No magic bullet
Joseph Paul Eder, M.D. (seated, foreground), and Donald Kufe, M.D. (standing), are treating patients suffering from advanced cancer with the drug Endostatin™. So far, it has proven to be remarkably free of side effects (photo by Kris Snibbe).
Although most clinical trials of angiogenesis inhibitors are in the early stages, many cancer researchers predict that inhibiting angiogenesis will play a continuing, and perhaps very important, role in cancer treatment. But few, if any, believe any single angiogenesis inhibitor will be the magic bullet that will cure all cancers. In fact, most scientists speculate that, just as multiple antibiotics are needed to fight infections, so, too, will many angiogenesis inhibitors be needed to combat different cancers. Nor do most researchers expect that angiogenesis inhibitors will necessarily replace other traditional cancer therapies. "In fact," says Judah Folkman, M.D., "these agents may prove to be most beneficial when used in concert with conventional treatments like chemotherapy, radiation therapy, and other modalities."
If angiogenesis inhibitors live up to their promise, it is possible that for some patients the goal of therapy may change from curing cancer to keeping it under control and managing it as a chronic condition, much like diabetes. "If we end up with a therapy that is convenient and well-tolerated in patients and helps them live longer, better lives, that would be a significant achievement," says Eder.
For all the excitement about angiogenesis and cancer treatment, it is important to keep in mind that this work is still in its infancy, cautions Stephen Sallan, M.D., Dana-Farber's chief of staff and chief medical officer of the Dana-Farber/Children's Hospital Cancer Center. "Many people at Dana-Farber, Children's, and around the world are focused intensely on fully understanding this process. We are making progress, but we still have a long way to go."
