- Seizing the moment: Introduction | 1940s | 1950s | 1960s | 1970s | 1980s | 1990s | 2000s and the future
1970s
Institute investigators in the mid-1970s were focused on developing new approaches to cancer chemotherapy.
The advent of chemotherapy in the 1940s and '50s changed the face of cancer care, but not the eventual result: Nearly all patients, after experiencing brief remissions with chemical agents, died of their disease.
By the 1960s, the state of the art in cancer treatment was what might be called sequential chemotherapy: A patient was given Drug A, which produced a remission lasting, say, nine months, then received Drug B, which produced another months-long remission, then, perhaps, Drug C. When that remission had run its course, the options were exhausted. Patients lived longer, but cures were elusive.
Conventional wisdom held that the punishing side effects of using several drugs at once would kill patients. But two young researchers, the like-named Emil "Tom" Frei III, MD, and Emil Freireich, MD, took on the conventional wisdom with the same singleminded intensity that they used in the fight against cancer itself. At the National Cancer Institute and M.D. Anderson Cancer Center in Texas, the duo conducted experiments in which mice with cancer were treated with combinations of drugs. Most of the animals died, but a few not only survived, they were rid of cancer. Frei and Freireich immediately launched a human trial of the drugs methotrexate and 6-mercaptopurine. Though all of their initial patients passed away, their remissions were prolonged. In later trials, a small but clearcut fraction of children with leukemia survived.
Emil "Tom" Frei, shown here in 1975, has helped transform the oncology field.
Frei, who joined Dana-Farber in 1972 and became its director upon Sidney Farber's death the next year, seized the sliver of positive results as evidence that drug combinations could be effective in humans. The key was to use the right drugs, in the right combination for each cancer type, at the right doses. So began a series of clinical trials known by their acronyms – Super CMF for breast cancer, VAPAIO for leukemia, MABCOD for non-Hodgkin lymphoma, among others – each letter representing a drug used in the regimen.
As with the tests on animals, the results of these studies were usually lopsided: most patients died, a few were cured. Undeterred, Frei insisted on finding lessons in the survivors that could be applied in the next round of trials, the next refinement of therapy. Determined to the point of recording dictation while pedaling his bicycle to work each morning, Frei drove himself and the growing cadre of cancer research "superstars" at Dana-Farber to, as he repeatedly put it, "move the field ahead."
The impact of combination chemotherapy on survival was dramatic and decisive. Success rates that for some cancers had been in the teens or lower rose into the 40-50 percent level and beyond. With some exceptions, combination chemotherapy remains the basis of most drug treatments for cancer today.
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- Seizing the moment: Introduction | 1940s | 1950s | 1960s | 1970s | 1980s | 1990s | 2000s and the future
