The Future of Cancer Research: Five Reasons for Optimism

DNA molecules wrapped around histones

Many cancers are fueled by biochemical changes of histones, the proteins that serve as spools for DNA in our cells (histones are shown in green with their cancer-induced changes in purple). New epigenetic therapies that reverse these changes are showing early promise in clinical trials.

Although the history of attempts to understand and control cancer is littered with disappointments, many significant advances in research and treatment have been made in recent years. Despite the challenges, Memorial Sloan Kettering scientists and doctors firmly believe we’re on the cusp of a brighter era in cancer care and research. Today, we have more reasons than ever to be hopeful. These are five of them.

Precision Medicine: Interpreting the Story of Genes

During his final State of the Union address in January, President Barack Obama announced an initiative focused on precision medicine — the vision that one day, all people will be offered customized care, with treatments that match our genetics and personal histories. Such individualized therapies promise to be more effective and cause fewer side effects than more traditional ones developed for the average patient.

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Basket trials test a drug or treatment that targets a specific genetic mutation.
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We have yet to realize the full potential of precision medicine, but we are making significant headway. Options for many people with cancer have dramatically improved through targeted therapies that reverse the effects of specific gene mutations in their tumor cells.

MSK scientists are working relentlessly to extend the promise of precision medicine to people with all kinds of cancer, both common and rare. Our pathologists — experts in diagnosing disease — are using a powerful tumor DNA sequencing test called MSK-IMPACT™ to guide therapy for patients with advanced disease, regardless of their tumor type.

In addition, MSK investigators are developing new research approaches and perfecting basket trials — a method of conducting clinical studies in which patients can enroll based on the mutations in their tumors — to help doctors deliver precision-medicine options to more patients, more quickly.

Checkpoint Inhibitors: Triggering Immune Defense

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Find out how immunotherapy became one woman's best option for beating melanoma.
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Using a patient’s own immune system to fight his or her cancer, known as immunotherapy, is the fruition of a century-old idea. MSK researchers have played a major role in the development of nivolumab and ipilimumab, two drugs that boost the cancer-fighting powers of the immune system’s T cells. These two drugs belong to a class of immunotherapy treatments called checkpoint inhibitors, which work by easing constraints on the immune system and thus helping it work better. So far both have produced remarkable results, eliminating cancer completely in some patients with highly advanced melanoma. Nivolumab is additionally approved for lung and kidney cancer, and another drug, pembrolizumab, is approved for lung cancer. Checkpoint inhibitors are also showing promise in bladder, head and neck, triple-negative breast, and other cancers.

These therapies don’t yet work in everyone, but scientists are making incredible strides in changing that. Recent MSK research has yielded important clues about how these drugs work and how they could be improved. In addition, MSK was recently named a founding member of the Parker Institute for Cancer Immunotherapy, which, thanks to a generous $250 million donation from tech entrepreneur Sean Parker, will hasten the study and implementation of new immunotherapy drugs.

Jedd Wolchok, Chief of the Melanoma Service at MSK, told Reuters that the new center “is paradigm shifting.”

“I have no doubt this will allow us to make progress, and to make it much more quickly,” he said.

Cell-Based Therapy: “Living Drugs” to Better Fight Cancer

In addition to drugs such as ipilimumab and nivolumab, MSK researchers are developing another immunotherapy strategy in which a patient’s own T cells are manipulated to more readily attack cancer cells. In this treatment, called chimeric antigen receptor therapy, or CAR therapy, T cells are collected from a patient’s blood, genetically engineered to recognize certain proteins on cancer cells, and infused back into the patient’s bloodstream.

The approach is showing early promise for relapsed B cell acute lymphoblastic leukemia and some other blood cancers, and might potentially be useful for treating solid tumors as well.

Karen’s Story
Karen’s own immune system was her most powerful weapon against chronic lymphocytic leukemia. After undergoing a new type of immunotherapy, CAR T cell therapy, she is now cancer-free.

“We’re creating living drugs,” Michel Sadelain, a pioneer in the field and Director of MSK’s Center for Cell Engineering, told the New York Times about CAR therapy. The concept of these drugs — therapies in which live cells are either infused or transplanted into patients — is exciting because cells are presumably more nimble than chemicals or biological compounds. For example, they can sense multiple cues from their environment and appropriately respond.

