Major Milestones Against Cancer

Major Milestones Against Cancer

The Cancer Progress Timeline is an interactive, data-rich resource that provides an historical overview of major advances in cancer that have led to better patient outcomes and quality of life. More than 400 milestones spanning 170 years are chronicled in the Timeline—from the advent of general anesthesia opening the door for cancer surgery in the mid-1800s to the first gene therapy for cancer approved by the Food and Drug Administration in 2017.

The Major Milestones Against Cancer Timeline highlights some of the most important advances across cancer care and research. Many of these milestones were supported by federal research funding, and nearly all of them are the result of rigorously conducted clinical trials, made possible by the participation of thousands of individuals with cancer. ASCO’s federally funded research badge is featured on milestones that stemmed from research funded at least in part by the National Cancer Institute or other federal agencies.

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2017

First gene therapy for cancer

First gene therapy for cancer

In a landmark trial, the chimeric antigen receptor-modified T cell (CAR-T) therapy tisagenlecleucel (Kymriah) causes complete remissions in a majority of young patients with B-cell acute lymphoblastic leukemia (ALL) that progressed despite previous treatment with standard therapies. Soon after, tisagenlecleucel becomes the first gene therapy to be approved by the FDA.

CAR-T therapy works by genetically modifying the patient’s own immune T cells to target a specific cancer protein and ultimately trigger the cancer cell’s destruction. Importantly, this “living therapy” needs to be given to the patient only once, because CAR T cells continue to multiply in the patient’s body, so the anticancer effects of CAR T cells persist and can even increase over time.

2016

Pembrolizumab extends NSCLC survival, with fewer side effects

Pembrolizumab extends NSCLC survival, with fewer side effects

Studies find that pembrolizumab (Keytruda) improves survival and causes fewer side effects than standard chemotherapy for patients with advanced non-small cell lung cancer (NSCLC) and high levels of PD-L1 protein in the tumor. These trials include patients who were newly diagnosed and previously treated with other therapies, leading the FDA to approve the drug for both populations of patients. These approvals establish a new treatment paradigm for this type of lung cancer, with immunotherapy becoming the preferred treatment over chemotherapy regimens for PD-L1-positive cancers. 

First new treatment for bladder cancer in three decades

First new treatment for bladder cancer in three decades

The FDA approves atezolizumab (Tecentriq) for treatment of advanced urothelial carcinoma, the most common form of bladder cancer. With this approval, atezolizumab becomes the first new bladder cancer treatment in 30 years and the first PD-L1 immune checkpoint inhibitor approved for any use. The approval follows an early clinical trial in which atezolizumab rapidly shrank tumors in patients with previously treated advanced urothelial cancer, particularly those with high levels of PD-L1 in the tumor and immune cells.

Childhood cancer survivors living longer and healthier

Childhood cancer survivors living longer and healthier

A federally funded analysis of over 34,000 five-year childhood cancer survivors shows significant gains in long-term survival over three decades, owing to steady refinements in treatment. The rate of death from any cause within 15 years of childhood cancer diagnosis declined by half (from 12% to 6%) among survivors treated in the 1990s compared to those treated in the 1970s. While treatment advances played a major role, reductions in treatment-related health complications likely had the greatest impact on long-term survival. This includes lower dose of radiation for certain cancers and less use of anthracycline chemotherapy. These advances helped make it possible for more than 400,000 childhood cancer survivors to be alive today in the United States.

2015

A new class of breast cancer treatment introduced

A new class of breast cancer treatment introduced

2015-2016

Palbociclib (Ibrance) becomes the first in a new class of medicines called cyclin-dependent kinase (CDK) inhibitors, which block key proteins that control cell division. In clinical trials, addition of palbociclib to standard hormone therapy extended the time until the cancer worsened by a median of 11 months when given as initial therapy and by about 5 months for women with previously treated cancer. In 2015, the FDA grants accelerated approval to palbociclib in combination with letrozole (Femara) as initial hormone-based therapy in post-menopausal women with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer. In 2016, the FDA grants accelerated approval to palbociclib with fulvestrant (Faslodex) to treat advanced breast cancer that worsens following initial hormone therapy.  

Three immunotherapies introduced for most common type of lung cancer

Three immunotherapies introduced for most common type of lung cancer

Three new immunotherapies are approved by the FDA for patients with advanced non-small cell lung cancer (NSCLC) that worsened during or following chemotherapy. In clinical trials, the three drugs, nivolumab (Opdivo), atezolizumab (Tecentriq), and pembrolizumab (Keytruda), were each shown to extend survival and cause fewer severe side effects than chemotherapy. These treatments target the so-called immune checkpoint proteins PD-1 and PD-L1, respectively, helping the immune system fight cancer.

