The Hope & The Hype

Unless you have gone through the experience yourself, or watched a loved one's struggle, you really have no idea just how desperate cancer can make you. You pray, you rage, you bargain with God, but most of all you clutch at any hope, no matter how remote, of a second chance at life.

For a few heady days last week, however, it seemed as if the whole world was a cancer patient and that all humankind had been granted a reprieve. Triggered by a front-page medical news story in the usually reserved New York Times, all anybody was talking about--on the radio, on television, on the Internet, in phone calls to friends and relatives--was the report that a combination of two new drugs could, as the Times put it, "cure cancer in two years."

In a matter of hours patients had jammed their doctors' phone lines begging for a chance to test the miracle cancer cure. Investors scrambled to buy a piece of the action, turning the shares of a little company called EntreMed into the most volatile stock on Wall Street. Cancer scientists raced to the phones and fax lines to make sure everyone knew about their research too, generating a new round of headlines and perpetuating the second major medical media frenzy in as many weeks. It was Viagra all over again, without the jokes.

The time certainly seemed ripe for a breakthrough in cancer. Only last month scientists at the National Cancer Institute announced that they were halting a clinical trial of a drug called tamoxifen--and offering it to patients getting the placebo--because it had proved so effective at preventing breast cancer (although it also seemed to increase the risk of uterine cancer). Then preliminary reports indicated that another drug, raloxifene, might prevent breast cancer without triggering new malignancies. Two weeks later came the Times's report that two new drugs can shrink tumors of every variety without any side effects whatsoever.

It all seemed too good to be true, and of course it was. There are no miracle cancer drugs, at least not yet. At this stage all EntreMed can offer is some very interesting molecules, called angiostatin and endostatin, and the only cancers they have cured so far have been in mice. By the middle of last week, even the most breathless TV talk-show hosts had learned what every scientist already knew: that curing a disease in lab animals is not the same as doing it in humans. "The history of cancer research has been a history of curing cancer in the mouse," Dr. Richard Klausner, head of the National Cancer Institute, told the Los Angeles Times. "We have cured mice of cancer for decades--and it simply didn't work in people."

Even that understates the scientific hurdles that lie ahead. No one knows yet whether angiostatin and endostatin will help people. Even if researchers do figure out how to make the compounds work, pharmaceutical companies estimate it would take as much as $400 million and at least 10 years--not two years--of thorough clinical trials to bring a drug to market.