To mark ASCO’s 50th anniversary, the Society called on the oncology community to select the five most pivotal advances in cancer research and patient care over the past 50 years. Now, with more than 2,000 votes cast, ASCO has announced the results on CancerProgress.Net, its interactive website on the history of progress against cancer.

The results offer a range of clinical research advances, from cancer prevention to chemotherapy, molecularly targeted therapy to supportive care.

Spotlight on NIH-Funded Research

Voters selected these milestones from a “ballot” of 32 advances drawn from CancerProgress.Net’s “Major Milestones” timeline, which was developed under the guidance of leading oncologists. The ballot also allowed voters to describe why they made their selection (see the sidebar, “Why They Voted”).

Importantly, federal research funding played a role in many of these advances, which were announced a day ahead of the second annual Rally for Medical Research Hill Day on September 18, in Washington, DC. The goal of this event is to call attention to the real and meaningful progress that has been made because of the federal investment in medical research through the National Institutes of Health (NIH). Patients and advocates will also join in a call to Congress for greater funding for the NIH, which actually lost almost a quarter of its purchasing power in the past decade, adjusting for inflation.

“Progress builds on progress. Over the past 5 decades, NIH-funded research has transformed the outlook for people with cancer. These Top 5 in 50 highlight transformational discoveries that represent a shining sliver of what we have learned from a sustained investment in federally funded research,” said ASCO President Peter Paul Yu, MD, FACP, FASCO. “However, without greater federal investment going forward, the pace of progress against cancer and other diseases will be far slower. We’re already seeing more high-quality research grants being turned down and a projected 40% cut to patient enrollment in NIH-funded cancer clinical trials just since 2009.”

Here are the results of the vote on the “Top 5 Advances in Modern Oncology”:

1. MOPP chemotherapy cures advanced Hodgkin lymphoma

In 1965, Vincent T. DeVita, Jr, MD, FASCO (ASCO Past President, 1977-1978) and his colleagues at the National Institutes of Health discovered that combination chemotherapy—mechlorethamine, vincristine, procarbazine (Matulane), and prednisone (MOPP)—induced long-term remissions in over half of adults with Hodgkin lymphoma. The discovery sparked the first hope that advanced cancers could be cured with drug treatment and paved the way for 90% cure rates in patients with this disease today.

2. HPV vaccine approved to prevent cervical cancer

The first human papillomavirus (HPV) vaccine—approved in 2006—brought 100% protection against the two strains of HPV known to cause most cervical cancers. Widespread vaccination, if fully implemented, could drive dramatic reductions in cervical and other HPV-related cancers in the United States and worldwide.

3. Imatinib transforms treatment of chronic myelogenous leukemia

The rapid U.S. Food and Drug Administration review and approval of imatinib (Gleevec) in 2001 transformed treatment for most patients with chronic myelogenous leukemia (CML). This easy-to-take pill turned a disease with no long-term survivors into one with 5-year survival rates of almost 90%. It also heralded a new era of research on molecularly targeted anticancer drugs. Today, over 60 of these medicines are available.

4. PVB chemotherapy cures testicular cancer

In 1977, Lawrence H. Einhorn, MD, FASCO (ASCO Past President, 2000-2001) and colleagues showed that a new three-drug combination chemotherapy regimen—cisplatin, vinblastine, and bleomycin (PVB)—produced complete remissions for 70% of men with aggressive testicular cancer. Prior chemotherapy treatments worked in just 5% of men. This discovery, coupled with later multidisciplinary advances, made testicular cancer treatment one of oncology’s biggest success stories.

5. Powerful antinausea drugs dramatically improve many patients’ quality of life

The introduction of ondansetron in 1991, together with other supportive care advances, dramatically changed the experience of cancer treatment for patients. These drugs not only brought relief from intense, treatment-induced nausea and vomiting, but also made it possible for patients to avoid once-routine hospital stays, complete their full course of treatment, and live longer and better overall.

“All of these advances mark major turning points for cancer care and have improved and saved the lives of countless Americans,” said Dr. Yu. “Federally funded research answers questions that are critically important to patients, questions that would otherwise go unanswered—like comparing the effectiveness of two regimens, exploring new uses for generic drugs, finding new ways to improve patients’ quality of life, and testing truly novel approaches like many of those highlighted in the Top 5 in 50 announced today.”

These results not only demonstrate the remarkable progress achieved in cancer research since ASCO’s founding, but also the payoff of federal investment in clinical research: NIH research grants played a role in many of the discoveries that made the “Top 5.”

For more information on the “Top 5,” including historic photos and more comments from people who voted, go to www.CancerProgress.Net/Top5. ■