HJAR May/Jun 2022

52 MAY / JUN 2022 I  HEALTHCARE JOURNAL OF ARKANSAS DIALOGUE COLUMN ONCOLOGY CANCER CLINICAL TRIAL RESEARCH: The Only Pathway to Cancer Cure AFTER the signature of the National Cancer Act in 1971 and the reorganiza- tion of the National Cancer Institute in its current form, funding for cancer research increased significantly. In 2020, of the $6.5 billion allocated to cancer research, almost $800 million was dedicated to clini- cal trials. Despite this major investment, the decrease of cancer mortality was not evenly distributed across the population. Childhood cancers benefited the most with decrease in mortality starting in the 1970’s that led to cure rates of these cancers greater than 80%. Adult cancers followed two decades later with much slower pace in annual decrease of mortality. What are the causes of this discrepancy between childhood and adult cancers, and how can we do better? It is believed that par- ticipation in clinical trials was the engine be- hind the amazing improvement of survival in childhood cancers. There is a strong cor- relation between high rates of enrollment in clinical trials and survival increases and mortality reductions in any cancer popula- tion. Childhood cancers are a small group (16,000) relative to the larger cancer popu- lation (1.8 million). However, enrollment in clinical trials has been consistently above 50% in childhood cancers and less than 5% “The best way to predict the future is to create it.” — ABRAHAM LINCOLN Significant strides in treating cancer have been achieved over the past five decades. Two major factors are behind this progress: better understanding of cancer brought about by the molecular and genomic revolutions that unraveled the mechanisms of many cancers and the translation of this understanding into the clinic through well conducted clinical trials.