AACR progress report highlights AI’s role in research and clinical care

Artificial intelligence is starting to transform life sciences by accelerating drug discovery and development, optimizing clinical trials, and creating personalized treatments for cancer patients, speakers said at the Sept. 18 unveiling of the American Association for Cancer Research 2024 Cancer Progress Report. 

However, advances in cancer made thus far fail to reach everyone, due to systemic and structural barriers, the speakers said. 

AACR’s 14th annual report looks toward the future of oncology while spotlighting progress made over the past year. That includes FDA’s approval of 15 new cancer therapeutics, one new imaging agent, the expanded use of 15 previously approved therapeutics to treat additional cancers, and a bevy of AI-based tools to improve detection and diagnosis of cancer.

Efforts in prevention, early detection, and treatment throughout the past several years have led to the overall cancer death rate in the United States dropping 33% from 1991 to 2021, with an estimated 4.1 million lives saved, according to AACR’s report.

“Unfortunately, the funding cuts NIH has experienced in fiscal year 2024… risk slowing these advances against cancer that have been achieved in recent decades,” AACR President Patricia LoRusso, the Amy and Joseph Perella Professor of Medicine, chief of the Early Phase Clinical Trials Program, and associate center director of experimental therapeutics at Yale Cancer Center, said at the event (The Cancer Letter, March 29, 2024).

Much of the progress made in combating cancer came from basic research, said John L. Cleveland, center director and executive vice president of Moffitt Cancer Center and Research Institute, professor and George V. Cortner and Theodore J. Couch Endowed Chair at the University of South Florida Health Morsani College of Medicine, and chair of the basic and translational research subgroup of the AACR Cancer Centers Alliance.  

“Without [basic research], there really would be no R in the R&D component of the pharmaceutical industry and the biotechnology industry,” Cleveland said at AACR’s event. 

For instance, sequencing the human genome propelled the field of cancer forward, he said. 

That feat of basic research cascaded into the discovery of oncogenes, tumor suppressor genes, chromosomal aberrations—and the subsequent development of therapies targeted to those issues. 

“We’re really at an inflection point right now, because everything we’ve done can now be accelerated by applying data science and AI and machine learning to what we do every day—not only to figure out what patients go in what trials from all the data that we can acquire from a patient’s tumor and from their immune system, but also for developing better drugs,” Cleveland said. 

“This kind of technology is really going to transform everything we do,” he said. 

LoRusso discussed two burgeoning AI applications that excite her: spatial transcriptomics, a diagnostic tool still in its infancy that can capture transcriptional activity in a tumor at the single-cell level, and liquid biopsies, which LoRusso uses to help evaluate whether patients are responding to their treatment regimens. 

“Artificial intelligence-based approaches are beginning to transform cancer detection, diagnosis, clinical decision-making, and treatment response monitoring. It is unquestionable that we are in a time of unparalleled opportunities in cancer research,” she said. 

“Not increasing investment in cancer research will impede this momentum against cancer and will result in the United States relinquishing its leadership status in cancer medical research and innovation,” LoRusso said. 

But recent advances in cancer detection, diagnosis, and care remain inaccessible to countless individuals. 

“Despite the progress we have already made and the excitement for new discoveries and potential cures, we must also recognize that much work remains to be done… Systemic and structural barriers continue to place a disproportionate burden of cancer on medically underserved populations, including those from racial and ethnic minorities,” LoRusso said. She highlighted the AACR Cancer Disparities Progress Report published earlier this year.  

“Even though the precision medicine revolution is improving outcomes for patients with cancer, equitable and affordable access to these treatments remains a significant challenge,” she said. 

More than 40% of patients with cancer can spend their life savings within the first two years of cancer treatment, according to an estimate in AACR’s report. The lifetime costs associated with a cancer diagnosis among adolescent and young adult survivors average nearly $260,000 per person.

Also, systemic and structural barriers influence exposure to modifiable cancer risk factors, Michael Pignone, the Rebecca and John Kirkland Distinguished Professor of Medicine and vice chair for quality and innovation at the Duke Department of Medicine, said at AACR’s event. 

“I think it’s really important to recognize… the importance of unmet social needs and social drivers of health, as well as the effects of structural racism on some of the risk factors for cancer,” he said. 

The risk factor of obesity, for example, is not a problem of willpower, but a systemic effect of one’s environment, Pignone said. “We’ve done a lot of things policy-wise to make it harder for people to get healthy food that is not obesogenic, and to have places and opportunities to exercise.” 

He praised the development of the GLP-1 class of anti-obesity medications—contributors to which received the 2024 Lasker~DeBakey Clinical Medical Research Award. (A story about all Lasker Award recipients appears in this issue) These drugs are quite expensive, though, and often not covered by health insurance for the purpose of weight management. 

Alcohol consumption is becoming increasingly recognized as a modifiable risk factor for several cancers, including breast, colorectal, head-and-neck, esophageal, and stomach cancers, Pignone said. More policy interventions to lower alcohol use, such as raising taxes on alcohol and rolling that money back into research, should be put in place, he said.  

“Probably 40% of cancers are preventable according to our best knowledge today,” Pignone said.

Cigarette smoking is the modifiable risk factor responsible for the largest percentage of U.S. cancer cases in adults above age 30, according to AACR’s report. 

“We’ve done an amazing job of reducing smoking in this country, and that has had an amazing effect, not only on cancer, but a number of other important health conditions,” Pignone said. 

“We need to keep going. We’re not done.”