for Disease Control and Prevention, and the American Cancer
Society report that the overall cancer death rate fell by 2.6 percent
between 1991 and 1995. Between 1991 and 2008 (the most recent year
available), the death rate has fallen by a total of 18 percent.
More Information:
Cancer
1998; 82(6): 1197-1207
NCI:
SEER Cancer Statistics
1990
Shift to 3-D radiation treatment plans increases precision, safety
of therapy
Thanks to the integration of powerful computers into medicine,
doctors are able to dramatically improve radiation therapy by creating
3-D treatment plans. These plans require highly complex calculations and
vastly more computing power than earlier, two-dimensional treatment
plans. Thanks to this advance, radiation can be targeted at tumors from
multiple angles, with beams of varying power, in ways that minimize the
damage to healthy, surrounding tissue.
More Information:
International
Journal of Radiation Oncology 1990; 18(6): 1485-94
Laparoscopic surgery minimizes pain, recovery time for several
cancers
Beginning in the 1990s, laparoscopic surgery – in which a surgeon
makes several small incisions and uses telescoping equipment to remove
tumors – emerges as an alternative to traditional open surgery for some
cancers, including kidney, prostate and colorectal cancer. This new
approach allows patients to recover faster and experience less pain,
without sacrificing effectiveness.
More Information:
Cancer.Net;
What is Cancer Surgery?
J Laparoendosc
Surg. 1993; 3(6): 577-81
N Engl J
Med 2004; 350: 2050-59
1988
Benzene discovered to cause blood cancers
Scientists find that occupational exposure to benzene, a chemical
commonly used as a solvent and in oil-related products, is associated
with increased risk of developing non-lymphocytic leukemia, non-Hodgkin
lymphoma, and other diseases. Following this discovery, workers begin
taking steps to protect themselves from benzene exposure and reduce
their cancer risk.
More Information:
N
Engl J Med 1987; 316: 1044-50
American
Journal of Industrial Medicine 1997; 31(3): 287–95
Adjuvant therapy proven for colorectal cancer
Pivotal clinical trials show that chemotherapy following surgery
(adjuvant treatment) in patients with stage III colorectal cancer
reduces the risk of cancer recurrence by about 40 percent. Later
refinements – using newer drugs, radiation and sophisticated treatment
schedules – help to lower recurrence rates even further. Together with
greater screening to detect colon cancer early, adjuvant therapy has
contributed to a 40 percent reduction in colon cancer mortality in the
U.S. since the 1970s.
More Information:
Cancer.Net;
Colorectal Cancer: Treatment Options
NIH
Consensus Statement
Cancer
2010; 116(3): 544–73
1986
Global guidelines help ensure proper pain management
Pain is common among patients with advanced cancer but hasn’t always
been well-managed. In 1986, the World Health Organization issues clear
guidance on the use of pain medications for cancer patients, focusing on
stronger, opioid-type drugs such as morphine. The guidelines address
widespread concerns about addiction, tolerance and abuse, which made
some providers reluctant to prescribe the drugs. Adherence to the
guidelines has been found to provide reliable pain relief for up to 90
percent of patients. In later years, other organizations, including
ASCO, propose guidelines to help doctors recognize and talk to their
patients about pain and its management.
More Information:
Cancer.Net;
Treating Pain with Medication
Annals
of Oncology 2005; 16(Supplement 4): iv132 –35
Journal
of Clinical Oncology 1992; 10(12): 1976-82
Tamoxifen reduces breast cancer recurrence
Tamoxifen (Novaldex) is approved as adjuvant therapy for
post-menopausal women following breast cancer surgery, based on studies
showing that use of the hormonal therapy for five years after surgery
reduces the risk of cancer recurrence and dramatically increases
survival.
