This year’s Nobel Prize for Medicine was given to path-breaking discoveries that led to the latest advances in cancer therapy. US scientist James P Allison and his Japanese peer Tasuku Honjo, who shared the prize equally, independently pursued work on proteins that prevented the body’s immune system from effectively attacking cancer cells. If these brakes on the immune system are removed, rogue cells can be efficiently tackled, they believed. Their several decades-long research not only proved them right but led to the development of a new class of immunotherapy agents, also called checkpoint inhibitors. This is touted as the most important advance against cancer since the advent of chemotherapy in the 1940s. The drugs derived from the work at Allison’s lab in the University of Texas’s MD Anderson Cancer Center in Houston and Honjo’s Kyoto University lab are already available in the market. Interestingly, former US president Jimmy Carter was cured of his cancer by immunotherapy, which is still an expensive form of treatment and used mainly in terminal stage cancers.

Despite decades of research, cancer remains a dreaded, enigmatic disease. For this reason, cancer research has received a lot of interest. Interestingly, discoveries that have a bearing on our understanding of cancer have been the toast of Stockholm at least four times in the last one decade. As against this, pure cancer-related discoveries received Nobel Prize only five times in the first eight decades of the prestigious award’s existence. However, the Nobel awards need to adapt to the present-day reality of collaborative, group-driven and often cross-border research increasingly becoming the norm.

Although medical science has been able to reduce mortality from cancers significantly, the beneficiaries have largely hailed from the rich countries. With the cost of treatment forbidding and most of India’s health spend not covered by health insurance, cancer not only kills but also drives families into poverty and debt. According to the Indian Council of Medical Research, annual cancer deaths, now at 7.3 lakh, are set to increase by another 20 per cent to 8.8 lakh by 2020. The number of new cases each year is expected to touch 17.3 lakh by 2020. In India, most cancer research is carried out in tertiary cancer centres and specialised institutions of biomedical science, against well-developed cancer research networks in high-income countries. According to estimates, there are only 2,000 cancer specialists in India for 10 million patients. The rising burden of cancer in India acts as a major drain on research time, particularly for clinical staff. Besides, infrastructure to support cancer research has a long way to go. However, the National Cancer Registry Programme, started in the early 80s, maintains registries of 23 different cancers, generating valuable data for collaborative research. Nothing tangible has come out from research on drug molecules.

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