The 2008 Nobel Prizes will be announced next week, starting with the Nobel Prize in Physiology or Medicine on Monday. There will be a live webcast on Monday at 9:30 AM GMT for those interested1. As every year just before the announcement, speculation about this year's winners is in full swing. M. William Lensch, here on Nature Network correctly predicted last year's winners2, and this year he is trying it again3. Thomson Reuters uses scientific methods for their predictions (including citation counts over 30 years and other awards), and they nominate4 these three discoveries:
- Toll-like receptors and innate immunity
- the role of microRNAs in gene regulation
- the development of meta-analysis and application to clinical medicine
There will be of course many more blog posts about the Nobel Prizes this week, both on Nature Network5 and elsewhere. But in this blog post I want to talk about someone who will not win a Nobel Prize, but who would very much have deserved to do so. I am talking about Judah Folkman who invented the field of angiogenesis research and worked on it for more than 35 years. But the prize can only be awarded to living people, and Judah Folkman passed away this January. A Nature obiturary6 and recent PNAS article7 summarize his life and scientific achievements. Here I want to explain my personal reasons why I think he would have deserved a Nobel Prize.
Angiogenesis reseach is hypothesis-driven
Folkman first published his concept of tumor angiogenesis in 19718. He postutaled that the recruitment of dedicated blood vessels is essential to tumor growth. It took 25 years of experimental work by Folkman and others until the concept of angiogenesis became widely accepted. Interestingly, another hypothesis that changed our understanding of cancer biology was also published that year: Knudson's two-hit hypothesis of tumor suppressor genes9. Judah Folkman often said Science goes where you imagine it. A lot of today's research is not at all about proving an important hypothesis, and some people even mistakenly propose that concepts are no longer needed10.
Angiogenesis research is full of failures
The story of angiogenesis research is a very complicated one. Not only took it Judah Folkman a long time and a lot of subbornness before his views became accepted, but there were many failures and setbacks along the way. Some scientific breakthroughs were an instant success, e.g. RNA interference awarded a Nobel Prize in 200611, but most research is just very complicated, including medical research. A September Science article about medical interventions found a median interval of 24 years between first description and earliest highly cited article12.
Angiogenesis research has had an impact
The number of Pubmed citations is one good indicator for the research activity in a given field. Pubmed today lists 37482 publications about angiogenesis, including 19985 publications from the last five years. This compares favorably to research about telomerase (8040 publications), and microRNA (3541 publications), two areas of research mentioned in the discussions about potential 2008 winners. Impact can be also measured in other ways, but it is clear that the concept of angiogenesis has not only profoundly changed cancer research, but is also important in many other diseases, summarized in a 2005 Nature article13.
Angiogenesis reseach is medical research
As the name already suggests, the Nobel Prize for Physiology or Medicine is actually two prizes in one. It is a Nobel Prize in Biology, awarded for major achievements in our understanding of all aspects of biology. But is also a Nobel Prize in Medicine, where major advances in our understanding of human disease are awarded. The 2005 Nobel Prize to Barry Marshall and Robin Warren for the role of Helicobacter pylori in gastric disease14 is a good recent example of the latter category.
The research by Folkman and others has changed the way we think about cancer, but also the way we treat cancer. Each year, more than one million patients with colon, lung or breast cancer are treated with the anti-VEGF antibody bevacizumab. Other drugs targeting angiogenesis are either already in clinical use (e.g. sunitinib for renal cancer) or in development. This makes angiogenesis research a prime example for translational research. I very much agree with the views expressed in a set of articles in Nature this June15, that more has to be done to connect our much better understanding of fundamental biological processes to the way we diagnose, prevent and treat diseases. And a Nobel Prize would be a strong signal.
fn2. Nobel Redux
fn3. Nobels 2008
fn6. Nature 2008 doi:10.1038/451781a
fn7. PNAS 2008 doi:10.1073/pnas.0806582105
fn8. N Engl J Med 1971 Tumor angiogenesis: therapeutic implications
fn9. PNAS 1971 Mutation and Cancer: Statistical Study of Retinoblastoma
fn12. Science 2008 doi:10.1126/science.1160622
fn13. Nature 2005 doi:10.1038/nature04478
fn15. Nature 2008 doi:10.1038/453839a