On December 23, 1971, President Richard Nixon signed the National Cancer Act of 1971 into law, establishing a national cancer program that included the National Cancer Institute (NCI), other research institutes, and federal and nonfederal programs; funding for 15 new cancer research centers and local control programs; and an international cancer research databank. The legislation also established the first NCI-designated cancer centers, which today number 71 across 36 states and the District of Columbia,1 and expanded the National Clinical Trials Network to focus scientific efforts on the understanding, prevention, detection, and treatment of cancer.
During the Nixon administration, more than $1.6 billion—almost $11 billion in today’s dollars—was spent on cancer research.2 Since the passage of the National Cancer Act, mortality rates for all cancers have decreased by 27% since 1971 and by 32% since 1991, when mortality rates were highest,3 and cancer survivorship has soared from just 3 million in the 1970s4 to more than 18 million today.5
President Nixon said he hoped “in the years ahead, we will look back on this action today as the most significant action taken by my administration.”6 To celebrate this historic legislative achievement, in December 2021, Nobel laureates, cancer center directors, physicians, scientists, politicians, public health officials, and patient advocates gathered at the Richard Nixon Presidential Library and Museum in Yorba Linda, California, to look at the past 50 years of progress in cancer care and predict advances over the next 50 years.
A year later, on December 7 and 8, 2022, a group of clinicians, researchers, NCI-designated cancer center directors, patients, and patient advocates came together at the second annual Nixon National Cancer Conference. The focus was on how the past advances in cancer are impacting today’s fields of science, including immunology, regenerative medicine and stem cell therapy, nutrition, and technology, as well as improving the lives of patients with cancer.
Here are some highlights from the conference.
Interrupting the Cancer Process
In his keynote address, Andrew C. von Eschenbach, MD, described how advances in cancer treatment are intervening in the cancer process in multiple ways to prevent, eliminate, or modulate and control the disease. Dr. von Eschenbach is President of Samaritan Health Initiatives; Adjunct Professor at The University of Texas MD Anderson Cancer Center; former Director of the NCI from 2002 to 2005; and former Commissioner of the U.S. Food and Drug Administration from 2005 to 2009.
“We’ve moved from seeking a cure for cancer to now being able to think about, if not curing cancer, preventing and even controlling, modulating it, so that cancer becomes a chronic disease, but one that does not cause the suffering and death we been so plagued by,” said Dr. von Eschenbach.
Entering the Multiomics Period
Anna Barker, PhD, Founding Director and Chief Executive Officer of Ellison Institute for Transformative Medicine, moderated a panel on immunology and inflammation. The panelists included Thomas F. Gajewski, MD, PhD, AbbVie Foundation Professor in Cancer Immunotherapy Departments of Pathology, Medicine, and the Ben May Institute Program Leader, Immunology and Cancer Program University Chicago Comprehensive Cancer Center; Carolyn Britten, MD, Vice President, Global Development, Early Development Oncology, Amgen; and Carlos Becerra, MD, Medical Director of Cancer Research at Hoag Family Cancer Institute, Newport Beach, California.
“We are in either the genomics period or the post-genomics period, but I think we are in the middle of the beginning of the multiomics period,” said Dr. Barker. “Right now, we are measuring patients for everything in terms of their omics, their genome, their transcriptome, their proteome, and their epigenome, and it is all now possible to get on a chip. That has become the basis for precision oncology. I will tell you that about 8% of people in this country who are eligible for precision oncology are getting that kind of treatment, so if you think we don’t have problems in this country with who needs to be treated vs who is being treated, you are hearing a lot of conversation about that.”
Dr. Barker continued: “Immunotherapy is not new, but the concept in terms of oncology is quite new. We are not treating a specific target when we treat the immune system; we are rebalancing or redirecting the immune system, so it is a systems approach, and I believe that cancer is a complex of that system. If you put cancer in the same space as you have the immune system, now you have an extraordinarily complex system, and I predict that in 10 years, that will absolutely be the only way we think about cancer.”
Focusing on Patients
Before moderating a panel on mathematics, physics, and cancer, Edward S. Kim, MD, MBA, reflected on how the focus of cancer advances must be on making life better for patients with cancer. Dr. Kim is Physician-in-Chief and Senior Vice President at City of Hope Orange County and Vice Physician-in-Chief at City of Hope National Medical Center.
“Our focus is on our people, our patients,” said Dr. Kim. “They are the ones who must benefit from all this [effort]…. We know when we are on the cusp of some significant discovery, we must measure that by the way it eases the burden on our patients. It should not only help them live longer, but live better….”
Dr. Kim continued: “When you consider all the cancer advances over the past half century, we must credit those who have also transformed the patient experience. We need to recognize there is equal importance to the science of care delivery. And that is where we need to transform. We can’t have people hiding from their diagnoses, to be scared, to let us know they need help, whether it is the patient [or] the caregiver. This is new education, participating in informed decision-making, equity in treatment, accessibility; they are all important and should never eclipse the burden of what cancer is….”
We are not treating a specific target when we treat the immune system; we are rebalancing or redirecting the immune system, so it is a systems approach, and I believe that cancer is a complex of that system.— Anna Barker, PhD
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“Advances in science have to align with advances in our humanity,” Dr. Kim added. “In this spirit, let’s come together, let’s learn, let’s collaborate, let’s become better. The next 50 years will be exciting.”
Members of the mathematics, physics, and cancer panel discussed how the use of mathematics and physics are leading to a better understanding of how cancer develops and spreads as well as more effective therapies. This panel included Dr. Kim; Mauro Ferrari, PhD, Professor of Pharmaceutics at the University of Washington and former special expert on nanotechnology at the National Cancer Institute; Robert Gatenby, PhD, Co-Director of the Center of Excellence for Evolutionary Therapy at Moffitt Cancer Center; and on video, Patrick Soon-Shiong, MD, Chairman of the Chan Soon-Shiong Family Foundation, Executive Chairman of ImmunityBio, Chief Executive Officer of NantHealth, and Executive Chairman of the Los Angeles Times.
REFERENCES
1. National Cancer Institute: NCI-Designated Cancer Centers. Available at www.cancer.gov/research/infrastructure/cancer-centers. Accessed February 8, 2023.
2. Emanuel G: 50 years ago, Nixon gave the U.S. a ‘Christmas present,’ launching the war on cancer. NPR, December 23, 2021. Available at www.npr.org/sections/health-shots/2021/12/23/1058107864/50-years-ago-nixon-gave-the-u-s-a-christmas-gift-it-launched-the-war-on-cancer. Accessed February 8, 2023.
3. Kratzer TB, Siegel RL, Miller KD, et al: Progress against cancer mortality 50 years after passage of the National Cancer Act. JAMA Oncol 8:156-159, 2022.
4. Parikh RB, Kirch RA, Brawley OW: Advancing a quality-of-life agenda in cancer advocacy: Beyond the war metaphor. JAMA Oncol 1:423-424, 2015.
5. National Cancer Institute Division of Cancer Control & Population Sciences: Statistics and Graphs. Available at https://cancercontrol.cancer.gov/ocs/statistics. Accessed February 8, 2023.
6. National Cancer Institute: Cancer Facts & the War on Cancer. Available at https://training.seer.cancer.gov/disease/war/. Accessed February 8, 2023.