For most of these cell-based treatments, scientists are still working to ensure their safety or manage their side effects.

Epigenetic Therapy: Setting Cancer Cells Straight

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Epigenetics-based treatments teach cancer cells to behave like normal cells.
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Doctors have long searched for ways to control cancer by cutting out tumors or poisoning them with chemicals and radiation. But what if cancer could be treated in a different way, by transforming cancer cells back to normal rather than destroying them?

Research into epigenetics — how genes can switch “on” or “off” depending on outside influences — is changing our understanding of cancer and many other diseases. It has also led to the development of a number of new drugs in clinical trials at MSK. All of them target epigenetic enzymes, which regulate a cell’s genetic programming. Rather than destroy cancer cells, the therapies seek to set the cells on a path back toward normal growth and development.

One such drug, called AG-221, is being tested in people with acute myeloid leukemia (AML) and myelodysplastic syndromes. As of September 2015, the drug had a 38% response rate in 159 patients whose AML had returned and been resistant to treatment. Similar results have been seen with some other new blood cancer drugs.

Research into Metastasis: Unmasking the Latent Enemy

For almost 200 years, scientists have been toiling to understand metastasis, the process that allows some cancer cells to break off from their tumor of origin and take root in a different tissue. Today, the problem is as urgent as ever. Metastasis causes nine out of ten deaths from cancer, and survival rates haven’t improved much since the 1960s.

The process has been challenging to study and control for many reasons. One is that metastatic tumor cells are very rare in the body compared with the millions of tumor cells that don’t cause metastasis, and they’re therefore hard to detect and isolate.

But the tide is finally turning. In recent years, scientists have identified genes and pathways that commonly drive the spread of breast cancer or neuroblastoma to the brain and kidney cancer metastasis to various organs. In 2014, our scientists discovered that metastatic tumor cells have a remarkable tendency to cling to blood vessels, a survival mechanism that might be important for the spread of many types of cancer. Our researchers have also shed light on how cancer cells hide out and remain undetected by our immune system, opening up a promising new avenue for treatment.

Our relationship with cancer will be much more like the one we have with infectious diseases, for which we have antibiotics and other treatments.
Joan Massagué Director, Sloan Kettering Institute

Scientists are also finding that tumors can hijack normal cells and tissues growing in their neighborhood and coax them into supporting cancer spread. To counter that, our researchers have discovered that drugs that act on a specific type of blood cell can slow breast-to-brain metastasis or block the progression of glioblastoma brain tumors in mice.

The more we learn about metastasis, the more likely we are to see new treatment options emerge. “Mankind is turning cancer from what we’ve known it to be — the way we’ve related to it in the 20th century as an impossible, obscure disease — into a ‘normalized’ disease,” Joan Massagué, Director of the Sloan Kettering Institute and a prominent metastasis researcher, said in an interview. “Our relationship with it will be much more like the one we have with infectious diseases, for which we have antibiotics and other treatments.”


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My friend is currently being treated for tongue cancer by an extraordinary team of physicians, speech therapists, nutritionists. It's a very challenging case. I am so appreciative that she is being treated with such concern and care. I wish that there were new treatments on the horizon for head and neck cancer (as we have seen for lung, melanoma, etc. etc.), which still seems to rely on surgery, very invasive radiation therapy, and chemotherapy for some patients.

Dear Laurie, we are glad to know that your friend is feeling well-cared for by her cancer care team.

Experts at Memorial Sloan Kettering are working to evaluate novel chemotherapy drugs, new drug combinations, and other strategies such as immunotherapy to improve the standard of care for head and neck cancer. We are also at the forefront of research to identify genes that play a role in head and neck cancers and are evaluating new techniques to identify these genetic markers. Our clinical investigators are using this information to develop new therapies that target these genes.

To learn more about our clinical trials evaluating new therapies for people with head and neck cancer, please visit

Thank you for your comment.

Heh my mom is 50 and in great health. She has stage IV colon cancer. She is about to begin folfiri With avastin chemotherapy. I was wondering what do y'all believe is the future for colon cancer treatment? Thank you so much!

