Cancer Deaths Fall by a Third with Targeted Medicines and Immunotherapy

The American Association for Cancer Research (AACR) 2023 Cancer Progress Report examines recent treatment innovations and how they improve life expectancy and quality of life for patients.

• Cancer deaths declined by 33% during 1991-2020.
• This corresponds to 3.3 million lives saved in the United States alone.
• The largest reductions were seen in breast, lung and prostate cancer deaths.
• Targeted therapies and immunotherapies are credited with the most important role in this decline.

The Era of Targeted Therapy and Immunotherapy

The Human Genome Project and The Cancer Genome Atlas were major milestones for contemporary treatment. These genomic studies accelerated targeted therapies with fewer adverse effects and greater anticancer activity. Immunotherapies brought a new dimension to cancer treatment.

The AACR report highlights targeted therapies approved by the US Food and Drug Administration (FDA) since the early 2000s and their distinctive mechanisms. They include, in 2003, gefitinib, in 2011, crizotinib and, in 2021, sotorasib. All were approved for lung cancer, and these approvals have contributed to declining lung cancer deaths.

The annual decline in lung cancer deaths increased from 0.9% during 1995-2005 to nearly 5% during 2014-2020.

The report also notes that between 1 August 2022 and 31 July 2023, the FDA approved 14 new cancer therapies and expanded 12 therapies to additional cancer types. Their sophisticated mechanisms include cell signalling inhibition, antibody–drug conjugates, bispecific antibodies and immune checkpoint inhibition.

Ten years ago, there was only one immune checkpoint inhibitor (immunotherapy). By 2023, the FDA had approved 11. Rather than the single disease treated a decade ago, they are now used for 20 diseases.

Between 1 August 2022 and 31 July 2023, the FDA also approved two new imaging agents: pafolacianine and flotufolastat fluorine-18.

Ongoing Challenges

Despite this progress, much work remains. Structural barriers persist, and medically underserved groups receive clearly unequal care. These include racial and ethnic minorities, but also often-overlooked rural communities, which participate infrequently in cancer clinical trials.

Similarly, precision oncology has improved outcomes, but ways are needed to extend it to more diseases. Pancreatic cancer and glioblastoma, an aggressive brain tumour, still have very low 5-year survival, so further advances are needed.

Nevertheless, the future of cancer research is bright. There is reason for hope in a time offering unprecedented opportunities.