While cancer continues to be the second most common cause of death in the world (after heart disease), the risk of cancer mortality has actually decreased over the past 25 years. This decrease is evident for certain cancer indications—such as lung, breast, colorectal, cervical and prostate cancers—where patients are living longer after diagnosis due to a combination of early diagnosis and improved treatments.
As the Covid-19 pandemic shadow still looms large, its presence has become one of the major problems encountered in cancer care over the last few years. Creating many challenges for the whole healthcare system, Covid has especially affected cancer patients with delays in diagnosis and treatment delivery, adding to the complexity of this difficult disease. Nevertheless, new cancer care developments have been numerous, offering the oncology industry innovation in diverse areas including cancer prevention, basic sciences, precision immunotherapy, artificial intelligence and real-world data, and others.
Let’s take a deeper dive into what advancements we can expect to see this year:
Early cancer diagnosis remains a vital factor in determining longer survival and improved quality of life for patients. Much effort has been made in improving chances of early diagnosis in a number of cancer indications that, until recently, were considered to have a bad prognosis. For example, lung cancer prognosis is more promising than it’s ever been. The number of new lung cancer diagnoses are declining steadily. Lung cancer deaths have been cut in more than half for men and by a third for women, largely due to new tests that are allowing doctors to diagnose the disease earlier. Additional medical advancements that are proving to increase survival rates include the development of newer techniques for diagnosis and biopsies; new understandings on the pathology, mutations and genetic profiling of the disease; and the availability of appropriate targeted therapies and specific immunotherapies.
Another area related to cancer prevention is the identification of biomarkers to help guide treatment planning and individual patient prognosis. In cancer research, biomarkers refer to substances that are indicative of the presence of cancer in the body and include genes and genetic variations, differences in messenger RNA (mRNA) and/or protein expression, posttranslational modifications of proteins, and metabolite levels. There are many examples of powerful biomarkers that are currently being used in clinical practice. Through non-invasive testing, usually hematological, we now have the ability to highlight biomarkers in patients that can assess individual risk and guide those at high risk to do regular check-ups and testing/imaging. There are other non-invasive tests under investigation that could also have an impact on early cancer detection, such as urine marker tests, stool tests and nasal and throat brushings. These tests are capable of assessing different localized cancer risk and we expect to see them being increasingly implemented.
Currently, the origin of all commercially-available drugs sits in basic scientific discovery, creating a driving force in the ongoing research surrounding drug discovery and development. Scientists are working to discover how cells interact with other molecules, allowing for the identification of new biomarkers that can be targeted with newer compounds to obtain improved, effective patient response to their given cancer treatment. This important work continues at an accelerated pace to provide new anticancer medications to help cancer patients to benefit from their given therapies with less toxic effects. Despite the slowdown due to the Covid-19 pandemic, there has been continued progress in the field of cancer research, with the FDA approving sixteen new cancer drugs and two new agents used in the detection and better identification of tumors during scan imaging and specific surgeries.
Based on particular tumor characteristics, it is possible to determine which cancer treatments might better suit the patient. This area has evolved over the years as investigations have been able to show the individual tumour characteristics of protein markers and genetic DNA changes. A precise understanding of these tumour characteristics can predict which patients may benefit most from immunotherapy (for example PDL-1) by increasing specificity and reducing toxicity. That is one of the ways that the fields of precision medicine and immunotherapy complement each other.
Artificial Intelligence (AI) and Machine Learning (ML):
Great strides have been made in recent years combining artificial intelligence and science to improve cancer care.The availability of artificial intelligence (AI) and machine learning (ML) technologies is enabling researchers to assess large volumes of data and generate meaningful insights more effectively and efficiently. These technologies essentially ‘connect the dots’ between observed data points to discover links or patterns, allowing researchers to gain deep insights into many overlooked aspects of cancer care. According to the National Cancer Institute, AI, machine learning and deep learning can all be used to improve cancer care and patient outcomes. Integrating AI technology in cancer care can improve the accuracy and speed of diagnosis, aid clinical decision-making and lead to better health outcomes. With the use of AI, researchers can create the next stage of precision oncology.
It is clear that the field of cancer research is rapidly progressing, with the digital surge of the last decade greatly contributing to its acceleration. As AI and ML technologies allow us to tap into new real-world insights on important patient-centric aspects of cancer care, and through the adaption of precision medicine, we are shifting to a more holistic approach. Our focus will no longer be on the size of the tumor, but in how the disease affects each individual patient in all aspects of their life and how they can be guided on the optimum journey to health. By refocusing efforts to improve prognosis and quality of life for cancer patients, 2022 is slated to see significant advancements in global cancer care.
Dr. Daniel Vorobiof is a renowned oncologist and the chief medical director of Belong.Life. He is the founder and former medical director of the Sandton Oncology Centre in Johannesburg and has published more than 120 peer-reviewed articles in international medical journals.
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