The American Society of Clinical Oncology ^[1] (ASCO) annually reviews key clinical research advances that significantly improve patient care for both new patients and the growing numbers of cancer survivors. The report, compiled by leading oncologists and other cancer specialists, includes research made public from October 2007 to September 2008.

Several important findings have been made in multiple myeloma this year, as well as recognition of key issues that affect all cancers.

• In 2008, there were 19,920 estimated new cases of multiple myeloma and 10,690 estimated deaths. These figures represent approximately 1.4 percent of all cancer cases in the United States this year and 1.9 percent of cancer-related deaths.
• The five-year survival rate for multiple myeloma increased by 8 percent between 1975 and 2003, from 26 percent in 1975-1977 to 34 percent in 1996-2003.
• The FDA approved Velcade ^[2] (bortezomib) as an initial therapy for multiple myeloma this June. Accepting the use of Velcade as a first treatment represents the final stamp of approval for the drug. Velcade was previously approved in 2003 for relapsed and refractory patients and later in 2005 for patients who had received at least one prior therapy.

Broader issues in clinical oncology this year concern the flat-lining of research funding, as well as limited participation and diversity in clinical trials.

The past five years have seen the longest period of flat funding to key research institutions such as the National Institutes of Health ^[3] and the National Cancer Institute ^[4]. Adjusted for medical research inflation, these budgets have declined by almost 13 percent. ASCO calls for increased funding to bring clinical cancer research in the United States up to speed and to maintain its world-class research infrastructure.

ASCO also calls for the removal of barriers to clinical research. Clinical studies provide a safe route for cancer patients to access new and publicly unavailable medications. However, only five percent of patients participate in clinical trials. The report recommends that health care insurers cover clinical trials in order to lower or remove the cost barrier.

Additionally, minority and elderly patients are severely underrepresented in clinical studies. Overcoming the financial, educational, and ideological barriers to their participation would help scientists in optimizing treatment across the board.

In spite of the obstacles in health care policy and funding, the outlook is bright from the basic science perspective. A recent information explosion in molecular biology has illuminated many of the cellular and molecular pathways leading to cancer and has paved the way for more advanced drug development. New treatments are increasingly tailored to each patient's unique genetics, tumors, and symptoms.

According to ASCO President Richard L. Schilsky, MD, "Scientifically, we have never been in a better position to advance cancer treatment."

ASCO represents more than 25,000 oncologists and other professionals worldwide who care for people with cancer. For more information, refer to the report at the Journal of Clinical Oncology ^[5] (published online December 22, 2008).