AACR Highlights Advances and Challenges in Cancer Research in Newest Progress Report

Author(s):

The American Association for Cancer Research has published their annual Cancer Progress Report outlining recent advances in cancer research, remaining challenges in cancer care, and requests for the federal government to continue—and ideally increase—its investment in oncology.

Philip D. Greenberg, MD

The American Association for Cancer Research (AACR) has published their annual Cancer Progress Report outlining recent advances in cancer research, remaining challenges in cancer care, and requests for the federal government to continue—and ideally increase—its investment in oncology.¹

“This 13th edition of the Cancer Progress Report continues a long tradition of trying to raise awareness of the advances that we're making in cancer research [by] delivering [information] to patients and [detailing] how that [research] is helping save the lives of people with cancer,” Philip D. Greenberg, MD, AACR president and the chair of the AACR Cancer Progress Report 2023 Steering Committee, said during the unveiling of the new report. In addition to heading the AACR, Greenberg is also the head of the Program in Immunology, Clinical Research Division, and The Rona Jaffe Foundation Endowed Chair at Fred Hutch Cancer Center in Seattle, Washington.

The report championed the recent advances in cancer care, noting that from 1991 to 2020 there has been a 33% reduction in the age-adjusted overall cancer death rate, which report authors said has translated to the prevention of an estimated 3.8 million cancer-related deaths. The FDA's approval of 14 new anticancer therapeutics between August 1, 2022, and July 31, 2023, was acknowledged. Study authors also highlighted the regulatory agency’s decisions to expand the indications of 12 previously approved anticancer agents and approve 2 new imaging agents during this time period. According to the report, researchers estimated that the May 2023 United States Preventative Services Taskforce draft recommendation to drop the age of breast cancer screening from 50 years to 40 years for average-risk individuals could save 19% more lives from breast cancer.²

“Patients with cancer have collectively gained nearly 14 million years of life over the past 4 decades as a result of National Cancer Institute [NCI]–funded research and clinical trials,” Greenberg said. “That's a lot of people living longer, being able to sit at the dinner table with their families and their loved ones, and have a productive life. That is what cancer research is all about.”

Special recognition was given to immunotherapies, with report authors writing that, “cancer immunotherapeutics work by unleashing the power of a patient’s immune system to fight cancer and, over the last decade, have emerged as one of the most exciting new approaches to cancer treatment.” They noted that the FDA has approved 11 immune checkpoint inhibitors since 2011, many of which are approved for more than 1 type of cancer, and at least 1 immune checkpoint inhibitor is approved as a treatment option for 20 different cancer types. The FDA has also approved 6 CAR T-cell therapies since 2017 for the treatment of various hematologic malignancies.

“Cancer immunotherapies are quite precise,” Greenberg said. "The enormous advance is that you get rid of the toxicities…Rather than using [a checkpoint inhibitor] to treat the single disease that it was approved for a decade ago, we now use it to treat 20 diseases. That's increasing, and a lot of this reflects the genomic revolution of understanding what makes [a cancer cell] different and how the immune system might be able to recognize it.”

The report’s authors also touched on some of the challenges that remain for patients with cancer and health-care professionals in the field of oncology. AACR estimated that approximately 2 million new cancer cases will be diagnosed in 2023 and more than 609,000 patients will die from the disease.1 Although the cancer mortality rate has declined, 40% of all cancers in the US were at least partially attributable to preventable risk factors.2 The cigarette smoking rate among American adults has fallen drastically, from 42% in 1965 to 11.5% in 2021. However, the prevalence of obesity in American adults has risen from 12.5% in 1960 through 1962 to 41.9% in 2020.

Report authors paid particular interest to the racial, ethnic, and geographic disparities that continue to persist in cancer care. Among older adult patients with newly diagnosed cancer, those from rural areas experienced a 78% higher 1-year mortality rate compared with their urban counterparts. Additionally, transgender patients with cancer have twice the risk of death from non-Hodgkin lymphoma, prostate cancer, and bladder cancer compared with cisgender patients.

From 2018 to 2020, the death rate from breast cancer was found to be 1.4 times higher in Black women compared with White women; the death rate from uterine cancer was 2 times higher. Compared with White men, American Indian and Alaskan Native men experienced higher death rates due to kidney (1.8 times), liver (2.1 times), and stomach (2.7 times) cancer. Regardless of gender, Hispanic patients had a 2-fold higher death rate from stomach cancer compared with White patients.

Additional challenges included financial toxicity, as the cost of cancer care continued to rise in the United States. Patients paid an estimated $16.2 billion in out-of-pocket costs in 2019, and an estimated $5 billion was lost in time costs.

Finally, AACR stressed how increased and consistent funding is paramount in order to continue the extraordinary progress that has been made in cancer care.1 The organization implored Congress to provide the National Health Institute (NIH), the NCI, the Centers for Disease Control’s Division of Cancer Prevention and Control, and the FDA’s Oncology Center of Excellence appropriations of $50.924 billion, $9.988 billion, $472.4 million, and $50 million, respectively.

“NIH research grants have been a good investment--they've helped sustain the US economy,” Greenberg said. “If you look at just the 2022 fiscal year, there's more than half a million jobs that are a consequence of NIH support, and that's generated $97 billion in economic activity. That's more than twice the budget that's provided to NIH…We believe that President [Joe Biden’s] goal of decreasing cancer deaths by 50% in next 25 years is certainly a realistic goal, but it's only a realistic goal if we invest in making that happen.”