A new era of personalised cancer treatments

Good news is flowing from the world’s cancer labs. Researchers are reporting encouraging clinical trial results for a diversity of novel treatments, including individualised cancer vaccines, as well as new diagnostic techniques. Various forms of immunotherapy — adapting the patient’s immune system to destroy cancer cells — are proving remarkably successful at extending survival times of some people with refractory tumours.

One reason for the rapid progress is that cancer research has been well funded by industry, governments and charities in comparison with other diseases. Almost 40 per cent of all pharmaceutical R&D investment is directed at clinical oncology — making it the leading field for precision medicine, with diagnostics and drugs tailored to the individual characteristics of patients.

This encouraging lesson about the productivity of research funding has not been lost on scientists working on different diseases, such as dementia and infections, where there is much unmet medical need but relatively less investment. They are right to point to cancer as an example of what can be achieved with more R&D resources.

Moving cancer research breakthroughs rapidly into regular clinical practice will require agile regulators and responsive healthcare providers. They must provide not only appropriate treatment facilities, but diagnostic services to detect tumours as early as possible when chances of a cure are highest.

The new wave of personalised treatments will be expensive when first introduced; immunotherapies often cost more than $100,000 per patient. Pharma companies will inevitably come under pressure to cut what their critics may portray as exorbitant pricing. While drug prices must be subject to some control, the industry’s return on investment should remain high enough to maintain its large, productive cancer research effort. Costs of new medical technologies do come down over time as they are applied more extensively.

Faster diagnosis and better treatments are needed more than ever, as the incidence of cancer continues to rise globally. Disturbingly, cases are growing most rapidly among younger people, for reasons that scientists are only just beginning to understand — and which require urgent investigation. Cancer rates in 25- to 49-year-olds increased by 24 per cent since 1995, according to the charity Cancer Research UK. Although cancer remains largely an affliction of old age, and under-50s still account for no more than 10 per cent of all patients, they represent a much larger proportion of years of healthy life lost to the disease.

Experts believe the rapid increase in obesity in recent decades is one factor driving the growth of tumours such as breast and colorectal cancer among the young. Data presented at the recent American Society of Clinical Oncology conference in Chicago suggests that taking the popular weight-loss drugs Ozempic and Wegovy would reduce the risk of developing many common tumours — though, as public health campaigners point out, it would be preferable to tackle obesity by changing people’s diets rather than by medication. Beyond obesity, scientists are looking for carcinogenic signals among the many environmental and lifestyle changes that have taken place over recent decades.

As the disease becomes more prevalent, people are living for longer on average after diagnosis, though progress is currently slow. Human biology means that cancer will always be with us. But the new diagnostic tools and treatments emerging from the world’s labs promise to accelerate the extension of survival time — and make oncology a shining example of the value of biomedical research spending.