Clinical Cancer Advances 2010: Annual Report on Progress Against Cancer From the American Society of Clinical Oncology

+ Author Affiliations

1. From the American Society of Clinical Oncology, Alexandria, VA.

1. Corresponding author: Steven I. Benowitz, MA, American Society of Clinical Oncology, 2318 Mill Road, Suite 800, Alexandria, VA 22314; e-mail: steven.benowitz@asco.org

Abstract

Like many health professionals who care for people with cancer, I entered the field because of specific patients who touched my heart. They still do. In an effort to weave together my personal view of what the American Society of Clinical Oncology (ASCO) stands for and the purpose the organization serves, my presidential theme this year is “Patients. Pathways. Progress.”

Patients come first. Caring for patients is the most important, rewarding aspect of being an oncology professional. At its best, the relationship between doctor and patient is compassionate and honest—and a relationship of mutual respect. Many professional organizations have an interest in cancer, but no other society is so focused on the entire spectrum of cancer care, education, and research. Nor is any other society as particularly interested in bringing new treatments to our patients through clinical trials as ASCO is. Clinical trials are the crux for improving treatments for people with cancer and are critical for continued progress against the disease.

“Pathways” has several meanings. Some pathways are molecular—like the cancer cell's machinery of destruction, which we have only begun to understand in recent years. But there are other equally important pathways, including the pathways new therapies follow as they move from bench to bedside and the pathways patients follow during the course of their diseases. Improved understanding of these pathways will lead to new approaches in cancer care, allowing doctors to provide targeted therapies that deliver improved, personalized treatment.

The best pathway for patients to gain access to new therapies is through clinical trials. Trials conducted by the National Cancer Institute's Cooperative Group Program, a nationwide network of cancer centers and physicians, represent the United States' most important pathway for accelerating progress against cancer. This year, the Institute of Medicine released a report on major challenges facing the Cooperative Group Program. Chief among them is the fact that funding for the program has been nearly flat since 2002. ASCO has called for a doubling of funding for cooperative group research within five years and supports the full implementation of the Institute of Medicine recommendations to revitalize the program.

ASCO harnesses the expertise and resources of its 28,000 members to bring all of these pathways together for the greater good of patients.

Progress against cancer is being made every day—measurable both in our improved understanding of the disease and in our ability to treat it. A report issued in December 2009 by the National Cancer Institute, the Centers for Disease Control and Prevention, the American Cancer Society, and the North American Association of Central Cancer Registries found that rates of new diagnoses and rates of death resulting from all cancers combined have declined significantly in recent years for men and women overall and for most racial and ethnic populations in the United States.

The pace of progress can be and needs to be hastened. Much remains to be done. Sustained national investment in cancer research is needed to bring better, more effective, less toxic treatments to people living with cancer. Pathways to progress continue in the clinic as doctors strive to find the right treatments for the right patients, to understand what represents the right treatments, and to partner with patients and caregivers for access to those treatments.

This report demonstrates that significant progress is being made on the front lines of clinical cancer research. But although our nation's investment in this research is paying off, we must never forget the magnitude of what lies ahead. Cancer remains the number two killer of Americans. Future progress depends on continued commitment, from both ASCO and the larger medical community.

George W. Sledge Jr, MD

President

American Society of Clinical Oncology

Source: http://jco.ascopubs.org/content/early/2010/11/09/JCO.2010.33.2742.abstract

Células madre del cáncer

Una de las cosas más llamativas del cáncer es que a partir de una célula malignizada (por mutaciones) se van formando masas de células que por más mutaciones, reacción al entorno más o menos hostil, factores de crecimiento, nutrición y demás,  son diferentes unas de otras (en la imagen, cada grupo de un color). Antes se pensaba que todas las células (o casi todas), eran capaz de recomponer la masa tumoral, y los tratamientos (quimio, radio, hormono, etc) fallaban simplemente porque no llegaban a matar todas las células, y al final las supervivientes desarrollaban resistencias al tratamiento.

Las evidencias actuales hablan de un modelo jerárquico, donde sólo un 1-5% de las células son capaces de reconstruir el tumor. Y no es teoría. Se están identificando y aislando en una larga lista de tumores: leucemias, mama, gliomas, cabeza-cuello, colon, ovario, próstata, páncreas... Expresan marcadores como CD26, 44, 133, y genes de vías interesantes para tratamientos novedosos como Hedgehog, Notch, CXCR4.Y tienen todas en común una increíble capacidad para resistir a la quimioterapia y a la radioterapia, y explican la clínica  actual de nuestros tratamientos habituales.

Aunque el pistoletazo lo refiero al artículo de Nature de 2001, la cosa está aún tan verde que los cinco resúmenes de ASCO 2010 sobre diferentes "cancer stem cell" no pasa de observaciones in vitro.

Os dejo con las diapos de mi sesión, que incluyen citas para seguir estudiando.

Fuente:  ¿Es cáncer?