Clinical Cancer Advances 2009: Major Research Advances in Cancer Treatment, Prevention, and Screening—A Report From the American Society of Clinical Oncology

Abstract

A MESSAGE FROM ASCO'S PRESIDENT As this report demonstrates—and as history shows—investment in clinical cancer research pays off. Since 1990, cancer mortality rates have declined by 15%. Today, two thirds of patients survive at least 5 years after diagnosis, compared with just half of patients 40 years ago. Patient quality of life has improved dramatically. In addition, thanks to basic research advances, we are entering an era of personalized cancer medicine, in which treatment is tailored to the unique genetics of the individual. Clinical cancer research is finally receiving an urgently needed boost in investment. For the first time in 5 years, federal funding for research has increased. The economic stimulus package infused billions into short-term biomedical research projects, and President Obama has pledged to invest in “a cure for cancer in our time.” However, despite this progress, cancer remains the number-two killer of Americans. Incidence is projected to nearly double by 2020 as the population grows and ages. Scientifically, cancer is highly complex; it is not one disease, but many, and is increasingly defined by thousands of genetic variations, epigenetic changes, post-transcriptional modifications, and combinations of these mechanisms, rather than by site of origin. Unraveling these complexities begins to explain why some cancers are especially resistant to treatment, a fact we have known for some time. Other cancers are fatal because they are typically diagnosed late in the course of disease, when treatment is less effective. To achieve new breakthroughs, the scale of the national response must match the scale of the problem. Years of flat federal research funding have resulted in abandoned or stalled clinical research projects, a deteriorating research infrastructure, and the loss of talented physicians to other fields. In this report, the American Society of Clinical Oncology (ASCO) commends the recent increases in funding and calls on Congress to make a multiyear commitment to sustained increases in clinical cancer research at the National Institutes of Health and National Cancer Institute. Major advances in cancer treatment cannot be expected to emerge without consistent and predictable investment at the federal level. Although a robust clinical research enterprise is essential to improving patient care, advances mean little if they do not reach people in need. For people with cancer, lack of health insurance can be the difference between life and death. It is estimated that 32% of patients with cancer in the United States are uninsured at some point during their treatment, and more than a quarter opt not to seek treatment as a result. We must end the inequality in health care access. ASCO believes that health care reform must ensure that everyone diagnosed with cancer has the coverage necessary to receive high-quality treatment. To that end, we have made access to cancer care a top priority in our advocacy agenda. I believe the advances described in this report should give all of us cause for hope. Although there is a long road ahead, by investing in a robust national clinical research program and by improving access to high-quality care, we can give every patient the best chance of survival. Douglas Blayney, MD President American Society of Clinical Oncology