Bruce E. Johnson, MD President, American Society of Clinical Oncology
Chief Clinical Research Officer, Dana-Farber Cancer Institute, Boston, MA, USA ASCO Translational Research Professor
As physicians and researchers, we are fortunate to be part of the dramatic innovation in cancer research and treatment brought about by precision medicine. Although the success of precision medicine may seem like an overnight success, it has actually been a thoughtful, strategic approach based upon decades of hard, disciplined work by dedicated scientists from around the world. In lung cancer, this has resulted in identifying oncogenes that can effectively be treated with targeted therapies, as well as the rise of immunotherapy, which is now playing a pivotal role in the treatment of many patients, within the last 10 to 15 years. The cumulative effect of these efforts has been transformative. Today, nearly half of all patients presenting with advanced lung cancer can receive initial treatment with oral targeted agents or immunotherapy, rather than chemotherapy. I am optimistic that a subset of our lung cancer patients might actually be cured with checkpoint inhibitor therapy. It has been the holy grail of oncology to develop potentially curative treatments for advanced common solid tumours, and this may now be on our doorstep, at least for some of our patients.
Of course, this issue of memo inOncology summarising results in the field of lung cancer care that were presented at the 2018 ASCO Congress focuses to a considerable extent on immunotherapeutic approaches. Combination treatment is currently being explored on a large scale to improve patient outcomes, which also applies to small-cell lung cancer. Another important field of research is determinants of the treatment success obtained with immunotherapy. Nonetheless, targeted therapy continues to play an essential role, which was reflected by the plethora of data presented at the conference. Some of these findings are outlined in the articles on EGFR- and ALK-directed treatment presented in this issue.
However, expanding the reach of precision medicine still requires ongoing effort. It is important to note that precision medicine aims at improving the lives of our patients, not only in terms of survival, but also with regard to their quality of life. As researchers, we are constantly exposed to response rates and survival curves, but the ultimate test should be whether these agents make our patients feel better while living longer. At this pivotal time in cancer research and cancer care, we need to extensively characterise our patients’ tumours, treat them with our most effective agents, and support a robust research infrastructure to improve the efficacy of drugs.