2014

Four new drugs transform CLL treatment

Four new drugs transform CLL treatment

In a span of eight months, the FDA approves four new treatments for chronic lymphocytic leukemia (CLL), a blood cancer that most commonly develops in older adults. Obinutuzumab (Gazyva) and ofatumumab (Arzerra), approved as initial treatments for CLL, delay cancer worsening by about a year when given with chemotherapy. Targeted drugs idelalisib (Zydelig) and ibrutinib (Imbruvica) were approved for use in patients with CLL that became resistant to or relapsed after standard treatment. In clinical trials, both slowed cancer worsening and ibrutinib also helped patients live longer.  All four new therapies are easier for patients to tolerate than prior therapies, making treatment possible for more patients than ever.  

FDA approves two immunotherapies for melanoma

FDA approves two immunotherapies for melanoma

FDA grants accelerated approval to pembrolizumab (Keytruda) and nivolumab (Opdivo) for patients with advanced melanoma that cannot be removed with surgery who no longer respond to other treatments.

These therapies, known as “immune checkpoint inhibitors,” work by blocking a pathway called PD-1, that prevents the body’s immune system from attacking cancer cells.

Approval comes following research showing that the therapies shrank tumors in up to 40% of patients. In one clinical trial, nivolumab extended survival compared to targeted therapy for patients with BRAF mutations. 

2013

Potential new approach to treating childhood leukemia found

Potential new approach to treating childhood leukemia found

An early clinical trial shows that a new approach called chimeric antigen receptor-modified T cell (CAR-T) therapy led to complete remission of acute lymphoblastic leukemia (ALL) that had not responded to previous aggressive treatment in two children. This is the first report on the use of CAR T-cell therapy in patients with ALL. 

CAR-T therapy works by genetically modifying the patient’s own immune T cells to target a specific cancer protein.

2011

Aromatase inhibitors cut breast cancer risk in postmenopausal women

Aromatase inhibitors cut breast cancer risk in postmenopausal women

2011-2014

A large Phase III trial shows for the first time that exemestane (Aromasin) – part of a group of drugs called aromatase inhibitors – greatly lowers the chance of developing invasive breast cancer in postmenopausal women who are at a high risk for breast cancer. This includes women with BRCA gene mutations, as well as other risk factors. In 2014, another aromatase inhibitor, anastrozole (Arimidex), was shown to lower the risk of breast cancer by nearly 50% over five years.

Two other drugs, tamoxifen (Nolvadex) and raloxifene (Evista), are also FDA-approved for breast cancer prevention in women at high risk for the disease Aromatase inhibitors work differently, however, and tend to carry milder side effects.

2010

Record number of Americans surviving cancer – nearly 14 million

Record number of Americans surviving cancer – nearly 14 million

The National Cancer Institute and the American Cancer Society report that the number of cancer survivors in the U.S. increased to an all-time high of 13.7 million. This represents a more than four-fold increase since 1971 (when just 3 million survivors were alive). By 2022, the number of survivors is expected to reach 18 million. The report highlights major progress in treatment that has led to improved survival rates, as well as the need to address the long-term health effects of cancer, and cancer treatment, among survivors.

New prohibitions on indoor tanning after it’s declared carcinogenic

New prohibitions on indoor tanning after it’s declared carcinogenic

2009-2017

In 2009, the International Agency for Research on Cancer, a working group of the World Health Organization, declared that UV-emitting tanning devices are “carcinogenic to humans.”

Between 2011 and 2017, several new pieces of legislation are enacted to restrict the use of indoor tanning, starting with a new California law prohibiting indoor tanning to people under the age of 18. Fourteen other states and the District of Columbia subsequently follow suit.  In 2014, the U.S. Food & Drug Administration issues an order requiring all indoor tanning devices to carry a visible black-box warning against use before age 18, and it reclassifies indoor tanning devices from a low to a moderate risk, allowing the agency greater control over the devices. Policy changes continue in Australia, where nearly all states enact bans on indoor tanning in 2015.

Adding palliative care to standard chemotherapy improves survival for advanced lung cancer patients

Adding palliative care to standard chemotherapy improves survival for advanced lung cancer patients

A head-to-head trial shows that patients who received standard chemotherapy along with palliative care (specialized treatment to address the symptoms of cancer, but not treat the disease) immediately after their diagnosis with advanced lung cancer lived three months longer and had a higher quality of life than patients who had chemotherapy alone. Patients who received the combination approach were also less likely to undergo aggressive therapy at the end of life, such as resuscitation. The results demonstrate the potential for palliative care to no only improve quality of life, but to extend patients' lives as well.

