On December 3, 1998, the Society for Medicines Research held a meeting entitled Trends in Medicinal Chemistry at the National Heart and Lung Institute, London. The meeting was conceived to alert researchers to compounds in early development or new discoveries likely to lead to new approaches to disease treatment in the near future. Presentations covered potential therapies for CNS disorders, through immune disease and cancer to cardiovascular diseases. Specific new discoveries described at the meeting included the antipsychotic agent ORG-23366; the anticonvulsants SB-204269, SB-258229 and SB-270664; the tyrosine kinase inhibitors CT-5269 and CT-4694; VEGF inhibitors from Zeneca; the elastase inhibitor GW-311616A; a serine protease inhibitor from Roche; the MMPI D-2163; two antimigraine follow-ons to rizatriptan, L-775606 and L-785103; the P(2T) inhibitor AR-C69931MX and a follow-on compound; and the PDE5 inhibitor sildenafil.