50 Years of Cancer Breakthroughs
When President Richard Nixon signed the National Cancer Act in December 1971, the goal was nothing short of eradicating cancer.
“The time has come in America when the same kind of concentrated effort that split the atom and took man to the moon should be turned toward conquering this dread disease,” Mr. Nixon said at the time.
Since then, this mobilization has been nicknamed a “moonshot” or a “war,” but according to Craig B. Thompson, President and Chief Executive Officer of Memorial Sloan Kettering Cancer Center (MSK), it’s better to think of it as an investment that has paid substantial dividends over time:
- Overall cancer death rates, adjusted by age, decreased by 31% between 1991 and 2018.
- One-third of people with cancer now receive some form of treatment using their own immune system to fight the disease.
- Early detection through screening has contributed to steep declines in deaths from breast, cervical, colon and prostate cancers.
—A new era begins
President Richard Nixon signed the National Cancer Act into law in December 1971, launching America’s first major effort to fight cancer. The act, which dramatically increased funding for cancer research, named MSK as one of only three institutions in the country designated as a Comprehensive Cancer Center, charged with translating laboratory research into clinical practice. MSK board member Benno Schmidt chaired the 26-member panel that developed the act.
—MSK performs first bone marrow transplant from an unrelated donor
Led by pediatric oncologist Richard O’Reilly and Robert Good, director of the Sloan Kettering Institute (SKI), MSK physicians conducted the first successful bone marrow transplant from an unrelated donor to a patient, thereby greatly expanding the pool for a potential bone marrow match. Dr. O’Reilly launched MSK’s bone marrow transplant program the following year. Today, MSK’s program continues to be world-renowned.
—New method identifies targets on cancer cells
Researchers led by immunologist Lloyd Old developed methods to detect tumor-specific antigens — proteins or other molecules found only on the surface of cancer cells — using blood serum from human patients. Tumor-specific antigens could now be used as possible targets for immunotherapy and targeted therapy.
—First psychiatric service for cancer patients
MSK became the first cancer center to create a full-time Psychiatry Service devoted solely to treating psychiatric and psychological problems unique to people with cancer. The service’s inaugural chief was Jimmie Holland. She is considered the founder of the field of psycho-oncology, which combines oncology and psychiatry. Today, the department is a national resource for training and research in psychiatric oncology.
—First supportive care clinic within a cancer center treats pain and related symptoms
With a mission to develop more effective pain relief, MSK established the nation’s first dedicated pain service within a cancer center. The program was led by neurologist Kathleen Foley, whose research helped make pain management a routine part of cancer care. MSK developed standards for pain and palliative care worldwide and still performs this role today.
—Filgrastim emerges as a critical cancer drug
MSK physician-scientists Malcolm Moore and Karl Welte isolated a protein from human cells that stimulates new blood growth. Called G-CSF, this molecule was developed for clinical use as filgrastim (Neupogen®), one of the most important and widely used drugs ever developed for people with cancer. It helps boost blood cell counts after chemotherapy, reducing the risk of infection and hospitalization.
—Targeted therapy takes off
Physician-scientist John Mendelsohn, who co-led the SKI Molecular Pharmacology Program and chaired the Department of Medicine at MSK, played a major role in the development of targeted therapies for cancer. With Gordon Sato from the University of California San Diego, he developed the concept of using antibodies to block the epidermal growth factor receptor (EGFR) to treat cancers that overexpress this protein. At MSK, he conducted important laboratory research that validated this approach. This work paved the way for antibody-based targeted drugs such as cetuximab (Erbitux®) and trastuzumab (Herceptin®).
—FDA approves revolutionary bladder cancer treatment
The FDA approved BCG (Bacillus Calmette-Guerin), a bacterial vaccine, for the treatment of bladder cancer, based on research conducted by immunologist Lloyd Old, urologic surgeon Harry Herr and immunologist Herbert Oettgen. First investigated in the 1950s by MSK researchers, BCG remains a primary treatment for non-muscle invasive bladder cancer.
