Incremental advance or seismic shift? The need to raise the bar of efficacy for drug approval.Sobrero A, Bruzzi P. J Clin Oncol. 2009 Dec 10;27(35):5868-73. Epub 2009 Oct 13. Targeted agents have improved outcomes in many common solid tumors and are available for clinical practice in most countries. There are many more drugs in the developmental pipeline that have the potential to improve the treatment of some of the most deadly cancers. It is estimated that there are more than 350 antineoplastic agents in clinical development for cancer indications.1 This number is likely to increase in the future since the most important breakthroughs will most likely come from the development of targeted agents rather than from new cytotoxic chemotherapy.