AACR President’s Vision: Envisioning the Next Era of Cancer Medicine Through Biological Discoveries
Over the course of my 25-year career as a physician-scientist, I have witnessed a remarkable transformation in our understanding of cancer and how we diagnose and treat patients, as reflected in the AACR Cancer Progress Report 2026 and the 15 previous editions. One of the biggest advances has been our ability to decode the cancer genome. Around the turn of the millennium, we began sequencing entire cancer genomes, and at nearly the same time, the approval of imatinib (Gleevec) demonstrated that identifying a specific molecular alteration could create a “lock-and-key” for targeted therapy, paving the way for more precise treatments matched to each patient’s cancer. That breakthrough unleashed a new generation of discoveries that continue to transform cancer medicine today.
Cancer remains one of the most complex human diseases. A single cell contains roughly 20,000 protein-encoding genes, and only a subset of those genes and pathways are co-opted by cancer to drive disease. Our challenge is not simply to catalog what is altered, but to determine which alterations truly matter, which requires years of investigation by a broad community of researchers working across disciplines. The future of cancer research will depend on our ability to reduce that complexity into actionable knowledge to create new therapeutic opportunities.
Beyond our growing genetic understanding of cancer, one of the most important advances over the past two decades has been uncovering how cancers evade the immune system. Foundational discoveries revealing the immune checkpoints—molecular “gas pedals” and “brakes” that regulate immune cells—led to therapies targeting the PD-1/PD-L1 pathway. These treatments have transformed outcomes for many patients with advanced solid tumors, allowing a subset of individuals who once faced fatal diseases to achieve long-term survival.
Similarly, engineered cellular therapies have produced extraordinary results for many patients with hematologic malignancies. Together, these advances demonstrate how deep biological understanding can fundamentally reshape cancer treatment.
Our growing understanding of cancer biology is also revealing new opportunities for therapeutic innovation in areas such as epigenetic regulation, metabolic reprogramming, and the tumor microenvironment. Cancer cells interact with immune cells, fibroblasts, blood vessels, and many other cell types within the tumor microenvironment that contribute to cancer development. Understanding these interactions will create new opportunities for therapeutic intervention and more rational combination therapies. The growing understanding of cancer–immune interactions is also fueling renewed optimism for cancer vaccines, where early clinical results suggest exciting possibilities for the future.
The technologies available to cancer researchers have also advanced at an unprecedented pace. We can now characterize DNA, RNA, proteins, and even individual cells within a patient’s tumor in extraordinary detail. These advances have generated an enormous volume of information—far more than any individual investigator can fully interpret. Artificial intelligence (AI) offers an opportunity to overcome this challenge by integrating these complex datasets and uncovering biological and clinical patterns that would otherwise remain hidden. I believe AI will become an indispensable partner in translating increasingly sophisticated molecular data to improve diagnoses and identify new therapeutic strategies.
Scientific progress must also extend beyond biology to ensure that every patient benefits from these discoveries. As outlined in the AACR Cancer Disparities Progress Report 2026, disparities in cancer outcomes are driven, in large part, by unequal access to screening, diagnosis, molecular testing, and cutting-edge therapies. As new technologies—including blood-based cancer detection and AI-assisted diagnostics—enable earlier detection and increasingly personalized treatments, addressing these disparities becomes even more urgent. Solving these challenges will require collaboration among basic scientists, translational investigators, clinicians, population scientists, and implementation researchers to identify practical solutions that improve access and outcomes for all patients.
One of AACR’s greatest strengths is its ability to convene the broad cancer research community around shared scientific goals. AACR Project GENIE®, for example, has demonstrated the power of that approach by pooling clinical and molecular data across institutions, creating a resource that enables discoveries no single center could achieve alone. More recently, AACR established the Center for Cancer Clinical Trials to leverage the diversity and expertise of its members in designing and executing multicenter investigator-initiated clinical trials. Together, these efforts illustrate how AACR’s unique role as a convener can accelerate discoveries and help translate them into better outcomes for patients.
We stand at a defining moment in cancer research. Decades of sustained investment have produced an unprecedented understanding of cancer biology, powerful new technologies, and a growing ability to translate discovery into improved patient care. Now is not the time to slow that momentum. Continued public investment in medical research, combined with support for the next generation of cancer scientists, will allow us to capitalize on the extraordinary foundation that has already been built. If we sustain that commitment, I believe we will usher in an era in which increasingly precise, biology-driven approaches will continue to transform the lives of patients with cancer.
Keith T. Flaherty, MD, FAACR
AACR President 2026-2027
