Every person needs a goal. And geneticist James Watson wasn’t done striving for his goals, even though he had discovered DNA’s double-helix structure. Watson, sadly, is done, however. He died 6 Nov 2025 at 97, his late-life goal within reach. “I want to see cancer cured in my lifetime,” he told the WSJ’s Allysia Finley in 2010.

As it turns out, Mr. Watson was also pragmatic. He believed he could live with “Cancer Cured,” if “only 100,000 were saved,” rather than if “only 100,000 people die.”

Not that long ago, reports Ms. Finley, a cancer diagnosis was considered a death sentence:

e.g., advanced melanoma, non-small-cell lung, and blood cancers—are now curable.

Rather than carpet-bomb cancer with chemotherapy and radiation, oncologists are deploying the pharmaceutical equivalent of drones and precision missiles.

• Checkpoint inhibitors. These work by preventing cancer cells from evading detection by the immune system. The Food and Drug Administration approved Merck’s immunotherapy Keytruda for metastatic melanoma in 2014. Keytruda has since been approved for some 40 types of cancer and become a mainstay in oncology treatment. Drugmakers are working to develop more next-generation immunotherapies.

• Oncolytic virus immunotherapies. These shoot a virus such as herpes into tumors, causing them to self-destruct. The bursting tumor shoots out flares that spur the immune system’s T cells to kill cancer cells around the body. One-third of melanoma patients who failed to improve on other immunotherapies experienced remission on one of these experimental treatments by Replimune.

• CAR T cells. This is another type of immunotherapy. Technicians remove a patient’s T cells in a lab and re-engineer them to recognize and attack cancer cells and leave healthy cells unscathed. More than a half-dozen CAR T-cell therapies have been approved since 2017 for blood cancers, and they can provide complete cures for some patients. CAR T-cell therapies have shown promise in early trials for hard-to-treat solid tumors like glioblastoma. More than 250 trials for CAR T-cell therapies were launched in 2023 alone.

• Antibody conjugates. These deliver a chemotherapy payload directly to cancer cells. This reduces harmful side effects from chemotherapy and can make immunotherapies more effective. The FDA has approved more than a dozen antibody conjugates since 2013, including for breast, lymph and ovarian cancers.

• Radioligands. They work like precision chemo-missiles, delivering radiation directly to cancer cells. The FDA has approved two such targeted radiation therapies since 2018. More than 100 trials on similar medications are under way.

• Cancer vaccines. Scientists are harnessing mRNA and other vaccine technologies to train the immune system to track down cancer cells lurking around the body. These have shown particular promise in aggressive cancers like pancreatic, triple-negative breast and melanoma. The aim is to destroy cancers and prevent recurrences. A small early-stage trial showed that an experimental vaccine by Elicio Therapeutics stimulated a strong anticancer immune response in about 85% of patients with a KRAS gene mutation. This mutation, which is present in 90% of pancreatic and 50% of colon cancers, was once thought “undruggable.”

• Microbiome. Why do immunotherapies help some patients but not others? Scientists are discovering that diet may be a critical factor. A study last week found that gut bacteria break down fiber and other nutrients to produce fatty-acid compounds, which fuel T cells to fight cancer.

• Multicancer-detecting blood tests. These have the potential to identify cancers that currently don’t have screenings at earlier stages, when they can be more easily treated. A recent study found that Grail’s Galleri test detected 73.7% of 12 cancers that are responsible for two-thirds of deaths in the U.S.

Only about 10% of cancer treatments that begin clinical trials are ultimately approved by the FDA, Ms. Finley informs readers.

But with more than 2,000 trials under way, odds are good that we will soon have many more breakthrough treatments. Artificial intelligence is also making it easier and faster to design treatments—and to predict which patients will benefit from them.

Torpedoed Treatments

Mr. Watson considered the FDA the biggest threat to further progress. During the 2000s, the agency’s oncology chief, Richard Pazdur, torpedoed treatments based on quibbles with their trial designs, continues Ms. Finley.

But (Pazdur) experienced a regulatory conversion of sorts when his wife was diagnosed with terminal ovarian cancer. “I have been on a jihad to streamline the review process and get things out the door faster,” Dr. Pazdur said in 2016. “I have evolved from regulator to regulator-advocate.”

Marty Makary, the FDA’s commissioner, last week elevated Dr. Pazdur to head of the agency’s drug reviews. Alas, Vinay Prasad, the agency’s head of biologics and chief medical officer, is on his own jihad against cancer drugs, because he thinks their benefits aren’t worth the cost.

Before joining the agency, Dr. Prasad criticized Dr. Pazdur for accelerating many of the above treatments. On Dr. Pazdur’s 25th anniversary at the agency last November, Dr. Prasad tweeted: “25 years of the bar getting lower. Pharma getting richer. Drugs costing more.”

If Dr. Prasad’s views prevail at the FDA, we might as well wave a white flag in the war against cancer, asserts Allysia Finley.

Walking to dinner last evening, Dick and I bumped into a friend, an artist and yogini, who lives on one of Key West’s most charming alleys. She knew I knew about her cancer. Melanoma. News in KW moves fast, as Jimmy, who himself died from skin cancer, used to sing, “through the coconut telegraph.”

As our friend was explaining how her cancer has thrown her life for a spin, a neighbor, also a friend, overhearing us while sitting on her nearby porch, joined the conversation. A little sobering, at a random meeting of four, in a random alleyway under the stars, half the group has cancer and is undergoing serious treatment.