Understanding Cancer Improvements in Surgery for Cancer: 2020 Advance of the Year in Cancer Care

Report Names ‘Refinement of Surgical Treatment of Cancer’ as the Advance of the Year

ASCO Cancer Advance of the Year

Each year, the American Society of Clinical Oncology releases its Clinical Cancer Advances report. This report covers the major advances made in cancer care over the past year. In each report, leaders in the oncology field also select an Advance of the Year, which is an area of research that has achieved the greatest progress over the course of the past year. The 2020 Advance of the Year is the Refinement of Surgical Treatment of Cancer. 
     
“It is fair to say that cancer treatment began with surgery, with accounts dating back to ancient times. In recent years, other treatments like systemic therapy emerged, changing the role of surgery in cancer care,” says 2019-2020 ASCO President Howard A. “Skip” Burris III, MD, FACP, FASCO. “ASCO’s 2020 Advance of the Year recognizes the way systemic cancer therapies have improved the effectiveness of surgery, minimized the extent of surgery required for many patients, and even eliminated the need for surgery for some patients.”

Advance of the Year: Refinement of Surgical Treatment of Cancer

While considerable progress in the understanding and development of systemic therapies has been made over the years, the effect of these improvements on surgical care has been seen only recently. The effectiveness of these treatments has led to reductions in the amount of surgery required for some cancer survivors, and even the need for it in others. At the same time, these advances have also increased the number of people who can undergo surgery when needed.
     
Advances in systemic therapies for melanoma as well as kidney and prostate cancers have helped reshape the role of surgical treatment, making them some of this year’s most impressive research successes.

  • Melanoma: Two featured studies examined the efficacy and safety of pre-surgery combination immunotherapy or targeted therapy treatments. These studies are already changing practice, helping people with locally advanced melanoma avoid surgery in many cases.
  • Kidney Cancer: Surgical resection has traditionally been the primary treatment of many solid tumor cancers, including renal cell carcinoma. Results from two randomized controlled trials provided evidence for targeted therapy-based approaches that might eliminate the need for surgery in this type of cancer.
  • Pancreatic Cancer: While surgical resection offers the best chance of survival for people with pancreatic cancer, many either have tumors that are difficult to surgically remove entirely or that cannot be removed at all. Two preliminary studies featured in the 2020 report suggest that more people with pancreatic cancer may be eligible for surgery following upfront treatment. 
Other research successes highlighted in Clinical Cancer Advances include progress in cancer prevention, biomarker-driven treatment, and therapy combinations that suggest that survival can be extended without increasing side effects. This progress could not have come about without federal support for clinical cancer research.
At the same time, these advances have also increased the number of people who can undergo surgery when needed.Research Priorities to Accelerate Progress Against Cancer
     
ASCO developed its list of Research Priorities to highlight areas where progress is promising and to spark momentum in areas of greatest need. These priorities, listed in no particular order, address areas of unmet need or help fill knowledge gaps in areas critical to improving patient care and outcomes:

* Identify strategies that better predict response and resistance to immunotherapies
* Limit extent of surgery by optimizing systemic therapy
* Increase precision medicine research and treatment approaches in pediatric and other rare cancers
* Optimize care for older adults with cancer
* Increase equitable access to cancer clinical trials
* Reduce adverse consequences of cancer treatment
* Reduce obesity and its impact on cancer incidence and outcomes
* Better identify premalignant lesions and predict when treatment is needed

Why Federal Funding for Research Matters
     
Federal research investments have driven many of the most important cancer prevention and treatment advances of the last half century. Roughly a quarter of the advances featured in the Clinical Cancer Advances report received funding from the National Institutes of Health and other federal agencies. Research funded by the U.S. government also generates billions of dollars in new economic activity and supports hundreds of thousands of jobs. 
     
Over the past few years, Congress has demonstrated tremendous bipartisan leadership by passing annual consecutive increases for the NIH. In Fiscal Year 2020, Congress provided a $2.6 billion funding increase for the NIH. ASCO is continuing to encourage Congress to build on its investment in cancer research to maintain the pace of scientific discovery and continue progress against cancer.

Clinical Cancer Advances, now in its 15th edition, is published online at asco.org/CCA and in the Journal of Clinical Oncology. You can learn more at ASCO.org or explore education resources for cancer survivors at Cancer.Net.