We are sorry to hear about your mom’s diagnosis. We and others are working hard to develop more-effective approaches for people with colorectal cancer. Avenues of research include uncovering changes in genes that drive the development and growth of the disease and developing targeted therapies that restore the genes’ normal activity. Here is one example of early research in this area:….

In addition, we are evaluating a number of new treatments, including immunotherapy, in people with colorectal cancer. To learn more about these trials, please visit:

We hope this information is helpful. Thank you for reaching out to us.

What does "CEA" number stand for, how is it calculated and what is a normal number?

Do you treat adenoid cystic carcinoma? My cancer started in my left parotid gland but has metastised to my right kidney, both lungs and my liver. I have been told there is nothing else to do? I am searching for any sort of help. Thank you in advance.

Dear Rose, we are sorry to hear about your diagnosis. We do treat people with this type of cancer. Here is a blog post we did about our latest research in this area:…. If you would like to make an appointment with one our specialists in this area to discuss possible treatment options, please call our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

There is some excellent information on these boards. A close friend is beginning treatment for stage 4 next week. They are treating the Melanoma with Nivolumab plus Ipilimuma and
Dabrafenib and Trametinib. Any suggestions where to find the best diets for this treatment? Since it's working with the bodies own immune system maybe certain super foods and other supplements can help boost it.

Michael, we recommend that your friend speak with his or her doctor or a nutritionist about this. Thank you for your comment.

I am a nurse at a teaching hospital in Virginia and work with Oncology patients. Also, I lost my father to Sarcoma in 2014. I was angry and ask all the what if questions (he was not treated where I work) but I learned long ago from my dad that God has a reason for everything. My father's life was cut short by an insidious beast called cancer. There seems to be a misconception from some of these posts that there is a singular cause of cancer. Not true. Each cancer has a unique signature of growth and potential for metastasis. Sure there are similarities and even the same kind of cancers don't act the same because each human being is not the same. I believe whole heartedly that epigentics and individualize therapy is the way we will beat the beast but it is only through research that we will be able to decode the genetic anomalies that results in its growth in the first place. For those of you that believe hospitals that have to apply for research grants to get funding are out for the money, you are sorely mistaken. Our present system for reimbursement for care given is set up by the insurance companies and the Centers for Medicare/Medicaid services. There goal is that hospitals barely break even or function in the red. If you want to gripe about big business and big money, you should look to insurance and drug companies because the truth is hospitals are barely surviving today. These same hospitals like MSK are big and for some may seem impersonal but I can assure you this they care about what they do. With all the disappointment and loss that we experience as caregivers, trust me I have cried over the loss of my patients, we still come to work every day looking for the answer and wonder why it is taking so long to find that CURE. Problem is there is more than one cure because there is more than one type of cancer.

My father has only one kidney, which has a transitional cell (urothelial) cerinoma growth in the kidney and tube. Grade G2 pta in the tube. The doctors are unable to confirm what grade the cancer is in the tumour due to restricted access, but the assume its the same. we are based in the UK. the best option they have given to my father is to remove the kidney, thus resulting in dialysis. is there anything you can do to help?

I am very impressed by the timely and consistent responses from MSK to so many of the questions asked. Keep up the excellent work and sincere dedication to cancer treatment.

Good efforts MSKCC. Only untiring efforts by untiring minds will bless us with better management prospects. I hope this comes soon to save my sister just diagnosed of ca breast with bony mets.

Dr. Agarwal, we are sorry to hear about your sister’s diagnosis. We wish her our best and appreciate you sharing your comments on our blog.

