AACR Cancer Progress Report highlights research breakthroughs, aims for increased funding
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American Association for Cancer Research unveiled its annual cancer progress report today, outlining advancements in the past year and highlighting breakthroughs in research since the signing of the National Cancer Act 50 years ago.
The report included policy recommendations to ensure the U.S. remains steadfast in its ongoing fight against cancer, addressing, among other issues, the effect of the COVID-19 pandemic on research and screening, as well as cancer health disparities affecting underserved populations.
“The AACR Cancer Progress Report is unique in that it details the remarkable progress made in the past year and provides a clear-eyed assessment of where improvements are needed to help markedly reduce the cancer burden,” David A. Tuveson, MD, PhD, FAACR, president of the American Association for Cancer Research (AACR), said in an association-issued press release. “As progress continues, I look forward to a world where people can live beyond their cancer. Indeed, our prospects for making substantial advances for cancer patients through research have never been greater than they are today.”
AACR shed light on the giant leaps forward in research and survivorship since President Richard Nixon signed the National Cancer Act on Dec. 23, 1971. The legislation led to groundbreaking research to combat cancer both in the U.S. and worldwide. Meanwhile, the number of cancer survivors in the U.S. has risen from 3 million in 1971 to 16.9 million in 2019.
Included in their observations:
- The overall age-adjusted cancer death rate dropped 31% from 1991 to 2018 within the United States, a reduction that translates into 3.2 million lives saved and includes a record single-year decline of 2.4% between 2017 and 2018.
- Lung cancer-related deaths decreased by 41% from 1991 to 2018, driven in part by efforts to reduce smoking rates among Americans.
- Discoveries within the last 50 years led to molecularly targeted therapeutics and immunotherapeutics that have substantially increased 5-year survival rates for patients with formerly intractable cancers, such as lung cancer and metastatic melanoma.
“The National Cancer Act marked a paradigm shift in the way that researchers understand, detect, diagnose and treat cancer,” Margaret Foti, PhD, MD (hc), CEO of AACR, said during a virtual briefing shortly after the report was released. “It has helped shape the current landscape of cancer science and medicine by creating the NCI’s cancer center program. The research at these state-of the-art research centers has accelerated innovation and advances that have led to novel diagnostics and early detection, cancer prevention and interception, and more effective treatments, many of which are highlighted in this report.”
The advancements in the last half century, Tuveson said, have resulted in everyone’s primary goal: saving lives of those fighting cancer.
“These advances are driving down overall U.S. cancer incidences and death rates and increasing the number of individuals who are surviving longer after cancer diagnosis,” Tuveson said. “In fact, as of January 2019, the number of cancer survivors living in the U.S. reached a record high of nearly 17 million people.”
Norman E. Sharpless, MD, director of the NCI, called the National Cancer Act a “watershed moment” in the battle against cancer and said the best way to commemorate the anniversary of the legislation is to continue with the original intention of uniting as a community to strive toward “ending cancer as we know it.” He urged the medical community to continue on the path in research and acquiring funding.
When the National Care Act was signed 50 years ago, “we didn’t know what we didn’t know back then,” Sharpless said in a panel discussion after the report was unveiled. “But now we know what we don’t know. We know where these therapeutic challenges remain and where these prevention in diagnosis in challenges remain. There are still significant, important challenges that really can only be solved through basic science investigation and translational investigation and by what we call investigator-initiated research.”
The AACR report also identified roadblocks in progress brought about by the COVID-19 pandemic. It noted that patients with cancer were on average twice as likely to die of COVID-19 infection, that patients recently diagnosed with cancer had a seven times higher risk for COVID-19 infection, and that Black women with a recent breast cancer diagnosis had more than five times higher risk for developing COVID-19 then white patients.
The report showed continued disparities in cancer incidence and mortality, with incidence of multiple myeloma more than twice as high among Black people vs. non-Hispanic white people. Researchers also found American Indian/Alaskan Native individuals living in Alaska are four times more likely to develop stomach cancer than white people and, from 2012-2016, early-onset colorectal cancer incidence increased 35% for those living in rural areas compared with less than 20% among those in urban areas.
“Moving forward, we have to make sure everyone benefits from the groundbreaking progress that we make against cancer. No one is immune from cancer; it can strike anyone of any age, gender, race or ethnicity or socioeconomic status,” Tuveson said. “Sadly, we know the advancements highlighted in this report have not been accessible to or beneficial for everyone equally. The stark reality is that certain segments of the population, including racial and ethnic minorities and other underserved populations, continue to shoulder a disproportionate burden of cancer.
