Presidential address at the European Society for Medical Oncology,Nice, 30 November 1986

Summary Medical oncology is now accepted in Europe as a branch both of internal medicine and of clinical oncology. In this article the present situation of this discipline is analysed with reference to the plateau in the results achieved in chemosensitive tumours and to the small effect of chemotherapy in tumours considered to be big killer. Although new avenues in tumour biology do not necessarily mean therapeutic success in the near future, at present basic discoveries are being developed for clinical therapy faster than before. Besides biological response modifiers, the development of new drugs should receive constant attention from medical oncologists. This attitude has persisted despite an awareness that the political community has had little interest in the allocation of funds for the development of new anticancer agents. Clinical trials have recently been subjected to some criticism. But unless large multicentre trials are continued with better quality control and organization it will not be possible to provide adequate resources for the many and various new drugs and biological response modifiers expected to enter the field in the next few years. The active involvement of medical oncologists in controlled clinical trials should then continue. Finally, the task and achievements of the scientific society, which allows close contacts among European medical oncologists, are briefly underlined.