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AACR report: Sustained federal commitment required to accelerate cancer research progress
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Extraordinary therapeutic advances, a renewed bipartisan commitment to medical research and the launch of the national cancer moonshot initiative have reinforced the importance of scientific investigation in the fight against cancer.
However, a coordinated effort to accelerate the pace of these advances must remain a priority, according to the AACR Cancer Progress Report 2016.
“Everything we know today about how to take care of people with cancer is built on decades of research. Today’s research is the foundation for tomorrow’s standard therapy,” Nancy E. Davidson, MD, president of the American Association for Cancer Research, wrote in the report. “Continued progress is going to require a sustained federal commitment to the research agenda.
“This is an amazing time scientifically for us; the momentum couldn’t be greater,” Davidson added. “We hope that, ultimately, this will translate into the crucial resources that are going to be required in order to make an even bigger difference against the complex diseases we call cancer.”
The number of cancer survivors in the United States has increased more than fivefold since 1971, reaching an estimated 15.5 million. Approximately 112,370 of these survivors are children or adolescents.
Meanwhile, the nation’s cancer death rate has fallen by 1.5% per year since 2003, largely due to better detection and the development of effective treatments.
Thirteen of the 40 novel drugs approved by the FDA’s Center for Drug Evaluation and Research between August 2015 and July of this year are intended for use in patients with cancer. During the same period, the agency approved 11 new indications for previously approved anticancer therapeutics.
AACR’s report detailed the rapid adoption of immunotherapies, including the approval of checkpoint inhibitors for the treatment of bladder cancer, head and neck cancer, Hodgkin lymphoma, kidney cancer, lung cancer and melanoma.
“The promise of immunotherapy for cancer therapy has never been greater, and the opportunity to make significant progress in this critical area is real,” Davidson said in a press release. “However, continued progress is going to require a sustained federal commitment to the research agenda. And, in fact, if the necessary funding is provided, we will accelerate the pace of progress and, in turn, markedly reduce morbidity and mortality from cancer.”
Despite considerable therapeutic advances, the statistics about the cancer burden in the United States remain sobering, according to Margaret Foti, PhD, MD (hc), CEO of AACR.
“Research has made tremendous advances against cancer,” Foti said in a press release. “However, we need to accelerate the pace of progress because it is unacceptable that one American will die of cancer every minute of every day this year.”
According to the report:
- More than 595,000 people in the United States are projected to die of cancer this year;
- Cancer is the number one cause of disease-related death among U.S. children;
- The number of new cases of cancer in the United States is predicted to increase from 1.7 million in 2015 to 2.4 million in 2035;
- Cancer health disparities are apparent in many population subgroups, including ethnic minorities, individuals with low socioeconomic status, the elderly, and those who live in certain geographic regions; and
- Direct medical costs of cancer care in the United States, estimated at nearly $125 billion in 2010, are projected to increase to $156 billion by 2020.
The report highlighted the need for more research geared toward best practices to help Americans reduce the risk for cancer — particularly with regard to tobacco use, obesity, lack of physical activity, exposure to ultraviolet light from the sun or tanning devices, and failure to use or comply with interventions that treat or prevent infection with cancer-related pathogens.
Adherence to screenings that can identify precancers or early-stage malignancies also remain an essential component of health care.
“As we develop and implement new strategies that pair increased molecular understanding of cancer development with knowledge of an individual’s unique cancer risk profile, we will move closer to a new era of precision cancer prevention and early detection,” the report’s authors wrote.
In its report, AACR also emphasized the importance of federal funding for the NIH, NCI and FDA. The report’s authors urged Congress and the president’s administration to:
- Support the Senate Appropriations Labor, Health and Human Services, Education, and Related Agencies Subcommittee’s fiscal year 2017 bill, which proposes a $2 billion increase for the NIH in fiscal 2017;
- Finalize a Senate version of the House-passed 21st Century Cures Act, which includes funding for the NIH to support the cancer moonshot initiative — intended to double the rate of progress toward a cure for cancer — and other strategic research initiatives;
- Support an FDA budget of $2.85 billion in 2017 — which would be $120 million above its 2016 level — to ensure support for regulatory science and the timely approval of safe, effective therapeutics; and
- Readjust the discretionary budget caps for fiscal 2018 and beyond to allow the policymakers to “continue to provide robust, sustained and predictable funding increases” for the NIH, NCI and FDA.
The report called for a continued increase in the understanding of the biology of cancer and the development of new approaches to translate this knowledge into health care advances. This call to action will require robust, sustainable and predictable federal funding for research and support for the cancer moonshot.
“The AACR is heartened by the renewed, bipartisan commitment from Congress and the administration to prioritize cancer research and by the research direction provided by the proposals from the NCI blue ribbon panelists,” Foti said. “We are committed to working to ensure that the momentum gained from these actions is translated into lifesaving advances for cancer patients everywhere.” – by Kristie L. Kahl
Reference:
American Association for Cancer Research. AACR Cancer Progress Report 2016. Clin Cancer Res. 2016;22:SI-S137.
Perspective
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Roy S. Herbst, MD, PhD
This report is important because it raises awareness about discoveries of new therapies for cancer. It also defines the problems, as well as the progress being made. This year, in particular, there has been exceptional progress in finding new drugs and therapies. Hopefully this will serve to promote government funding to the NCI, the national cancer moonshot initiative and future collaborations. This report serves as a vehicle for bringing groups together to fight cancer, which will kill almost 600,000 individuals this year in the United States.
The American Association for Cancer Research is an exceptional organization because the group goes from the lab to the clinic and back again. With all of the new immunotherapies and targeted therapies, we need to figure out a way to get more indications that will benefit more people, and the way to do that is a more personalized approach. The AACR helps bring together teams of researchers to address important clinical questions. The clinic has become our lab, and we have to run clinical trials and analyze samples. The AACR is really promoting the translational aspects and bringing these therapies to the clinic. The AACR emphasizes the importance of not only the quality of life for these patients, but also the economic impact they bear. This report lets people know this really is a personal disease, and we need to find ways to make these drugs affordable and to fund further research. The awareness across all of the spectrums is very important.
The next step is going to be how to integrate all of these therapies together, and to use chemotherapy, targeted therapy and immunotherapy in combination, because it is clear that — as good as all of these drugs are — there are still people who do not benefit. Then, of course, we need to think about prevention — for example, primary prevention with tobacco and other toxins, as well as helping people who are at increased genetic risk to prevent cancer from ever developing. All of these new therapies, developing science and pathways have an even greater impact on the burden of this disease in this country.
This report truly helps the public. The thing that amazes me about these reports is that I, as a physician, read it with great interest. However, a relative of mine would read it, relate to it and find interest in it, as well. It has something to offer to everyone. These reports, given the relevance of cancer, are describing the societal impact of cancer — the cost and the need for resources, and the science that appeals to such a wide spectrum of people. This increases awareness and offers people a vehicle to help make the case for more funding, research and collaboration. This AACR report gets better every year. It gets more concise and more targeted. The main reason it gets better is because research has improved at an exponential pace.
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