The US death rate from cancer has fallen 34 percent from its 1991 peak through 2023, with the five-year relative survival for all cancers combined reaching 70 percent for people diagnosed between 2015 and 2021. This progress is the result of decades of steady advancements, including a significant shift towards immunotherapy and early prevention strategies.
A pivotal moment occurred at the American Society of Clinical Oncology’s (ASCO) annual meeting in Chicago on May 31, where a trial of the drug daraxonrasib showed it nearly doubled median overall survival in patients with previously treated advanced pancreatic cancer. The results prompted a rare, prolonged standing ovation from oncologists, with ASCO’s chief medical officer calling the outcome a “grand slam” and another oncologist deeming it a “game changer.”
Pancreatic cancer, known for its resistance to treatment and a five-year survival rate in the low teens, has historically been one of the most challenging cancers. For decades, despite initiatives like President Richard Nixon's “war on cancer,” progress remained limited, with many patients succumbing within months of diagnosis.
Immunotherapy and Personalized Vaccines
Immunotherapy, which harnesses the patient's immune system to fight cancer cells, has been a major driver of recent successes. A notable example is former President Jimmy Carter, who, at age 90, saw his metastatic melanoma vanish after treatment with the immunotherapy drug pembrolizumab, surgery, and radiation, allowing him to live another decade.
Scientists are further refining these approaches. A combination of a personalized mRNA vaccine, adapted to each patient’s tumor, and pembrolizumab reduced the risk of recurrence or death by 49 percent after five years for high-risk melanoma patients. Early trials of similar vaccines have also shown promise in helping pancreatic cancer patients remain cancer-free longer after surgery, with seven out of eight responders in one small trial still alive four to six years later.
For blood cancers, CAR T-cell therapy, which involves infusing a patient with reengineered immune cells, is achieving near-curative results. Emily Whitehead, the first child treated with CAR T-cell therapy, has been cancer-free for over a decade and is now attending college.
Shifting Focus to Prevention
The ambition in oncology is expanding from treatment to prevention. Researchers are developing methods to identify individuals at high risk for certain cancers years before diagnosis. A study led by the Francis Crick Institute’s Charles Swanton reported on a blood test measuring 14 proteins, combined with risk factors like age and smoking, that could help identify potential lung cancer development. An anti-inflammatory drug also showed potential in cutting lung cancer risk in individuals with high inflammation levels.
This preventive approach is compared to how statins work for heart disease, where cholesterol tests identify risk and statins lower it. Similarly, protein tests could identify cancer risk, and drugs could then reduce it.
GLP-1 drugs, known for their use in diabetes and weight management, are also showing potential in cancer prevention. A study of over 110,000 women found that taking GLP-1 drugs like Ozempic was associated with approximately 30 percent lower breast cancer incidence.
Challenges and Concerns
Despite these advancements, significant challenges remain. The new cancer medicines are exceptionally expensive, with the average monthly price of a new cancer drug more than doubling between 2009 and 2019. Roughly half of surveyed American cancer patients and survivors incur debt to cover treatment costs.
A more pressing concern is the potential throttling of the scientific engine driving these breakthroughs. Many of these advances trace back to federally funded basic research, which has faced significant cuts. In 2025, thousands of National Institutes of Health (NIH) and National Science Foundation (NSF) grants were reportedly frozen or canceled, leading to billions in reduced NIH awards. While Congress later mitigated the deepest proposed cuts, the impact was substantial, disrupting hundreds of NIH-funded clinical trials and making it harder for early-career scientists to secure major grants. These funding reductions risk jeopardizing future discoveries at a time when cancer research is yielding significant returns.
The human cost of these potential losses was underscored at the ASCO meeting by ASCO’s outgoing president, who spoke about his partner’s death from metastatic clear cell ovarian cancer, a disease with limited treatment options. The ovation Dr. Brian Wolpin received for his pancreatic cancer trial results symbolized a broader realization within the oncology community: that a disease once considered nearly untreatable is beginning to lose its devastating power.