Two blockbuster targeted therapies burst on the cancer scene in late 1990s, and arguably changed forever the concept of cancer treatment, converting what often was a fatal disease into a chronic illness.
The first involves Herceptin, a drug that targets a type of breast cancer that is characterized by a specific cancer gene -- an oncogene -- called HER-2.
Women whose cancers express HER-2, which is estimated to be about 25 percent of women with breast cancer, will respond to Herceptin even when other powerful chemotherapy drugs have failed.
Dr. Kimberly Blackwell of Duke University Medical Center said doctors received a standing ovation when they presented the results of Herceptin drug trials.
"The introduction/approval of Trastuzumab (Herceptin) and lapatinib (TyKerb) in breast cancer will prevent many women's breast cancers from recurring and have significantly improved survival for many women faced with breast cancer," said Blackwell. "More important, these drugs represent highly effective agents that target the cancer, not the patient.
"Probably one of the only standing ovations I will witness in my career was when [it was] presented by Edward Romond at the annual meeting of the American Society of Clinical Oncology," Blackwell added.
The other therapy, using a cancer pill called Gleevec, targets genetic mutation called bcr-abl (b.c.r. able) that causes cancer cells to grow and multiply in patients with a variety of cancers, including chronic myeloid leukemia, or with a stomach cancer called GIST.
The two breakthrough agents opened the door to a number of cancer drugs that targeted specific molecules that control not only cell growth, but also the blood supply that feeds tumors.
Since the introduction of highly active anti-retroviral therapy, or HAART, as this combination therapy approach is called, HIV/AIDS has evolved into a serious, but chronic disease with survival stretching into decades.
Moreover, this "cocktail" approach to treatment, where drugs are combined in different ways or different sequences has become a model for treating other diseases ranging from lung cancer to heart disease.
"In 1996, a 20-year-old person in the U.S. with AIDS expected to live about 3 to 5 years and now expects to live to be 69 years. That is amazing," said Dr. John Bartlett, past president of the Infectious Diseases Society of America. "Think of it: In 1996, everyone in our HIV clinic was prepared to die. Now, they all live. And most of them look great. They just need to take the meds."
"Next challenge is the cure," Bartlett said.
In more than a decade since the emergence of HAART, researchers have constantly refined the regimens to improve results, with evidence now emerging that some combinations may be more effective on patients with more extensive disease.
Dr. Thomas Coates, of the University of California Los Angeles, pointed out that the HIV death rates still are dropping because of continual HIV research.
"The drop in death rates from HIV in the developed world [is] due to improved medications," Coates said. "There was the 10 percent drop in deaths due to HIV in the U.S. between 2006 and 2007."