【经济学人】癌症治疗：多领域取得进展 [美国媒体]

Progress on many fronts

多领域取得进展

New types of therapy mean cancer is going to become ever more survivable

新型疗法意味着癌症生存率会越来越高

Science is making cancer treatments more precise in many different ways

科学正在以多种方式提高癌症治疗的精确性



THERE are few whose lives have not been touched by cancer. It cuts down friends, loved ones, siblings, spouses, parents and children. And it does so more than it used to. A generation ago, one in three people in the rich world could expect one day to hear the fateful words, “I’m afraid you have cancer.” In some countries it is now approaching one in two. The longer other things do not kill you, the more of the wear and tear that leads to cancer your cells accumulate. Live long enough and it will be the reward.

一生从未遭遇癌症的人寥寥无几。它夺走朋友、亲人、兄弟姐妹、爱人、父母、孩子的生命，而且比过去更多。约三十年前，发达国家有三分之一的人可能听到致命消息：“您恐怕得癌症了”。在当今某些国家，比例接近二分之一。你幸免于其他死因越久，细胞积累的致癌损伤就越多，癌症是长寿的奖励。

Worldwide, cancer is the second leading cause of death after heart disease; it killed 8.8m people in 2015, three-quarters of them in low- and middle-income countries. Between 2005 and 2015 the number of cases increased by 33%, mostly owing to the combined effects of ageing and population growth. New cases are expected to increase by 70% in the next 20 years.

在世界范围内，癌症是仅次于心脏病的第二大死因；2015年880万人死于癌症，其中四分之三来自中低收入国家。2005-2015年癌症病例增加33%，主要是老龄化和人口增长的综合因素造成的。未来二十年，癌症病例将增加70%。

Set against this rise is the fact that, in rich countries, cancer is becoming more survivable. Today 67% of patients in America will survive for at least five years. Different cancers fare differently, as do different sorts of patients—cancer has proved more treatable in children than in adults. Some cancers, such as that of the pancreas, have seen barely any improvement. But there are general grounds for optimism.

相比病例的增加，发达国家的癌症生存率有所提高。如今美国67%的癌症患者能至少生存5年。不同的癌症有不同的情况，不同的患者也是如此，儿童患者比成年人更易治疗。有些癌症几乎没有任何进展，如胰腺癌。但总体上有理由保持乐观。

New research tools, such as easily generated antibodies, rapid gene sequencing and ever easier genetic engineering, have revolutionised biologists’ understanding of cancer. This understanding has allowed more specific approaches to the disease to be developed, and the trend will continue. What is more, the tools of molecular biology have moved out of the lab and into the clinic. Genetic tests are used to find the precise vulnerabilities of a particular patient’s cancer. Antibodies attack the specific molecules that have gone haywire. The cells of patients with cancer are engineered to better fight the disease.

新的研究工具彻底改变了生物学家对癌症的认识，例如容易产生的抗体、快速的基因测序、更简便的基因工程。生物学家利用这些知识研发出更多的特效疗法，这一趋势将持续下去。另外，分子生物学工具已从实验室走向临床。生物学家利用基因检测精确找出每位患者的癌症存在的弱点。抗体会攻击那些出现问题的特定分子。癌症患者的细胞经过改造拥有更强的抗癌能力。

And in the current decade a whole new branch of therapy has sprung up. Unshackling the immune system’s response to cancer, once a pipe dream, has become practical medicine, with approved therapies for eight kinds of cancer. The excitement at oncology conferences is palpable.

最近十年兴起一种全新的治疗领域。唤醒免疫系统对癌症的反应曾经是一个梦想，如今已成为实用医学，针对八种癌症的此类疗法已得到批准。在肿瘤会议上，科学家的喜悦之情溢于言表。

As these advances have arrived regulators have increased the speed with which treatments for life-threatening diseases are approved. This is in some ways a mixed blessing—some expensive drugs with little if any benefit are nevertheless getting to market. But it has encouraged an unprecedented wave of investment and innovation. The pipeline of oncology drugs in clinical development has grown 45% in the past decade. There are currently about 600 drugs under development at biotech and pharma companies.

随着医学的进步，监管部门针对危及生命的疾病，加快审批相关疗法。这在一定程度上喜忧参半，一些疗效并不显着的昂贵药物开始进入市场，但也激起前所未有的投资与创新热潮。过去十年来，临床研发的肿瘤药物产量增长了45%，目前生物科技企业和药企正在研发600多种抗癌药物。

The picture is not uniformly rosy. In both treatment and prevention the poor are ill served. Basic chemotherapy and pain relief is difficult to come by in many parts of the world. The failures are not limited to poor countries. Cancers due to bad diet, obesity, alcohol abuse and smoking could all be reduced a great deal in wealthy ones. And while vaccination against human papilloma virus is routine in Rwanda, it is still limited in America—which means thousands of American women will face cervical cancers they could have avoided in years to come. 

形势并非一片大好。穷人得不到足够的治疗和预防，世界许多地区的患者得不到基本的化疗和止痛。不只是贫穷国家存在不足；在富裕国家，不良饮食、肥胖、酗酒、吸烟导致的癌症可以大幅减少。在卢旺达，人类乳头瘤病毒疫苗是例行性疫苗，但在美国依然存在局限，这意味着成千上万的美国妇女在未来几年将面临本可预防的子宫颈癌。

But if some low-hanging fruit still go tragically, lethally unpicked, progress is not merely possible. It is happening.

但如果人类继续对唾手可得的某些成果可悲、致命的视而不见，那么进步不仅是可能的，而且一直在路上。