AACR Cancer Progress Report 2013 Special Feature on Making Research Count for Patients: A Continual Pursuit Immunotherapy www.cancerprogressreport.org • www.aacr.org AACR Cancer Progress Report 2013 Making Research Count for Patients: A Continual Pursuit Please cite this report as: American Association for Cancer Research. AACR cancer progress report 2013. Clin Cancer Res 2013;19(Supplement 2):S1-S86 www.cancerprogressreport.org • www.aacr.org Table of Contents AACR Cancer Progress Report Writing Committee......................................................................................................................iv A Message from the AACR............................................................................................................................................................vi Executive Summary ....................................................................................................................................................................viii A Snapshot of a Year of Progress..................................................................................................................................................1 The Status of Cancer in 2013 ........................................................................................................................................................2 Definitive Progress has Been Made Against Cancer ...................................................................................................2 Even in the Face of Progress, Cancer Remains a Significant Problem.......................................................................3 Cancer: An Expensive Disease. Biomedical Research: A Wise Investment ................................................................7 What is Cancer?.............................................................................................................................................................................8 The Origins of Cancer ...................................................................................................................................................8 The Genetic Basis of Cancer.........................................................................................................................11 Beyond Genetics: The Role of Epigenetics.....................................................................................................13 Outside Influences ....................................................................................................................................................15 The Immune System.....................................................................................................................................15 Blood and Lymphatic Vessel Networks..........................................................................................................16 Developing Cancer ....................................................................................................................................................17 Prevention and Early Detection...................................................................................................................................................18 Healthy Living Can Prevent Cancer ............................................................................................................................18 Eliminating High-Risk Activities.....................................................................................................................19 Tobacco Use and Cancer .............................................................................................................19 Outdoor and Indoor Tanning and Cancer ......................................................................................22 Cancer-associated Infectious Agents ............................................................................................................23 Energy Balance: Weighing in on Cancer ........................................................................................................24 Obesity and Cancer .....................................................................................................................25 Type 2 Diabetes Mellitus and Cancer ...........................................................................................26 Physical Activity and Cancer ........................................................................................................26 Looking For Cancer: Who, When, and Where.............................................................................................................27 Classifying Risk ............................................................................................................................................28 Prevention and Early Detection of Primary Tumors.......................................................................28 Prevention and Detection of Tumor Recurrence............................................................................33 Making Research Count for Patients: A Continual Pursuit ........................................................................................................35 Special Feature on Immunotherapy: Decades of Research Now Yielding Results For Patients..............................38 Releasing the Brakes on the Immune System ...............................................................................................38 Boosting the Killing Power of the Immune System ........................................................................................43 ii AACR Cancer Progress Report 2013 Flagging Cancer Cells for the Immune System..............................................................................................45 Molecularly Targeted Therapies .................................................................................................................................47 A Direct Hit: Targeting Chemotherapy to Breast Cancer.................................................................................47 Blocking Tumor Sustenance..........................................................................................................................49 Lessons Learned From CML .........................................................................................................................50 Two Drugs: One Cancer-driving Pathway.......................................................................................................53 Helping Some Lung Cancer Patients Breathe Easier......................................................................................53 Closing RANK on a Rare Bone Tumor ............................................................................................................55 Technology Advances for Patient Benefit ..................................................................................................................55 Nanotechnology: Tiny Technologies Make a Big Impact.................................................................................55 Mapping Cancer’s Escape Route...................................................................................................................55 Clear Images with Lower Radiation Doses ....................................................................................................57 Seeing the Wood Through the Trees: Improving Breast Cancer Detection.......................................................57 Genomic Medicine ....................................................................................................................................................57 On the Horizons............................................................................................................................................................................63 The Near Horizon.........................................................................................................................................................63 The Distant Horizon ....................................................................................................................................................64 What Is Required for Continued Progress Against Cancer? ......................................................................................................65 Advancing Regulatory Science and Policy.................................................................................................................65 Engaging Patients in Clinical Research .....................................................................................................................66 Integrating Research and Patient Care ......................................................................................................................67 Improving Biospecimen Repositories ........................................................................................................................67 Cultivating a Highly Skilled and Diverse Cancer Research Workforce .....................................................................67 Funding Cancer Research and Biomedical Science Drives Progress........................................................................................69 Funding Cancer Research and Biomedical Science Saves Lives and Boosts the Nation’s Economy......................69 Sequestration and a Declining Research Budget Threaten the Future of Our Nation’s Health................................70 The AACR Call to Action