Speculations for 2003 and beyond

Abstract

It is now apparent that the genomic capacity of mammalian cells to produce biological substances that have medicinal value is enormous. Only the first few lymphokines/cytokines, growth and maturation factors, cellular therapies, and antibody-based approaches are being explored. Even now, there is clear evidence of clinical activity with respect to colony-stimulating factors (CSF),blocking factors for epidermal growth receptors (EGF), interferon (IFN), interleukin 2 (IL-2), activated cells, vaccines, monoclonal antibodies, and their immunoconjugates. If one analyzes the current level of clinical activity for biotherapy in the historical context of chemotherapy, it is obvious that much more rapid progress is being made in biotherapy, leading to development of improved, less toxic and more selective forms of treatment. From the earliest days of chemotherapy, massive searches were done among tens of thousands of chemical compounds, searching for the one right drug that might have antitumor activity without excessive toxicity for the patient. The successes were few. From analyzing nearly 1 million chemical structures, less than 60 anticancer drugs have come to the clinic, and no more than 20 of these can be considered even moderately active.