75 years ago the 1st edition of the British Journal Cancer was published, in 1947. It is suggested that 95% of what we have learned about cancer biology has been accrued in the last 5 years, spearheaded by basic science methodology and discovery, translational clinical research, discovery of new therapeutic drugs and their clinical application. As a result, over 50% of cancer patients are now cured and survival rates for common cancers continue to improve. Of course, this exponential success is built upon many previous decades’ work and in this Special Anniversary Edition I highlight some of the most highly cited articles from the BJC over that time. Where possible, previous authors have been asked to provide an overview of their work, in others leading experts give an overview of the field and important key lessons and ideas.

There are 22 articles or commentaries on these papers, which cover many areas, including early cancer cytogenetics, at a time when DNA structure and chromosome numbers were unknown. Work on multistep carcinogenesis, tumour hypoxia and vascular proliferation was described 54-68 years ago. Immunotherapy is probably the most significant therapeutic advance in the last 5 years, yet the evidence supporting the immune response to cancer was established 54 years ago. The discovery of PDL1 and the development of PDL1 blockade therapy is an outcome of this. Many of these papers show the extensive lag from discovery to effective therapy, a process that has been greatly improved.

Sometimes, something we all see but do not recognise, creates a new field of research, as in the ‘apoptosis’ paper in 1972. New methods for analysing clinical outcome were developed in the 70’s and the importance of now following these trials in the long term is emphasised, often a problem in both commercial and charity-funded trials.

Tumours for which initially modest chemotherapy effects were noted, in major randomised trials, showed worthwhile activity and became a backbone to encourage further trials, over 25 years ago. Alongside this, better quality and internationally agreed criteria for trial and biomarker analysis, enabled better comparisons and interpretations of these trials. The conduct of more complex innovative therapy trials will help speed up drug development.

A major effort to develop an early diagnosis, prognostic markers and tumour stage non-invasively has used many new technologies e.g., miRNA, breath analysis and exosomes dating back 15 years for the earliest. But potentially effective strategies that do not involve these methods relate to the organisation of health care pathways.

The fundamental biology of tumour heterogeneity and tumour infiltrating lymphocytes continue to be critical for the development of new therapies targeting drug resistance. Novel therapies often face difficult pharmacology barriers, despite the sound science behind them, but sometimes the science is not critical enough, as in miRNA therapy.

Although our understanding of cancer biology and molecular mechanisms is increasing rapidly, many simple observations remain unexplained e.g., late relapse in breast cancer, dormancy and patterns of recurrence.

Finally, an unexpected disease, such as Covid, can rapidly have a major impact on diagnosis and treatment, hence outcomes. Much can be learned by analysis of how this epidemic was handled to reduce its impact in the future.

In conclusion, our present success is built on 75 years of progress, in areas in which we continue to publish:

  • Clinical studies

  • Translational therapeutics

  • Molecular diagnostics

  • Genetics and genomics

  • Cellular and molecular biology

  • Epidemiology