The role of the gut in cancer treatment, more equitable access to optimal cancer care and digitization of clinical trials are among topics that will take center stage this year

Leaders at City of Hope, one of the largest cancer research and treatment organizations in the United States, forecast that in 2024 more people will benefit from cancer breakthroughs, including research that unlocks the biology behind cancer disparities, wider access to CAR T cell therapy and rapid whole genome sequencing.

“Research-driven breakthroughs in cancer prevention and treatment are transforming cancer care as we know it and improving the lives of millions of patients each year,” said Robert Stone, CEO of City of Hope and the Helen and Morgan Chu Chief Executive Officer Distinguished Chair. “At City of Hope, we are fortunate to be surrounded by health care’s leading researchers, innovators and experts, and we are extremely optimistic about the future and expect the pace of innovation in cancer care to accelerate in 2024. That’s why I have never been more excited about the promise and hope we’re bringing to people around the globe.”

Here are City of Hope’s top eight predictions for the future of cancer care:

Prediction No. 1: Unlocking the biology behind cancer disparities

Despite significant advancements in cancer research and treatment, racial disparities in cancer incidence and outcomes remain a pressing concern. African American men have a 111% higher risk of dying of prostate cancer than white men. Asian/Pacific Islander adults are twice as likely to die of stomach cancer than white people. “Multidisciplinary approaches to study cancer disparities will become a bigger focus in 2024 as academic medical centers, affected communities and researchers partner to identify and mitigate those factors that dictate disproportionate incidence and mortality rates between populations,” said John D. Carpten, Ph.D., director of City of Hope's National Cancer Institute-designated comprehensive cancer center, director of Beckman Research Institute of City of Hope, chief scientific officer, the Irell & Manella Cancer Center Director’s Distinguished Chair and the Morgan & Helen Chu Director’s Chair of the Beckman Research Institute. City of Hope is leveraging its geography as a national cancer research and treatment system and its diverse patient population to study a number of cancer disparities, including triple-negative breast cancer in African American women, lung cancer in the Asian population and colorectal cancer in the Hispanic population. “By uncovering genetic variations and the socioeconomic risk factors behind every person’s cancer, we can offer new strategies in education, early detection and intervention,” said Carpten.

Prediction No. 2: Gut reactions help shape treatment

We all have bacteria, fungi and viruses living in our digestive tracts. In fact, we have as many of these microbes in our guts as we have cells in our bodies. Why is this important for cancer treatment? “The microorganisms in the gut modulate the immune system. There is a direct correlation between a healthy gut and the effectiveness of immune therapies, such as CAR T,” said Marcel van den Brink, M.D., Ph.D., president of City of Hope Los Angeles and City of Hope National Medical Center, chief physician executive and the Deana and Steve Campbell Chief Physician Executive Distinguished Chair. Expect to see an acceleration of the research and focus on the gut microbiome in 2024, said Van den Brink, who has been studying it for many years. City of Hope plans to enhance its program that spans from basic to clinical research in this area. “City of Hope has one of the largest and most successful transplantation programs in the country, with nearly 19,000 bone marrow transplant procedures performed to date. We are continuing to study the role the gut microbiome plays in protecting transplant patients from complications in their recovery,” added Van den Brink.

Prediction No. 3: Reading every letter of a patient’s genome for targeted therapies

For cancer patients, speed is crucial in determining the most effective and appropriate treatment. Equally important is a patient’s complete genetic information, which provides insight into the best treatment for each patient’s unique cancer. This combination of speed and the complete genomic data set is particularly important for people with blood cancers who have to go through multiple rounds of genetic testing. Some patients wait for days, weeks or even months to get results of all the genetic testing that is pivotal to guiding treatment. City of Hope, along with the Translational Genomics Research Institute (TGen), is one of only two centers in the world that can return equivalent results of all of this testing in two days rather than two or more weeks. “Rapid whole genome sequencing will ultimately replace the current standard testing, providing physicians with rapid insight to support both diagnosis and individualized treatment options for our patients,” said Jeffrey M. Trent, Ph.D., president and research director of (TGen), part of City of Hope. City of Hope is leveraging TGen’s ability to provide information to treating physicians for patients when time is a critical factor.

Prediction No. 4: Cancer prevention as the first line of treatment

According to the American Association for Cancer Research, the number of cancer cases in the U.S. will increase to 2.3 million by 2030. We know that only about 35% of cancers are caused by environmental and hereditary factors. The majority are caused by an accumulation of mutations in the DNA of cells over time. The most advanced cancer institutions are focusing on the promise of “precision prevention,” which combines molecular knowledge and risk stratification to develop an accurate understanding of an individual's actual cancer risk. Other advances point to blood tests that screen for a multitude of cancer types in their earliest stages. “City of Hope will soon launch a comprehensive research study validating a blood test developed by researchers at City of Hope and TGen to detect cancers early. Early detection is the key to curing cancer for many,” said Annette Walker, president of City of Hope Orange County.

