A Medical Magic Bullet

A Nobel Prize Winner’s 100-Year Wait

Killing Cancer Cells With Precision Accuracy

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On March 14, 1854, in the Prussian province of Silesia, in what is now Poland, an infant boy was born to the Ehrlich family – prosperous innkeepers who also distilled fine liquors. They named the baby Paul.

From his early childhood, Paul Ehrlich had a fascination with colors. When he was a schoolboy, this fascination led to a deep interest in staining skin-tissue samples on microscope slides. He retained the passion into medical school, where he developed an expertise in color chemistry, dyes, and histology – the microscopic anatomy of biological tissues. Ehrlich became known for walking the halls in signature lab coats splattered with vivid, dye-stained hues.

Over time, Dr. Ehrlich’s work staining biological tissues led him to a foundational insight: different dyes could bind selectively to different cell types. But if different dyes could selectively bind to different cells… could medicines be designed to identify and selectively bind to different cell types, too?

In 1906, Ehrlich elaborated on this idea in a research paper, since celebrated as one of the most important and influential in the history of medicine. In this paper, “On the Present State of Chemotherapy,” Ehrlich proposed the possibility of a “magic bullet” – a precision medicine that could seek out and destroy targeted diseased cells, such as cancer cells, without harming healthy tissue. The magic bullet would be a vast improvement over the current practice of chemotherapy, which kills cells indiscriminately, cancer cells and healthy cells alike… leaving patients to cope with devastating side effects.

A few years later, Dr. Ehrlich turned his magic bullet theory into reality when – working with his collaborator, Japanese bacteriologist Sahachiro Hata – he discovered a medicine that came to be named Salvarsan. Salvarsan functioned as a miracle-like cure for syphilis, ridding patients of the bacteria that caused this dread disease without resulting in harmful side effects. Ehrlich and Hata’s discovery was a quantum improvement on the mercury and salts that had been the prior standard of care for syphilis patients. For many years, Salvarsan was the most widely prescribed drug in the world. 

Paul Ehrlich’s work earned him the Nobel Prize for Physiology or Medicine in 1908, and he is remembered today as a giant in the field.

But interestingly, it would take medicine almost 100 years to translate Dr. Ehrlich’s seminal idea of a “magic bullet” for cancer into reality. Magic bullets exist today, and they go by the name of antibody-drug conjugates (“ADC”). The U.S. Food and Drug Administration (“FDA”) approved the very first ADC, Mylotarg, in 2000. In the two decades since then, and especially in the past few years, ADCs have emerged as one of the hottest areas of cancer medicine… and of biotech deal making.