From the Editor-in-Chief: The Way Up

Evidence-Based Oncology, October 2021, Volume 27, Issue 7
Pages: SP256

As we live through these strange, tragic, extraordinary times, the phrase, “Trust the science” has become a mantra. The ubiquity of this phrase, with its intertwined messages of imploration and admonition, reflect the evolution of the power of social media and messaging driven by an infinitely expanding cyberspace universe. For all the silly ways in which this message has been communicated in a time when 30-second TikTok videos represent the level of discourse, there is value in acknowledging the power of science to unlock the unknown—and there is transformative value in that knowledge. Over the course of my career, progress in understanding the genetic, genomic, and epigenetic underpinnings of cancer, as well as our growing understanding of the role of the immune system in eradicating cancer cells, has unleashed a wealth of innovative and effective anti-cancer treatments. The last 2 American Cancer Society (ACS) Cancer Statistics reports demonstrated the greatest decrements in cancer mortality ever reported. In reality, the aforementioned advances in science are leading to improved survival outcomes for patients with cancer.

Not all Americans, however, realize these benefits. While it is reasonable to "Trust the science,” we need to do much more. This includes the creation of better systems of ensuring that this care is equitably available to all who need it, when they need it. Moreover, we need to ensure that the barriers of geography, distance, poverty, scientific literacy, and other social determinants of health impede equitable access to this level of care innovation. At this year’s Patient Centered Oncology Care®(PCOC) conference, presented by The American Journal of Managed Care®, we heard about both advances in the science of care and exciting new models for ensuring that the life-saving benefits of cancer care advances are better realized by more patients and families. Throughout the two-day conference we heard from speakers and panelists who, while noting the growing impact of precision medicine, also described the ways in which underserved populations remained underserved. These gaps in care include access to clinical trials, trial design that fails to incorporate the needs of a diverse population, biospecimen banking practices that failed to include sufficient human diversity for the creating of new genomic analytics, the challenges of improving health literacy, and limited patient access to the requisite care expertise. Beyond the science, we need better care models that more accessible and sustainable for the underserved; we also need more effective reimbursement models that incentivize more patient access and align with greater investment into holistic and humanized care delivery. Moreover, if we are to achieve better patient outcomes and ensure more equitable patient access, our system will need to grow beyond its current ”bricks and mortar” mindset. During the PCOC meeting our discussants embraced that creative challenge and described the ways in which wearable devices, the Internet of Things, and more effective use of artificial intelligence tools to create more powerful means of engaging patients and their communities in the support of life-saving cancer care.

This year’s PCOC meeting marked a shift in our thinking. Beyond reviewing the extraordinary assets of cancer science and technology, which we have discussed for the past decade, this year began a reconsideration of the types of systems that we will need to build to find the way up beyond the limitations of our current care delivery models. As the ACS data show, the life dividend of getting better care to the millions of patients who fail to benefit fully from our current cancer care revolution is enormous. The shift toward an equitable realization of the culminated fruits of our scientific endeavors is where we venture forth toward the challenge of making the science a reality for those who need it most.