Also speaking was AACR President Judy E. Garber, MD, MPH, Director of the Center for Cancer Genetics and Prevention at Dana-Farber Cancer Institute and Professor of Medicine at Harvard Medical School: “Almost everything that I am able to do for my patients today is due to progress in the last 40 years….but a decline now in National Institutes of Health funding for cancer research could not come at a worse time.”
That, she said, is because cancer “is more complex than we could have imagined 40 years ago,” and it is more important than ever for researchers to step up their efforts to understand the biology of the more than 200 different diseases.
Garber, whose specialty is breast cancer research, said there is an especially urgent need for research on how to prevent cancer metastasis. “We all would like the easy fix…most people don't want to have the side effects.” She added, “Education, education, education—that's how we're going to get to prevention.”
‘Our AZT Moment’
“Now is absolutely not the time to back down on the commitment to medical research….This is not the time to back off and coast,” agreed Keith Flaherty, MD, Director of Developmental Therapeutics for Massachusetts General Hospital Cancer Center. Citing the AIDS drug AZT as a major advance, he said, “the AZT moment was the beginning of things to come; in cancer we are having our AZT moment.”
He cited progress against melanoma as particularly impressive, and said funding must remain strong to continue progress against this cancer. Flaherty was principal investigator for the first clinical trials of the first prospectively developed selective BRAF inhibitors, and noted that about half of melanoma patients have a BRAF gene mutation. He is now co-principal investigator of a Phase III trial of the investigational BRAF inhibitor PLX4032, which he said has emerged as the most active single-agent therapy ever evaluated in metastatic melanoma patients.
Fragile Cancer Research Ecosystem
“This is a really difficult economic time,” said Geoffrey M. Wahl, PhD, Professor in the Gene Expression Laboratory at the Salk Institute and an Adjunct Professor in the Department of Biology at the University of California, San Diego. “The ecosystem in cancer research is fragile…it is in peril. NIH funding is not keeping pace with inflation.”
Noting that only about 7% of NIH grant applications are being funded, Wahl, a former AACR president, stressed that it is very important for the United States to preserve that fragile ecosystem and ensure that the investment of the last 40 years in cancer research continues, and that it is important in both economic and human terms.
The US invested an estimated $90 billion in the last 40 years in cancer research, he said, leading to about a 20% decrease in mortality since 1991; that mortality decrease translates into about $10 trillion saved.
Still, that is probably an underestimate, he said: According to statistics supplied by AACR, a 10% reduction in cancer deaths would be worth $4.7 trillion in social value — the value of reduced mortality and increased quality of life. In 2010, federal investment in NIH research had a 150% multiplier effect on the economy—leading to the creation of 487,900 jobs and generating $68 billion in new US economic activity—and the $3.8 billion the federal government invested in the Human Genome Project from 1988 to 2003 helped drive $796 billion in economic impact and helped generate $244 billion in total personal income.
‘Cholesterol’ for Cancer
This is a time to be hopeful about cancer research, Wahl said, but only if Congress sustains a strong fiscal commitment to the research enterprise. “Imagine if we had a ‘cholesterol’ for cancer. That's what we need.” Should such a marker be discovered, he noted, it would lead to advances in early detection, prevention, and treatment.
And while current knowledge has not yielded such a general cancer biomarker or biomarkers, there may be a subset of changes in the body—in pancreatic cancer, for example—that could herald the very early presence of cancerous cells. “We're already working on circulating cancer cells,” he said, and research on these cells may yield clues to cancer prevention and early detection.
Finally, melanoma survivor and clinical psychologist Roslyn Milstein Meyer, PhD, put in a strong plea for cancer research by telling her personal story. Diagnosed in 2005 with stage IV metastatic melanoma, she knew her prognosis was grim. “An NIH-funded clinical trial saved my life; there is no question about it,” she said.
She had immunotherapy with tumor-infiltrating lymphocytes (TIL) and high-dose interleukin 2 (IL-2), riding what she described as a rollercoaster of recurrences and multiple surgeries until August 2008, when dozens of tumors appeared in her abdomen. Although her initial TIL treatment in 2005 had not worked, this time TIL grown from her latest tumor surgeries allowed her to be treated successfully with a specific variation of such therapy. And, by March 2009 all but one of her melanoma tumors had disappeared; that one was removed surgically, and now, in 2012, she has lived to see her children marry and have children.
AACR CEO Foti commended her for telling the story of her personal cancer journey—”a memorable example of the progress that has been made—even in people with advanced cancer.”© 2012 Lippincott Williams & Wilkins, Inc.
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