Principles of Molecular Oncology

At the midpoint of the 20th century, our knowledge of cancer was based on epide- ology and pathology, and treatment consisted of surgery and radiation therapy. At mid-century, Medawar and colleagues initiated the understanding of transplantation immunology, Farber described the first use of an antifolic drug to treat leukemia, and Jacobson and coworkers described the irradiation-protection effect of spleen cells. These observations opened the door to the development of chemotherapy and tra- plantation in the treatment of cancer. Despite the rapid development of these new disciplines, progress was usually based on empiric observations and clinical trials. The rapid advances in molecular biology at the end of the 20th century mark a new era in our knowledge of cancer. Molecular immunology, molecular genetics, mole- lar pharmacology, and the Human Genome Project are in the process of providing a level of understanding of cancer undreamed of in the past. Optimism is based on the firm belief that understanding at the molecular level will lead to better and earlier di- nosis, to new forms of treatment, and, most importantly, eventually to prevention of many types of cancer.