The nation’s academic cancer centers are a national resource that will increase in value as remarkable changes continue in biomedical research, cancer care, and health policy.
Research advances stemming from academic cancer centers have had an immense impact on the care of patients with cancer. Breakthroughs including development of signal transduction inhibitors such as imatinib, monoclonal antibodies such as rituximab, stem cell transplantation and newer advances such as checkpoint blockade and chimeric antigen receptor T cells, would never have happened without research conducted at academic cancer centers. The same is true for advances in cancer prevention and early detection. Untold numbers of individuals in the U.S. and beyond have benefited from these advances.
Research conducted at academic centers has been at the center of the realization that cancer is much more complex at the molecular level than previously imagined. Cancers that we previously considered “common” can now be classified based on their molecular makeup, and increasingly are viewed and treated as distinct entities.
Thus, essentially all cancers are proving to be rare cancers. This complexity is already resulting in new treatment paradigms for a variety of cancers even though we are just at the dawn of this revolution, all made possible in large part by our academic cancer centers. Our ability to probe, understand and leverage this complexity to help individual cancer patients is progressing at an unprecedented rate, in large part because of the ability of academic cancer centers to integrate their major missions of research, clinical care and education.
With this rapid evolution and ever-increasing enhanced understanding of the complexity of the many diseases known as cancer, it is difficult for even the most outstanding general oncologist to keep up. Academic cancer centers are well positioned to collaborate with general oncologists to minimize the gap between state-of-the-art therapy based on this new knowledge, and the actual care provided to patients. Academic cancer centers are home to multidisciplinary teams of clinicians and investigators with expertise in specific cancer types.
These teams are often involved in generating the scientific and clinical advances. They are able to keep up with rapidly changing and complex factors, including molecular analysis, that increasingly affect the provision of optimal patient care. Providing the highest quality, affordable cancer care based on state-of-the-art science will require close collaboration between academic, multidisciplinary teams of experts and community oncologists. Only through such collaborations can we assure the most effective treatments are selected and provided to patients as efficiently and conveniently as possible.
While some patients will require specialized care that can only be delivered in the academic setting, many others will be able to receive their care closer to home. In the area of research, the pharmaceutical industry is increasingly relying on discoveries made in academia. The highly collaborative and interdisciplinary nature of academic cancer centers, as well as the access they afford to patient samples and patient data, serves as an incubator for ideas that provide great value to the pharmaceutical and biotech industries. These commercial entities are also dependent on academic cancer centers to train laboratory and clinical investigators who chose industry as a career path. The cancer centers provide a skilled pool of clinicians who are in short supply across the country, at a time when cancer is becoming more common in our aging population.
Academic cancer centers have an outsized positive economic impact on both their local communities and the nation. Each research laboratory is the equivalent of a small business providing jobs for highly skilled employees. The ideas and discoveries generated by academic cancer centers have played a central role in the development of the biotech industry, which in turn has been a leading economic engine for the U.S. and a key to country’s competitive edge internationally.
The current inflationary rate of health care expenditures cannot be sustained. Cancer care is responsible for a significant fraction of this inflation. Academic cancer centers are vital if we are to respond effectively to this challenge as well. They conduct health services research and are central to development and implementation of guidelines and pathways that will be increasingly important as both academic and community oncologists seek to provide evidence-based, optimal patient care while not bankrupting the nation.
Those of us who work in academic cancer centers and have the privilege of participating in this incredible era of advancement know that the statements made above concerning the role of academic cancer centers are true. However, as believers in data-driven decision-making, we know that simply making that statement is not enough. We need to back it up with evidence.
With this in mind, the Association of American Cancer Institutes (AACI) has begun an initiative to gather information on the value of academic cancer centers with respect to clinical care, research, education and economic impact. We will use various platforms to share this information with various audiences including the general public, leadership at academic institutions, payers, corporations, chambers of commerce and government officials at the federal, state, and local levels. The goal of the initiative is to gather and distribute data that highlights the unique and indispensable role played by academic cancer centers and why these efforts should be supported.
Academic cancer centers are an incredible success story. They leverage their three mutually supportive missions of research, clinical care and education to create knowledge, provide complex cancer care, serve as a resource for community oncologists and educate the next generation of investigators and clinicians all while having a positive effect on the economy. They must continue to be supported based on their unique ability to play a leading role in leveraging the remarkable scientific opportunity before us to reduce the pain and suffering caused by cancer. The AACI “Academic Difference” initiative is designed to help us do a better job of explaining why.
The author is director of the University of Iowa Holden Comprehensive Cancer Center.
He became president of the Association of American Cancer Institutes Oct. 26, during the association’s annual meeting in Chicago, where he delivered a talk about his presidential initiative, “The Academic Difference.”