AACR President’s Vision: Envisioning a Healthier Future for All Cancer Patients Through Clinical Research

In the more than three decades that I have been in the cancer drug development arena, I have seen tremendous progress in the diagnosis and treatment of cancer. When I first started as a young investigator, there was only one chemotherapeutic available to treat metastatic colon cancer. Thanks to basic science unraveling many of the molecular alterations in cancer, we now have drugs that can even target specific subtypes of colorectal cancer.

Sequencing of the human genome and more specifically of tumors has unveiled targets that are responsible for cancer initiation and growth. As a result, researchers have made amazing advances in developing drugs against these targets, and patients have more treatment options available to them. For example, patients with lung cancer, even those with metastatic disease, have had significant improvements in their survival, because of precision medicine. And we continue to make significant progress for many other cancer types. We are also combining molecularly targeted therapeutics and immunotherapeutics to overcome treatment resistance and reduce toxicity.

Basic research is pivotal to progress against cancer. Without basic research, we would not be where we are today in diagnosing and treating patients with cancer. While it is important to translate from laboratory research to the clinic, it is also critical to bring clinical research back to the bench. For example, analyzing tumor samples from patients can help us understand why certain patients respond to a drug, while others do not. This continuum of bench to bedside back to bench is critical if we are going to improve outcomes for our patients.

When I first started in the clinic, most pediatric patients would die of acute lymphoblastic leukemia (ALL). In 2024, at least 85 percent of children with ALL are cured. One of the reasons for this progress is that over 60 to 70 percent of children with cancer are treated on clinical trials. We can study every patient to understand their disease to a greater extent. We need to keep the participation of children with cancer in clinical trials high and do better to increase clinical trial participation among adult patients.

Over the course of my academic career, clinical research has changed significantly, both in design and execution. We now need fewer patients to answer whether a drug is truly effective, in part, because of a better understanding of the biology of the disease. We are also increasingly bringing patient advocates into clinical practice. As many patient advocates have either lived through cancer or have cared for a patient with cancer, they bring more realistic viewpoints of what it takes to participate in a clinical trial.

Despite all the progress, we still have much work to do. The more we learn about cancer, the more we realize that it is a complex disease, and each patient is unique. We know that early detection of cancer is pivotal to reducing the burden of the disease. We need to invest more in early detection of cancer. There are also huge cancer disparities in the United States (US). Underrepresented populations, such as rural, Black, Hispanic, and LGBTQ communities, are faced with many challenges. These population groups do not have equitable access to treatments, diagnostics, and preventive interventions. Unfortunately, one of the drivers of these disparities is health care insurance, and many patients, often from underrepresented populations, are still uninsured.

Funding by the federal government in cancer research is pivotal to progress against cancer. The impact of the US taxpayers’ investment in cancer research has been astronomical. However, the next step is the hardest. And it will require robust and sustained federal funding. I know that amazing strides against cancer will continue if we maintain our investment in medical research.

I truly believe that the future of cancer science and medicine is promising. Cancer diagnostics are becoming more sophisticated. New technologies, such as spatial transcriptomics, are helping us study tumors at a cellular level. Artificial intelligence–based approaches are beginning to transform cancer detection, diagnosis, treatment decision making and response monitoring. Convergence science, where we bring many disciplines together to leverage the astronomical amounts of patient data, is becoming an important aspect of cancer research for a more in-depth and integrated understanding of the disease and for developing the next generation of drugs.

I went into cancer research because I lost both of my parents to cancer when I was young. I recognized the personal challenges that come as a result of a loved one dying of cancer—and even though the pain dissipates with time, it never goes away. So, my dream is that one day cancer will become a chronic disease, even in patients with metastatic disease, and people will live much longer, healthier lives. What an impact it would have, not only for the patient or patient’s family and friends, but also for the world, if that dream could come true.

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