Eliminating cancer was once thought of as a war. This analogy is still apt today; however, we now realize that cancer is a much more formidable enemy than scientists originally perceived, and in some cases, it harbors a profound ability to thwart our best efforts to defeat it. However, before we were aware of the complexity of cancer, chemotherapy against childhood acute lymphoblastic leukemia (ALL) was successful because it applied the principles of pharmacology. Herein, we provide a historic perspective of the experience at St. Jude Children’s Research Hospital. In 1962, when the hospital opened, fewer than 3% of patients experienced durable cure. Through judicious application of pharmacologic principles (e.g., combination therapy with agents using different mechanisms of action) plus appropriate drug scheduling, dosing, and pharmacodynamics, the survival of patients with ALL now exceeds 90%. We contrast this approach to treating ALL with the contemporary approach to treating medulloblastoma, in which genetics and molecular signatures are being used to guide the development of more-efficacious treatment strategies with minimal toxicity. Finally, we highlight the emerging technologies that can sustain and propel the collaborative efforts to squeeze the life out of these cancers.

中文翻译：

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利用药理学来缩短儿童白血病的生命，以及在髓母细胞瘤治疗方面取得突破的潜在策略。


消除癌症曾经被认为是一场战争。这个比喻在今天仍然很恰当。然而，我们现在意识到，癌症是一个比科学家最初认为的更可怕的敌人，在某些情况下，它具有强大的能力，可以阻止我们尽最大努力击败它。然而，在我们意识到癌症的复杂性之前，针对儿童急性淋巴细胞白血病（ALL）的化疗因其应用了药理学原理而取得了成功。在此，我们从历史角度回顾圣裘德儿童研究医院的经历。 1962 年医院开业时，只有不到 3% 的患者得到了持久治愈。通过明智地应用药理学原理（例如，采用不同作用机制的药物联合治疗）加上适当的药物安排、剂量和药效学，ALL 患者的生存率现在超过 90%。我们将这种治疗 ALL 的方法与当代治疗髓母细胞瘤的方法进行了对比，后者使用遗传学和分子特征来指导开发更有效且毒性最小的治疗策略。最后，我们强调新兴技术可以维持和推动合作努力，以消灭这些癌症。