World on the edge of a new era of drug discovery

The next 10 years promise huge advances as a new generation of designer drugs and treatments turns killers such as cancer into chronic complaints.

Years of research into the basic science of biological systems is starting to bear fruit. Within the next decade new drugs tailored to individuals that will be safer and more effective are set to appear on the market.

Patients will have access to stem cells from which new tissue can be grown, DNA profiling setting out their risks of developing or passing on inherited disease and tests for predicting individual drug response.

Gene therapy for certain childhood blood conditions such as severe combined immunodeficiency disorder has already proved effective, heralding a revolution in treatments for inherited disease.

In fertility treatment, scientists are working on making sperm and eggs from skin cells in a process known as haploidisation. If successful, it could bring hope to the one in six infertile couples who are unable to produce their own genetic offspring.

The new drug for breast cancer, Herceptin, is a harbinger of drug developments to come. It is one of a new class of cancer drugs that some experts claim will transform cancer from a killer disease to a chronic condition such as diabetes. Herceptin is among the first of the new "personalised" medicines - effective only in the 20 per cent of breast cancer patients with a specific genetic profile, marked by the presence of Her2-positive receptors. This new class of "designer" cancer drugs, built from research on cancer at the molecular level and designed to have a specific action, will mean better targeted treatments suitable for specific groups of patients.

"The molecular era is starting in which we will be able to break down diseases into more specific entities. It has started in cancer in a dramatic way," said Sir David Weatherall, Regius Professor of Medicine at Oxford University.

But there is a downside to this new era of personalised treatment. The drugs will be much more expensive because they are suitable for fewer people.

One reason for the high cost of Herceptin - around £20,000 ($56,000) a year - is that the potential market is only one fifth of that for other breast cancer drugs. (In New Zealand it is estimated that treatment with the drug could cost between $80,000 and $190,000).

The new drug for lung cancer, Tarceva, is being hailed as a breakthrough in the treatment of the disease but it costs £75 a day and must be taken for life.

Progress will not only come from drug development. New surgical techniques combined with developments in anaesthetics will mean more treatment can be delivered outside hospitals in clinics and GP surgeries.

One of the most urgent areas of research is in vaccines against avian flu. The H5N1 virus that has decimated poultry flocks in the Far East, infected 176 people and killed 97, is slowly evolving.

The risk of a flu pandemic is higher than it has been for 30 years. Scientists are racing against time to develop an effective vaccine. The lives of millions may depend on it.

Additions to the bathroom cabinet will include:

* Powerful statins to cut cholesterol.

* Enzymes to promote digestive health.

* New classes of painkillers geared to personal pain receptors.

* Powerful cancer-fighting agents which could transform cancer from a killer disease to a chronic condition such as diabetes.

- INDEPENDENT