Why Hope and Hubris Trump Clinical Evidence and Sustain the Oncology R&D Fairy Tale

Humans are enthralled with making predictions that range from bold to outright wacky. From the Y2K crisis or ending federal debt in 2001, to Nostradamus or the Mayan end of the world, people like to believe that it is possible to predict the outcomes of complex issues. Over the past ten years, the idea of ending or curing cancer has continued to evolve as a near-term goal among seemingly rational people. How could this type of prediction have gained enough traction to influence scientific research at a time when actual drug discovery successes have been rather dismal? Market research reveals that target-first oncology R&D has not developed superior treatments to supplant existing chemotherapies, but has led to more expensive treatments. These sales numbers have not only misled, but have inspired scientists to believe that target-first oncology research will dramatically impact those 570,000 cancer mortalities each year in the near future. This talk presents this contradictory evidence, attempts to tone down the scientific bravado wrapped around the expectations of target-first oncology research, and highlights an obvious but somehow neglected pivotal ingredient of oncology research – novel chemical diversity. It will explore whether the hope of finding a cure has clouded scientists' judgments. The brutal challenges of drug development, including high failure rates, unpredictable timelines, and irreproducible data, are also interwoven into the discussion to add a little more reality to this noble endeavor. No predictions or prophecies will be made. However, the reality of further extending the lives of cancer patients without dramatically expanding the chemical space examined in oncology research is questioned.