While the bulk of immune checkpoint inhibitor use has been confined to advanced cancers and those with high mutational burden, researchers are starting to look at their use in tumors with low mutational burden. ![]() Major trends in checkpoint blockade include combined approaches with radiotherapy, chemotherapy, and immunomodulatory drugs, neoadjuvant use and perioperative therapy, and expanding use to a wider range of cancers and settings ( J Exp Clin Cancer Res 2019 doi: 10.1186/s1304-0). “Over the last several years, the rapid development of these approaches has been remarkable.”Ĭheckpoint inhibitors and CAR-T therapy represent the main drivers of innovation in immunotherapy. People were skeptical about it,” he said. “I was in fellowship training not long ago, at which time cancer immunotherapy was this far away mirage. Immunotherapy, liquid biopsy techniques, and artificial intelligence technologies likely rank among the top innovations for most people in the oncology community today, according to Gopal. Solutions that are generated by these types of efforts are much more creative and versatile-often more impactful-than solutions developed in relative isolation.” Top Innovations have been establishing collaborations that facilitate these opportunities. “Over many decades, the NCI and other cancer centers in the U.S. “To pursue these really exciting opportunities in cancer research and deliver impactful treatment and prevention, it requires engagement with the rest of the world,” he said. Gopal calls this “comparative oncology” because it involves studying common cancers in different settings, populations, health systems, and geographies. It also provides opportunities to better understand cancers that are common around the world, like breast and prostate cancer. Apart from clear humanitarian goals, international collaboration provides opportunities to understand cancers that are relatively rare in the U.S., but more common in other parts of the world. Over the next 10 years, only about 10 percent of cancers worldwide will occur in the U.S., while 70 percent will occur in low- and middle-income countries. “It is undoubtedly true that a more collaborative approach really does open up a universe of scientific discovery that is not possible otherwise.” “What I propose is not a space race in isolation, but something that is more like an international space station,” he said. still playing a leading role, but at the same time collaborating with low-to middle-income countries to improve cancer research in the U.S. Since then, cancer research has evolved away from a space race mentality to a collaborative effort, with the U.S. It conjures images of nationalistic competition, like the arms race and the space race. ![]() has been involved in the “war on cancer.” The term harkens back to the Cold War era and the National Cancer Act of 1971. Satish Gopal, MD, MPH Space Station Not Space Raceįor decades, the U.S.
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