Abstract
The medical history of cancer began millennia ago. Historical findings of patients with cancer date back to ancient Egyptian and Greek civilizations, where this disease was predominantly treated with radical surgery and cautery that were often ineffective, leading to the death of patients. Over the centuries, important discoveries allowed to identify the biological and pathological features of tumors, without however contributing to the development of effective therapeutic approaches until the end of the 1800s, when the discovery of X-rays and their use for the treatment of tumors provided the first modern therapeutic approach in medical oncology. However, a real breakthrough took place after the Second World War, with the discovery of cytotoxic antitumor drugs and the birth of chemotherapy for the treatment of various hematological and solid tumors. Starting from this epochal turning point, there has been an exponential growth of studies concerning the use of new drugs for cancer treatment. The second fundamental breakthrough in the field of oncology and pharmacology took place at the beginning of the ‘80s, thanks to molecular and cellular biology studies that allowed the development of specific drugs for some molecular targets involved in neoplastic processes, giving rise to targeted therapy. Both chemotherapy and target therapy have significantly improved the survival and quality of life of cancer patients inducing sometimes complete tumor remission. Subsequently, at the turn of the third millennium, thanks to genetic engineering studies, there was a further advancement of clinical oncology and pharmacology with the introduction of monoclonal antibodies and immune checkpoint inhibitors for the treatment of advanced or metastatic tumors, for which no effective treatment was available before. Today, cancer research is always aimed at the study and development of new therapeutic approaches for cancer treatment. Currently, several researchers are focused on the development of cell therapies, anti-tumor vaccines, and new biotechnological drugs that have already shown promising results in preclinical studies, therefore, in the near future, we will certainly assist to a new revolution in the field of medical oncology.
Highlights
Epidemiology of CancerCancer is often referred to as the “Pathology of the Century” assuming the connotations of an endemic disease spread throughout the world
Avicenna introduces the removal of tumors of the rectum Averroes of Cordoba describes the tumors of the esophagus and rectum and introduces the hysterectomy for the removal of uterine tumors Paracelsus questions Hippocrates and Galen theories and hypothesizes that tumors develop due to an accumulation of “salts” in the blood Andreas Vesalius published the manuscript “De Humani corporis fabrica” containing anatomical information resulting from post-mortem examinations Doctors and surgeons propose that the coagulation and fermentation of blood and/or lymph are the cause of the development of tumors Invention of the microscope Boerhaave hypothesizes that cancer is most likely induced by elements, present in water or in the ground, which defines viruses
Unlike the classic chemotherapy approach, which acts on both normal cells and cancer cells, the targeted therapy intervenes on altered key oncogenes or tumor suppressor genes involved in tumor promotion
Summary
Cancer is often referred to as the “Pathology of the Century” assuming the connotations of an endemic disease spread throughout the world. Some tumor types, such as lung cancer and pancreatic cancer, have still maintained mortality rates almost unchanged compared to 40 years ago (Figure 1) These epidemiological data show that, even nowadays, cancer represents a global health problem and one of the greatest challenges in the medical field, despite the important pharmacological and therapeutic discoveries we have seen since the second post-war period up to the present day (Gittelman, 2016). Modern radiotherapy only began in 1920, when Claudius Regaud demonstrated that radiation fractionation could be used to treat several human cancers, by reducing the side effects of the treatment itself (Deloch et al, 2016; Moulder and Seymour, 2017) Despite these achievements, medical and interventional approaches to tumors before the Second World War were essentially radical methods, aimed at the complete eradication of the disease before it can spread and metastasize throughout the organism. The in silico and preclinical screening of thousands of different pharmacological molecules has allowed the researchers to obtain new oncological drugs which are currently used in clinical practice while significantly reducing mortality from oncological diseases
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