Elizabeth M. Jaffee, MD: Envisioning Longer, Higher Quality Lives for Cancer Patients

 

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Elizabeth M. Jaffee, MD
AACR President, 2018-2019
Deputy Director, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, Maryland

During the almost 30 years since I began my fellowship in oncology, we have made unprecedented progress against cancer. These advances occurred largely because of tremendous progress in basic research. A continued increase in federal funding for both basic and clinical research will allow us to make major headway moving forward. We will be able to develop cures for more cancers, as well as new treatments that will convert metastatic cancers from deadly to chronic diseases for many more patients.

When I first started my career, we had very few good treatments. A diagnosis with metastatic cancer was almost always a death sentence. Cancer care has evolved rapidly, and now there are treatments that result in responses that last years for some metastatic patients. For these patients, we can think of cancer as a chronic disease that needs to be controlled much like diabetes and cardiovascular disease.

Immunotherapy is a great example of how tremendous progress has been made because of basic research. Many of the recently approved immunotherapeutics—the checkpoint inhibitors and CAR T-cell therapies—work by altering immune cells called T cells, which can recognize and kill cancer cells. We were able to develop these new treatments, which are yielding durable responses for some patients, because of decades of basic research that taught us about T cells and how they are activated and regulated.

I believe that to advance cancer research even further, we must increase the integration of researchers from diverse disciplines into the cancer field. Bringing together researchers from a wide array of disciplines to address a single complex disease, such as cancer, is referred to as convergence science.

We have already seen that the convergence of immunotherapy and genetics has brought the concept of precision oncology to immunotherapy with the recent approval of an immunotherapeutic for treating any type of solid tumor characterized by a specific genetic characteristic, or biomarker. Enlisting experts from an even broader spectrum of disciplines, including physics, chemistry, engineering, mathematics, and computer science, will significantly accelerate the pace of progress in the future.

Convergence science will also help drive new technologies from the bench to the bedside. For example, technologies such as liquid biopsies have great potential for transforming early detection, diagnosis, and treatment of cancer by identifying markers of disease, therapeutic response, resistance, and recurrence. However, we need to improve the precision of these technologies before they can become a standard part of cancer care for most patients.

Another way that new technology will shape the future of cancer research and care is through a field of computer science called machine learning, which involves using small sets of data to develop programs that allow us to draw inferences about larger populations of patients with similar characteristics. Other areas of computer science will also be key to integrating and harnessing large sets of patient data, including patient history, outcomes, and tumor genetics, to expedite progress in precision oncology.

Because recent research findings are allowing more people to survive longer after a cancer diagnosis, one area in which we will see advances in the near future is in the identification of ways to minimize the risks of short- and long-term side effects from cancer treatment. We need to ensure that the new treatments we develop confer maximal benefit and minimal risk. We also need to ensure that we are using current therapeutics in ways that give patients the best possible quality of life for the long term.

I foresee a future in which a patient with cancer, even one with metastatic disease, would visit his or her oncologist periodically during which the patient might receive a treatment or have the treatment regimen tweaked. The cancer would be under control, and it will be possible for the patient to live a normal life.

If we are to realize this bright future for cancer patients and survivors, we need robust annual increases in federal funding for research. These resources are vital if we are to achieve our goal of bringing research advances against cancer to all Americans.

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