Prediction No. 5: Digitization and decentralization of clinical trials

Clinical trials offer patients access to promising new therapies long before they become the standard of care, but 19 out of 20 people with cancer cannot enroll in a trial because of rigid and outdated eligibility criteria, which often discriminate against older and sicker patients, people of diverse ethnicities and genders, and people with limited transportation. Digitization and decentralization — where all or some of the trial-related activities occur outside of traditional trial sites — is part of the solution, according to Edward S. Kim, M.D., M.B.A, physician-in-chief, City of Hope Orange County, vice physician-in-chief, City of Hope National Medical Center, and the Construction Industries Alliance City of Hope Orange County Physician-in-Chief Chair. “Digital innovation can enhance every stage of clinical trials,” said Kim. “This year, we’ll see more organizations introducing scalable electronic platforms to remove barriers to trials and standardize access to them. Artificial intelligence will be increasingly leveraged, as AI-powered data sets, protocol designs and monitoring systems will create efficiencies.”

Prediction No. 6: Policy changes and partnerships expand access to optimal cancer care

There will be an even greater focus on policy discussions about value and access in cancer care, building on recent momentum in this area. Collaborative partnerships and policy reforms will begin to catalyze equitable access to the latest innovations, including clinical trials, precision medicine and genomic technologies. The result will be more lives saved and a better quality of life for patients, according to Harlan Levine, M.D., president of health innovation and policy for City of Hope. “Cancer care is different from other chronic illnesses. The speed of discovery, drug development and evolving practices increasingly requires more specialized expertise. Unfortunately, 60% of Medicare Advantage plans do not include access to treatment at a National Cancer Institute-designated comprehensive cancer center, contributing to significant disparities in cancer care outcomes. I expect to see increased momentum around making sure insurance networks include appropriate access to the latest treatments. We’ll also see tighter partnerships between community oncologists and academic medical centers, so patients can seamlessly receive the care they require in the right place at the right time.”

Prediction No. 7: CAR T reaches more people

One promising area of cancer research and treatment is immunotherapy, which harnesses the patient's own immune system to combat cancer. Chimeric antigen receptor (CAR) T cell therapy is a powerful form of immunotherapy in which immune cells are reprogrammed to recognize and attack a specific protein found in cancer cells. CAR T technology will likely have wider application for more cancer types. However, access to CAR T cell therapy faces formidable challenges — manufacturing complexities, high costs and inadequate reimbursement. Additionally, cancer centers lacking essential infrastructure are ill-equipped to handle potential CAR T cell-related adverse events. “While we are optimistic about CAR T cell therapy, we are acutely aware that we must address health care disparities, enhance physician expertise and establish more specialized centers in more communities,” said Leslie Popplewell, M.D., hematology and blood and marrow transplant medical director, City of Hope Atlanta. “This is a primary reason City of Hope expanded its National Cancer Institute-designated expertise to Chicago, Phoenix and Atlanta. We believe that the future of cancer care is in widening access to breakthrough cancer therapies like CAR T.”

Prediction No. 8: Generational shifts in philanthropic giving

Millennials have surpassed baby boomers as the biggest generational group in the United States, with an estimated population of 72.24 million. These generational shifts also impact philanthropic giving as more younger people understand the importance of supporting organizations that are making significant changes in health. More than 100,000 donors and volunteers advance City of Hope’s mission to eradicate cancer and diabetes and nearly 90 million Americans now live within driving distance of a City of Hope location. “Our diverse philanthropic community is helping City of Hope move more quickly and extend care to more people. Every gift — big and small — means more lives improved and saved,” said Kristin J. Bertell, chief philanthropy officer of City of Hope. This year, you’ll see City of Hope grow its philanthropic community and impact in numerous ways, including expanding its Walk for Hope fundraiser to new locations across the United States.

About City of Hope

City of Hope's mission is to deliver the cures of tomorrow to the people who need them today. Founded in 1913, City of Hope has grown into one of the largest cancer research and treatment organizations in the U.S. and one of the leading research centers for diabetes and other life-threatening illnesses. City of Hope research has been the basis for numerous breakthrough cancer medicines, as well as human synthetic insulin and monoclonal antibodies. With an independent, National Cancer Institute-designated comprehensive cancer center at its core, City of Hope brings a uniquely integrated model to patients spanning cancer care, research and development, academics and training, and innovation initiatives. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. City of Hope’s affiliated group of organizations includes Translational Genomics Research Institute and AccessHope^TM. For more information about City of Hope, follow us on Facebook, Twitter, YouTube, Instagram and LinkedIn.

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