Since 1971, when the US president Richard Nixon initiated the ‘war on cancer’, our approach to cancer has been engulfed in military language. Even as recently as 2009, President Obama stated:
Science will lead the way to a new cancer narrative
Current gaps in care highlight a wider reality: therapeutic advances alone won’t eradicate cancer as a leading cause of death.
It’s a commitment that’s led to tremendous progress in treating cancer, but current gaps in care show there’s much more to do.
The basics of cancer are understood, its hallmarks having been identified*. Research has generated a rich and complex body of knowledge revealing cancer to be a disease involving dynamic changes in the genome. Scientists have dissected signaling pathways to pinpoint treatment targets and mechanisms that have informed the development of new drugs and combinations, moving the field away from the age of systemic, burdensome chemotherapy regimen. Current treatments have started to realize precision treatment possibilities, with targeted oral small molecule inhibitors, monoclonal antibodies, immune checkpoint inhibitors and antibody-drug conjugates (ADCs) directed at a range of cancer cell-specific surface markers. In fact, multiple ADCs, bispecific antibodies, and even immuno-oncology bispecific antibodies, are in late-stage clinical development to further expand the anticancer toolset. These are aimed at driving remission with curative intent in the early stages, or chronic cancer management in later stages.
The innovation is brilliant; early-stage screening is recommended more broadly, while biomarker testing, and companion diagnostics are advancing across many tumour types, driving early diagnoses, and guiding treatment decision-making. AI is transforming medical imaging, helping us recognize patterns undetectable by humans to improve and accelerate diagnosis, treatment, and outcomes. And if the tumour has progressed, we can use the same tools to detect the tumour’s evolution to help identify and overcome its mechanisms to treatment resistance. Novel therapies and treatment combinations are subsequently utilized to best match the evolved biology of the tumour.
However, current gaps in care highlight a wider reality: therapeutic advances alone won’t eradicate cancer as a leading cause of death. If we are to reframe cancer as a manageable condition, we need to go deeper. Research Leadership has the potential to help us get to the causative contributors and beyond.
In recent discussions with American and International experts, novel ideas were proposed for scientific cross-fertilization. For example, one American breast cancer expert argued that recent advances in understanding the role of GLP-1 in diabetes may lead to understanding the role of obesity in tumorigenesis – building on the well-established links between obesity and breast cancer and (potentially) guiding ways to address it.
Interestingly, analysis of precancer or intraepithelial neoplasias - non-invasive lesions with genetic abnormalities, loss of cellular control functions, and some phenotypic characteristics of invasive cancer – might enable us to predict the likelihood of developing invasive cancer. The AACR recommends focusing on such precancer targets for the development of new agents, thus reducing the risk of cancer development and the need for invasive interventions.
Moreover, a Japanese discussant suggested that gene therapy may be the solution –challenging the notion that cancer, as a multi-gene disease, is not fertile ground for gene therapy. “Maybe in the future, a gene will be identified as a driver of cancer,” he said – an idea supported by recent research on cancer cells trying to identify the phenotypic characteristics of the cells that mediate cancer regression**.
Pharma can play a central role in this by combining experts in different R&D divisions and portfolios to further advance knowledge in tumorigenesis. This can then be validated in clinical trials, in turn fuelling a revolutionary new approach against cancer.
Science can open the door to a brighter future. But as science outpaces clinical practice, doctors are finding it hard to keep up with the latest interventions, invariably defaulting to more familiar – sometimes outdated – options.
Which proves that point that the “war on cancer” must go beyond progress in the treatment of disease. Breakthrough science isn’t enough. To move the needle, therapeutic advances must be amplified by disruptive communications that demonstrate their value to all relevant audiences, long before the point of critical need. If we want to drive earlier intervention in the prevention, diagnosis, or treatment of cancer, medical education, health literacy, and payer engagement all need to align around a single cause: the patient. They must each work in tandem to drive awareness and uptake of life-changing treatment options. Crucially, comms strategies should connect from end-to-end, working with all stakeholders and regulators to establish relevant endpoints that are meaningful in clinical practice and facilitate approval and broad access. It requires the emotionalization of data and creative storytelling to ensure a drug’s value is understood and felt. And it means embracing AI, marketing tech and omnichannel principles to deliver hyper-relevant, personalized communications, anytime, anywhere.
Ultimately, science, no matter how ground-breaking, won’t change the world by itself. If we’re going to make life-changing medicines available to all those that need them – and help eradicate cancer as a leading cause of death – communications agencies that connect the ecosystem will play a vital role.
We won’t solve cancer alone, but TOGETHER WE CAN REINVENT BETTER.
* D. Hanahan, R.A. Winberg: The Hallmarks of Cancer; Cell 2002Cancer; Cell vol 100; 2002.
** Sri Krishna, F. Lowery et al; Science 370,2020