In the release of its annual report on progress against cancer, Clinical Cancer Advances 2019, ASCO recognized progress in treating rare cancers as the Advance of the Year. The report catalogs a year’s worth of remarkable research advancements, reinforces the need for continued federal research funding, and details other major trends in oncology.

“Progress is moving at a quicker pace than ever before,” said 2018-2019 ASCO president Monica M. Bertagnolli, MD, FACS, FASCO. “From new success with immunotherapies and targeted therapies, to new insights for molecular diagnostics and the microbiome, we’ve seen truly impactful advances in many types of cancer, especially in rare cancers.”

This year’s Clinical Cancer Advances report not only reviews the prior year’s progress, but also looks forward to highlight areas where progress is most promising. For the first time, ASCO has published a list of Research Priorities for the cancer community, designed to address vital unmet needs in cancer care.

The report, now in its 14th year, is available online and in the Journal of Clinical Oncology.

Advance of the Year: Progress in Treating Rare Cancers

According to the National Cancer Institute’s (NCI) International Rare Cancers Initiative, rare cancers are those that occur in fewer than 6 out of every 100,0000 diagnosed cancers, yet together they account for about 20% of all cancers diagnosed each year in the United States.

“Research progress in rare cancers historically has not kept pace with advances we’ve seen in more common forms of cancer,” said Bruce E. Johnson, MD, FASCO, ASCO immediate past president and co-executive editor of Clinical Cancer Advances 2019. “After decades of incremental advances, we’re thrilled that so many achievements against rare cancers have been realized in just a year’s time.” 

The past year brought several major steps forward in treating rare forms of uterine, neuroendocrine, joint, and thyroid cancers, as well as sarcomas. These five advances, among others, prompted ASCO to name “Progress in Treating Rare Cancers” as the Advance of the Year:

• Anaplastic thyroid carcinoma (ATC): The U.S. Food and Drug Administration (FDA) approved the first treatment for this type of thyroid cancer in nearly 50 years: a targeted-therapy combination of dabrafenib plus trametinib for patients with BRAF-mutated ATC.
• Desmoid tumors: Research identified sorafenib as the first therapy to improve progression-free survival for patients with this rare form of sarcoma.
• Neuroendocrine tumors (NETs): The FDA approved lutetium Lu 177 dotatate, which delivers targeted radiation to tumor cells, for patients with advanced somatostatin receptor-positive NETs in the foregut, midgut, and hindgut.
• Uterine serous carcinoma: Research showed that trastuzumab slowed the progression of HER2-positive uterine serous carcinoma, one of the most aggressive forms of endometrial cancer.
• Tenosynovial giant cell tumor: Pexidartinib was shown to be the first promising therapy for this rare cancer of the joints.

“Rare cancers pose unique obstacles for research, but thanks to years of cumulative progress and our nation’s continued investment in cancer research, we now have promising, evidence-based treatments for patients who would have previously had few—if any—good options,” said Sumanta K. Pal, MD, co-executive editor of Clinical Cancer Advances 2019.

Nine Research Priorities to Accelerate Progress Against Cancer

ASCO’s inaugural “Research Priorities to Accelerate Progress Against Cancer” list was developed to spark new momentum in overlooked areas of research, and to provide the cancer community with direction to focus their investments and resources. The current list reflects the diversity of needs and opportunities in oncology and will evolve over time with the cancer research landscape. In no particular order, ASCO’s Research Priorities are:

1. Identify strategies that better predict response to immunotherapies
2. Better define the patient populations that benefit from post-operative (adjuvant) therapy
3. Translate innovations in cellular therapies to solid tumors
4. Increase precision medicine research and treatment approaches in pediatric cancers
5. Optimize care for older adults with cancer
6. Increase equitable access to cancer clinical trials
7. Reduce the long-term consequences of cancer treatment
8. Reduce obesity and its impact on cancer incidence and outcomes
9. Identify strategies to detect and treat premalignant lesions

“These priorities represent our vision for finding the next generation of cancer cures and reducing cancer’s impact on patients’ lives,” said ASCO senior vice president and chief medical officer Richard L. Schilsky, MD, FACP, FSCT, FASCO, co-executive editor of the report. “From prevention through survivorship, these priorities are intended to identify areas where progress is most needed and most promising.”

To learn more about the research questions represented by these priorities, read the report online or in the Journal of Clinical Oncology.

Voices for Cancer Research

Clinical Cancer Advances 2019 includes the personal stories of oncologists who have dedicated their lives to clinical cancer research and the patients who inspire them to continue their work. These researchers and patients are featured in ASCO’s “I Live to Conquer Cancer” campaign, which aims to put a human face on cancer research and underscore the importance of federally funded research in making progress against cancer.

One such story is that of Raymond U. Osarogiagbon, MD, FACP, director of the Multidisciplinary Thoracic Oncology Program at the Baptist Cancer Center in Memphis, TN. Dr. Osarogiagbon always knew that he wanted to work on a disease where the outlook was poor and the opportunity to make a difference was great. This led him to focus on lung cancer, which he describes as “not just a personal tragedy. It affects families, communities, and populations. There is a tremendous loss of life, productivity, and happiness,” he said. 

His patient, Gina Hollenbeck, a mother of two, an active runner and tennis player, and a non-smoker, was 38 years old when she was diagnosed with adenocarcinoma, the most common type of lung cancer seen in non-smokers. Despite living a healthy lifestyle, a persistent cough revealed that she had a collapsed left lung with multiple tumors. She has undergone several surgeries and is being treated with therapies that specifically target a genetic mutation in the cancer.

Ms. Hollenbeck is the president of ALK Positive Outreach, a Facebook support group for patients with ALK-positive non-small cell lung cancer and their caregivers. She credits her quality of life to clinical trials and federally funded research. “I’m grateful for clinical trials—I think they are the way we make progress in medicine. Even 5 years ago, stage IV lung cancer would have been a death sentence. Now, thanks to cancer research, people have a range of personalized therapies available to them with minimal side effects,” she said.

“We are at a point in the evolution of medical science where a lot of investments in cancer biology and care delivery are now coming together to bear fruit. Applying this knowledge to the people who will benefit most is part of the reason why we need ongoing—greater, even—funding for cancer research,” Dr. Osarogiagbon said.

Importance of Federal Funding

For 14 years, ASCO’s Clinical Cancer Advances report has highlighted the year’s most important cancer advances, many of which were driven by federal research investments. This year, nearly one-third of the advances featured in the report received funding from the NIH and other federal agencies, including three of the five rare cancer studies featured as part of the Advance of the Year.

“With U.S. cancer cases set to rise by roughly a third over the next decade, we must continue to advance research that saves lives,” Dr. Bertagnolli said. “Federal investment plays a key role in continuing progress—in rare and common cancers alike. We need to prioritize federal funding of cancer research in the years to come. Americans are counting on it.”

According a recent ASCO survey, 67% of Americans say the U.S. government should spend more money on finding treatments and cures for cancer, even if it means higher taxes or adding to the deficit.

Clinical Cancer Advances 2019 is supported in part by ASCO’s Conquer Cancer Foundation.