The Hunt For Cures: Cancer

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Such therapies will not, on their own, be able to rid the body of large tumors. So it is likely that oncologists will put together cocktails of treatments, each using a different strategy to outfox the cancer. In the future, traditional chemotherapy will be combined with other cell-killing treatments like the COX-2 inhibitors, drugs that are chemically related to pain-killers like ibuprofen and that appear to force cancer cells to self-destruct. Chemotherapy will also be used with treatments that aim simply to stop tumors from growing, such as the so-called antiangiogenic factors, relatively nontoxic compounds that blunt the growth of new capillaries.

Tumors, it turns out, cannot grow much beyond the size of a peppercorn without an ever expanding network of blood vessels. Clinicians are testing more than a dozen treatments aimed at halting that process, including some old-line drugs that have turned out to have antiangiogenic properties. Thalidomide, which caused devastating birth defects in some 12,000 children worldwide before it was withdrawn in the early 1960s, is finding a new lease on life against multiple myeloma and liver cancers. Pharmaceutical giant Bristol-Myers Squibb is testing an antiangiogenic drug that was initially developed to keep cancer from worming its way into surrounding tissue. It's also investigating whether low, steady doses of traditional chemotherapy may be able to beat back blood vessels, a treatment that would have the added benefit of minimal side effects.

It's clearly too soon to declare victory in the war on cancer, since 9 out of 10 new treatments will fail clinical trials. But doctors who treat the disease are experiencing a surge of optimism the likes of which they have never felt before. "It's no longer spin the wheel, let's try this drug, maybe it will work," says Henry Friedman, a neuro-oncologist at Duke University Medical Center. "We're going to know why a drug is or isn't working." And given the nature of cancer and the scientists who study it, if one approach doesn't fly, there will be no shortage of other ideas to try.