"2022年AACR癌症进展报告：整合科学，转变患者结果，揭秘癌症复杂性"

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The AACR Cancer Progress Report 2022 provides a comprehensive overview of the latest advancements in cancer research and treatment. The report emphasizes the importance of integrating scientific discoveries into clinical practice to improve patient outcomes. By decoding the complexity of cancer, researchers and healthcare professionals are able to develop more effective therapies and diagnostic tools. Through innovative research and collaboration, significant progress has been made in understanding the underlying mechanisms of cancer development and progression. This knowledge has led to the development of targeted therapies that are tailored to the specific molecular characteristics of individual tumors. Additionally, advancements in immunotherapy have revolutionized cancer treatment by harnessing the body's own immune system to target and destroy cancer cells. The report highlights the importance of continued investment in cancer research to drive progress and improve survival rates for patients. Funding for research is essential to support the development of new treatments, diagnostic tools, and prevention strategies. Additionally, funding is needed to support the training of the next generation of cancer researchers and healthcare professionals. Overall, the AACR Cancer Progress Report 2022 emphasizes the transformative power of science in the fight against cancer. By integrating scientific discoveries into clinical practice, researchers and healthcare professionals are able to provide patients with personalized, cutting-edge care that improves outcomes and quality of life. Continued investment in research is crucial to further advance our understanding of cancer and develop new and improved treatments that will ultimately lead to better outcomes for patients.

the United States, government investments in medical

research are administered mostly through the 27 institutes

and centers of the National Institutes of Health (NIH).

The largest component of NIH is the National Cancer

Institute (NCI), which is the federal government’s principal

agency for cancer research and training. Medical research

funded by the public sector contributes significantly to

novel drug development, which is critical to saving and

improving lives (6,7). Federal investments in government

agencies conducting research, such as FDA and the Centers

for Disease Control and Prevention (CDC), are also of

particular importance.

The Medical Research Community:

Driving Progress Together

Progress against cancer is made when all stakeholders dedicated to fundamentally changing the burden of cancer work

together. Further increasing collaboration will accelerate the pace of future breakthroughs. The key stakeholders are:

Adapted from (1).

SAVING

LIVES

Patients, survivors, and

their caregivers, family

members, and friends

Health care

providers

Academic and government

researchers from a diverse

array of specialties

Biotechnology,

pharmaceutical, diagnostics,

and medical device company

research teams

Individual citizen

scientists, patient

advocates, and members

of advocacy groups

Health

insurance

payers

Federal funding

organizations

Regulators

Policy

makers

Philanthropic organizations,

cancer-focused professional

organizations, and

cancer-focused foundations

AMERICAN ASSOCIATION FOR CANCER RESEARCH® • 9

Cancer: An Ongoing Public

Health Challenge in the United

States and Worldwide

Although we have made incredible progress against cancers,

this group of devastating diseases continues to be an enormous

public health challenge in the United States and around the

world. In the United States alone, it is predicted that 1,918,030

new cases of cancer will be diagnosed in 2022 and that

609,360 people will die from the disease (1) (see Table 1, p.

11). ese estimates do not account for the consequences of

COVID-19, which has proven to have an adverse impact across

the spectrum of cancer research and patient care including

signicant declines in cancer screening and diagnosis (8).

In addition, data from the past two years have clearly shown

the heightened risks of SARS-CoV-2 infection and severe

COVID-19 among patients with cancer, albeit COVID-19-

related mortality among this population has decreased over

time (8,9). Ongoing research will uncover the long-term eects

of COVID-19 on cancer outcomes (10).

VARIABLE PROGRESS AMONG STAGES AT

DIAGNOSIS AND TYPES OF CANCER

Progress against cancers has not been uniform for all stages of a

given type of disease (5). is issue is illustrated by the fact that

the ve-year relative survival rates for U.S. patients vary widely

depending on the stage at diagnosis (5). As one example, among

women with breast cancer and people with colorectal cancer,

those whose cancer is conned to the breast, or to the colon or

rectum, have ve-year relative survival rates of 99 percent and

92 percent, respectively, while those whose cancer has spread to

a distant site have ve-year relative survival rates of 30 percent

and 16 percent, respectively (5).

FIGURE 1

Increasing Treatment Options for Melanoma

Until 2000, the standard of care for patients

with metastatic melanoma of the skin was a

chemotherapeutic called dacarbazine and/or an immune

system stimulant called aldesleukin (Proleukin); however,

neither treatment had shown a signiﬁcant eect on

overall survival in clinical trials. From January 1, 2011, to

July 31, 2022, the U.S. Food and Drug Administration

(FDA) approved ﬁve immunotherapeutics for

use alone or in combination with either another

immunotherapeutic or with molecularly targeted

therapeutics in the treatment of patients with metastatic

melanoma; these immunotherapeutics are atezolizumab

(Tecentriq), ipilimumab (Yervoy), nivolumab (Opdivo),

pembrolizumab (Keytruda), and relatlimab-rmbw

commonly referred to as relatlimab (Opdualag). In

addition, the agency approved six molecularly targeted

therapeutics for use alone, or in combination with

either another molecularly targeted therapeutic or

an immunotherapeutic for treating certain patients

with metastatic melanoma; these therapeutics are

binimetinib (Mektovi), cobimetinib (Cotellic), dabrafenib

(Taﬁnlar), encorafenib (Braftovi), trametinib (Mekinist),

and vemurafenib (Zelboraf). Together, these innovative

new therapeutics have helped improve the ﬁve-year

relative survival rate for individuals diagnosed with

metastatic melanoma from 18 percent (2006-2012) to

32 percent (2012-2018), the most recent time for which

these data are available) (4,5).

