The model and the dream of how to discover a drug that will cure cancer belongs to Barnett Rosenberg, a 54-year-old biophysicist.
In the 1960s, as a professor at Michigan State University, Rosenberg was conducting biological experiments in which he wanted to stop the division of cells. By chance, he says, he decided to use particles of platinum in his experiments. It worked. It stopped cell division.
Cancer, simply defined, is the uncontrolled division of cells.
"We had the idea," Rosenberg recalled, "that maybe we could use platinum to treat cancer." He put that idea to the test in 1968, injecting cancerous mice with a platinum compound. "It worked beautifully," according to Rosenberg. The platinum destroyed the mouse tumors. He submitted his findings to the National Cancer Institute here and to British cancer researchers.
Within three years, clinical studies in both countries showed that platinum had activity against some forms of cancer.
In the United States, the experimental drug was shown to cure some testicular cancer.
In Britain, the drug was curing some ovarian cancer.
"I was -- and am -- euphoric," he said in a recent interview. "It's kept me floating off the ground for a number of years. It is a rare appearance in scientific research when you start with an idea, go through all the experiments, and then see it through to results in people. Better than I could have hoped for."
In fact, Cisplatin, the commercial name of the platinum drug, is one of the most widely used anticancer drugs in America today. Current data shows that use of the drug, usually after surgery, can lead to an 85 percent cure rate in testicular cancer and a 40 percent cure rate in ovarian cancer. It also has increased the life span of some patients with cancers of the head and neck, bladder, prostate, brain and foot.
Dr. Lawrence Einhorn of Indiana University is credited with developing the successful treatment of testicular cancer with Cisplatin.
Rosenberg's discovery is one of the few success stories in developing anticancer drugs in the United States in the last decade. The two other top-selling anticancer drugs in use today were discovered in other countries -- Adriamycin in Italy, Bleomycin in Japan -- although the NCI takes credit for putting the two into general use in the United States by quickly moving them into large clinical trial programs. The other three major drugs -- Methotrexate, Cytoxin and Vincristine -- were discovered in the 1950s. Those drugs, too, have been put into wide use through the NCI clinical trial programs.
The manner in which Rosenberg made the platinum discovery -- by chance, or serendipity, as many scientists say -- is essentially the concept behind the National Cancer Institute's drug development program.
"It's the most useful technique we have," Rosenberg said, "since we don't have any theory to guide us. We don't have anything else."
Rosenberg still does not know why platinum is able to effectively fight cancer. "We're looking for the basic mechanism of action of the platinum drugs," he said. "Why does it work against cancer cells and not normal cells? That is perplexing."
Cisplatin almost was abandoned as an anticancer drug in the early 1970s because the first human experiments showed severe kidney damage as a side effect. But doctors found that by infusing a patient with gallons of liquid at the same time as the drug was infused, the kidneys could, in effect, be "washed out," and protected from serious harm from the drug.
Cisplatin thus is one of a handful of commonly used drugs that in numerous cases can cure these cancers: acute lymphocytic leukemia and osteogenic (bone) sarcoma in children; Burkitt's lymphoma, choriocarcinoma, embryonal rhabdomyosarcoma, Ewing's sarcoma, histiocytic lymphoma, Hodgkin's disease, breast cancer, retinoblastoma, testicular carcinoma, testicular sarcoma and Wilm's tumor.
There are no statistics showing how many people are cured each year by anticancer drugs. Estimates range from 11,000 to 46,000 -- or about 1.5 to 6 percent of the some 805,000 cases of cancer that occur in the United States each year. Surgery and radiation therapy account for most cancer cures; about 30 to 35 percent of all cancers can be cured by surgery, and about 5 to 10 percent can be cured by radiation. The term cure means five-year survival after the treatment.