Some drugs are thought to be more powerful together: aspirin and coffee, cannabis and alcohol, and the antibiotics ampicillin and gentamicin, to name a few. In the case of cancer drugs, scientists have long thought discovering synergistic drugs, where one agent paves the way for another to target a tumor more aggressively, is the epitome of combination therapy.
But a growing line of research is beginning to shatter the idea that “synergy” should be a high priority in cancer treatment. The latest study, published Thursday in Clinical Cancer Research, examined 13 combinations with cancer immunotherapy drugs and found that the benefits of all the pairings seem to come from each drug independently, not how they work together. The finding points to a concession in cancer research: For all the advances made in cancer biology and combination therapy, scientists are still largely in the dark about tumors and the drugs that target them.
“We were so embedded in the mindset that [searching for synergy] is the way to do things,” said Adam Palmer, a pharmacologist at the University of North Carolina at Chapel Hill and a co-author of the study. “It’s been a real journey of questioning my assumptions, discovering data that contradicts everything you thought you knew about something. Exciting and scary and almost like a loss of faith.”
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