I'm about to write a book here so bare with me. I've had stage 4 lung cancer since 2013 and I am alive today and cancer free because of the fine doctors and treatment of MSK. This is my story.
It started with a bad cold/cough which took me to a pulminologist then a biopsy was done to discover I had a form of cancer on my lymph nodes. I was advised by my family to go to the best there was in NYC which was Msk. They figured out it was stage 4 lung cancer after it had gone out of the body into my brain. I had bouts of headaches but even before that my pulminologist recommended I do an MRI of my brain-smart guy. Came back suspicious then another MRI was done which told me it had traveled to the brain. I had then electrostatic radiation which is kinda like Gama knife but was a procedure with a head set with a few times a set up at Msk in Commack Long Island then a one shot deal one day.
I was seeing a Dr. Lee. I had to deal with the brain before I could take any medication for the cancer in my lymph nodes. Then I was put on a cancer pill because I was found to have an ALK mutation which only 3 % of all lung cancer patients worldwide has. I never smoked and 20 % of lung cancer patients are non smokers. I had no chemo therapy even tho at some point I had a port put in me then removed because I didn't need it nor was it working. As I said I was diagnosed in Oct 2013 and received my pill as of 2/24/14. I remember this date b/c I had to call my oncologist to say I was starting the pill. After talking it for 13 months a new pill (2nd generation)came out approved FDA and my oncologist felt it was time to change as my cancer had grown some. Even before that in the winter of 2014 I experienced headaches & the inability to speak then another MRI was done and they found Edema on the brain which brought me to have Awake Brain Surgery in NYC at Msk. Then some cancer was found in the edma so I was advised by Dr. Lee to have 5 treatments of radiation at the Commack facility. Then I moved on to a 2nd generation pill. After taking it for a few weeks I contracted a staph infection that nearly killed me and was in Mercy Med Center in Rockville Center for 1 month in April 2015 then I pulled through by the grace of God. I was on no cancer medication after I was hospitalized b/c you can't be on any of that having a high kidney function, seizures and the staph infection. It was in my right leg & my back. After 2 wks in the hospital I made improvements. One month there then 2 months in Meadow Brook Rehab in Freeport LI which taught me how to walk all over again. Since being out of the hospital and rehab for over a yr now after numerous checkings by Msk taking MRIs and Cats scans plus one Pet scan I was declared cancer free! Dr. Ng is my oncologist at the RVC facility. My original Doctor at Sloan was Dr. Rivzi. Msk has saved my life and I can not thank them enough. I know I am not the norm and not everyone can be saved but more and more they are discovering cures for cancer and in our life time it can happen. I was 55 in 2013 and now turned 58 in 2016. It can happen to you. Don't give up hope. I advise all to think positive. It's the only way to make it through this disease. I had faith and learn a lot. I was proactive every step of the way. Yes I had good insurance too being a retiree of the Dept of Education. There are a lot of insurances Msk will take. Don't give up is what I'm saying. I have survived and I'm cancer free right now and plan to stay that way by eating right, staying as fit as I can and enjoying each and everyday. Thank God for Memorial Sloan Kettering! I owe my life to them.

Dear Lea, thank you for sharing your experience on our blog. I’m sure it will resonate with many readers. We are glad to know that you have felt well-cared for by your MSK care team. Wishing you all our best.

I was diagnosed over 5 years ago (at the age of 27) with a brain tumor - MSK was the ONLY institution that was able to accurately a read my pathology report and determine my specific diagnosis of Anaplastic Astrocytoma. Had it not been for MSK my local hospital would have considered it a benign tumor! I wouldn't be been dead a long time ago, likely before the age of 30. The doctors and researchers at Sloan have given me 5 great years of life, even despite multiple surgeries and treatments. I am now tryIng one of the immunotherapy drugs mentioned in this article and I am very optimistic that it will help me, and then many other brain tumor patients after me. I can't thank my team at Sloan enough for what they have done for me...

Dear Jaclyn, we are sorry to hear about your diagnosis but are glad to know that you have felt well-cared for by your care team at MSK. Thank you for sharing your thoughts on our blog.

I am a patient of MSK under Dr Moskowitz's care. Is there any immunotherapy gains with NHL -t cell? If so what are the trials to look at? I have had a rare re-occurence of t-cells that infiltrated into gum tissue. There has been no other spread as of yet I am concerned once radiation is completed and we may not have controlled disease process .

Dear Denise, we are sorry to hear that your cancer returned. We recommend that you follow up with Dr. Moskowitz, who can answer your questions and address your concerns. Thank you for reaching out to us.