“For many of the same reasons, these populations have also been disproportionally impacted by COVID-19. This is unacceptable. And it is imperative that all stakeholders in the medical community work together to better understand and address health disparities.”
With those challenges in mind, AACR made the following policy recommendations to Congress:
- to prioritize robust, sustained and predictable growth for the NIH and NCI by providing increases in their fiscal year 2022 base budgets of at least $3.2 billion (NIH) and $1.1 billion (NCI);
- to provide at least $10 billion for the NIH in emergency supplemental funding to restart research and clinical trials that have been put on hold due to the pandemic; and
- to support the creation of an Advanced Research Projects Agency for Health (ARPA-H), designed to prioritize high-risk, high-reward approaches to prevent, diagnose and cure diseases such as cancer.
Foti noted that funding for the NIH has increased in each of the last 6 years, from around $30 billion in 2015 to just under $45 billion in 2021, and that steady, significant annual funding has directly led to regular advancements in cancer research.
Within the progress report were stark reminders that cancer continues to be the leading cause of death in the U.S. In 2021 alone, the AACR projected nearly 1.9 million new cases and more than 600,000 deaths due to cancer.
But even as the pandemic continued to have an impact on both cancer diagnoses and research, AACR reported several areas of progress within the last year (the report covered Aug. 1, 2020 to July 31, 2021). Among the highlights that helped improve, extended, or saved lives:
- The United States Preventive Service Task Force updated guidelines for lung and colorectal cancer screening, lowering the age of screening initiation for both cancers. The changes may lead to increased early detection, which could improve treatment outcomes.
- The FDA approved numerous anticancer therapeutics (16 new and 11 previously approved that now also are approved for treating new cancers), three new diagnostic imaging agents, and other technologies to benefit patients (including two new surgery-guiding devices, two multipanel next-generation sequencing liquid biopsy companion diagnostic tests, and an artificial intelligence-driven endoscopy device.
- Recent breakthroughs in precision medicine such as sotorasib (Lumakras, Amgen), the first FDA-approved therapeutic to successfully target the previously “undruggable” KRAS; the first approval of an antibody-drug conjugate, fam-trastuzumab deruxtecan-nxki (Enhertu; Daiichi-Sankyo, AstraZeneca), for treating patients with HER2-positive gastric cancer; and relugolix (Orgovyx; Myovant Sciences, Pfizer), the first oral hormone therapy approved for treating patients with advanced prostate cancer.
- Advancements in immunotherapy that led to FDA approvals of idecabtagene vicleucel (Abecma; Bristol Myers Squibb, bluebird bio), the first approved CAR T-cell therapy for treatment of patients with multiple myeloma; dostarlimab-gxly (Jemperli, GlaxoSmithKline), a new checkpoint inhibitor to treat patients with endometrial cancer who have certain biomarkers in their tumors; and the checkpoint inhibitor nivolumab (Opdivo, Bristol Myers Squibb) in combination with ipilimumab (Yervoy, Bristol Myers Squibb) for treating patients with mesothelioma—the first new front-line treatment for this disease in 16 years.
Sharpless said that current research has been so constant and practice-changing that he refers to it as the “Golden Age of Research.”
“Cancer mortality has been declining since the 1990s but that rate has really accelerated in the last few years,” he said during the AACR virtual briefing. “We’ve also seen a boom in the FDA approvals for cancer drugs and devices in recent years, and we have exciting new technologies that have created new opportunities across the spectrum, from prevention, to diagnosis, to treatment, to survivorship.”“And on top of that,” he continued, “we have this very strong bipartisan support for cancer research from Congress and a new administration that is so committed to making progress for cancer. … I really believe and know we are up to the challenges that await. Let us all harness the promise of this Golden Age of cancer research to end cancer as we know it for all patients with cancer — to help these individuals live long and healthy lives.”
References:
AACR Cancer Progress Report highlights how discovery science is driving clinical breakthroughs. https://www.aacr.org/about-the-aacr/newsroom/news-releases/aacr-cancer-progress-report-highlights-how-discovery-science-is-driving-clinical-breakthroughs/. Published Oct. 13, 2021. Accessed Oct. 13, 2021.
AACR Cancer Progress Report: Discovery science driving clinical breakthroughs. Available at: https://cancerprogressreport.aacr.org/progress/. Accessed Oct. 13, 2021.
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