150 Years of Advances Against Cancer - 1990s
1990s
| 1990 | Eric Fearon and Bert Vogelstein define the multi-step nature of colon carcinogenesis. They find that the mutation of more than one gene is required for a colon cell to become cancerous. The prevalence of U.S. adult smoking declines to 25.5 percent. |
| 1991 | Results of a randomized clinical trial show that adjuvant radiation therapy and chemotherapy improve the survival of patients with rectal cancer. Two colony-stimulating factors (G-CSF and GM-CSF), which stimulate the growth and development of white blood cells, are approved by the FDA to treat the loss of neutrophils (neutropenia) caused by cancer chemotherapy. Ondansetron is approved by the FDA to treat nausea and vomiting induced by cancer chemotherapy. Stephen Fodor and his colleagues develop the technology to produce DNA and protein microarrays. DNA microarrays, which can be used to measure the expression levels of thousands of genes at the same time and to detect single-nucleotide polymorphisms (SNPs) in DNA, become important tools in cancer research. |
| 1992 | The Mammography Quality Standards Act is passed by Congress. The Act, which will become effective in 1994, requires mammography facilities across the United States to meet uniform quality standards. Paclitaxel, the first of a class of drugs known as taxanes, is approved by the FDA for the treatment of advanced ovarian cancer. Originally purified from the bark of the Pacific yew tree (Taxus brevifolia), paclitaxel stabilizes microtubules and interferes with cell growth and division. However, rapidly dividing cells, such as cancer cells, are particularly sensitive to the toxic effects of this drug. |
| 1993 | The results of a randomized controlled trial show that annual screening with FOBT substantially reduces colorectal cancer mortality. An NCI-convened international workshop on screening for breast cancer reports that screening with mammography reduces breast cancer mortality among women ages 50-69. This conclusion is based on a review of published and unpublished data from eight randomized controlled trials. The first gene (MSH2) associated with hereditary nonpolyposis colon cancer (HNPCC) is cloned. People with HNPCC are at increased risk of developing colon cancer. The protein produced by MSH2 functions in DNA repair. Later, additional DNA repair genes will be associated with HNPCC. MicroRNAs (miRNAs) are first identified in the roundworm Caenorhabditis elegans, and their role in regulating gene expression by interfering with the translation of messenger RNAs into proteins is proposed. miRNAs are later found in humans. It has been estimated that the human genome may encode at least 300 different miRNA species, making these non-protein-coding RNAs one of the largest classes of gene regulators identified. Changes in miRNA expression have been associated with many different cancers. |
| 1994 | The BRCA1 gene is cloned. Women who inherit specific mutations in this gene have greatly increased risks of breast and ovarian cancer. Human herpesvirus 8 (HHV-8), which causes Kaposi sarcoma, is identified. HHV-8, also known as Kaposi sarcoma-associated herpesvirus (KSHV), will later be linked to primary effusion lymphoma and multicentric Castleman disease. |
| 1995 | The BRCA2 gene is cloned. Women who inherit specific mutations in this gene have greatly increased risks of breast and ovarian cancer. The FDA approves tretinoin, a differentiating agent related to vitamin A, for use in the treatment of acute promyelocytic leukemia. Tretinoin is also known as all-trans retinoic acid (ATRA). Porfimer sodium, a photosensitizing drug that can be absorbed by tumors, is approved by the FDA for the photodynamic therapy of some types of cancer. When photosensitizing drugs are exposed to light of a specific wavelength, they become active and kill cancer cells. Information in NCI's PDQ database becomes available on the World Wide Web via the NCI Web site CancerNet. |
| 1996 | The first sustained decline in cancer death rates in the United States since record keeping began in the 1930s is reported. NCI, the Centers for Disease Control and Prevention, and the American Cancer Society jointly report that the overall cancer death rate fell by 2.6 percent between 1991 and 1995. Topotecan, the first of a class of drugs that interferes with the enzyme topoisomerase I, is approved by the FDA for the treatment of metastatic ovarian cancer. Topoisomerases uncoil DNA during DNA replication, and altering the activity of this enzyme leads to tumor cell death. Topotecan is derived from the bark of a Chinese tree known as Camptotheca acuminata. The FDA approves another topoisomerase I inhibitor—irinotecan—for the treatment of metastatic colorectal cancer. |
| 1997 | The FDA approves the first biotechnology product to treat patients with cancer—a monoclonal antibody called rituximab. Rituximab is initially approved for the treatment of non-Hodgkin lymphoma (NHL) that is resistant to other treatments, but it will later be approved for use as a first-line treatment for several types of NHL. NCI scientists and their Chinese collaborators find that occupational exposure to the chemical benzene is associated with increased risks of acute non-lymphocytic leukemia and related myelodysplastic syndromes as well as NHL. The National Cancer Advisory Board recommends that NCI advise all women age 40 years or older to receive screening mammograms every 1 to 2 years. Cancer stem cells are first identified, in acute myelogenous leukemia (AML). They will later be identified in additional cancer types, including cancers that form solid tumors. Cancer stem cells in solid tumors are the only cells that have the ability to initiate new tumors. |
| 1998 | Results from the NCI-sponsored Breast Cancer Prevention Trial show that the drug tamoxifen reduces the incidence of breast cancer by 50 percent among women who are at increased risk of the disease. The FDA subsequently approves tamoxifen for the prevention of breast cancer in high-risk women. Trastuzumab, a monoclonal antibody that targets cancer cells that overproduce the protein HER2, is approved by the FDA for the treatment of metastatic breast cancer. |
| 1999 | The Hybrid Capture II HPV DNA test is approved by the FDA for use in conjunction with the Pap test in cervical cancer screening. |