Despite the benefit seen by some patients treated with chemotherapy, overall cancer mortality did not begin to decline until 1990.
And the cancer research field began to move from screening new drugs randomly against a panel of tumours, to specifically targeting critical molecular targets.
The Philadelphia chromosome translocation causing chronic myelocytic leukemia was discovered in 1961.
And imatinib, a tyrosine kinase inhibitor targeting the resulting Bcr-Abl fusion protein, was approved in 1996.
Use of monoclonal antibodies targeting specific genetic alterations also began in the 1990s, often in conjunction with chemotherapy, these include trastuzumab for HER2+ breast cancer, rituximab for non-Hodgkin’s lymphoma and ipilimumab for melanoma.
The past few years have seen some of the first multiple-tumour type approvals of targeted therapy, mainly focused on mAbs targeting PD-1 and PD-L1 in lung, bladder, skin and several other cancers.
The discovery of these mechanisms of what is now called immunotherapy led to a Nobel Prize in 2018.
And the effects of these new treatments, particularly when combined with chemotherapy, have doubled survival in some patients.
Newer combinations, such as FOLFIRINOX have demonstrated significant improvements in hard-to-treat pancreatic cancer in recent years.
Future combinations of chemotherapy, targeted therapies and immunotherapy will hopefully continue to improve patient survival and quality of life.