The developmental process for many of these older drugs was based on a form of trial and error, i.e. candidate chemicals were administered to cancer cells to see if they stopped them from growing. If they did, they were taken to further levels of testing and ultimately given to patients with cancer. As such it is not surprising that activity was often marginal, and toxicity was common.

There is now a much greater understanding of the molecular basis of malignancy, and multiple potential molecular targets for new drugs have been identified. The introduction of novel rationally designed molecularly targeted treatments has revolutionised the treatment of some types of cancer. The best example is imatinib, an agent which has resulted in a dramatically improved outcome for patients with chronic myeloid leukaemia, and with gastro-intestinal stromal tumours. Another drug, trastuzumab (better known as herceptin) has resulted in substantially improved outcome for patients with one of the most aggressive forms of breast cancer. Molecular treatments have also improved the outcome for patients with other tumours including cancers of the colon, kidney, lung and lymph system.

The developmental process for these new anticancer drugs has undergone radical change in the molecular era. Unlike the empirical approach used to discover chemotherapy drugs, the new approach is mechanistic and molecular.

Another critical difference is that the new approach is “translational”, i.e. it involves intense interaction between laboratory and clinical investigators. Thus, modern cancer drug development begins with recognition of clinical need, and progresses through molecular target identification, drug synthesis, pre-clinical testing, clinical trials and molecular analysis of tissue samples from treated patients

Many critical components of the development process for molecular cancer therapeutics exist in Ireland, but are dispersed across multiple institutions. Molecular Therapeutics for Cancer Ireland represents an attempt to capitalise on potential synergies between these resources, in order to develop “Ireland Inc.” as a site for cancer drug development.