I'm surprised about the snarky comments I see here. I have a very different tale to tell. I am eternally grateful to MSK for saving my son's life and the wonderful people who did just that. From the parking garage attendants to the maintenance staff to physicians known the world over, everyone acted like they wanted to do their part to help. The nurses on the ninth floor have the patience of saints and comfort not only the patients but also their devastated and heartbroken parents. My son's surgeon walked to the hospital just to see him on a blizardy Christmas day. When my son spiked a fever on a Friday night as everyone was about to leave for the weekend, his dedicated (pediatric sarcoma) physician and an amazing nurse--not even my son's own nurse--stayed with him and me in the ICU until 2 am. He had gone into septic shock and could have died, but I watched these 2 uber dedicated professionals jump in and literally save his life before my own eyes. As long as I live I will not forget that night and whenever I think of things for which I'm grateful, MSK is high on my list. You do amazing things and make miracles happen. Please know how grateful so many families are for all the good you do.

Dear Debbie, we are glad to know you and your son felt well-cared for by your care team at MSK. Thank you for sharing your experience and kind words on our blog.

My mother currently has stage 4 breast cancer which metastasized to her liver, lungs and recently her brain. She had radiation done recently and now is on an immunotherapy drug called tremelimumab. She is currently at MSK as a patient.

Are there any other immunotherapy drugs or other clinical trial she can try out at MSK? Is there a link or list of current trials?

Is the MSK-IMPACT test necessary for the trials and if she hasn't received it can we request that one be performed?

Dear Armen, we are sorry to hear about your mother’s diagnosis. Every clinical trail has it’s own unique protocol of tests and treatments that needs to be followed. We are actively studying various treatments, including immunotherapies, in clinical trials for people with advanced breast cancer. You may browse through those studies here:…. We recommend that you to circle back with your mother’s oncologist with questions about her eligibility to participate in any of these trials. We hope this information is helpful and appreciate you reaching out to us.

Any research on thyroid cancer?

What research is being done on metastasized alveolar rhabdomyosarcoma? Our 20-year old daughter finished the current pediatric protocol at OHSU 9 months ago. She now has recurrence in her lungs. We are looking for clinical trials and information.

Teresa, thank you for reaching out. Memorial Sloan Kettering currently has two clinical trials for rhabdomyosarcoma:…

In addition, the government also has a website listing clinical trials specfically for alveolar rhabdomyosarcoma:…

If you are interested in learning about making an appointment at MSK with one of our experts, please call the Department of Pediatrics at 212-639-5954.

You can learn more about treatment for pediatric sarcomas at Memorial Sloan Kettering here:

I found this helpful

My husband is a patient at MSK diagnosed with stage four colorectal cancer currently on folfiri. We are working with Dr Kelsen. We had ask about immunotherapy but he said it was not an option. However I see Cody Bennetts comment earlier on Nivolumab and would like to find out how they were given that option. Can you please connect me with Cody? I'm going to print this out at next meeting with the team. Codys response gives us more hope.

Hi Thao, we are not able to share the contact information of the people who comment on our blog due to privacy concerns. If you want to connect with others who may be going through the same experiences as you and your husband, you may want to look into Connections, MSK’s online community where patients and caregivers share their stories and talk to each other. You can learn more at…. We also recommend that you discuss this with Dr. Kelsen at your next appointment. Thank you for your comment, and best wishes to you and your husband.

My wife has Stage IV breast cancer and is being treating at MSK. She is currently taken Xeloda which has reduced her CA 15-3 marker dramatically. Is there another drug that can be taken with Xeloda that together is even more effective? Thanks!

Dear Frank, we recommend that you discuss this with your wife’s healthcare team at MSK. Thank you for your comment, and best wishes to you.

I would like to thank all the staff at Sloan for the their daily work in caring for people who are struggling with the devastating diagnosis of cancer. I come from a family who has battled cancer for generations. My father was a patient at Sloan in 1960 and lost his battle with Hodgkins at 38 and his sister at 40 due to breast cancer. She was not a patient at Sloan. I believe that the struggles they went threw, with very challenging treatments, helped paved the way for future generations to have the opportunity to receive treatments that would put them into remission or cure them. I admire their courage and the expertise that was tapped into for their care.

