Forecasting Advances Against Cancer in 2017
Cancer experts discuss the potential breakthroughs in cancer prevention, disparities, precision medicine, and immunotherapy in the coming year.
What progress against cancer can we expect to see in 2017?
Three prominent American Association for Cancer Research (AACR) members and leaders in the field of cancer research and treatment – immunotherapy expert Elizabeth Jaffee, MD, precision medicine expert George Demetri, MD, and cancer prevention and disparities expert Electra Paskett, PhD – recently shared their insights and expectations for what the year will bring.
“The good news in the field of immunotherapy is that we are learning a lot more about the signals that tumors send to inhibit an effective immune response against them,” said Dr. Jaffee, who is a past board member of the AACR.
Dr. Jaffee said that this year we might see U.S. Food and Drug Administration approvals of checkpoint inhibitors – a type of immunotherapy that releases the brakes on the immune system to destroy tumor cells – for more cancer types and as first-line treatment for some cancers.
Checkpoint inhibitor immunotherapeutics are currently approved to treat melanoma, lung cancer, bladder cancer, kidney cancer, Hodgkin lymphoma, and head and neck cancer.
And she said we might also see progress with finding new ways to lower the toxic side effects from immunotherapeutics, the development of new drugs that target additional immune checkpoints, clinical trials of combinations of immunotherapies and other treatment types such as radiotherapy and targeted therapies, and the development of some personalized cancer treatments with vaccines.
“Cancer diagnostics are going to get better and better,” Dr. Demetri said. And he predicted that we may be on the verge of putting together a composite set of predictive and prognostic biomarkers.
Dr. Demetri also predicted that in 2017 we will gain further understanding into the smaller, molecularly defined subsets of cancer; develop even better, more precisely targeted therapies; and launch more clinical studies testing combinations of epigenetic therapies with targeted therapies and immunotherapies.
Progress with breaking the barriers of genomic data sharing will come from continued advocacy from the patients rather than the professionals, Dr. Demetri said. “It is vital to leverage our interactions with patients and patient advocates who want the same things that we do to push the kind of data sharing that will advance the field.”
One such effort, AACR Project Genomics Evidence Neoplasia Information Exchange (GENIE), recently announced the public release of a large data set of nearly 19,000 de-identified genomic records collected from patients who were treated at eight international institutions. The GENIE data set includes genomic details and a limited amount of linked clinical data on 59 major cancer types, including data on nearly 3,000 patients with lung cancer, more than 2,000 patients with breast cancer, and more than 2,000 patients with colorectal cancer.
“We know a lot about how to lower one’s risk for certain cancers, but the challenge is with getting people to adhere to cancer prevention behaviors at the level that they should,” said Dr. Paskett. An example of the major challenges we face with cancer prevention is the suboptimal uptake of HPV vaccines, she noted.
Cancer health disparities are influenced by where we live a lot more than most people think, Dr. Paskett noted, adding that location affects factors such as the availability of fresh produce and ability to stay physically active, which impact cancer risk.
While we may not be able to solve the problem of poverty, we can make sure that people in poverty have access to good treatments and early detection, she stressed. “A good health care system is one that can offer state-of-the-art treatment for everyone.”
We need more research on understanding the differences in the fundamental biology of cancers in order to address the issues with disparities better, but to do that, we first need enough tumor samples that are diverse, Paskett noted.