What Progress Does the Future Hold?
Cancer Progress Report 2014: Contents
In this section you will learn:
The increasing use of genomics and computational biology will soon spur the development of many more anticancer therapeutics and new uses for our current treatment arsenal.
Through research some of the significant cancer health disparities that exist today can be eliminated tomorrow.
Unquestionably, advances in cancer research have spurred spectacular progress against cancer, with many more people living longer and leading fuller lives after a cancer diagnosis than ever before. Despite this progress, more than 1.6 million U.S. residents are projected to receive a cancer diagnosis and more than 585,000 are expected to die from the disease in 2014 alone (1). Therefore, it is imperative that we continue to use and explore all possible strategies for the prevention, detection, diagnosis, treatment, and cure of cancer if we are to make future lifesaving progress.
Fortunately, many researchers, like AACR President, 2014–2015,
Carlos L. Arteaga, MD, think the future is bright. The explosion of new knowledge about cancer and the exciting technological advances, along with our ever-increasing understanding of how to apply them, will provide innovative ways to reduce the global burden of cancer.
Greater Deployment of Large-scale Genomics and Computational Biology
As discussed by Dr. Arteaga, technological advances in DNA sequencing have dramatically increased the number of known cancer-associated genomic alterations. This progress is anticipated to continue over the coming years, and it will multiply many times over the number of molecules that could provide a potential target for anticancer therapeutics.
To efficiently mine the enormous amounts of information generated by the genomic analyses of tumors and to identify the genomic alterations most likely to yield therapeutic targets with the potential to benefit patients, we will need to engage researchers in the fields of computational biology and bioinformatics. In fact, our ability to interpret all the information we collect to inform cancer care will be possible only by creating new storage infrastructure, educating the current and future workforce to understand the meaning of the data generated, and assembling teams of physicians and researchers from multiple disciplines, including nonbiological disciplines such as the physical, chemical, engineering, and mathematical sciences.
In addition to identifying the most promising therapeutic targets, computational biology and bioinformatics may help pinpoint the best combinations of therapeutics. Although molecularly targeted therapies have transformed the lives of many patients, the majority of tumors eventually develop resistance to these agents (see sidebar on
The Challenge of Treatment Resistance). As a way of starting to address this challenge, the FDA approved a combination of two molecularly targeted therapeutics for the same disease for the first time in January 2014 (see
Two Approaches to Address Treatment Resistance). This so-called rational combination of therapeutics, based on our understanding of cancer biology, is being tested in clinical trials as a way to overcome treatment resistance. Given that the number of potential combinations of molecularly targeted therapies is already immense, and will increase dramatically as the number of these cancer treatments rises in the future, continued progress will require investment in the power of computational biology and bioinformatics to help identify the most likely effective drug combinations.
Greater Effort to Reduce Cancer Health Disparities
Great strides have been made in cancer prevention, detection, diagnosis, treatment, and, in certain cases, cure. However, some groups of individuals in the United States—in particular, racial and ethnic minorities—experience notably higher incidence of some types of cancer than the general population and/or suffer significantly poorer treatment outcomes (see sidebar on
Racial and Ethnic Differences in Cancer Incidence and Mortality).
Among the many complex and interrelated causes of cancer health disparities are differences in access and use of cancer-screening programs (149). A number of initiatives have been developed and deployed to begin to address this aspect of cancer health disparities. One such initiative, which has been successful in eliminating colorectal cancer disparities, is the cancer control program that has been running in Delaware since 2003 (see sidebar on
Eliminating Colorectal Cancer Disparities in Delaware) (150). Through this program, many patients from racial and ethnic minorities, including
Eleuterio Peguero Rosa, have learned about and received colorectal cancer screening.
Unfortunately, substantial financial, infrastructure, and social challenges may prevent the implementation of identical programs nationwide. As a result, other approaches to increasing colorectal cancer screening among currently underserved populations are being developed (151).
Differences in access to and use of cancer-screening programs constitute just one component of cancer health disparities. We urgently need to increase our understanding of other causal factors and to develop and implement new interventions if we are to eliminate cancer for all.
Progress Report 2014 Contents