On World Cancer Day: City of Hope Offers 10 Bold Solutions to End Cancer

The American Cancer Society reports that younger women are an astounding 82% more likely to be diagnosed with cancer compared to men, with Black women among those most at risk — a situation that underscores the urgent need for targeted research, more accessible screening and tailored interventions that not only address cancer for the short term but also address the risk of recurrence.

"We are making progress," says Veronica Jones, M.D. "Research is underway to understand the multiple contributors of the higher breast cancer mortality rate in Black women. This research incorporates tumor biology and social determinants of health to advance precision medicine in historically underserved populations." Other studies focus on improving treatments for triple-negative breast cancer — which is prevalent among younger women. Better and earlier screening of younger women is also seen as part of the solution, especially those who are most at risk yet fall below age guidelines for screening for the general population. "For women with a family history of breast cancer it is recommended to start screening mammograms at age 40 or 10 years before the youngest known family member with breast cancer was diagnosed, whichever comes first, and to start even earlier for women with known genetic mutations, such as BRCA 1/2," says Jamie Rand, M.D.

An alarming increase in colon, colorectal, breast, uterine and other cancers in people under 50 highlights the need for new treatments and more effective early detection strategies. City of Hope is advancing new screening technologies, including a liquid biopsy test for the identification of lymph node metastasis in early-stage colorectal cancer, an exome-based liquid biopsy test that detected 97% of early-stage pancreatic cancers and other tests that detect cancer through a simple blood draw. “By more broadly implementing advances like liquid biopsies, we can identify cancer at its earliest and most treatable stages,” said Ajay Goel, Ph.D., AGAF, City of Hope professor and chair of the Department of Molecular Diagnostics and Experimental Therapeutics. City of Hope experts agree that primary care physicians and oncologists on the frontlines also will play an increasingly pivotal role in earlier screening for at-risk patients, which is essential for cancer survival and, as more young patients live decades after diagnosis, will help reimagine maintaining quality of life postcancer.

With the paradigm-shifting potential of artificial intelligence (AI) in health care, emphasis will expand beyond enhancing treatment efficacy to include strategies to reduce health care disparities, a persisting issue in the U.S. Research released in the American Cancer Society statistics publication found mortality rates for many preventable cancers are at least twice as high for native American and Black people than for white people. Genomic science for earlier screening tools and risk assessments and clinical trials to understand an individual’s unique biological and psychosocial needs are key approaches that can help close these gaps in cancer mortality and incidence. However, 19 out of 20 cancer patients currently cannot enroll in clinical trials because of rigid eligibility criteria, and genomic data used for clinical studies are still predominantly derived from white European populations, which risks perpetuating existing biases and health inequities.

“To realize AI’s full potential in cancer care, it is crucial to integrate diverse genomic data and address the social determinants of health to ensure equitable treatment outcomes across all racial and ethnic groups,” said John D. Carpten, Ph.D., chief scientific officer at City of Hope and Irell & Manella Cancer Center Director’s Distinguished Chair, who studies how genes affect disease risk and treatment outcomes with particular focus on cancers that disproportionately affect underserved and historically marginalized populations. “We must also cultivate a diverse workforce in medicine that reflects the communities we serve. This approach is essential for enhancing participation in clinical trials and ensuring equitable health care outcomes for all.”

Research into the body’s trillions of microbes will expose new ways to prognosticate cancer outcomes and personalize cancer treatments. Changes in the gut are a major modulator specifically for cancer immunotherapies, as evidenced by recent data from City of Hope highlighting the potential of fiber intake post-stem cell transplant to help reduce complications and potentially improve overall survival.

“Biorepositories, including those that have microbiome samples, are pivotal in accelerating this research,” said Marcel van den Brink, M.D., Ph.D., president of City of Hope Los Angeles and City of Hope National Medical Center, and Deana and Steve Campbell Chief Physician Executive Distinguished Chair. “By housing vast amounts of biological data, these repositories will help to unravel the complex mechanisms of cancer development, evolving cancer care from a one-size-fits-all approach to one defined by each individual’s unique biology and lifestyle.”

City of Hope is building a first-of-its-kind biorepository that will transform microbiome research, advancing understanding of how gut health and nutrition can enhance outcomes and improve the efficacy of cancer treatments.

Remarkably, a miniature surgical robot on the International Space Station recently completed a surgical simulation guided by surgeons on Earth; this new technological advancement will help forge a new generation of remote cancer surgeries, enabling patients across geographies to access the surgical expertise of highly specialized physicians.

Said Yuman Fong, M.D., City of Hope’s Sangiacomo Family Chair in Surgical Oncology and professor and chair of the Department of Surgery, “Another benefit is greater patient safety because we are allowing for immediate intraoperative consultation amongst surgeons when unexpected findings are encountered.”

The next generation of robots are more compact, easier to train on and able to help underserved communities have access to surgical experts, Dr. Fong said. Already, he and others are performing preclinical studies on remote cancer surgeries.