More Information:
Lancet
1983; 322(8347): 450
Lancet
1998; 351(9114): 1451-67
PSA test enables early detection of prostate cancer
The FDA approves the first PSA (prostate-specific antigen) test to
screen for prostate cancer – the most common form of cancer in men – in
men aged 50 and older. In the years that follow, widespread use of PSA
testing leads to a significant jump in early-stage prostate cancer
diagnoses, sparking debate about whether such screening improves
survival or simply leads to diagnosis and unnecessary treatment of
slow-growing cancers that would never have become life-threatening.
More Information:
J Urol. 1992;
147(3): 931-34
1981
First cancer vaccine prevents cancer-causing hepatitis B
infection
The FDA approves the first vaccine against hepatitis B, one of the
primary causes of liver cancer. In 1991, the U.S. begins routine
vaccination of all children against hepatitis B, and by 2007, the number
of acute hepatitis B cases among children under 15 years declines by 98
percent. Over time, routine vaccination is expected to reduce rates of
liver cancer in the U.S. and globally among adults who were vaccinated
as children.
More Information:
CDC;
Hepatitis B VIS
J Natl Cancer
Inst 2009; 101: 1348–1355
1977
Growing use of mammography saves lives
Regular breast cancer screening with mammography becomes increasingly
common, helping to detect cancers at an earlier, more treatable stage.
By the mid-1980s, nearly one-third of U.S. women over age 40 are
screened. By 2008, the proportion screened approaches 70 percent. High
screening rates – and resulting early detection – have contributed to a
27 percent reduction in breast cancer mortality among U.S. women since
1975.
More Information:
Cancer.Net;
Mammography
CDC Report:
Health, United States, 2009
Many women with breast cancer can opt for breast-conserving
surgery
Studies show that a procedure called lumpectomy – involving the
removal of only the tumor, and not the entire breast – followed by
radiation therapy is as effective as mastectomy for women with
early-stage breast cancer. The finding helps dramatically reduce the
physical and cosmetic side effects of breast cancer treatment and
enables women to recover more quickly after surgery and return to their
normal lives.
More Information:
Cancer.Net;
Talking With Your Doctor About Breast Surgery Options
Cancer 1977; 39(6):
2822-26
N
Engl J Med 1981; 305: 6-11
New treatments cure men with testicular cancer
A pivotal trial shows that combining the drugs cisplatin, vinblastine
(Velban, Velsar) and bleomycin (Blenoxane) can cure 70 percent of
patients with advanced testicular cancer. Cisplatin is approved by the
FDA the following year. Today, the overall cure rate for testicular
cancer (all stages) is a remarkable 95 percent.
More Information:
Ann
Intern Med. 1977; 87(3): 293-98
1975
First adjuvant chemotherapy increases cure rates for early-stage
breast cancer
After overcoming concerns in the cancer community about whether the
benefits outweigh the risks, Drs. Bernard Fisher and Gianni Bonadonna
demonstrate that chemotherapy after surgery – known as adjuvant
chemotherapy – prolongs the lives of women with early stage breast
cancer. Their studies involve use of the drugs l-phenylalanine mustard
or a combination of cyclophosphamide (Cytoxan), methotrexate and
fluorouracil. Adjuvant chemotherapy becomes a major component of
treatment for the disease, improving survival and cure rates in the
years ahead. Today, about nine in 10 women with early-stage breast
cancer are alive five years after their diagnosis.
This finding sets the stage for research on adjuvant therapy in other
common cancers, including colon and lung cancer, making it one of the
most important advances in modern cancer care.
More Information:
Cancer.Net;
Breast Cancer: Treatment Options
N
Engl J Med 1975; 292: 117-122
Annals of
the Royal College of Surgeons of England 1981; 63(4): 239–243
Use of cancer-causing asbestos declines
As studies confirm long-suspected links between asbestos and certain
cancers, use of asbestos begins to decline. In the 1980s, its use is
banned in a growing number of applications, and environmental and health
regulations help to dramatically limit exposure to asbestos in
workplaces and homes. Asbestos exposure has been shown to increase a
person’s risk of lung cancer, mesothelioma (an aggressive cancer in the
chest or abdomen), and other serious health problems. Because these
problems often occur decades after exposure, however, the impact of
preventive efforts will be felt gradually in the years ahead.
