Five-year View
Surgery is highly powerful to treat cancer as long as all malignant tissues can be resected in toto. The potentially lethal properties of cancers, that is, invasion and metastasis formation, often require extended and systemic treatment. In the past, such therapies were based on the principles of cancer cell destruction, essentially by chemotherapy and irradiation. More recently, host factors have become 'targetable,' by the introduction of treatments affecting angiogenesis or the immune system. Although some of these approaches brought progress, there is still a tremendous need for improvements. Key contributions may come from any or hopefully many of the specialists involved in research and development. Likely, a better understanding of lethal cancer mechanisms will require intense collaboration of specialists. Thus, studies may include assessment of cancer cells, vessel formation, immune responses and further hallmarks of cancers, to understand how cancer cells exploit the body to their advantage, and to find key targets that can be blocked therapeutically. Among the host factors, the immune system plays a key role as it can either support or suppress tumor growth. Comprehensive characterization of this balance will likely help to improve biological therapies, applied either for cancer patients in conjunction with other approaches, or for prevention as well as long-term maintenance of remissions. The high potential of immunotherapy for long-lasting effects is remarkable and superior to other therapies, thus motivating intense investments for further improving immune-based approaches.