The number of new individuals diagnosed with cancer in the United States is predicted to rise from 1.7 million in 2017 to 2.3 million in 2030.
According to the seventh annual American Association for Cancer Research (AACR) Cancer Progress Report significant advances in the treatment of cancer were made in 2017 and immunotherapy and precision medicine continue to be at the forefront.
Highlights from the Cancer Progress Report 2017 includes the following:
- According to the latest data, the U.S. cancer death rate declined by 35 percent from 1991 to 2014 for children and by 25 percent for adults, a reduction that translates into 2.1 million cancer deaths avoided.
- Between Aug. 1, 2016, and Oct 1, 2017, the FDA approved 13 new anti-cancer therapeutics, and eight previously approved anticancer therapeutics for treating new types of cancer.
- A new class of immunotherapeutic precision medicines called checkpoint inhibitors are now available for the treatment of an increasing number of cancers.
- The FDA approved two CAR-T immunotherapies for the treatment of leukemia and lymphoma.
- Research discoveries continue to advance precision medicine: Seven of the new anticancer therapeutics are molecularly targeted agents.
- Thanks to public education and policy initiatives, total U.S. adult cigarette consumption, which is the leading cause of lung cancer, decreased by 39% from 2000 to 2015.
- HPV vaccination could prevent nearly all cases of cervical cancer, as well as many cases of oral and anal cancer, but only 63% of girls and less than 50% of boys had received at least one dose of HPV vaccine in 2015.
Precision Cancer Medicine
The purpose of precision cancer medicine is to define the genomic alterations in the cancer’s DNA that are driving that specific cancer. Cancer used to be diagnosed solely by a visual microscopic examination of tumor tissue and all patients received the same chemotherapy. Precision cancer medicine utilizes molecular diagnostic and genomic testing, including DNA sequencing, to identify cancer-driving abnormalities in a cancer’s genome. Once a genetic abnormality is identified, a specific targeted therapy can be designed to attack a specific mutation or other cancer-related change in the DNA programming of the cancer cells. Precision cancer medicine uses targeted drugs and immunotherapies engineered to directly attack the cancer cells with specific abnormalities, leaving normal cells largely unharmed.
In May 2017, the U.S. Food and Drug Administration heralded a new dawn for precision medicine when it approved the precision cancer immunotherapy Keytruda (pembrolizumab) for treating patients with any solid tumor harboring specific genetic characteristics. This is the first anticancer therapeutic approved based on cancer biomarkers rather than the location in the body where the cancer originated.
The immune system is a network of cells, tissues, and biologic substances that defend the body against viruses, bacteria, and cancer. The immune system recognizes cancer cells as foreign and can eliminate them or keep them in check—up to a point. Cancer cells are very good at finding ways to avoid immune destruction, however, so the goal of immunotherapy is to help the immune system eliminate cancer cells by either activating the immune system directly or inhibiting the mechanisms of suppression of the cancer.
Chimeric Antigen Receptor (CAR) T-cell Immunotherapy: In CAR T-cell therapy, a patent’s immune system’s T-cells are collected and reprogrammed in the laboratory to recognize and attack a patient’s cancer cells. Once the T-cells multiply and reach a certain number in the laboratory (usually hundreds of millions to billions), they are re-infused into the patient. The infused T-cells then circulate throughout the body, attacking the patient’s cancer cells. The key step is to genetically modify a patient’s T-cells to express a CAR that is designed to target an antigen protein expressed on the cell surface. As a result, the reprogrammed T-cells, or CAR T-cells, make proteins that find and attach to antigens on cancer cells to help destroy the cancer cells.