The one factor that best predicts which new therapeutic agents make it commercially is a new mechanism of action. Entirely new mechanisms of action tend to yield successful new compounds. This pattern has been repeated many times in cancer drug development, such as when the anthracyclines were discovered as topoisomerase-II inhibitors and when platinum compounds were found to be interstrand DNA-crosslinking agents. Drugs with new mechanisms of action, including a proteasome inhibitor, cancer vaccine, antisense to the Bcl-2 protein, and targeted therapies, as well as new investigational compounds, will be among the new drugs soon to be available for the treatment of a variety of cancers.
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