More Information:
NCI:
Asbestos Exposure and Cancer Risk
1974
CT scanning provides clearer images of tumors, guiding radiation and
other treatments
Researchers perform the first computed tomography (CT) scan on a
human patient – a woman with a suspected brain tumor. CT scanning uses
X-rays to create images or “slices” of the brain, allowing doctors for
the first time to clearly see tumors arising in the soft tissue of the
brain. Over the following decades, CT scanning enables doctors to assess
the size, shape and location of many other types of tumors, and to
carefully target radiation and surgery to hit the tumors without harming
healthy tissue.
More Information:
Radiology. 1981;
140(3): 751-61
X-Ray
Computed Tomography in Biomedical Engineering
1971
More limited mastectomy proven effective for early-stage breast
cancer
While radical surgery had been routinely used to treat breast cancer,
a more limited surgical procedure called total mastectomy (removing just
the breast tissue instead of removing the breast, chest wall muscle and
underarm lymph nodes) is confirmed to be as effective for women with
early-stage breast cancer. The procedure reduces pain after surgery and
speeds recovery for patients. This advance paves the way for future
breast-conserving surgeries.
More Information:
Cancer
2006; 28(6)
N
Engl J Med 1989; 320: 822-828
Annals of
Surgery 1969; 170(6): 880–882
National Cancer Act of 1971 becomes law
President Richard M. Nixon signs the National Cancer Act in December,
less than a year after launching a national “War on Cancer” in his State
of the Union address. The act leads to a major expansion of cancer
research efforts in the U.S., paving the way for much of the progress
achieved over the next 40 years. Among other changes, the Act provides
unprecedented levels of funding for the National Cancer Institute ($400
million in 1972 and $600 million by 1974) and directs NCI to expand
federal cancer research facilities and award new research grants.
More Information:
NCI:
National Cancer Act of 1937
Screening tests for colorectal cancer dramatically reduce
deaths
In 1967, the guaiac fecal occult blood test (FOBT) is introduced as a
screening test for colorectal cancer, one of the most common forms of
cancer. This simple and inexpensive tool detects the presence of blood
in stool, a sign that cancerous or precancerous growths (called polyps)
may be present. Within the next few years, two new screening techniques
– flexible sigmoidoscopy and colonoscopy – enable physicians to examine
the colon using a small camera attached to a flexible lighted tube. The
widespread use of these approaches leads to better detection of
precancerous polyps and early stage cancers that are usually curable
with surgery. Over the coming decades, routine screening contributes to
major reductions in colorectal cancer mortality – a total decline of
more than 40 percent since 1975.
More Information:
Cancer.Net;
Colonoscopy
JAMA
1967; 201(12): 943-945
ASCO
Guideline
1970
Increased use of radioactive “seeds” to target prostate and other
cancers
Studies suggest that an approach called brachytherapy extends the
lives of patients with prostate cancer, compared to surgical removal of
the prostate and surrounding tissue. In this approach, tiny radioactive
sources or “seeds” are implanted directly into the prostate gland,
delivering a high dose of radiation directly to the tumor while leaving
healthy tissue beyond the prostate relatively unaffected.
Brachytherapy has been used since the early 1900s, but became less
common after the widespread adoption of external beam radiation. With
refined techniques and conclusive data on its effectiveness, the
approach once again becomes a central part of treatment for prostate,
cervical and other cancers.
More Information:
Can J Surg.
