President of AACR Discusses Sixth Annual Cancer Progress Report Interview with:

Nancy Davidson, MD President of the American Association for Cancer Research (AACR) and Director, University of Pittsburgh Cancer Institute

Dr. Nancy Davidson

Nancy Davidson, MD
President of the American Association for Cancer Research (AACR) and
Director,  Cancer Institute
University of Pittsburgh

Dr. Davidson discusses the 2016 AACR Cancer Progress Report. “The report serves as an educational document for both Congress and the public, alike. The report is a call to action, designed to urge Congress and the American public to stand firm in their commitment to the conquest of cancer”. What is the background and goals for this report?

Dr. Davidson:

  • This is the sixth edition of our annual Cancer Progress Report.
  •  The annual report is the cornerstone of the AACR’s educational and advocacy efforts:
  • The report outlines efforts to increase public and Congressional understanding of cancer and the importance of cancer research to public health and
  • Efforts to advocate for increased federal funding for the NIH, NCI, FDA, and other federal agencies that are vital for fueling progress against cancer
  • The first report was written in 2011, the year that marked the 40th anniversary of the signing of the National Cancer Act of 1971, to commemorate the advances in cancer research that had been made to date and to paint a picture of where the science was leading us. How has the current cancer situation changed over time?

Dr. Davidson: Research is powering progress against cancer:

  • In 1971, there were 3 million cancer survivors, on Jan. 1, 2016, there were 15.5 million cancer survivors.
  • U.S. 5-year relative survival rate for all cancers combined rose from 49 percent in the mid-1970s to 69 percent in 2011, the latest year for which the data are available.
  • The overall U.S. cancer incidence rate declined 0.7% per year from 2003 to 2012, the latest year for which the data are available.
  • The overall U.S. cancer death rate declined 1.5% per year from 2003 to 2012, the latest year for which the data are available.
  •  Despite the progress, it is predicted that there will be 1,685,210 new cancer cases diagnosed in the United States in 2016.
  •  In addition, it is anticipated that 595,690 people in the United States will die from some form of cancer in 2016. What are the main types of cancer in the United States? Has this changed over the last decade?
Dr. Davidson:

• In 2016, the five most commonly diagnosed cancers in the United States are expected to be: breast cancer, lung cancer, prostate cancer, colorectal cancer, and bladder cancer.
• In 2016, the five most common causes of cancer-related death in the United States are expected to be: lung cancer, colorectal cancer, pancreatic cancer, breast cancer, and liver cancer.
• The most commonly diagnosed cancers and the most common causes of cancer-related death have remained largely been unchanged over the past decade.
One exception is the rise in incidence of liver and pancreatic cancers. What are some of the challenges facing cancer researchers?

Dr. Davidson:
• Cancer is a disease of aging: 55% of U.S. cancer diagnoses occur among those age 65 or older.
• The segment of the U.S. population age 65 and older is growing: it was 46.3 million in 2014 and is expected to increase to 61.6 million by 2030.
• Advances have not been uniform for all forms of cancer. For example, overall 5-year relative survival rates for women with invasive breast cancer and men with prostate cancer are 89 percent and 99 percent, respectively, while those for U.S. adults with liver or pancreatic cancer are just 17 percent and 7 percent, respectively. Are there ethnic, social or racial disparities in cancer diagnosis and treatment?
Dr. Davidson:
• Not all segments of the U.S. population have benefited equally from the great strides that have been made in cancer prevention, detection, diagnosis, and treatment.
• As a result, differences that should not exist in cancer incidence, prevalence, death, survivorship, and burden of cancer exist among certain segments of the U.S. population.

These are referred to as cancer health disparities.

Some examples of cancer health disparities are:

  •  The overall cancer death rate among black women is 14 percent higher than among white women.
  • Prostate cancer death rates among black men are more than double those for any other racial or ethnic group.
  •  Hispanic children are 23 percent more likely to develop leukemia than non-Hispanic children.
  • American Indian/Alaska Native women are 62 percent more likely to develop kidney cancer than white women, and 80 percent more likely to die from the disease.
  • Colorectal cancer death rates in the lower Mississippi Delta, west central Appalachia, and eastern Virginia/North Carolina are elevated compared with the rest of the United States.
  •  Advanced-stage ovarian cancer patients of low socioeconomic status are 32 percent less likely to receive standard overall care compared with those of high socioeconomic status.
  • Lesbian women are less likely to undergo screening for breast and cervical cancer compared with heterosexual women; however, more research is needed to determine whether this finding translates into a disparity in cancer incidence. Would you explain what immunotherapy is and how it intersects with precision medicine?
Dr. Davidson:
• Cancer immunotherapy refers to therapeutics that can unleash the power of a patient’s immune system to fight cancer the way it fights pathogens.
• These therapeutics are called immunotherapeutics.
• Not all immunotherapeutics work in the same way.
• Immunotherapy is revolutionizing the treatment of many types of cancer.
• But not all patients have cancers that respond to currently available immunotherapeutics and some cancers respond initially but then progress after becoming resistant to the treatments.
• Researchers are investigating whether cancer genomics research, which is the mainstay of precision medicine, can identify genomic signatures that identify which patients are likely to respond to a particular immunotherapy. What are some recent FDA approved cancer therapeutics?
Dr. Davidson:

  • During the period covered by the report (Aug. 1, 2015, to July 31, 2016) the FDA approved 18 new medical products for use in oncology—13 new anticancer therapeutics, one new cancer screening test, one new diagnostic test, two new diagnostic imaging agents, and a new medical device. During this period, the FDA also approved new uses for 11 previously approved anticancer therapeutics.
    • Four of the 13 new anticancer therapeutics are immunotherapeutics (atezolizumab, daratumumab, elotuzumab, and T-Vec).
    • Four of the 13 new anticancer therapeutics are molecularly targeted agents (alectinib, cobimetinib, osimertinib, and venetoclax).
    • The utility of immunotherapy is expanding rapidly: At the start of the report period (Aug. 1, 2015) checkpoint inhibitors were approved for treating two types of cancer (melanoma and lung cancer). By the end of the report period (July 31, 2016) they had been approved for an additional three types of cancer (bladder cancer, Hodgkin lymphoma, and kidney cancer). Since Aug. 1, 2016, they have been approved for another type of cancer (head and neck cancer).
    • 13 of 40 (32%) novel drugs approved by the FDA’s Center for Drug Evaluation and Research from Aug. 1, 2015, to July 31, 2016, were for use in oncology. Is there anything else you would like to add?
Dr. Davidson:
• Federal funding through the NIH and NCI is the lifeblood of biomedical research and forms the foundation upon which the majority of scientific and medical discoveries are made.
• A strong federal investment in cancer research is good, both for our nation’s health and our economy: It is estimated that every dollar invested in the NIH yields $2.21 in local economic growth.
• Even though members of the U.S. House and Senate came together to agree to a $2 billion increase in the National Institutes of Health (NIH) budget for fiscal year 2016, this came after the biomedical research community had faced more than a decade of stagnant federal investments in the NIH and NCI.
• Thus, the AACR urges Congress and the Administration to ensure that the NIH, NCI, and U.S. Food and Drug Administration (FDA) receive robust, sustained, and predictable budget increases each year and that the National Cancer Moonshot Initiative is strongly supported with the new funds required to ensure its success. In addition, elected leaders must readjust the current discretionary budget caps upward to allow for healthy and lasting growth in the annual funding levels for the NIH, NCI, and FDA. Thank you for your contribution to the community.


View the AACR Sixth AACR Cancer Progress Report

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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