Oncology’s de-escalation is underway with advances such as new nontoxic, more effective immunotherapy and improvements that significantly reduced recovery times for complicated surgeries. On the horizon are more ways to give patients the greatest chance of survival while also reducing negative consequences of treatment. Some therapies also will improve the experience, with quick subcutaneous injections instead of hours in an infusion chair. “It’s not just about the cure but how we get there,” said Stephen J. Forman, M.D., director of the Hematologic Malignancies Research Institute. “At City of Hope, we don’t rest until we’ve found a safer and better treatment. We already administer cell therapy in the outpatient setting; our focus now is ensuring patients receive the most innovative treatment first. We’re moving leading-edge therapies like CAR T closer to frontline, altogether avoiding the need for the high-risk, multiyear commitment to chemotherapy or a bone marrow transplant.”

Cancer advances are emerging rapidly, including personalized cancer vaccines that target unique mutations, radiotherapy that simultaneously targets and treats cancer, and targeted therapies becoming new standards of care for cancer types that appeared “undruggable.” With longer survival rates now a reality, recognition that cancer impacts every aspect of a person’s life is elevating the need for evidence-based supportive care to become a national standard of care, with technologies such as AI playing a part of this new movement.

“We are exploring how technology can cross over into supportive care through the development of AI-assisted apps that can provide practical resources from diagnosis through to survivorship and that can facilitate care coordination and emotional support,” said Simon Nazarian, City of Hope’s system executive vice president and chief digital and technology officer. “By placing the whole patient at the center of our precision health design, these digital tools will expand the understanding of and equitable access to multidisciplinary, personalized supportive care services aimed to redefine treatment for both patients and caregivers facing cancer — what it means to not only heal but also to thrive.”

Diabetes and pancreatic cancer are two life-altering diseases with similar metabolic pathways, which is why City of Hope advances research into both illnesses. Emerging studies now reveal that diabetes may significantly elevate the risk of developing cancer, and there is the potential for interventions such as GLP-1 receptor agonists to aid in improving metabolic control. Putting this in perspective, Debbie C. Thurmond, Ph.D., director of the Arthur Riggs Diabetes & Metabolism Research Institute at City of Hope and Chan Soon-Shiong Shapiro Distinguished Chair in Diabetes, said, “A patient with diabetes has an increased risk of certain types of cancer. Whether that risk is twofold or tenfold depends on the specific type of cancer and how well the patient manages their diabetes.” Added Vincent Chung, M.D., an oncologist and research professor in City of Hope’s Department of Medical Oncology & Therapeutics Research, recent work in better understanding the link between these diseases is paving the way for promising earlier detection and more targeted therapies.

Cancers like pancreatic, brain and stomach cancer and diseases such as sickle cell disease have been long underfunded and under-researched — The American Cancer Society report reveals pancreatic cancer remains the third leading cause of cancer death, and despite national legislation, treatment advances are still lacking. A recent surge in national attention and resources for these diseases will see improved patient outcomes. In 2025, due to the wider availability of potentially life-changing gene therapies for sickle cell disease, combined with City of Hope’s capacity to administer these therapies at significant scale, the first people in a commercial setting may be cured of this debilitating disease. There is also new hope for people with aggressive glioblastoma as City of Hope researchers are finding initial success with delivering CAR T cell therapy directly to the brain tumor and the cerebrospinal fluid, said Christine Brown, Ph.D., The Heritage Provider Network Professor in Immunotherapy and deputy director of City of Hope’s T Cell Therapeutics Research Laboratories. “City of Hope scientists are at the forefront of uncovering innovative treatments for these cancers and diseases that are so difficult to treat,” Dr. Brown added. “In 2025, our team will continue to improve CAR T cell therapy for brain tumors by combining different CARs that can target multiple antigens and by engineering T cells to be more resilient in the hostile tumor microenvironment.”

Only 1 in 5 patients live near a major academic medical center, significantly limiting their access to treatment options and potentially better outcomes. Expanding access to high-quality care for underserved and disproportionally impacted communities will help to decrease current disparities. “The future of cancer is the intersection of incredible science and innovative care delivery that makes the greatest advances accessible to millions,” said Harlan Levine, M.D., City of Hope’s president of Health Innovation and Policy. One way National Cancer Institute-designated cancer centers are bridging the access gap is through innovative programs such as AccessHope™, which virtually connects 7 million people — many in underserved regions — to highly specialized cancer expertise. Another is through transformative initiatives such as City of Hope’s new Hope Plaza in Los Angeles, which offers advanced outpatient cancer care, and the opening of Orange County’s only cancer specialty hospital. “The hospital completes the continuum of advanced cancer care in our region, offering local access to nationally recognized lifesaving expertise, more first-in-human clinical trials and a future filled with immense hope,” said Annette M. Walker, president, City of Hope Orange County.