ASCO Connection

July 2017

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initiatives that will help all of us trans- late these wonderful discoveries into our routine clinical care. I am excited about changes in health care delivery that will incentivize us even further to deliver high-quality care to our patients. I am excited about advances in survivorship. Above all, I am excited about how ASCO is here to help us all overcome these challenges and accomplish our mission, "Conquering cancer through research, education, and promotion of the highest quality patient care." Work- ing together through ASCO, we will reach our vision, "A world where can- cer is prevented or cured, and every survivor is healthy." Let's start with research, a fundamen- tal tenet of our progress. ASCO serves several roles in regards to research. One is as a sounding board for report- ing major clinical and translational advances in cancer. We do this through our meetings and through our journals, which are some of the most highly respected in our field. Let me return to my cousin, Kim. If only our science could move faster! A graph taken from a paper by Drs. Stephen Hunger and Charles Mullighan last year is one we wish we could show for every cancer type (Fig. 1). It shows the remarkable increase in expected overall survival and subsequent cure rates in cohorts of children with acute lymphoblastic leukemia [ALL] from 1968 to 2008. The respective Kaplan- Meier curves increase step-wise from an approximate cure rate of 10% in the first cohort treated from 1968 to 1970 —a huge symbolic step above the 0% chance a decade earlier—to 90% in the cohort diagnosed from 2000 to 2005. This success story didn't happen by accident. It is the culmination of years of laboratory, translational, and clinical research funded in great part by our federal government. But this success is threatened by diminished support for the National Institutes of Health (NIH) and specifically the National Cancer Institute (NCI). NCI funding was flat from 2003 to 2016, while, of course, inflation was not. Accounting for infla- tion, NCI's budget has decreased by more than $1.1 billion since 2003. This deficit is driving a wedge between where we should be and where we are in federally funded cancer research. I fear this wedge is pushing young and highly gifted investigators out of biomedical and, in particular, cancer research. Look at the odds of being awarded an NCI-funded grant in 2016: 11.2%. Would you take a job if you only had a 1-in-10 chance of being paid? ASCO has worked tirelessly to advocate for increased federal funding of all types of research, and we support it ourselves through grants administered by the Con- quer Cancer Foundation of ASCO. (See p. 36 for more information about this year's grant and award recipients.) Furthermore, ASCO itself is now con- ducting research. Led by our chief medical officer, Dr. Richard L. Schil- sky, ASCO has initiated the Targeted Agent and Profiling Utilization Registry Cleland. As the evening wore on, John confided that he was a patient of Dr. Larry Einhorn's at Indiana University Medical Center and that Dr. Einhorn had cured him of widespread, meta- static testicular cancer just a few years previously. I didn't know that was pos- sible —but he sure looked good to me! In the ensuing months, I was assigned to the oncology ward at University Hospital, and lo and behold, Dr. Einhorn himself was the attending physician. He made it clear to me that I was destined to be a medical oncologist. Through the years, John Cleland and I have con- tinued to remain in touch, sharing our mutual passions of basketball, track and field, and, of course, Dr. Einhorn. I tell you these two stories to highlight the progress we have made, but also to emphasize that we don't make it fast enough. Had Kim been diagnosed just 10 years later, he would have had a 15% to 20% chance of being cured. Had he been diagnosed now, his chanc- es of being cured would exceed 90%. In contrast, had John been diagnosed 5 years earlier, I would not be telling you the wonderful story of his life. These two stories illustrate the chal- lenges that we all face in fighting can- cer. Challenges that we have overcome, in part, and challenges that we can overcome in the future. Over the past year as ASCO president, I have seen many challenges in many different arenas that prevent our cur- ing every cancer. This experience leads me to admit I don't know when, but I do know how we will cure more, if not all, cancers, and how we will cure them faster: by working together to over- come these challenges. I am excited about laboratory, transla- tional, and clinical research that offers new hope to those for whom there was none. I am excited about educational ASCOconnection.org I 29 "I don't know when, but I do know how we will cure more, if not all, cancers, and how we will cure them faster: by working together." —Dr. Daniel F. Hayes

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