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CPI and Cancer Prevention

Why does CPI focus on cancer prevention?

Our organization focuses on cancer prevention because the best way to avoid cancer and the associated human and economic burdens is to keep cancer from happening. We want the story of cancer to be akin to the story of polio. As with polio, a cure for most advanced cancers does not exist, so prevention is the best strategy. With the discovery and use of the Salk/Sabin polio vaccines, most of the world is free from polio.

Why do research and drug development programs rarely focus on cancer prevention?

Cancer prevention clinical trials have a longer timeline than therapeutic trials and the outcomes (success or failure) are harder to test. These inherent difficulties make cancer prevention research less attractive to both the academic and pharmaceutical scientists. Academics are under pressure to publish regularly on a shorter timeline than prevention studies can meet. Similarly, many pharmaceutical companies need a quicker return on investment than cancer prevention drug development allows. There are exceptions. For example, the successful development of the HBV vaccines for hepatitis and liver cancer prevention, and HPV vaccines, which prevent cervical and head & neck cancers have been both lifesaving and profitable.

How can CPI enable cancer prevention drug discovery and development?

The hope for CPI-funded research projects is that they will lead to discoveries that provide the basis for the development of cancer prevention medicines. Our resources therefore fund scientists and physician-scientists who are interested in moving scientific discoveries from the laboratory to the clinic to make them available to patients. Overall, CPI aims to bridge the gap between basic scientific discoveries and practical therapies by encouraging research that brings cancer prevention discovery and development together.

What support does the National Institutes of Health (NIH) provide for cancer prevention research? How do the CPI resources complement the NIH’s National Cancer Institute (NCI)’s?

The NCI’s current cancer prevention programs include pre-clinical drug development funding and early clinical trial funding to develop therapeutic agents that can prevent cancer. CPI’s funding can precede the NCI’s as we will fund early-stage research to discover candidate targets in inherited cancers and enable scientists to then apply for funding from the NIH. More information on the NCI’s cancer prevention program can be found here.

Why is cancer prevention so important?

Cancer is a growing human and financial burden. Investing in cancer prevention research is necessary to:

  • Reduce the number of new cancer cases and cancer-related deaths
    It is estimated that 18.1 million new cases and 9.6 million cancer-related deaths occurred worldwide in 2018 [1]. Cancer incidence is on the rise worldwide in part due to the growth and aging of the population.
  • Cut the rising economic costs associated with cancer
    In the US, cancer cost including direct medical expense and lost wages, was estimated to be about $157 billion in 2010 [2, 3]
  • Discover and develop new cancer preventatives
    There are a limited number of cancer preventatives available and each have their share of adverse events. Discovery of more prevention options would especially benefit people at high risk due to inherited cancer gene mutations.
  1. World Health Organization – IARC GLOBOSCAN
  2. NCI Cancer prevalence and cost of care projections https://costprojections.cancer.gov/
  3. Mariotto AB, Yabroff KR, Shao Y, Feuer EJ, Brown ML. “Projections of the Cost of Cancer Care in the U.S.: 2010-2020”. J Natl Cancer Inst. 2011 Jan.
What are some of the challenges for the initiation and completion of cancer prevention drug studies?
  • To prove that a drug is useful as a preventative, large, elaborate and long-term placebo-controlled, double blind studies are required.
  • There are few immediate financial or professional incentives for researchers to investigate ways to prevent cancer. Researchers are drawn to research, which is feasible. Feasibility includes the ability to accumulate reliable data in a reasonable period of time and to have funds to carry out those studies.
What is the advantage of using inherited cancers to discover cancer preventatives?

Hereditary cancers are caused by mutations in genes that protect us from cancer and are found in every cell of the body. Many genes can be mutated and predispose us to cancer. Examples are mutations in BRCA1, BRCA2, PALB2, ATM and MLH1. All of these mutations can cause cancer to occur at younger than “normal” ages because the inherited mutation gives the cell a head start in cancer development. Because we know the first molecular step that leads to inherited cancers, there are more ideas for how to prevent such cancers. Furthermore, the earlier onset of disease accelerates the timeline to discovery and allows for a more rapid path to the development and testing of candidate preventatives.

What is the current state of clinical cancer prevention?

Cancer prevention measures include a healthy diet, exercise, smoking cessation, limiting alcohol intake, knowing your family history of cancer, genetic testing if indicated, and if at high risk undergoing earlier and more frequent screenings and/or prophylactic surgeries. In addition, vaccination and chemoprevention drugs are outlined in the Table below.

Available vaccines and drugs effective in cancer prevention

Prevention Method Type of Cancer
Human Papillomavirus (HPV) vaccination (Gardasil) Cervical, head & neck, squamous anorectal cancer
Hepatitis B vaccination Hepatocellular carcinoma
Tamoxifen Breast cancer
Raloxifene Breast cancer
Exemestane Breast cancer
Anastrozole Breast cancer
Finasteride Prostate cancer
Oral contraceptives Ovarian cancer
Aspirin or nonsteroidal anti-inflammatory drugs Colorectal cancer in high risk patients such as those with Lynch Syndrome

Resources on Cancer Prevention

National Cancer Institute (NCI) Division of Cancer Prevention

Center for Disease Control and Prevention

Cancer Prevention

HPV and Cancer

HPV-IMPACTCDC-led program that monitors 18-39 y.o women with high-grade cervical lesions in five different communities in the US. One of the HPV-IMPACT main objectives is to determine HPV vaccine effectiveness.

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