First drug shown to improve survival for patients with advanced melanoma

First drug shown to improve survival for patients with advanced melanoma

In a Phase III study, the targeted drug ipilimumab (Yervoy) – which boosts a specific component of the immune system – is found to improve survival and delay disease progression in patients whose advanced melanoma progresses despite other therapies. The drug is approved for this use in early 2011.

Soon after, a second trial finds that treatment using a combination of ipilimumab and dacarbazine (a chemotherapy drug commonly used in melanoma) extends survival compared to dacarbazine treatment alone.

CT scanning reduces lung cancer deaths among heavy smokers

CT scanning reduces lung cancer deaths among heavy smokers

Results from a large clinical trial show that annual screening with low-dose spiral CT (LDCT) scans reduces the risk of lung cancer death by 20 percent, compared to annual chest X-rays, in current and former heavy smokers.

The National Lung Screening Trial, funded by the National Cancer Institute, compared LDCT scanning to standard chest X-rays in this group of people at high risk for developing lung cancer. This finding marks the first-ever lung cancer screening approach that has been shown to reduce lung cancer mortality. The debate about the appropriate use of LDCT screening for lung cancer among the general population, however, continues.

2009

Major studies report conflicting results about benefits of PSA testing

Major studies report conflicting results about benefits of PSA testing

The proper role of PSA testing remains uncertain after large, randomized trials provide conflicting results on whether routine testing reduces deaths from prostate cancer. Initial results from two studies indicate that PSA testing has minimal, if any, effect on overall survival and leads to the over-diagnosis and treatment of slow-growing cancers that are unlikely to be life-threatening. A third study finds that PSA testing reduces the risk of prostate cancer death in some men by 40 percent. Given the conflicting evidence, leading medical societies urge men to discuss the risks and benefits of screening with their doctors.

2006

First vaccine approved to prevent cervical cancer

First vaccine approved to prevent cervical cancer

The FDA approves the first vaccine to prevent infection with two high-risk strains of the human papillomavirus (HPV16 and HPV18) that are known to cause about 70 percent of all cervical cancers. The vaccine, called Gardasil, is approved for girls and young women aged 9 to 26, based on a clinical trial showing that the vaccine was safe and was 100 percent effective against these types of HPV, and those that cause genital warts, for at least four and a half years after vaccination. A second vaccine, Cervarix, is approved in 2009 to prevent infection against the cancer-causing HPV strains in young women aged 10 to 25. Gardasil is later approved to prevent additional HPV-related diseases in children and young adults aged 9 to 26, including vaginal, vulvar and anal cancers in females, and anal cancer and genital warts in males. Studies have also linked HPV infection to head and neck cancers, suggesting that the vaccine may help prevent these cancers as well.

2005

Two targeted drugs approved for advanced colon cancer

Two targeted drugs approved for advanced colon cancer

The drugs cetuximab (Erbitux) and panitumumab (Vectibix) are approved to treat colon cancer that has spread to other parts of the body (metastatic disease). These drugs attack tumors that express the epidermal growth factor receptor (EGFR) protein, which is involved in cancer cell growth. Later, a coordinated analysis of multiple studies shows that cetuximab and panitumumab are effective only in patients with the normal form of a gene known as KRAS. This discovery helps physicians ensure that the drugs are used only for patients who stand to benefit, while eliminating unnecessary treatment and costs for patients who will not.

Research sheds light on long-term health problems of cancer survivors

Research sheds light on long-term health problems of cancer survivors

In the 1990s, researchers begin a major study of the long-term effects of cancer and its treatment, focusing on survivors of childhood cancer. In 2005, the Childhood Cancer Survivors Study reports that survivors' risk of long-term health problems – including heart problems, second cancers and scarring of the lungs – was five times greater than that of their healthy siblings. Similar results have been found for survivors of other cancers with high cure rates, such as testicular cancer.

The results are helping oncologists and primary care providers monitor and better manage the long-term health of the millions of cancer survivors alive today.

U.S. launches effort to map cancer genomes

U.S. launches effort to map cancer genomes

The National Cancer Institute and the National Human Genome Research Institute team up to launch The Cancer Genome Atlas project. In its initial phase, the project aims to develop a comprehensive atlas of the genomes of three common cancers – lung, ovarian, and glioblastoma, a form of brain cancer. By gaining a deeper understanding of the genetic pathways involved in the development and growth of these cancers, researchers hope to identify molecular targets that can guide development of effective new treatment.

2004

Adjuvant therapy proven effective in lung cancer

Adjuvant therapy proven effective in lung cancer

In findings that quickly change the standard of care, clinical trials show that giving chemotherapy after surgery dramatically improves survival for patients with early-stage non-small cell lung cancer, the most common form of the disease. Previously, chemotherapy was considered to be largely ineffective for lung cancer. These study results demonstrate that adjuvant chemotherapy could have an equal or greater impact on survival in lung cancer as it does in breast or colon cancer.

