The war on cancer—a status report  pg. 2

Toward that end, the NCI is serving as a “catalyst”—bringing scientists from diverse fields together to develop new research strategies, and pursuing partnerships with pharmaceutical companies to hasten drug discovery and development.

The discovery that Celebrex can inhibit pre-cancerous polyps in high-risk patients emerged from just that kind of partnership. “That was just a six month trial, very fast, very small, very efficient,” says Hawk, who participated in the research, “and yet it had a profound impact … both for immediate clinical care of a high-risk group and then more broadly for the potential of many others.”

Tests of other potential drugs have been disappointing, in part because of the way they are tested both in animals and humans. “When we give a mouse cancer, we start treating immediately,” says Lynn Matrisian, Ph.D., chair of Cancer Biology at Vanderbilt, whereas experimental drugs traditionally are tested first in patients with advanced disease.

What’s needed is the development of smaller clinical trials looking at earlier stages of disease, says Harold L. Moses, M.D., former director of the Vanderbilt-Ingram Cancer Center. The studies should measure biological markers or “correlates” of drug activity, and be flexible enough to change course quickly if it becomes apparent that the drug is most effective in a subgroup of research subjects.

“The idea is to do it better, more quickly and with less expense,” he says.

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