I was reading an article from the New Yorker this morning by Malcolm Gladwell on the Annals of Innovation. You can read the abstract here.
The article centres around the story of Synta/GSK's elesclomol in melanoma in 2007. The drug, like many others, started off promisingly but the final results showed that the patients did more poorly in the treatment arm. What the researchers didn't know at the time was that the target in melanoma was actually different from the one they were aiming at. The understanding of the biology had yet to evolve beyond chemotherapies at that time and our understanding of biomarkers in melanoma was sketchy at best.
Essentially, the author concluded:
“When will we find a cure for cancer?” Gladwell writes, “implies that there is some kind of master code behind the disease waiting to be cracked. But, so far as we can see, there isn’t a master code. There is only what can be uncovered, one step at a time, through trial and error.”
In some sense Gladwell's right, the process of finding new cancer drugs based on the biology of the disease goes one step at a time, science and research is necessarily iterative, after all. But he missed the reason why.
It's because cancers are heterogeneous.
Photo Credit: Cnet