The stories behind chemotherapy development

It’s easy to see chemotherapeutic agents, which look like clear or milky liquids that come in bags or brilliantly colored vials, as “unnatural.” But a number of chemo drugs are natural in origin: derived from plants, albeit poisonous ones.

Periwinkle provides the active ingredient in vinblastine, a drug that inhibits microtubule formation and stops cancer cells from dividing. Consider podophyllotoxin, found in the American Mayapple and the “happy tree,” from which the DNA replication-stopping drug etoposide is derived.

One drug that has been greatly studied (and used) is Taxol. It is derived from the lowly Pacific yew tree. This FSU article describes the path towards making Taxol a commercial reality, and the snarly legal battles that followed it. There were chemists, environmentalists, doctors, government officials, pharma execs, and of course, patients, who all participated in this story.

I was really struck by how much personality came into it: Bob Holton’s workaholic, crazy-driven determination to achieve his goals, how much he demanded of himself and the people around him. Those people are rare–perhaps rightfully so–but essential to the drug development process.

I was also surprised by the fact that it took multiple decades and perhaps over $1 billion from the federal government and Bristol Myers Squibb…the piece by piece, excruciating pace of the consolidation and application of experimental findings. I was galled by the many legal shenanigans involved as different actors tried to grab what they wanted, and the extent to which having business advisers and lawyers seems to be necessary just to survive in translational research.

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