Abstract
Cancer research has been severely impacted by COVID-19. What does the future of cancer research look like in the new year after the pandemic?
Cancer research has been severely impacted by COVID-19. What does the future of cancer research look like in the new year after the pandemic?
Main Text
Keeping Patients at the Center
Solange Peters
Lausanne University Hospital and European Society of Medical Oncology (ESMO)
With oncology being an area experiencing rapid growth, the topic of sustainability of healthcare systems is no longer avoidable. Oncology professionals will increasingly face situations where they will have to select treatments based on their allocated budgets. As physicians, researchers, caregivers, and politicians, one of our missions is to facilitate equal access to optimal cancer care for all patients.
From the research side, supporting solid science above marketing, allowing for the transition from all-comers treatment strategies to personalized approaches still represents an unmet need. The ongoing academic search for biomarkers that will allow us to optimize and rationalize cancer immunotherapy delivery represents an obvious example.
From the clinical side, the European Society for Medical Oncology (ESMO) developed a robust tool, the ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS), to determine the benefit of systemic anticancer therapies in a rational and robust manner. ESMO-MCBS also serves as a screening tool to identify cancer treatments that have potential therapeutic value and warrant full evaluation for inclusion on the WHO Essential Medicines List. To complement it, ESMO is currently working on a geographically adapted value-based reimbursement model that aims to tackle issues related to the reimbursement of innovative medicines. As importantly and beyond, ESMO will create a new foundation in 2021 to start to work together following these aims, no matter where our patients are.
Optimism in Cancer Research
Qimin Zhan
Peking University Health Science Center
The malignant cancers present a global threat to human health. Currently, there are still limited efficacious therapies to fight these diseases. It requires great additional efforts to develop more effective treatment strategies in order to save more lives and improve life quality. As the end of the COVID-19 pandemic becomes sooner and more certain, given the upcoming access to vaccines, I hope important cancer research will thrive in the year of 2021.
To explore the underlying mechanism(s) of tumorigenesis, multi-omics analyses including genomics, epigenomics, transcriptomics, proteomics, and metabolomics can be used to obtain multi-dimensional and dynamic insights. Additionally, multi-omics studies are critically important to identify molecular markers to diagnose cancer early, predict prognosis, and instruct individualized therapy. Moreover, big data approaches and AI technologies are particularly powerful for optimizing clinical trials. Furthermore, improving cancer immunotherapy is urgently needed. Better understanding of how the tumor microenvironment becomes suppressive and how tumor cells evade immune surveillance can provide insights to develop new therapeutics. Combinations of different types of immunotherapy, targeted therapy, and chemo and radiation therapy might help overcome resistance. Finally, population and epidemiological studies can help realize precision prevention. The high-risk groups can be identified using effective molecular markers, which will promote the utilization of effective intervention approaches and reduce cancer occurrence.
A New Normal
Sherene Loi
Peter MacCallum Cancer Centre
As we are nearing the end of this incredible year, it feels that 2020 never actually came to pass; yet massive changes have occurred to facilitate clinical practice during the COVID-19 pandemic. For example, clinical trials became more accessible, as border closures meant that many patients could not travel to trial sites. Telehealth became the norm, and satellite sites could deliver study medication. In Australia, our large and sparsely populated country, these changes will be of considerable benefit to all cancer patients and augment clinical trial participation.
Laboratory research, however, did suffer, as the prolonged lockdown restrictions on personnel and animal work meant that most of the basic research at Peter Mac came to a grinding halt. When much of our research is focused on the immune microenvironment, work with models that have competent immune systems is vital.
With Australia’s geographic location, researchers will also miss the interactions during international conferences, as we are now unable to travel until a vaccine is widely implemented. Who knows what collaborative opportunities may have been missed due to these forced border constraints. Critical issues in immunology-based cancer research remain similar to those in 2019: identifying new immune targets, devising biomarkers that can predict those patients who will respond to checkpoint inhibition and those who will need more, bispecific agents that engage the patient’s immune system and induce epitope spreading, and next-generation CAR-Ts and antibody conjugates, for example. However, like a branch in Darwin’s evolutionary tree, Australia could be moving on a different tangent until travel is widely possible again. One refreshing local consequence of COVID-19 has been that researchers from diverse disciplines have come together to address the pandemic. A notable example of this is that cancer researchers from the Peter Mac, who were using CRISPR-Cas13b to target oncogenic mRNA transcripts for degradation, collaborated with infectious disease researchers from the Doherty Institute, together adapting the technology to degrade SARS-CoV-2 genomic RNAs. The approach suppressed viral replication in vitro by up to 90% as well as mutation-driven viral evolution. The strategy may prove effective for those infected with SARS-CoV-2 but may also potentially be applied to combat other viruses, including those that cause cancer.
A Turning Point
Tobiloba Oni
Cold Spring Harbor Laboratory
In January 2020, most people were unbothered, blithely planning for another regular year. However, the COVID-19 pandemic upended those plans and radically changed our daily lives. The science world dramatically changed, too. Experiments ground to a halt for most scientists, scientific exchange became virtual, and we had to adapt to a new reality. In May 2020, most of us were still adjusting to the new normal until the killing of George Floyd ruptured that normalcy and laid bare the systemic racism that perpetuates bias and inequalities in science.
One year into the pandemic and only a few months after the harrowing events in Minneapolis, we now stand at a turning point. We have a real chance to not only address the long-standing disparities in our scientific communities but also to reimagine scientific exchange. The constraints imposed by the pandemic have made scientific conferences and workshops more accessible; collaborations have soared, and discoveries are being rapidly disseminated. Similarly, the awakening to the racial disparities in science has prompted concerted efforts from individuals, scientific organizations, and funding agencies to devise action plans to increase and support diversity in science. If these efforts are sustained, I envision a more diverse scientific workforce with an increased ability to solve the most challenging scientific problems. As the new year begins and the world awaits a return to normalcy, I hope science does not return to the old normal.