A Message from the AACR
This is a time of extraordinary promise in cancer science and medicine. In the United States, overall cancer incidence and death rates are declining steadily, and an increasing number of individuals are surviving longer after a cancer diagnosis. Transformative research and technological innovation enabled by five decades of federal investments, which were catalyzed by the National Cancer Act, have led to unprecedented progress against formerly intractable cancers such as metastatic melanoma and lung cancer. Since the onset and spread of Coronavirus Disease 2019 (COVID-19) in early 2020 the pandemic has negatively impacted every aspect of cancer research and patient care. Encouragingly, cancer researchers were uniquely positioned to respond to COVID-19 and have played a vital role in combating the public health crisis of COVID-19 while continuing their quest to prevent and cure cancer.
The AACR Cancer Progress Report 2021 provides a comprehensive overview of the remarkable progress being made because of medical research supported primarily by federal investments in the National Institutes of Health (NIH) and in particular the National Cancer Institute (NCI). As emphasized in this report, federal funding for medical research has deepened our knowledge of the complexities of cancer and accelerated the rate at which this knowledge is being harnessed to develop new and better approaches to preventing, detecting, diagnosing, treating, and curing cancer.
Among the 16 new treatments that were approved by the U.S. Food and Drug Administration (FDA) in the 12 months covered in this report are 11 molecularly targeted therapeutics that are an integral part of the precision medicine revolution in cancer care. The surge in the number of molecularly targeted therapeutics is being fueled by discoveries in cancer genomics wrought by multidisciplinary teams of researchers. The first ever approval of a molecularly targeted therapeutic against KRAS, one of the most frequently altered genes linked to cancer and long assumed to be “undruggable,” underscores the remarkable progress in our understanding of cancer biology and a watershed moment in cancer drug discovery.
Another area of cancer treatment in which extraordinary progress is being made is immunotherapy. The use of immune checkpoint inhibitors—therapeutics that work by releasing brakes on natural cancer-fighting immune cells called T cells—is continuing to expand. In 2011, there was only one checkpoint inhibitor approved by the FDA for treating just one type of cancer. As of July 31, 2021, there are eight checkpoint inhibitors approved by the FDA, and one or more of these therapeutics have been approved for the treatment of 18 types of cancer and any type of solid tumor characterized by certain molecular characteristics. A breakthrough in cancer immunotherapy discussed in this report is the first approval of a CAR T-cell therapy for patients with multiple myeloma. By expanding our knowledge of the immune system and its interactions with cancer cells and by facilitating the convergence of experts from an increasingly diverse array of disciplines, more clinical breakthroughs in immunotherapy will be achieved for the benefit of patients worldwide.
Despite these significant strides, we must continue our quest for newer and more innovative methods to detect and eradicate cancer while keeping our patients healthy. This urgent need is underscored by the sobering reality that cancer will claim more than 608,000 lives in the United States this year. This number is predicted to increase considerably in the coming decades because cancer is largely a disease of aging, and the segment of the U.S. population age 65 and older is growing. Therefore, it is critical to actively develop and successfully implement newer and more effective strategies for cancer prevention, early detection, diagnosis, and treatment.
Moving forward, we must ensure that everyone benefits from groundbreaking advances against cancer. Cancer can strike anyone— regardless of age, gender, race, ethnicity, socioeconomic status, location, or political affiliation. No one is immune to this devastating disease. Yet, as highlighted in this report, advances against cancer have not benefited everyone equally; racial and ethnic minorities and certain underserved populations shoulder a disproportionate burden of cancer. Participation of minorities and other underserved populations in clinical trials that are testing lifesaving new anticancer therapeutics continues to be disappointingly low. We must adopt new approaches to encourage and enroll an ever-increasing number of cancer patients in clinical trials so that research can identify the most efficacious approaches to help all patients. Minorities and the underserved have also been disproportionately impacted by COVID-19 as well as by the pandemic-related disruptions to health care, including cancer care. It is imperative that all stakeholders in the medical research community work together to eliminate the health care disparities related to both cancer and COVID-19.
We are at an inflection point in cancer research. Major milestones in discovery science over the past five decades have created opportunities for the next wave of breakthroughs that were not previously possible. We now have the scientific knowledge, cutting-edge technologies, and capability to deliver unprecedented advances to cancer patients. Also, there is bipartisan leadership in Congress that has delivered steady, significant annual funding increases for the NIH and in particular the NCI. As we recover from the impact of COVID-19, ensuring that medical research remains a high priority for our nation’s policy makers is vital if we are to maintain the momentum against cancer. The AACR urges Congress to continue to support robust, sustained, and predictable annual growth of the NIH budget, and to provide consistent and sufficient annual funding for the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC). These actions will ensure that major strides are made toward the goal of preventing and curing all cancers at the earliest possible time.
David A. Tuveson, MD, PhD, FAACR
Margaret Foti, PhD, MD (hc)
Chief Executive Officer