Journal of Clinical Oncology, Vol 1, 75-90, Copyright © 1983 by American Society of Clinical Oncology
Karnofsky Memorial Lecture. Breaking the cure barrier
JF Holland
Breaking the cure barrier is a biologic and a conceptual problem that has
already been accomplished for several tumors. It is helpful to consider
neoplasms in mathematical terms as many-celled tumors (polycytomas:
kilocytomas, megacytomas, gigacytomas, and teracytomas). A new
chemotherapeutic taxonomy recognizes curable, subcurable, and precurable
cancers each with definable characteristics. A simplified technique of
recognizing early cures is described by calculating the probability that an
interruption in an exponential failure slope occurred by chance. Examples
of cures of acute myelocytic leukemia, of superior chemotherapy for
Hodgkin's disease in young adults, and of superior adjuvant chemotherapy
for breast cancer are given. The interaction of surgery with chemotherapy
is illustrated in pure form in acute myelocytic leukemia and in ovarian
cancer. Curative chemotherapy is closer at hand than is generally believed.
Nomograms for cure prediction are presented as inducements to contemplate
curative approaches to cancer therapy.
