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Updated: May 2, 2026

Monitoring the Cancer-Immunity Cycle and Exploring Tumor Microenvironment Dynamics
Published on: June 7, 2024
Imagine a world without cancer
Björn L D M Brücher1, Gary Lyman, Richard van Hillegersberg
1Theodor-Billroth-Academy®, Munich, Germany. b-bruecher@gmx.de.
Background:
Since the "War on Cancer" was declared in 1971, the United States alone has expended some $300 billion on research, with a heavy focus on the role of genomics in anticancer therapy. Voluminous data have been collected and analyzed. However, in hindsight, any achievements made have not been realized in clinical practice in terms of overall survival or quality of life extended. This might be justified because cancer is not one disease but a conglomeration of multiple diseases, with widespread heterogeneity even within a single tumor type.
Discussion:
Only a few types of cancer have been described that are associated with one major signaling pathway. This enabled the initial successful deployment of targeted therapy for such cancers. However, soon after this targeted approach was initiated, it was subverted as cancer cells learned and reacted to the initial treatments, oftentimes rendering the treatment less effective or even completely ineffective. During the past 30 plus years, the cancer classification used had, as its primary aim, the facilitation of communication and the exchange of information amongst those caring for cancer patients with the end goal of establishing a standardized approach for the diagnosis and treatment of cancers. This approach should be modified based on the recent research to affect a change from a service-based to an outcome-based approach. The vision of achieving long-term control and/or eradicating or curing cancer is far from being realized, but not impossible. In order to meet the challenges in getting there, any newly proposed anticancer strategy must integrate a personalized treatment outcome approach. This concept is predicated on tumor- and patient-associated variables, combined with an individualized response assessment strategy for therapy modification as suggested by the patient's own results. As combined strategies may be outcome-orientated and integrate tumor-, patient- as well as cancer-preventive variables, this approach is likely to result in an optimized anticancer strategy.
Summary:
Herein, we introduce such an anticancer strategy for all cancer patients, experts, and organizations: Imagine a World without Cancer.
Insights
Despite decades of research and billions spent, cancer survival has not significantly improved due to tumor heterogeneity. A new personalized, outcome-based strategy is proposed to optimize anticancer therapy.
Area of Science:
- Oncology
- Genomics
- Cancer Research
Background:
- Significant investment in cancer genomics research has yielded limited clinical benefits in survival or quality of life.
- Cancer is a complex group of diseases with substantial heterogeneity, even within specific tumor types.
Purpose of the Study:
- To propose a novel, personalized, outcome-based anticancer strategy.
- To shift from a service-based to an outcome-based approach in cancer care.
- To integrate patient- and tumor-specific variables for optimized treatment.
Main Methods:
- Review of existing cancer research and treatment paradigms.
- Analysis of limitations in current cancer classification and treatment strategies.
- Development of a conceptual framework for personalized, outcome-based cancer therapy.
Main Results:
- Current targeted therapies face challenges due to cancer cell adaptation and resistance.
- Existing cancer classification systems require modification to incorporate recent research findings.
- A personalized approach considering tumor and patient variables is crucial for effective treatment.
Conclusions:
- A paradigm shift towards personalized, outcome-based cancer treatment is necessary.
- Integrating patient-specific response assessments can guide therapy modifications.
- The proposed strategy aims to optimize anticancer strategies for improved patient outcomes and long-term cancer control.
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