A group of leaders in the basic and clinical sciences met in San Antonio to consider specific objectives and goals for the coming decades. In addressing the group, I pointed out that such a plan was fundamentally flawed because discoveries are commonly serendipitous. The best plan over many decades has been no plan. For lack of essential knowledge, timetables for assaults on particular disease targets have little meaning. Nor could we have anticipated the confrontations with novel diseases, such as AIDS, Legionnaire's Disease, septic shock and drug-resistant tuberculosis.
Medical research is still more a game of pool than billiards.
You score points regardless of which pocket the ball goes into. Varmus' studies on breast cancer led to the discovery of cellular oncogenes, honored by a Nobel Prize he shared with J. Michael Bishop in 1989. Actually, Varmus' studies yielded no insights into human breast cancer, but they did provide an important advance in understanding brain development. At the same time, a research program headed by Robert Weinberg at MIT, directed toward a rat brain tumor, did make a major contribution to understanding human breast cancer. Of the several genes now known to be involved in human breast cancer, all but one were discovered by researchers working on something other than breast cancer.