Embracing the incredible complexity of cancer

Try naming every type of cancer you can think of. It can quickly get overwhelming, and that’s just listing names. The reality is that cancer isn’t one disease. It’s a constellation of diseases, a dizzying array of types and subtypes with different causes and characteristics. They just happen to share a common feature: uncontrolled growth of abnormal cells.  

Every person’s cancer is as unique as the person themself – a product of the combinations of genetic and molecular changes that cause abnormal growth, the interactions between cancer cells and normal cells, and much more. To say that cancer is complex is an understatement. When it comes to developing medicines and treatments that can potentially make a difference in the lives of people with cancer, we’ve learned that we can’t struggle against this complexity – we have to embrace it. But what does embracing complexity entail?

First, a truth: There is no single approach that will solve cancer 

Surgery, radiation, and chemotherapy – for much of history, these were essentially our only tools for cancer care. Then, a few decades ago, we entered the genomic era. A disease we once visualized as tissues and cells morphed into one of intricate networks of genes and molecules. This allowed us to create targeted therapies to go after specific molecular changes that drive certain cancers. Even more recently, we’ve begun learning how best to activate our immune systems against the disease.  

These are the foundational pillars of modern cancer care, which can be effective against many forms of the disease. But cancer is still far from solved. Numerous types and subtypes still have few or no treatments, and critical questions need answers, like why some patients respond to a treatment but other patients don’t, and how do we prevent cancer cells from developing resistance to drugs? 

“We want to come at cancer from as many different angles as possible to ensure that it cannot continue, but we preserve, fully, the human being who happens to possess that disease.” - Cory Johannessen

The lesson learned from decades of scientific and clinical study is that no single approach on its own is enough to address cancer in all its complexities.  

That’s why we need more "shots on goal”  

Today, we know that people with cancer need the right treatment for their unique disease at the right time, the goal of precision oncology. But we can be precise only when we have the right understanding and the right solutions – and as many of them as possible, to maximize our chances of potentially transforming peoples’ lives. 

So, at Novartis, we’re committed to unraveling the inner workings of cancer and to building as broad and deep a toolbox of approaches as we can. It’s why we we’re working to develop new therapies for a vast range of cancers, both common and rare; why we’re investing in diverse technology platforms and experimenting with combination approaches; why we’re pursuing powerful new tools like artificial intelligence, and much more. 

We’re excited about approaches we think may have potential to someday serve as new pillars for cancer care – ones that highlight not only innovative science, but also the imagination and creativity involved in realizing that science. In the coming weeks, we’ll dive deeper into a few approaches – radioligand therapy, which delivers radiation to tumors in a targeted manner (with a goal of limiting harm to healthy cells); next-generation CAR-T therapy, immune cells that are genetically engineered to go after cancer cells; and targeted protein degradation, a way to put cancer-driving proteins in the trash.  

 But again, why so many different approaches? Cory Johannessen, global head of Oncology Innovative Targets & Technologies at Novartis, explains.