It’s a long way to Tipperary
It’s a long way to Tipperary
It’s a long way to Tipperary
Mariano Bizzarri
In an article recently published by an Italian newspaper (Il Corriere della Sera), it was hypothesized that the "rate of curability of cancer, in the next 10-15 years will be astonishingly increased". That exploit should mainly be ascribed (no doubt on that!) to the new generation of molecular drugs designed to block one or more genes involved in cancer “causation”.
Unfortunately, this ‘candid’ optimism cannot be shared.
Firstly, because we are waiting for a “magic bullet” since the eighties, but this is rather late in coming. Secondly, because the (incontestable) progress actually achieved (especially for leukemias, breast , prostate and testicular tumours), is mostly attributable to synergy expressed by surgery, chemotherapy, radiotherapy and hormone therapy. The graph, underneath reported in figure, evidences that in oncology (from 1950 and 2008) no significant reduction has been achieved in mortality rate, meanwhile a complete different picture is observed for other diseases. It 's highly unlikely that a drug designed to block a single gene can actually "cure" a tumor: gene alterations found in tumors are indeed variable, displaying a random behaviour; they vary from individual to individual, and also within each tumour. As a matter of fact , no common genetic mechanism has so far been revealed. Tumors are diseases beginning at the tissue level (cancer does not arise from a single cell), and they recognize a complex array of causal factors, and only partially known, till now. In the last decade has come proposing a new interpretative paradigm, proposed by Profs. C. Sonnenschein and A. Soto (Tuft Boston University). According to which them an alteration in tissue architecture should be considered the initial and prominent cause of malignant disease. The new theory (TOFT) is based on compelling evidence and it was the subject of a recent comparison with the "classical" theory (SMT), which recognizes instead a causal role for mutations. Indeed, mutations “are not so important”: that statement explains the failure of drugs designed to cure by hitting a single gene-target. In point of fact, by concentrating all efforts on drugs "target-based", is leading to failure of many pharmaceutical companies (we should reflect about what happens in Nerviano, former Pzifer, Milan). Hopefully, this even does not lead to failure oncology.
Mortality rates (years 1950-2008) for infectious, herat, cerebrovascular diseases (From American Cancer Society (ACS) 2010 Cancer Facts & Figures; Atlanta, USA, 2008).
