A record number of 887 new drugs for various of cancers are in clinical trials or awaiting US FDA review, well over double the number in the pipeline just six years ago, according to a report by the Pharmaceutical Research and Manufacturers of America (PhRMA).

When PhRMA released its first account of medicines in development for cancer in 1988, only 65 were recorded. The numbers over the next decade grew gradually. As recently as 2005, there were fewer than 400 medicines in development for cancer.

“Unprecedented insights into how cancer cells develop, grow and spread are providing new targets and new ways of attacking the disease,” said John J. Castellani, president and CEO, PhRMA. “Rapidly advancing technologies and the commitment of researchers to follow new clues are providing hope,” he added.

One promising development is the increased understanding about the many ways a tumour can protect and feed itself by co-opting the body’s own mechanisms, for example by reducing the efficacy of the immune system and by proliferating the growth of blood vessels, said Dr Garry Neil, corporate vice president, science and technology,  Johnson & Johnson who is also the chair of PhRMA’s Science and Regulatory Affairs Executive Committee.

Other new developments in cancer research include a better understanding of the key role that cancer stem cells play in resistance to chemotherapy, and the interplay between cancer cells and the supporting tissue that surround them, said Dr Scott Waldman, Kimmel Cancer Centre.

Advanced gene sequencing is revealing the genetic basis of cancer and leading to opportunities for personalized medicine. Not only has genetic sequencing become available to many more researchers, but it has advanced into “next generation” and “multiplexed deep sequencing, he added.

Combination therapies, which were so successful in fighting HIV/AIDS, also represent an important step in cancer treatment. “As we develop the ability to block, with precision, the drivers of tumour growth, we must also block the escape mechanisms facilely used by these cells. Regulatory agencies are recognizing the need to simplify the testing of multiple medicines in development in order to realize this potential breakthrough”, said Dr Neil.

Although five-year survival rates have increased across cancers since 1975 and have increased dramatically for breast, prostate, colon, rectum and lung cancer, the disease remains a leading cause of death. We are hopefully moving to the beginning of the end for many cancers, he said.