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Managing the Nation’s Cancer Research Portfolio

Profiles of Research Progress

The disease we call cancer is, in actuality, a collection of diseases, each of which poses a different set of questions for the researchers who search for causes, mechanisms, and commonalities that will inform better prevention, detection, diagnosis, and treatment. The pages that follow present profiles of five cancers, which represent a small slice of NCi’s extensive research portfolio. For some of these cancers, we’re able to tell a story of important and recent progress in controlling them. Other cancers we profile remain resilient and difficult to treat, despite our research efforts, but our growing understanding of the basic cancer biology in these cancers offers promise for effective intervention.

For the vast majority of cancers, it takes years—often decades—for the complement of mutations necessary to drive the disease to occur. This is why three-quarters of all cancers in the United States are diagnosed in people who are 55 years of age or older. For some cancers, such as colorectal cancer, many of the molecular steps that silently accumulate during the cancer’s quiescent stages have been identified, and improved screening methods—which offer the best control for colorectal cancer—have been developed. For renal cancer, studies of highly affected families have provided insight into the genetic underpinnings of not only inherited forms of the disease but also of sporadic, or non- inherited, forms. Comprehensive genomic analysis is also facilitating classification of diseases such as B-cell lymphoma, which should inform research and lead to individualized treatments. For some cancers, such as those of the pancreas, a better understanding of the tumor microenvironment and host factors may help achieve the improvements in patient outcomes that have been elusive to date. Targeted therapies, such as imatinib (gleevec®) in gastrointestinal stromal tumors, illustrate the potential power of therapies directed at genetic targets.

NCi is committed to answering the most pressing questions for each cancer type and continuing to pursue fundamental knowledge about the inner workings of cancer cells, building upon past discoveries, so that we can eventually control cancers of all types.