—Landmark research establishes colonoscopies prevent colon cancer
MSK researchers Sidney Winawer and Ann Zauber found that removing precancerous polyps in the colon could reduce the risk of colorectal cancer by as much as 90%. The study, published in the New England Journal of Medicine, also confirmed the cost-effectiveness of colorectal cancer screenings. Since then, MSK experts have led the establishment of guidelines for when people should be screened.
—Protein transport deciphered
SKI biochemist James Rothman analyzed the mechanism that cells use to package and transport proteins. For this work, he shared the 2013 Nobel Prize in Physiology or Medicine. Dr. Rothman was a member of SKI from 1991 to 2003 and was founding Chair of the Cellular Biochemistry and Biophysics Program.
—Structure of critical tumor suppressor determined
Nicknamed the “guardian of the genome,” the p53 gene is mutated in more than half of all cancers. Using X-ray crystallography, SKI structural biologist Nikola Pavletich determined the structure of the p53 protein, showing how it binds to DNA, a major milestone in cancer research.
—Role of BRCA1 gene established
SKI molecular biologist Maria Jasin showed that the cancer-predisposition gene BRCA1 makes a protein necessary to repair double-strand breaks in DNA. Inherited mutations in the BRCA1 and BRCA2 genes are responsible for a large share of familial cancers. This work paved the way for using PARP inhibitors to treat cancers with a BRCA mutation.
—First CAR T cells made for cancer immunotherapy
SKI researchers Michel Sadelain and Isabelle Rivière, along with Renier Brentjens made an important advance in cancer immunotherapy by building the first usable chimeric antigen receptor (CAR) T cells. These CAR T cells were able to survive, proliferate, and kill prostate cancer cells in the lab. This historic development established the possibility of CAR T cell therapy, which harnesses the body’s own immune system to fight cancer. MSK investigators continue to develop new CAR T therapies today for both blood cancers and solid tumors.
—MSK discovers preventive surgery reduces cancer risk in women with BRCA mutations
MSK researchers overseen by Kenneth Offit conducted a landmark study, published in the New England Journal of Medicine, which confirmed removing the ovaries and fallopian tubes of women with BRCA mutations reduced their risk of developing breast and ovarian cancer. Testing for cancer predisposition genes is now an integral part of cancer prevention and treatment.
—Targeted therapy for kidney cancer approved
Based on clinical trials led by MSK medical oncologist Robert Motzer, the FDA approved the drug sunitinib (Sutent®) for advanced renal cell carcinoma, marking the beginning of the era of targeted therapy for advanced kidney cancer.
—FDA approves first immune checkpoint inhibitor
The FDA approved ipilimumab (Yervoy®), the first immune checkpoint inhibitor, which blocks a molecule on immune cells called CTLA-4. This approval was based on a collaboration between SKI immunologist James Allison, who carried out fundamental studies of the role of the immune checkpoint inhibitor CTLA-4, and MSK physician-scientist Jedd Wolchok, who led clinical trials of the drug. Establishing an entirely new principle for cancer therapy, this type of drug works by taking the brakes off a patient’s own immune cells and unleashing them to fight the cancer. Many of the patients treated on the early clinical trials remain alive today. In 2018, Dr. Allison won the Nobel Prize in Physiology or Medicine for his work.
—FDA approves treatment for advanced prostate cancer
The FDA approved enzalutamide (Xtandi®), developed by MSK investigators Charles Sawyers and Howard Scher, for men with castration-resistant prostate cancer. The drug significantly increased survival in men with advanced disease who had stopped responding to other treatments.
—MSK-IMPACT® genetic test sequences first tumor
Scientists began using MSK-IMPACT®, a comprehensive genetic test, for the first time to analyze a patient's tumors. Created by a team of genome scientists, bioinformaticians, and molecular pathologists, MSK-IMPACT detects gene mutations and other genetic changes in both rare and common cancers, thereby helping doctors pinpoint the right treatment. MSK-IMPACT received FDA authorization in 2017 and has been used to sequence tumors from tens of thousands of patients.