1983; 26(4): 363-65
Int J Radiat
Oncol Biol Phys. 1991; 21(3): 537-47
1965
Chemotherapy found to cure Hodgkin lymphoma
Researchers led by Vincent DeVita discover that a new chemotherapy
regimen called MOPP (mechlorethamine, vincristine, procarbazine and
prednisone) cures up to 50 percent of patients with advanced Hodgkin
lymphoma. This regimen quickly becomes the standard treatment. In the
1970s, a different chemotherapy combination (doxorubicin, bleomycin,
vinblastine and dacarbazine – known as ABVD) proves even more effective,
curing about 70 percent of patients with advanced Hodgkin lymphoma. The
ABVD combination remains a mainstay of treatment today.
More Information:
Cancer
Research 2008; 68(21): 8643-53
1959
Smoking linked to cancer; cessation campaigns begin
In the 1950s, studies begin to show that smoking is a major cause of
cancer, particularly lung cancer. In the early 1960s, both the U.S.
Surgeon General and the U.K. Royal College of Physicians issue reports
linking smoking to cancer and other serious health problems. In later
years, smoking is also established as a major cause of pancreatic
cancer, and second-hand smoke is declared a threat to the health of
non-smokers. Tobacco control and smoking cessation soon become the most
important strategies for reducing the worldwide toll of lung cancer.
More Information:
British
Medical Journal 1950: 84-93
1955
U.S. government establishes national research network to test new
cancer treatments
The Clinical Trials Cooperative Group Program is established by the
U.S. National Cancer Institute. Over time, this nationwide cancer
research network proves the safety and efficacy of many of the most
important advances in cancer treatment, screening and prevention.
Cooperative Group trials have brought breakthroughs in adjuvant
chemotherapy for breast and colon cancers; breast-conserving lumpectomy
to avoid mastectomy; and new standards of care for blood cancers, brain
tumors, and many others. Perhaps most striking is the impact of these
trials on pediatric cancer survival rates. Fifty to 60 percent of
children with cancer are enrolled in clinical trials, and childhood
cancer survival rates have increased from less than 10 percent in the
1950s to nearly 80 percent today as a result.
More Information:
IOM Report: A
National Cancer Clinical Trials System for the 21st Century
1947
First-ever remission of pediatric leukemia
Sidney Farber, a physician at Children’s Hospital Boston, achieves
the first partial remission of pediatric leukemia in a 4-year-old girl
using the drug aminopterin. He soon documents 10 cases of remission in a
landmark scientific paper. Until this time, children with acute leukemia
usually died within weeks of being diagnosed. While early remissions
prove temporary, they pave the way for therapies that cure thousands of
patients in the decades to come, allowing most childhood cancer patients
to live long, healthy lives.
More Information:
Boston
Children’s Hospital
N
Engl J Med 1948; 238:787-793
1903
First use of radiation to treat cancer
Five years after Marie Curie’s discovery of radium, doctors report
the first successful of use of this radioactive element to treat cancer,
in two Russian patients with skin cancer. In the following decades,
radiation becomes widely used to treat many different cancers, including
cervical, prostate, breast and other tumors. In these first decades,
doctors use an approach known as brachytherapy, in which small pieces of
radioactive material are implanted inside or next to tumors, delivering
radiation to cancer cells at close range. Brachytherapy remains an
essential part of cancer treatment today, but has been refined to more
precisely target tumor cells while leaving healthy tissue unharmed.
More Information:
Cancer
Journal 2006; 76(10)
American
Brachytherapy Society; Introduction of Brachytherapy
NCI:
250 Years of Advances Against Cancer
1884
Radical mastectomy ushers in more aggressive surgical approaches for
cancer
Baltimore surgeon William Halsted pioneers a new approach to removing
breast tumors, radical mastectomy, in which the entire breast and the
surrounding lymph nodes and chest muscles are removed. This helps reduce
recurrences of the disease, which was previously nearly always fatal.
Halsted’s work also leads to similar approaches for other cancers, in
which both the tumor and surrounding tissue are removed. These
techniques are still an important part of treatment for some cancers
today. For breast cancer, however, surgeries have become far more
conservative and effective, enabling many women to avoid mastectomy
altogether.
More Information:
Annals
of Surgery; Operations for Cure of Cancer of the Breast