* This timeline focuses on systemic treatments for metastatic melanoma of the skin; other therapeutics have been approved for the prevention of disease recurrence or the

treatment of localized lesions. Also not included are therapeutics that are approved for other rarer forms of melanomas. For example, in January 2022, FDA approved tebentafusp

(Kimmtrak) for the treatment of certain patients with uveal melanoma, an aggressive cancer of the eye.

2013

trametinib

dabrafenib

2014

combination of

trametinib

and dabrafenib

pembrolizumab

nivolumab

2018

combination of

encorafenib

and binimetinib

2011

ipilimumab

vemurafenib

2015

combination of

ipilimumab

and nivolumab

combination of

cobimetinib and

vemurafenib

2020

combination of

atezolizumab and

cobimetinib and

vemurafenib

2022

combination of

relatlimab-rmbw

and nivolumab

1975

Dacarbazine

1995

Interferon

alfa-2b

Chemotherapy

Immunotherapy

Molecularly Targeted Therapy

1992

IL2

10 • AACR CANCER PROGRESS REPORT 2022

TABLE 1

Estimated* Incidence and Mortality

for Selected Cancers

*Rounded to the nearest 10.

Source: Estimated new cases are based on 2004-2018 incidence rates reported by the North American Association of Central Cancer Registries (NAACCR). Estimated

deaths are based on 2005-2019 U.S. mortality data, National Center for Health Statistics, Centers for Disease Control and Prevention. Table is modiﬁed from (1).

ESTIMATED 2022 INCIDENCE ESTIMATED 2022 DEATHS

Total Male Female Total Male Female

All Sites 1,918,030 983,160 934,870 609,360 322,090 287,270

Head and Thorax Region

Brain & other nervous system 25,050 14,170 10,880 18,280 10,710 7,570

Eye & orbit 3,360 1,790 1,570 410 220 190

Tongue 14,490 8,490 6,000 3,020 1,810 1,210

Mouth 14,490 8,490 6,000 3,020 1,810 1,210

Pharynx 19,270 15,670 3,600 3,980 3,140 840

Other oral cavity 2,380 1,660 720 1,440 1,090 350

Larynx 12,470 9,820 2,650 3,820 3,070 750

Lung & bronchus 236,740 117,910 118,830 130,180 68,820 61,360

Breast 290,560 2,710 287,850 43,780 530 43,250

Gastrointestinal (GI) System

Esophagus 20,640 16,510 4,130 16,410 13,250 3,160

Stomach 26,380 15,900 10,480 11,090 6,690 4,400

Liver & intrahepatic bile duct 41,260 28,600 12,660 30,520 20,420 10,100

Gallbladder & other biliary 12,130 5,710 6,420 4,400 1,830 2,570

Pancreas 62,210 32,970 29,240 49,830 25,970 23,860

Small intestine 11,790 6,290 5,500 1,960 1,110 850

Colon and Rectum 151,030 80,690 70,340 52,580 28,400 24,180

Anus, anal canal, & anorectum 9,440 3,150 6,290 1,670 740 930

Endocrine System

Thyroid 43,800 11,860 31,940 2,230 1,070 1,160

Urogenital System

Kidney & renal pelvis 79,000 50,290 28,710 13,920 8,960 4,960

Ovary 19,880 — 19,880 12,810 — 12,810

Penis and other genital organs, male 2,070 2,070 — 470 470 —

Prostate 268,490 268,490 — 34,500 34,500 —

Testis 9,910 9,910 — 460 460 —

Uterine cervix 14,100 — 14,100 4,280 — 4,280

Uterine corpus 65,950 — 65,950 12,550 — 12,550

Urinary bladder 81,180 61,700 19,480 17,100 12,120 4,980

Vulva 6,330 — 6,330 1,560 — 1,560

Vagina and other genital organs, female 8,870 — 8,870 1,630 — 1,630

Skin (excluding basal & squamous)

