A Plan of Attack for Deadly Cancers

The NCI has released strategic plans for making progress against two of the nation's deadliest cancers—lung and pancreatic cancers.

The plans were developed in response to the Recalcitrant Cancer Research Act, passed by Congress in 2012, which required the NCI to develop a scientific framework for advances against recalcitrant cancers. Although the Act defined recalcitrant cancers as those with 5-year relative survival rates below 50%, it directed the NCI to first issue reports spelling out research priorities for at least two recalcitrant cancers with 5-year survival rates of less than 20% that are estimated to kill at least 30,000 Americans a year. Lung and pancreatic cancers are the only two diseases that meet this more limited definition.

The scientific framework for small cell lung cancer (SCLC) was issued on July 1; a plan to address pancreatic cancer was released in March.

“I highly doubt that without the Recalcitrant Cancer Research Act we would have seen a small cell lung cancer report,” says Laurie Fenton Ambrose, president and CEO of the Lung Cancer Alliance, a national nonprofit organization that has advocated for a national research plan and will be working with the NCI on its implementation and oversight.

SCLCs account for about 15% to 20% of all lung cancers, and they tend to spread more quickly and resist treatment compared to other types.

The scientific framework identifies five initiatives that could make an impact against SCLC: new tools for tissue collection and tumor models that represent distinct phases of the disease; genomic profiling of SCLC; new diagnostic tests for people at higher risk of developing the disease; molecular-based therapies; and research into factors that define treatment response or resistance. Ambrose expects that the plan will lead to a renewed focus on SCLC research, especially in the areas it highlights.

The scientific framework for pancreatic cancer focuses on research priorities for pancreatic ductal adenocarcinoma, which accounts for 95% of all pancreatic cancers. Priorities include investigating a link between the disease and diabetes; investigating biomarkers for early surgical intervention; developing immunotherapy approaches; and testing treatment strategies that target mutations in KRAS, which are present in 95% of pancreatic ductal adenocarcinomas.

Julie Fleshman, CEO of the Pancreatic Cancer Action Network, a nationwide advocacy group, says that the framework is already leading to new projects and funding opportunities. For example, the NCI has launched a major initiative to target RAS mutations, which “could potentially have a great impact on pancreatic cancer,” Fleshman says.

The frameworks will also help other funding and advocacy organizations complement the NCI's efforts. The Pancreatic Cancer Action Network, for instance, is launching a fellowship award that will fund a researcher to collaborate with the NCI's RAS initiative.

For more news on cancer research, visit Cancer Discovery online at http://CDnews.aacrjournals.org.