I became a patient at Sloan and fought the Hodgkins battle with a very different outcome then my father. Due to the sacrifices of people who came before me and their courage to try new treatments and participate in clinical trails I believe I was one of the fortunate people who survived.
We are fortunate to have doctors and technicians that have chosen this profession and have the courage to use research to try to identify treatments that will prolong life or put the cancer into remission or cured. We are also blessed that patients opt to try new treatments when many realize they will not benefit from them but maybe somebody in the future will.

Cancer is not a pretty disease. It is insidious and challenging and presents differently in many patients. All the professionals at Sloan work tirelessly to try to control and cure this disease.
As I journeyed into Sloan on a weekly basis I thought of how lucky I was that there were people who dedicated their life to this disease and people who chose to work with us and encourage us not to give up. I was also thankful that there were treatment options for me that did not exist in 1960. The people who work in Sloan deal with very sick people and families who are scared and upset. For the most part they were very supportive and do the best they could do...I often wondered how they face this every day...when I could not walk into an elevator or go for a test without tearing up watching the struggles of patients and families in the elevators and waiting rooms.

The process for me was a battle but one I could not win without the care and people who helped me win! These people are humans who come to work and deal with sick people and scared families daily...I thank God there are people who choose to do this. Thank you for giving me the gift to continue my life!

Dear Pat, thank you for sharing your story. Best wishes to you, and happy new year!

Is there aything new being used to treat the chronic intractable pain from RIBP (radiation induced brachial plexology)? How about any new surgical procedures to repair the nerves, median and ulner, detroyed by the radiation done following Stage 2b breast cancer? Perhaps nerve regeneration using embryonic cells? Please let me know, thank-you!

Dear Patricia, we’re very sorry to hear that you’re experiencing this pain. We recommend that you ask your doctor for a referral to a physiatrist with expertise in working with people who have been treated for cancer. A physiatrist is a doctor who specializes in helping patients cope with pain, weakness, or other problems as a result of injury or illness. If you were treated at MSK, you can ask your oncologist for a referral to a specialist at our Sillerman Center for Rehabilitation. Thank you for your comment, and best wishes to you.

How do I save my beautiful wife of 49 heathly years of living to present stage 4 lung cancer. She doesn't smoke.She has test for 1 single mutation. Can someone help her? I am a man in most agony.David

Dear David, we are sorry to hear about your wife’s diagnosis. If you would like to make an appointment for her to consult with one of our specialists about possible treatment options, please all our Physician Referral Service at 800-525-2225. You may also be interested in asking about the support resources that we offer for both patients and their caregivers as they navigate living with advanced cancer. Thank you for reaching out to us.

Does Immunotherapy have any role in refractory Rhabdomyosarcoma treatment ?

Subject: Dendritic Cell Immunotherapy for Gall Bladder Adenocarcinoma, T2N0Mx (after Radical Cholecsystectomy)

Dear Doctor,

I will be so grateful if you can guide me on my query below.

My mother, aged 73, from India has recently undergone a Radical Cholecystectomy for Gall Bladder Adenocarcinoma (Well Differentiated), with 2 cm adjoining Liver removed.
The stage is T2N0Mx.

We are in a dilemma for the subsequent Adjuvant treatment.

One school of doctors have recommended Adjuvant treatment of ONLY Chemotherapy (Oral, Capecitabine).

Another school of doctors have recommended Adjuvant treatment of Chemotherapy (Oral, Capecitabine) + Dendritic Cell Immunotherapy.

Can you please guide me as to which would be the best option as the treatment for my mother?


Dear Probal, we’re sorry to hear about your mother’s diagnosis. We are not able to make treatment recommendations on our blog, but if you are interested, you can contact our International Center about arranging to have her medical records reviewed. You can learn more here:…

Thank you for your comment and best wishes to you and your family.

I had surgery 2017 for endometrial ca stage 1b with class 3 agressve cell type., over 1/2 thru wall and n am over 70. Had no lymphatic system or lymph node involvement ( sentinel nodes in total 26 nodes.). Had 6 rounds of chemo ( taxol n pacitel?) n 3 sessions of brachy therapy at a teaching hospital cancer center. Go in every 3 months for 2 years and then every 6 months. NED!!
After adjuvant tx was given( completed Feb 2018) given good prognosis 84% + chance of nonrecurrence -However this watching n waiting is very stressful. Do you have trials of any drugs to prevent recurrences?