FDA approves first "anti-angiogenic" drug, bevacizumab

FDA approves first "anti-angiogenic" drug, bevacizumab

Bevacizumab (Avastin) is the first of a new generation of targeted drugs, called anti-angiogenics, that attack cancer by blocking the growth of blood vessels that tumors needs to grow. First approved to treat colorectal cancer, in 2004, the drug has since become an important treatment for patients with advanced lung, ovarian and kidney cancers, and for certain brain tumors, who have few other effective options.

2003

First targeted drugs for lung cancer attack "EGFR" receptor

First targeted drugs for lung cancer attack "EGFR" receptor

The FDA approves two new targeted treatments for advanced, non-small cell lung cancer, gefitinib (Iressa) and erlotinib (Tarceva). Both drugs target the epidermal growth factor receptor (EGFR), a protein on cell surfaces that is involved in driving lung cancer growth and spread. Approval is based on data showing that erlotinib extends survival in patients with advanced lung cancer – a rare finding for any treatment – and that gefitinib delays the time before a patient's cancer progresses. Around the same time, studies show that the drugs only work for patients with specific mutations in the EGFR protein. These mutations are found most often in lung cancer patients who never smoked.

To date, the two drugs are approved only for certain patients whose cancer no longer responds to other therapies. But recent studies indicate that for people with the relevant EGFR mutations, the drugs could also be valuable first-line treatment options.

Obesity pinpointed as cause of many cancer deaths

Obesity pinpointed as cause of many cancer deaths

An important prospective analysis involving nearly 1 million Americans reports that obesity could account for up to 20 percent of U.S. cancer deaths. Obesity is linked to a higher risk of death from liver cancer, along with several other cancer types. The researchers also estimate that 90,000 cancer-related deaths could be prevented annually if Americans maintained a healthy weight.

As obesity becomes more prevalent, researchers project that deaths from liver cancer and other forms of the disease will rise as well.

Scientists decode the human genome

Scientists decode the human genome

Scientists announce that they have successfully mapped the 3 billion DNA letters in the human genome. This marks the completion of the Human Genome Project, an unprecedented international collaboration between researchers in the U.S. in and six other countries, funded primarily by the U.S. government. Results of the 13-year effort are made freely available to scientists around the world, paving the way for research to identify the genetic defects that fuel cancer, and for new ways of screening for and treating the disease.

2002

Doubling of U.S. biomedical research budget expands cancer research

Doubling of U.S. biomedical research budget expands cancer research

Beginning in 1998, President Bill Clinton and Congressional leaders enact a series of large, annual budget increases for the National Institutes of Health, doubling the agency's biomedical research efforts over the next five years. The new investments accelerate the pace of cancer research in the lab and in the clinic, leading to important advances over the next decade. More recently, however, federal support for cancer research has declined in real terms, potentially slowing the pace of progress against the disease.

2001

Imatinib found highly effective against rare gastrointestinal tumor

Imatinib found highly effective against rare gastrointestinal tumor

Just weeks after being approved to treat chronic myelogenous leukemia, the targeted drug imatinib is shown to be effective against a rare abdominal tumor called GIST (gastrointestinal stromal tumor). Prior to imatinib, available drug treatments had little effect on GIST tumors. Imatinib works like a "circuit breaker" to block enzymes that can send faulty signals to trigger tumor cell growth. In GIST, it blocks the growth signal of a gene called c-Kit.

New targeted therapy transforms treatment for rare leukemia

New targeted therapy transforms treatment for rare leukemia

The FDA approves imatinib (Gleevec) after just three months of review – the fastest approval in FDA history – based on data showing the drug halted the growth of chronic myelogenous leukemia (CML) in the majority of patients. Imatinib is the first drug proven to counteract a molecular defect on the so-called "Philadelphia chromosome," first discovered in 1960. It has since become the standard of care for this disease, and its effectiveness and easily-administered pill form enables most patients to live with CML as a manageable, chronic disease.

2000

Study links household radon exposure to lung cancer

Study links household radon exposure to lung cancer

The Iowa Radon Lung Cancer Study demonstrates that ongoing exposure to residential radon – a naturally-occurring radioactive gas that can emerge through basements and crawl spaces – is associated with increased risk of lung cancer. The Environmental Protection Agency now estimates that more than 20,000 lung cancer cases in the U.S. are due to long-term radon exposure in the home. Since the study, radon inspections have become a routine part of homeownership, promising to reduce the future burden of the disease.