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Where we've been, where we're going
As we head into 2014, there are lots of predictions as to what the New Year will bring, many of them optimistic. The economy might perk up a bit more, the Super Bowl is forecast to be snow-free (in the northeastern U.S. in February? Really?) and gas prices are expected to fall slightly. But the New Year is also a time to look back at the previous year, at what was experienced and what was learned.
And in terms of cancer news and research, there was a lot.
Though official numbers most likely won’t be in for another few months, 2013 was expected to see roughly 1.6 million new cases of cancer in the United States, according to the American Cancer Society, with some 580,000 deaths attributed to the disease.
There’s been some good news, though. A new report from the American Cancer Society has revealed that cancer death rates have dropped 20 percent in the United States in the last two decades. The report notes that the rate of death attributed to cancer has dropped from roughly 25 per every 10,000 people in 1991 to approximately 17 per 10,000 people in 2010, which comes to about 1.3 million cancer deaths prevented.
Lung cancer remains the deadliest type of cancer in the nation, with breast, prostate and colorectal cancer representing the rest of the four leading cancer killers. (Fun fact: January 11, 2014 marks the 50th year since Smoking and Health, the 1964 report to the U.S. Surgeon General, was published; that piece was responsible for the Surgeon General’s pronouncement that smoking causes lung cancer and the start of a massive revamp of the opinion of tobacco in our society.)
Twenty-seven new molecular entities were approved by the U.S. Food and Drug Administration in 2013, and of those, nine were indicated for some form of cancer, including Lymphoseek, a radioactive diagnostic imaging agent. The drugs are indicated for a variety of cancer types, including leukemia, breast cancer, prostate cancer, melanoma, mantle cell lymphoma, multiple myeloma and non-small cell lung cancer. Of the three products to gain approval under the FDA’s breakthrough therapy program, two have been targeted toward cancer: Gazyva, a leukemia drug from Roche Holding AG, and Imbruvica, a treatment for mantle cell lymphoma, a rare form of non-Hodgkin lymphoma, from Johnson & Johnson.
These numbers are down slightly from 2012, in which 13 of the 39 NMEs approved by the FDA were indicated for cancer, with two of those consisting of Neutroval, a treatment for chemotherapy-induced neutropenia, and Choline C 11 injection, a PET imaging agent to aid in the detection of recurrent prostate cancer. The indications these drugs covered include renal cell carcinoma, basal cell carcinoma, breast cancer, multiple myeloma, colorectal cancer, prostate cancer, chronic myelogenous leukemia, medullary thyroid cancer and Philadelphia chromosome positive acute lymphoblastic leukemia.
Several of our Special Reports covered the field of oncology in 2013, with Randall Willis examining some of the hurdles faced by pharmaceutical and biotech companies in attempting to develop new cancer therapies. Willis also looked at some of the side effects associated with cancer treatments and the efforts that are underway to try to mitigate or minimize what has become an accepted part of cancer therapy.
The desire to avoid chemotherapy- and radiation-associated side effects is key to one of the leading cancer trends in 2013: immunotherapies. Immunotherapies are something of a Holy Grail, particularly in the field of oncology, as they could provide the ability to treat cancer by training the immune system to recognize and destroy tumor cells, thereby offering both a sustained immune response (similar to vaccinations) and the ability to avoid the toxic side effects of chemotherapy and radiation. In a previous CRN commentary, Helen Sabzevari of EMD Serono discussed the potential and aims of immunotherapies.
It should come as no surprise, then, that 2013 saw a number of partnerships announced in pursuit of such therapies. In September, Roche and Inovio Pharmaceuticals announced a license agreement to develop multi-antigen DNA immunotherapies for prostate cancer as well as hepatitis B. August saw the establishment of a collaboration and license agreement between Compugen and Bayer HealthCare for the development of antibody-based cancer immunotherapies. Just a month later, Bayer HealthCare also announced the beginning of a collaboration with the Broad Institute of MIT and Harvard to discover and develop therapeutic agents capable of targeting cancer genome alterations. Another big-name partnership was struck between the MD Anderson Cancer Center and GlaxoSmithKline for the development of antibodies capable of soliciting an immune response against cancer.
Another growing trend of last year was increased work into the genomics of cancer. Looking at cancer on the genetic level has led to a variety of new diagnostics, enabling doctors to determine, by the presence or absence of certain genomic variants, whether patients will respond to a certain therapy or if they are at risk of metastasis or recurrence. In March 2013, BGI and H3 Biomedicine Inc. launched a partnership to sequence and public genomic data from preclinical cancer models in hopes of identifying and validating recurrent gene mutations, and a few months later in September, one of BGI’s subsidiaries, BGI Tech Solutions Co., LTD, and South Texas Accelerated Research Therapeutics announced the San Antonio 1000 Cancer Genome Project, a study aiming to link genetic alterations specific to different cancer types to detailed clinical outcomes. In both cases, the participating parties will make their findings publicly available to the global research community once their work is complete. Additionally, in October, researchers led by a team from Yale University identified several cancer triggers within sections of non-coding DNA.
So what are we likely to see going forward? Cancer will no doubt remain one of the leading therapeutic areas within the industry, as the American Cancer Society forecasts that 2014 will see some 1.7 million new cancer cases. Companion diagnostics to determine which patients will respond positively to certain cancer therapies will likely continue to gain prevalence, to the point that I don’t imagine anyone would be surprised to see them become standard with new treatments. Work will undoubtedly continue in the fields of immuno-oncology and cancer genomics as well (with new updates already in the news for the latter).
A new year is a time of optimism and anticipation, and as we settle in to 2014, keep your eyes peeled here on our Cancer Research News site for the latest stories of cancer research and advancements. And from all of us here at DDNews, Happy New Year!