AACR report: Cancer deaths decline 2.3% amid treatment advances, but disparities persist
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Key takeaways:
- Cancer mortality declined 2.3% between 2016 and 2019.
- The number of cancer survivors has reached record numbers, with more than 18 million Americans living with a history of cancer as of January.
- The report emphasized the ongoing need to narrow cancer disparities, increase access amid global crises and increase funding to the NIH and the NCI.
In its 12th annual Cancer Progress Report, American Association for Cancer Research outlined substantial strides against cancer, including a 2.3% decrease in cancer deaths between 2016 and 2019.
Major advances and innovations in cancer treatment have also led to an unprecedented number of Americans living longer and fuller lives after diagnosis, according to the report.
“As of this year, more than 18 million cancer survivors are living in the United States who quite likely would not be alive had there not been very significant advances in biomedicine,” AACR President Lisa M. Coussens, PhD, FAACR, Hildegard Lamfrom endowed chair in basic science, chair in the department of cell, developmental and cancer biology, and associate director for basic research at Oregon Health & Science University School of Medicine, said in an interview with Healio. “That is a direct result of federal investment in basic science and applied cancer science.”
The introduction of eight new anticancer drugs, breakthroughs in molecularly targeted therapeutics and immunotherapies, and a reinvigoration of the cancer moonshot are among the many other advanced described in the 174-page report.
‘Revolution of targeted therapies’
The reduction in cancer mortality is, in part, due to advances in treating the four most common cancer types in the United States: lung, colorectal, breast and prostate cancer. Over the past 3 decades, the adjusted mortality rates have decreased by 44% for lung cancer, 42% for female breast cancer and 53% for colorectal cancer.
“There has been a steady decline in the overall cancer death rate in the past 3 decades,” Coussens told Healio. “From 1991 to 2019, this accounts for 3.5 million cancer deaths that were avoided.”
Moreover, significant inroads have been made in research against previously recalcitrant cancers such as melanoma. A range of new therapeutics have been developed against melanoma and have progressed rapidly through the regulatory process to attain FDA approval.
Between Aug. 1, 2021, and July 31, 2022, the FDA approved eight new anticancer drugs, as well as two imaging agents, several artificial intelligence-based tools to improve cancer detection and diagnosis, and new uses for 10 existing anticancer treatments.
The new anticancer agents approved during that period include:
- tebentafusp-tebn (Kimmtrak, Immunocore), the first T-cell receptor therapeutic to receive regulatory approval for treatment of uveal melanoma, the most common form of ocular cancer in adults;
- belzutifan (Welireg, Merck), the first FDA-approved molecularly targeted drug against hypoxia-inducible factor-2 alpha for patients with solid tumors linked to von Hippel-Lindau syndrome, a rare inherited genetic disorder; and
- relatlimab-rmbw (Opdualag, Bristol Myers Squibb), the first new immune checkpoint inhibitor against a novel target in 8 years, for treatment of unresectable or metastatic melanoma.
Also in 2022, FDA approved the radioactive diagnostic agent gallium Ga 68 gozetotide (Locametz, Novartis) and the radiotherapeutic agent lutetium Lu 177 vipivotide tetraxetan (Pluvicto, Novartis) to detect and destroy metastatic prostate cancer cells.
In molecularly targeted therapy, 2022 ushered in the first approval of a combination of two molecularly targeted therapeutics, dabrafenib (Taflinar, Novartis) and trametinib (Mekinist, Novartis), to treat certain patients with BRAF V600E-mutated unresectable or metastatic solid tumors.
“Understanding the molecular aspects of cancer has certainly led to a revolution of targeted therapies that have impacted individuals with cancer,” Coussens said. “When we put that together with the awareness that we can target the immune system to enhance the ability of certain types of immune cells to kill cancer cells in the form of immune therapeutics, that completely changes the game.”
Other key developments include the approval of asciminib (Scemblix, Novartis), a new BCR-ABL-targeted therapeutic with a novel mechanism of action, for treatment-resistant chronic myelogenous leukemia and tisotumab vedotin-tftv (Tivdak; Genmab, Seagen), the first antibody-drug conjugate approved for women with cervical cancer.
Challenges ahead
The report highlighted numerous challenges and obstacles to continued progress against cancer, noting that an estimated 600,000 lives will be lost to the disease in 2022.
Disparities in cancer care and research remain a major public health issue, with racial and ethnic minorities, as well as other underserved U.S. populations, incurring a disproportionately higher cancer burden. Although progress has been made in identifying and mitigating these disparities, Coussens said additional research and policy solutions are needed.
“Not all segments of our society benefit equally from advances in scientific discoveries and clinical breakthroughs,” Coussens said. “We still have issues of access for ethnic and racial minorities, individuals living rural or other medically undeserved populations, and individuals who belong to sexual minorities. These individuals continue to shoulder a disproportionate burden of cancer in our society, and we need to be able to address that.”
Restriction of reproductive rights following the U.S. Supreme Court decision on Dobbs v. Jackson Women’s Health Organization and the ensuing legislation in many states could hinder access to quality health care and may make it more difficult for patients with cancer to access necessary care, according to the report. Disruption or delay in cancer treatment due to concerns over terminating a pregnancy could cause cancer progression.
Moreover, global crises such as the COVID-19 pandemic and ongoing wars have affected all aspects of cancer research and patient care. Given these crises and an aging global population, researchers warned that the worldwide burden of cancer may increase in the coming decades.
“Public health challenges remain a significant issue for all preventable diseases, but certainly for preventable causes of cancer,” Coussens said. “The rising prevalence of obesity in our society, and the fact that young people are being lured into smoking e-cigarettes when we don’t know their long-term consequences, pose significant risk factors that present public health challenges for these preventable issues.”
To address these challenges and facilitate sustained progress against cancer for all patients, the AACR Cancer Progress report outlined policy recommendations, calling on Congress to:
- continue support of funding growth to NIH and NCI budgets with increases of at least $4.1 billion to NIH and $853 million to NCI’s base budgets for fiscal year 2023;
- fully fund initiatives outlines in the 21st Century Cures Act, including the National Cancer Moonshot;
- reauthorize the comprehensive Childhood Cancer Survivorship, Treatment, Access and Research Act, as well as at least $30 million for its implementation;
- invest in essential cancer-related projects at CDC and FDA; and
- structure tax policies to promote philanthropy so that nonprofit cancer research organizations can fund high-risk, high-reward research proposals, leading to the discovery of new treatments and cures.
Continued federal investment in developing a robust therapeutic pipeline will be essential to ongoing progress against all forms of cancer, Coussens said.
“There is an absolute need to continue federal investments in basic science,” she said. “We need to feed the pipeline, and just investing in late-stage drug development doesn’t help us for the future. We have to continue basic science investments.”
For more information:
Lisa Coussens, PhD, FAACR, can be reached at American Association for Cancer Research, 615 Chestnut St., 17th Floor, Philadelphia, PA 19106-4404; email: coussenl@ohsu.edu.
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