Melanoma-skin 99,780 57,180 42,600 7,650 5,080 2,570

Other nonepithelial skin 8,700 5,640 3,060 4,340 2,980 1,360

Hematological System

Acute lymphocytic leukemia 6,660 3,740 2,920 1,560 880 680

Chronic lymphocytic leukemia 20,160 12,630 7,530 4,410 2,730 1,680

Acute myeloid leukemia 20,050 11,140 8,910 11,540 6,730 4,810

Chronic myeloid leukemia 8,860 5,120 3,740 1,220 670 550

Other leukemia 4,920 3,180 1,740 5,270 3,010 2,260

Hodgkin lymphoma 8,540 4,570 3,970 920 550 370

Non-Hodgkin lymphoma 80,470 44,120 36,350 20,250 11,700 8,550

Myeloma 34,470 19,100 15,370 12,640 7,090 5,550

Other Cancers

Bones & joints 3,910 2,160 1,750 2,100 1,180 920

Soft tissue (including heart) 13,190 7,590 5,600 5,130 2,740 2,390

AMERICAN ASSOCIATION FOR CANCER RESEARCH® • 11

An additional challenge that we face is the uneven progress against

various cancer types (5). For example, the overall ve-year relative

survival rates of nearly 91 percent for women with breast cancer

and 97 percent for men with prostate cancer stand in stark contrast

to the overall ve-year relative survival rates of 21 percent for

people with liver cancer and less than 12 percent for those with

pancreatic cancer (5). While some of these dierences could be

attributed to early detection of breast and prostate cancers through

population level screening (see sidebar on Ways to Screen for

Cancer, p. 48), disparities in ve-year relative survival rates hold

true for patients with these four cancer types even when their

diseases are diagnosed at an advanced stage. e ve-year relative

survival rates of greater than 30 percent for advanced-stage female

breast and male prostate cancers are signicantly higher than the

ve-year relative survival rates of less than ve percent for those

with advanced-stage liver or pancreatic cancer (5).

Among children ages one to 14 years, cancer is the second-

leading cause of death, and the most diagnosed cancers are

leukemia and brain tumors (1). anks to extraordinary

advances in treatments for childhood leukemia, the age-

adjusted mortality rate from the disease has almost halved

in the past two decades. Unfortunately, mortality rates from

childhood brain and other central nervous system tumors have

essentially remained unchanged (5).

Developing new and eective tests for early detection of more

types of cancer as well as better treatment options for all cancer

types and for all stages of diagnosis could help address the

challenges of variable progress against dierent types of cancer.

DISPARITIES IN PROGRESS FOR CERTAIN

POPULATION GROUPS

Cancer health disparities are one of the most pressing public

health challenges in the United States. NCI denes cancer

health disparities as adverse dierences in cancer such as

number of new cases, number of deaths, cancer-related health

complications, survivorship and quality of life aer cancer

treatment, screening rates, and stage at diagnosis that exist

among certain population groups (12) (see sidebar on Which U.S.

Population Groups Experience Cancer Health Disparities?, p. 13).

As outlined in the AACR Cancer Disparities Progress Report

2022, racial and ethnic minorities and other medically

underserved U.S. populations shoulder a disproportionately

higher burden of cancer (see sidebar on Disparate Burden of

Cancer in the U.S.

, p. 14) (13). As one example, the U.S. Black

population has long experienced cancer health disparities.

In 1990, the overall cancer death rates for Black people were

33 percent higher than for White people (5). ere has been

some progress in recent years as evidenced by the narrowing

of the gap in cancer death rates between the Black and White

populations to 13 percent in 2019, a 60 percent decline in the

disparities since 1990 (5,14). However, even in 2019, overall

cancer death rates were higher among Black men and women

compared to all other U.S. racial and ethnic groups (14).

Sexual and gender minorities (SGM) are another U.S.

population that experiences cancer health disparities. According

to a new report, gay men are more likely than heterosexual men

to report lifetime diagnoses of cancers, and gay men and lesbian

women are more frequently unable to aord many types of

health care services compared to heterosexual men and women

(15). Unfortunately, there are limited data on the epidemiology

of cancer incidence and outcomes among SGM individuals

making it dicult to evaluate the true burden of cancer in this

underserved population. It is imperative that researchers collect

disaggregated data by sexual orientation and gender identity,

as well as within sexual minority groups (e.g., gay versus

bisexual) and gender minority groups (e.g., transgender versus

nonbinary) to accurately capture cancer epidemiology in these

heterogeneous populations (13).

Research has identied complex and interrelated factors, oen

referred to as the social determinants of health, including

socioeconomic, cultural, behavioral, environmental, and

clinical factors that contribute to cancer health disparities.

It is increasingly evident that structural racism and systemic

injustices cause adverse dierences in social determinants of

health, creating conditions that perpetuate health inequities,

including cancer health disparities (see sidebar on

Why Do U.S.

Cancer Health Disparities Exist?, p. 15).

One of the drivers of cancer health disparities is general health

of a population group. For instance, individuals with underlying

health conditions, such as diabetes, or those infected with

certain pathogens, such as human immunodeciency virus

(HIV), experience a greater burden of cancer (see sidebar

on Cancer Burden Among People Living with HIV, p. 16). It

should be noted that individuals with intersectional identities

oen experience multilevel barriers to optimal health care

• Overall U.S. cancer incidence has been declining during the past

two decades, albeit the rates have stabilized more recently.

• However, the incidence of certain cancers, such kidney,

pancreatic, and uterine cancer, is rising.

• For example, between 2000 and 2018, pancreatic cancer

incidence increased signiﬁcantly, with the greatest increase

observed among women ages 15 to 34 years.

Data from (5,11).

2018

2000

12 • AACR CANCER PROGRESS REPORT 2022

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