ASCO report highlights health inequity in research and care, personalized medicine, and the need for increased funding in 2021

The American Society of Clinical Oncology (ASCO) Clinical Cancer Advances 2021 report, published in February, highlights current trends in oncology and identifies cancer research priorities. A key focus of this year’s report is the issue of health equity in cancer research and solutions. While tremendous progress has been made in cancer prevention, early detection, and treatment, disparities remain. Blacks, patients in rural areas, and those with lower income and education levels continue to experience lower survival rates for many cancers. All populations should have equal opportunity to be included in, and benefit from, research studies and methodologies.

Another highlight of this year’s report is the announcement that molecular profiling in gastrointestinal (GI ) cancers is the “2021 Advance of the Year,” suggesting a shift toward personalized medicine for these cancers. The ability to identify molecular and genetic signatures enables oncologists to deliver targeted therapies matched to the molecular profile of their patients’ tumors for extended survival with minimal adverse effects. Other major advances include use of targeted therapies in patients with earlier-stage cancers; biomarker-driven personalized treatment approaches for patients with lung, colorectal, and gastric cancers; combinations of therapies that extend survival without increasing toxicity; and targeted therapies for patients with difficult-to-treat cancers.

With regard to research, priorities are largely unchanged from the Clinical Cancer Advances 2020 report. However, one notable change is the addition of artificial intelligence, on the basis of its growing potential to solve complex problems and drive diagnostic, therapeutic, and translational research. Other research priorities include predicting response and resistance to immunotherapies, optimizing multimodality treatment, increasing precision medicine approaches, optimizing care for older adults with cancer, reducing obesity’s impact on cancer, and improving identification of potentially malignant lesions.

High level
In this year’s Clinical Cancer Advances report, the authors implore all stakeholders—patients, caregivers, providers, policy leaders, pharmaceutical organizations, and advocacy groups—to work collectively to reduce disparities in cancer research and treatment. Clinical investigators and industry can support this initiative by designing trials and supporting research programs that adequately represent patients from all racial, ethnic, and other minority populations. As in the Clinical Cancer Advances 2020 report, this year’s report highlights the importance of federal funding for cancer research in driving key advances. 2021 marks the 50th anniversary of the signing of the National Cancer Act, which led to vital funding for cancer research that resulted in a 29% decline in overall cancer death rates since 1991 and 150+ new cancer drug or indication approvals since 2006. Sustaining this funding is of even greater concern during the COVID-19 pandemic, which has slowed or halted some research progress during the past year.

Ground level
Last year’s advances in cancer care reflect a trend toward increased use of personalized medicine, particularly for patients with more-difficult-to-treat cancers. For example, recent research showed that targeting human epidermal growth factor receptor 2 (HER2) improves survival in gastric cancer and potentially in HER2-positive colorectal cancer. In the rapidly changing field of oncology, it is important to be knowledgeable about the latest advances and discuss them with patients who may benefit from those advances, with a goal of overcoming disparities in care and outcomes.