This was certainly true for Paul Ehrlich, the inspiration for the Timeline article by Klaus Strebhardt and Axel Ullrich on page 473. Ehrlich recognised early on the value of what we now call targeted therapy or 'magic bullets', which target the disease and not the normal cells of the patient. It is interesting to note, 100 years after Ehrlich was awarded his Nobel Prize, that although targeted therapies have significantly improved the treatment of several cancers, such therapies are yet to be truly free of side effects. Interestingly, many are now suggesting that multi-targeted approaches might be more suitable for total disease eradication.
But will it always be necessary to fully remove a patient's tumour? The Review by Sandy Chang and colleagues on page 450 launches our new series of articles on senescence. That there are rigorous pathways in cells that mediate permanent cell cycle arrest was recognised a long time ago, but many studies focused on the proteins that regulate this, rather than the biological significance of senescence in terms of tumour formation. However, this has recently changed, in part owing to the robust in vivo markers for cellular senescence that have been identified. Many data now indicate that senescence is an important tumour-suppressive mechanism, akin to cell death, although this might well vary on a tissue-by-tissue basis. Over the coming months our articles on senescence will examine what triggers this outcome in mutated cells and the potential therapeutic implications of the senescence pathway. Indeed, a better understanding of how DNA damage induces senescence will be required before we book that vacation to Mars!
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