Panel, Conference Presentation
Humankind vs. Cancer: The Scorecard
Milken InstituteJonathan Simons, Chris Boshoff, André Choulika, Carlo Greco, Nils Lonberg, Richard Paulson, Suzanne Topalian
- Prostate cancer mortality has decreased by 52 percent over two decades following $704 million in early-stage research funding from the Prostate Cancer Foundation over 23 years, contributing to the highest number of cancer survivors in history, with over four million in the United States.
- Future detection capabilities aim to identify tumors the size of a pinhead or pen, moving beyond the current capability to detect lesions the size of a centimeter, while advanced radiation techniques may cure over 37 cancers and new targeted radiopharmaceuticals are reported to induce remission in 10 billion cancers.
- Precision oncology strategies are shifting from cytotoxic poisons to "right patient with right medicine" approaches, utilizing blue driver mutation testing, intravenous T cells, and monoclonal antibodies for tumors expressing neoantigens.
- Cellular therapies, specifically CAR-T cells, involve in-vivo amplification within approximately two weeks to kill billions of cells, with initial University of Pennsylvania patients from five years ago remaining in complete remission.
- Immune checkpoint blockers, now totaling six with the recent addition of Dervalumab from AstraZeneca, have improved outcomes for advanced melanoma, changing median life expectancy from less than 12 months ten years ago to long-term survival for many, with four biomarker tests developed to identify responsive patients.
- A treatment paradigm shift envisions managing cancer as a chronic, controlled disease similar to HIV, while other experts anticipate potential negative study results for empirical combination therapies, necessitating rational combinations based on specific biological understanding.
- Radiation oncology is transitioning toward hypofractionation with a few sessions rather than fractionated therapy, including single-dose treatments deliverable remotely to support tumor cures in the developing world where surgical expertise is limited.
- Amgen projects that a 1% reduction in cancer mortality yields over $500 billion in societal value, noting that biopharmaceuticals have driven 80 percent of the benefit from the over 22 percent reduction in mortality rates.
- Prevention strategies involving smoking cessation, diet, alcohol reduction, and vaccination are predicted to have the largest impact on smoking-related cancers in the next 20 years, particularly in China, Russia, and the developing world.
- Strategic outlooks emphasize that immunotherapy is one pillar alongside radiation, surgery, and targeted therapies, with major pharmaceutical companies committed to extensive partnership models and a timeline goal to move from discovery to treating 500 patients with elimination or suspended animation.
- Calls for collaboration include overcoming intellectual property disincentives through new corporate law frameworks and leveraging social media and education to foster leadership and basic-level partnerships.