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May 18, 2021 05:00 AM

The president's cancer pledge brings opportunities to get it right

Dr. Edward S. Kim
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    Dr. Edward S. Kim

    Dr. Edward S. Kim is physician-in-chief at City of Hope Orange County and vice physician-in-chief, City of Hope National Medical Center.

    President Joe Biden’s pledge to “end cancer as we know it” starting with a $6.5 billion investment in cancer and other medical research is welcome news to anyone affected by this disease—and that’s all of us. With cancer impacting 1 in 3 Americans in their lifetime, cancer is one of the most pressing health challenges of our time.

    Cancer did not stop during the COVID-19 crisis and, even as we begin to get the pandemic under control, cancer remains an urgent cause for the medical community and, more importantly, for our patients and their families. Although cancer deaths are decreasing, the disease still claims the lives of about 600,000 people each year. We need bold measures and bold leadership.

    Extraordinary precedent fills our sails for this journey. We are buoyed by the scientific community that pioneered successful COVID-19 vaccine research in record time. Their efforts were paradigm-shifting for modern medical research. We need this speed, focus and innovation to continue with cancer—the crisis we have yet to end.

    I’m optimistic about what lies ahead, but cancer is complex; it’s not just one disease. There are more than 200 distinct kinds of cancer with myriad mutations. More focus on and funding for research is essential. The presidential plan includes a new agency that promises to move basic research further along toward practical application. It will establish new collaborations among the private sector, academia and government programs. And it will assign time frames and specific goals for research and demand transparency.

    I join my research colleagues and cancer center leaders in feeling optimistic about this approach and the direction of cancer care and research on the global, national and local stage. However, I believe we must also recognize that we have a critical window of opportunity to re-examine many aspects of our research process for cancer studies. If we take a stand in correcting and re-focusing how research will be carried out, we can make sure that this initiative against cancer is successful.

    Topping the list is addressing long-standing underrepresentation of large swaths of the population in clinical research trials. For too long, cancer studies have followed rigid eligibility requirements that overlook real-world cancer patients’ diversity, leaving many needlessly shut out. Most clinical trial participants are white, and only 9% are African-American, 9% Asian, and 18% Hispanic. Further, restrictions on age, co-morbidity and other factors limit participation. An estimated 17%-21% of patients cannot enroll in clinical trials due to restrictive exclusionary criteria.

    While it is understood that clinical trial exclusions are intended to protect participant safety and define an appropriate study population, the opposite may result. Patient safety can be compromised when a trial results in insufficient evidence to inform care for those underrepresented in the study. Clinical trials must be inclusive and representative of our populations.

    Additionally, this new age of medical research must start by keeping a steady focus on cancer, recognizing that the breakthroughs we develop often impact other disease research. Cancer is the cause of 22% of all American deaths and the major illness for which the world awaits a cure, yet many of the deadliest or most common cancers receive uneven not-for-profit research funding. It’s time to get back on track and aligned on the all-important goal of ending the disease, in every form.

    I know that leaders in the cancer field have taken a stand many times. Given the impact of cancer, now is the time for all healthcare leaders to work together as the nation anticipates that we will make bold moves and move toward more breakthrough results. Now is the time to rethink our traditional way of delivering care to speed tomorrow’s pioneering discoveries to the people who need them today.

    With this presidential push for research, combined with the work of the National Institutes of Health, National Cancer Institute, other agencies and the continued efforts at institutions like the one where I’m privileged to serve, we are poised to take new leadership in confronting cancer.

    Let’s make this the generation that eliminates cancer once and for all. That’s a vision all of us share.

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