[Oncology]

The historic change in medicine from a holistic approach to methods based on natural sciences still reverberates in current practice as well as in the social and political framework of cancer treatment. Only recently has the perception of patients as suffering humans rather than carriers of disease to be eradicated lead to the introduction of palliative care. Advances in general pharmacotherapy have much relied on the concept of specific interaction between drug and target molecule first authored by Paul Ehrlich using the romantic term of a magic bullet. This theme of specificity was explored and described in detail as drug protein interaction during the next century. Specific cellular target proteins are ionic channels, enzymes, transporter proteins and receptors. While these may be targeted by antineoplastic agents they occur not exclusively in tumour cells but also in normal stem cells. Nonetheless, small differences in cellular behaviour after sustaining injuries have been exploited in such way that curative treatment regimens are now available for several tumour entities even in advanced state. Drug screening and development as well as principles of cancer treatment derived by empirical rationalism have been cornerstones in this process lasting for about five decades. Molecular biology has helped to elucidate several mechanisms of drug resistance, and finally gave insight how genes govern the checkpoints leading to either differentiation, proliferation or cell death. The internal control of cellular fate may be influenced via signal transduction at the level of receptors or kinases and other enzymes. Ultimately the immense specificity of nucleic acid hybridisation opens new horizons for specific drug target interaction. Immunotherapy has originally been the most successful approach in systemic therapy and is now being developed to an impressive range of passive or active treatments including vaccination.