University of Chicago researchers contributed to three scientific articles over the past year that were identified by the American Society of Clinical Oncology as being among those highlighting advances in cancer research with the “greatest potential to improve patient care and quality of life.”
ASCO’s annual selection of clinical cancer advances, now in its ninth year, documents important progress being made and highlights emerging trends. The chosen studies, published January 10, 2014 by the Journal of Clinical Oncology, “attest to the current state of the science” and reflect on “where cancer research is heading,” the authors note.
The 76 highlighted advances were chosen by a 19-person board of prominent oncologists with expertise in pertinent areas. They selected research published in peer-reviewed journals or presented at major meetings over a one-year period, from October 2012 to September 2013.
UChicago Medicine contributors made particularly strong showings in alleviating cancer disparities and advancing pediatric oncology.
One of the chosen studies, led by Susan Cohn, MD, professor of pediatrics and director of clinical research for the section of pediatric hematology and oncology, focused on the link between ethnic disparities and genetic variation in patients with neuroblastoma, one of the most common types of childhood cancer.
In Cohn’s study, involving 2,709 patients, African ancestry was associated with high-risk disease and shorter event-free survival. One specific genetic variant associated with high-risk disease was more common among African American patients.
This variant contributed to worse outcomes. The results affirms the value of genomic profiling, the authors note, and may ultimately “be used to develop new, more effective therapies.”
Blase Polite, MD, assistant professor or medicine, co-authored a studyevaluating a statewide colon cancer screening and treatment program. This statewide project, begun in 2002, provided free screening and covered the costs of up to two years of cancer treatment for people who lacked insurance.
It nearly eliminated substantial disparities in colon cancer outcomes for African American patients in Delaware while decreasing overall health care costs.
Between 2001 and 2009, colorectal cancer screening rates for Delaware residents 50 years of age and older increased from 57 percent to 74 percent. For African Americans, screening rates rose from 48 percent to 74 percent, equaling the rate among whites.
Colon cancer incidence rates for African Americans fell by 33 percent and the mortality rate declined 42 percent. The percentage of cancers diagnosed at an early stage increased from 15 percent to 50 percent. By detecting potential cancers early and reducing the need for aggressive therapy in patients with advanced cancer, the program saved the state more than $8 million each year.
One more paper cited by ASCO was listed under “Quality Cancer Care.” Rena Conti, PhD, assistant professor of pediatrics, evaluated the extent of off-label chemotherapy use in community oncology practices. Her team found that the ten most commonly prescribed patent-protected intravenous anticancer drugs were used off-label about 30 percent of the time. Only half of that use was supported by established clinical guidelines.
The 10 drugs included in the study are costly; national spending on them totaled nearly $12 billion in 2010. “Future work,” the ASCO authors suggest, should evaluate how often unsupported use is inappropriate or potentially harmful.
The scientific progress demonstrated in the selected studies is “thoughtful, deliberate, and sometimes slow,” according to Clifford Hudis, MD, who wrote an introduction to ASCO’s “special article.” But each advance, while helping patients, “now also points toward new research questions and unexplored opportunities,” he noted. “The insights described in this report … enable us to envision a future in which cancer will be even more controllable and preventable.”