The American Society of Clinical Oncology's Blueprint for Transforming Clinical and Translational Cancer Research

Abstract

In November 2011, the American Society of Clinical Oncology (ASCO) released a report that articulates the society’s vision for a clinical and translational cancer research system. The report, Accelerating Progress Against Cancer: ASCO’s Blueprint for Transforming Clinical and Translational Cancer Research, describes how we can improve our research system by taking full advantage of today’s scientific and technological opportunities. Using a 5to 10-year horizon, the report describes how bold action today can result in transformative advances in cancer prevention and treatment. As the executive editors of the blueprint, we wish to inform the readership of Journal of Clinical Oncology and the membership of ASCO of the motivation for this publication, its content, and the commitment that ASCO is making to ensure the success of its vision for the future. Rapid advances in the understanding of cancer biology coincident with technological progress are leading to identification of new targets for prevention and treatment. In addition, improvements in drug development enable us to cultivate new agents that directly affect these molecular targets. Similarly, we are experiencing a revolution in the ability to manage and rapidly analyze large quantities of data, both scientific and clinical. It is now evident that individualization of cancer care, on the basis of detailed molecular characterizations of patients and tumors, is within reach, but the models, processes, and structures that support therapeutic development are not keeping pace with these innovations. The blueprint describes ASCO’s vision for how cancer prevention, diagnosis, and treatment can be transformed in the shortterm and represents a call to action for its membership and colleagues in patient and professional organizations, government agencies, academia, and industry to work together to overcome current impediments to leveraging the science and technologies that exist today. Publication of the blueprint coincides with the 40th anniversary of the National Cancer Act. This landmark represents an optimal time to reflect on the tremendous work that has been done in the last forty years—and to galvanize our energies to further hasten advancement and prepare for future challenges. As we pause to celebrate progress, it is fitting to take stock of our current state and to imagine the possibilities ahead. ASCO recognizes that research progress requires strong public support. Because of the need to collaborate with people and organizations outside the ASCO membership and in extended clinical and scientific communities, ASCO crafted this report for a broader audience. The report aims to inform and inspire policy makers, patient advocates, and the media. In doing so, we hope to strengthen the partnerships necessary to achieve our vision. The report is freely accessible on ASCO’s website, and the society has released information on Cancer.Net (ASCO’s resource for people living with cancer and those who care for them). The blueprint focuses on three areas that are critical for moving our research agenda forward. First, we have a detailed understanding of many of the molecular processes that characterize cancers, yet we often do not understand which processes drive tumors and how best to measure the impact of pharmacologic perturbation of these processes. Moving forward, we need to prioritize targets for therapeutic development, identify and validate biomarkers early in drug development, and overcome legal, financial, and regulatory barriers in the pursuit of the most promising clinical applications. A second topic addressed in the blueprint is the design and conduct of clinical trials. In recognition that we are entering an era when more cancers are molecularly defined as representing “rare” cancers, the design and conduct of clinical trials requires an overhaul. Small incremental gains may no longer be adequate, and new surrogate end points that accurately predict clinical impact must be aggressively identified. As clinical trials seek to enroll patients with tumors that have specific and sometimes uncommon molecular characteristics, it is essential that clinical trials be widely available to all patients with cancer, and tissue availability for research and treatment assignment is a matter of course. Seamless mechanisms for screening patients and tumors for clinical trial participation must be implemented. Biomarkers and diagnostic assays must be codeveloped with new treatments, and financial and regulatory barriers to doing so need to be overcome. Third, the blueprint announces that the era of health information technology has arrived. ASCO recognizes the importance of harnessing technology to seamlessly integrate clinical research and patient JOURNAL OF CLINICAL ONCOLOGY E D I T O R I A L S