The future of cancer treatments depends not just on researchers around the country, but also on the nonprofit foundations that support them. As a result, dramatic breakthroughs in cancer have been made possible, these panelists reported.
Solid Tumor Treatment Holds Promise
Researcher Mike Foote, MD, of Memorial Sloan Kettering Cancer Center, reported on recent rectal cancer immunotherapy trials supported by fundraising nonprofits like Swim for America. He also won a Young Investigator Award from Conquer Cancer, the American Society of Clinical Oncology (ASCO) Foundation.
For rectal cancer patients whose tumors had a unique biomarker called a mismatch repair deficiency, which occurs in about 10% of patients, use of a stage IV rectal cancer treatment was applied to patients at an earlier stage. Within 2 to 3 months, tumors disappeared, and patients had virtually no side effects from the oral therapy. Plus, the patient did not have the standard treatment, which includes chemotherapy, radiation, and surgery, which necessitates a life-long colostomy bag.
“There are so many projects when you’re a physician and scientist that you want to do, but it’s hard to justify the dollars and the cents to the financial companies,” said Dr. Foote. “That’s where donors and people like you whose lives have been affected by cancer can make an enormous difference. It’s changed the way we view this cancer.”
Tumor Cell Microenvironment Research
Sam Urrutia, MD, a Hematology Fellow and Genomic Medicine Scientist at MD Anderson, reported on how investigating tumor microenvironments, which contain many cells, is linking diseases and pointing toward future treatments. For example, inflammatory cells in tumors are not just related to cancer but also to cardiovascular disease.
“We’re trying to see if these [inflammatory] cells, when they get into the tumor microenvironment, have any effect on the immunotherapy that we’re giving these patients,” says Dr. Urrutia, who also is a Young Investigator Awardee. His research focuses on lung cancer, with expansion into melanoma and other immunotherapy-treated tumors.
Researchers and Funding Organizations
Nancy Daly, MS, MPH, the CEO for ASCO’s Conquer Cancer organization, noted that funding early career researchers like Dr. Foote and Dr. Urrutia is critical to making advances such as these 2 studies. Because the competitive application requires mentors, career researchers such as Steven Rosen, MD, FACP, FASCO, FAIMBE, Executive Vice President for City of Hope, and Jedd Wolchock, MD, PhD, FASCO, Director of the Meyer Cancer Center at Weill Cornell Medicine, become involved with young investigators at the start of their research journey.
The Young Investigator Award can jumpstart a researcher’s career, she added: “It gives them some dedicated time and also shows the institution where they are that they [have received a competitive] ASCO award and they’re coveted.”
Nonprofits are also supporting each other, as Swim for America does with Conquer Cancer, to support research projects around the country.
Diet, Exercise, and Cancer
Melissa Habedank, Senior Director of External Relations, American Institute for Cancer Research, noted that 40% of cancer in the United States is related to diet and exercise—and is therefore preventable.
There are unchangeable risk factors, like age and genetics, but exposure to tobacco and sunlight is more modifiable, she said. Obesity, however, is a strong risk factor for 13 different kinds of cancer. Alcohol consumption is a strong risk factor for 6 different kinds of cancer.
Since obesity and alcohol consumption are related to 13 and 6 kinds of cancer, respectively, Ms. Habedank said her organization’s educational messages are targeted at clinicians as well as people who want to prevent cancer in themselves or their loved ones, cancer patients and their caregivers who want to improve tolerance of treatment, and survivors who want to improve their outcomes and overall well-being.
“We work with all of these audiences, and we focus on physical activity and nutrition, eating better and moving more,” she says. “The research shows that those things make a difference. That information is empowering and it’s useful for people who want to do something themselves, their caregivers, their family members.”
What the Future Holds
Dr. Rosen of City of Hope said he anticipates that future blood tests will be able to detect cancer, with improved imaging technologies finding solid tumors at a very early stage.
He said he also has switched one-third of his focus to pancreatic cancer: “We have very exciting results that we’ve applied to blood cancers that now seem to be equally exciting in pancreatic cancer.”
Dr. Wolchock of the Meyer Cancer Center at Weill Cornell Medicine agreed that the advances in cellular therapies used in blood cancer and other cancers will expand to solid tumors. The next important step will be more sensitive blood-based screening for cancers.
“We’re very likely overtreating many of our people,” he said. “That causes both financial as well as physical toxicity for people when we want people to take a step back to their normal lives,” he said.
Dr. Foote reported that while most gastrointestinal (GI) cancers are not treated with immunotherapy, some upper GI cancers are starting to be.
“But we still have a lot of patients that are getting traditional cytotoxic chemo. I’m really hoping that we can start to replace those with some of the innovative technologies that [train] the immune system to fight cancer, introducing super soldiers that we’ve developed in a laboratory targeted against your specific cancer. That sort of precision medicine is very exciting for making cancer treatment more effective [and reducing] the amount of side effects that a patient gets.”
Dr. Urrutia said: “I hope we can move away from [symptom-inducing] systemic chemotherapy and move on to personalized medicine,” he said. “I think that we have the tools to do all that right now. We just need to fine tune them. We need to find the right balance of drug, patient, genomic landscape of the tumor and the patient’s family history.”
