Six important advances in clinical cancer research were made in 2007, as well as 18 other notable advances in prevention, screening, treatment, and survivorship, according to a report released by the American Society of Clinical Oncology. The report can be accessed online at www.plwc.org .

"This report demonstrates what many of us in the cancer research and practice community have known for some time. The long-term federal investment in cancer research is paying off," said Nancy E. Davidson, MD, ASCO President.

"But this impressive pace of progress will slow if we don't recommit to funding cancer research. Adjusted for inflation, cancer research funding has actually declined 12 percent since 2004-this has never happened in our nation's history. Without additional funding, the chance to build on the extraordinary new scientific knowledge, and provide new treatments for 1.4 million Americans diagnosed with cancer every year, will be delayed or lost," Davidson said.

Following is an unranked summary of the six advances identified by the report's 21-member oncologist editorial board as the most significant in clinical cancer research in 2007.

The first systemic treatment for primary liver cancer, sorafenib, was identified. Primary liver cancer is the third leading cause of cancer death globally. In a significant advance in the treatment of the disease, a large study found that patients who took the targeted therapy sorafenib for advanced liver cancer lived about 44 percent longer than patients who did not. This is the first non-surgical treatment for liver cancer.

Treatments for advanced kidney cancer were expanded. Adding bevacizumab to standard kidney cancer treatment nearly doubled progression-free survival. While progress against kidney cancer was largely stalled for decades, in recent years several targeted therapies have proven effective, giving patients a range of new treatment options.

Researchers found that magnetic resonance imaging was superior to mammography for screening women at high risk of breast cancer. In 2007, new guidelines were issued based on findings from several studies that magnetic resonance imaging can be effectively used in women at high risk of developing cancer. 1.4 million women in the United States are at high risk. Magnetic resonance imaging is still not yet recommended for most women as a breast cancer screening tool.

Human papillomavirus was found by two studies to be present in 72 percent of several types of head and neck cancers. For reasons that are not yet clear, the presence of the virus corresponded with better treatment outcomes. The new research suggests further research should be done to see whether there is a possible new role for the papillomavirus vaccine in preventing head and neck cancers.

Two studies in 2007 reported that the recent significant reduction in incidence of breast cancer appears to correlate with reduced use of hormone replacement therapy in menopausal women since 2002.

One study for the first time showed that whole brain radiation therapy for patients with advanced small cell lung cancer reduces risk of brain metastasis by roughly two thirds, resulting in a doubling of one-year survival rates. The advance is particularly remarkable because this patient population has had very poor outcomes historically.

In addition to listing major advances, the Society made two major recommendations. The first was for an increase in funding of cancer research after the longest sustained period of flat funding (four years) in U.S. history.

"We've made extraordinary progress in preventing and treating cancer, but we still have a lot of work to do," said Julie Gralow, MD, director, breast medical oncology, University of Washington School of Medicine and Fred Hutchinson Cancer Research Center, and co-executive editor of the report. "The pace of progress is in jeopardy. Because of funding cuts, we're already seeing reductions in the proportion of funded National Cancer Institute grant applications, cutbacks in clinical trial enrollment and the elimination of entire research programs. We've never known more about how cancer grows and spreads. We need to accelerate progress for our patients, not slow it down."

To reverse the effects of these cuts and maintain the nation's world-class research infrastructure, the Society calls for substantial funding increases, at a minimum to keep pace with medical inflation.

The other major recommendation concerned increasing participation in clinical trials. Cancer trials are the engine of cancer research and can represent a patient's best chance for effective therapy, but data suggest that only about 5 percent of cancer patients currently participate. The report calls for public and private insurers to cover the costs of participation. Some insurers do not cover participation in clinical trials because they are classified as "experimental." Several states have passed legislation or established agreements requiring that health plans pay for routine medical care for patients in clinical trials. The Society urges other states to do the same and encourages Medicare to continue to cover trial participation.

"Clinical trials are critical to advancing cancer research and improving care for patients. We need to do everything possible to remove barriers to participation in clinical trials," said Robert F. Ozols, MD, PhD, senior vice president for medical science at Fox Chase Cancer Center, and co-executive editor of the report.

The report, Clinical Cancer Advances, was developed under the guidance of a 21-person editorial board made up of leading oncologists and other cancer specialists, including specialty editors for each of the disease- and issue-specific sections.

Editors of the report reviewed studies published in peer-reviewed scientific journals and early results of research presented at major scientific meetings over a one-year period (November 2006-October 2007). Only studies that significantly altered the way a cancer is understood or had an important impact on patient care were included.