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Future of Cancer Therapy Professor David Kerr, University of Oxford, Department of Clinical Pharmacology, Radcliffe Infirmary, Woodstock Road, Oxford OX2 6HE

There are two broad areas in which the application of knowledge should improve outcomes for cancer patients. The first would be to use existing evidence to construct care pathways ad management guidelines which would provide a more homogeneously high standard of treatment. This utilitarian approach can be coupled to public health initiatives (smoking cessation, dietary advice, etc) to save many thousands of lives. This is not rocket science, but rather the systematic application of best practice. The other area in which we have made considerable advances is in understanding the molecular basis of carcinogenesis, uncontrolled proliferation, invasion and metastasis. In a political context, Bacon said that knowledge is power, and these molecular insights can be used to define novel diagnostic and therapeutic modalities. New treatments such as immunotherapy, gene therapy and receptor blockers are being developed and are likely to add value to more conventional therapies. It may also be possible to use modern pharmacogenomic techniques to select the cytotoxic drugs or their doses to optimise treatment for individuals. Advances are likely to be of steady increments rather than stepped “breakthrough”, but there future is well lit.