—Pioneering “basket trial” analyzes tumors by mutation instead of location
A landmark study published by MSK researchers in the New England Journal of Medicine illustrated how data from tumor sequencing could group patients whose tumors share the same mutation — regardless of where the cancer originated. The trial tested a drug called vemurafenib (Zelboraf®) against any cancer that had a BRAF mutation, although vemurafenib was initially developed to treat melanoma. Two years later, the FDA approved vemurafenib for a rare blood cancer — the first approval of a targeted therapy based on a “basket trial."
—Basis discovered for how metastatic cancer cells evade detection
SKI Director Joan Massagué and members of his lab identified the mechanisms that allow latent metastatic cancer cells to evade detection by the immune system and remain hidden in the body for potentially years at a time. Stopping metastasis is a major focus of research at SKI.
—FDA approves first CAR T cell therapy
The cancer immunotherapy treatment called CAR T cell therapy received FDA approval for certain types of leukemia and lymphoma. MSK physician-scientists were pioneers in devising and testing this type of “living drug,” administered just once to a patient to harness their own immune cells to find and fight cancer. MSK investigators continue to lead development of CAR T therapies for other cancers.
—FDA approves novel leukemia drug
The FDA approved the drug enasidenib (Idhifa®) for the treatment of IDH2-mutant acute myeloid leukemia that has stopped responding to other therapies. MSK researchers Craig B. Thompson, Ross Levine, and Eytan Stein played key roles in both the laboratory research and clinical trials that led to the approval of the drug, which is a type of epigenetic therapy: It steers cancer cells back to normal.
—FDA approves first drug based on mutation type rather than tumor origin
The FDA approved the drug larotrectinib (Vitrakvi®) for cancers caused by a genetic mutation called a TRK fusion. A landmark in precision medicine, it was the first time a targeted drug was approved based on mutation type rather than on where in the body the tumor originated. David Hyman, then Chief of the Early Drug Development Service at MSK, led the pivotal clinical trial. He has been succeeded by Alexander Drilon, who continues to lead groundbreaking research.
—FDA approves first prostate cancer drug for advanced hormone-sensitive disease
The first drug to treat hormone-sensitive prostate cancer that has spread to other parts of the body was approved by the FDA to be used in combination with hormone therapy. The drug, apalutamide (Erleada®), was developed in the lab by Charles Sawyers and underwent early clinical testing by Howard Scher.
—FDA approves treatment for advanced bladder cancer
Based on clinical trials led by MSK oncologist Jonathan Rosenberg, the FDA approved enfortumab (Padcev®) to treat advanced bladder cancer that has progressed despite two previous therapies. MSK continues to be a leader in bladder cancer research.
—First targeted therapy approved for HER2-low breast cancer
The FDA approves the first targeted therapy for patients with HER2-low breast cancer that has spread to other parts of the body and is unable to be surgically removed. The drug, trastuzumab deruxtecan (T-DXd or Enhertu), is approved based on an international clinical trial led by MSK breast medical oncologist Shanu Modi. The study showed that T-DXd is able to block HER2 even when levels of the protein are low — the case for about 55% of people with breast cancer.
—Immunotherapy for rectal cancer results in 100% remission
In a small but historic trial led by MSK medical oncologist Andrea Cercek and medical oncologist Luis Diaz, the checkpoint inhibitor immunotherapy drug dostarlimab (Jemperli) completely eliminates rectal cancer in people with certain gene mutations. This enables the patients to avoid debilitating side effects from the standard treatment of radiation, surgery, and chemotherapy.
As the first cancer hospital in the United States, MSK has a storied history. Today, we are evolving more rapidly than ever before.
We've learned that cancer is not one disease but hundreds.
We are building technologies that show us how tumors evolve and spread, and we are gaining ground.