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8 Cancer Breakthroughs to Watch in 2023

Editor’s Note: City of Hope is investing $1.5 billion on a comprehensive cancer center and a planned specialty cancer hospital in Irvine.

What follows are predictions from eight of its experts.

The Business Journal’s annual Special Report on Healthcare begins on page 17.

Prediction #1: Increasing AI

City of Hope uses AI to predict specific events likely to occur during treatment, including a tool for predicting surgery complications. Also under development are AI models that could help discover more about genetic mutations and clarify subtle details in medical images.

“The best use of AI will involve going from data to real-world evidence to action and continuously monitoring and optimizing these models based on clinician feedback and new data generated,” says Wendy Austin, senior vice president, operations, City of Hope Orange County.

Prediction #2: Clinical Trials Open Up

Clinical trials provide patients with promising new treatments long before they become standard of care but 19 out of 20 cancer patients cannot enroll in a trial because of rigid eligibility criteria.

This year, more limitations will be eliminated, including trial exclusions for reasons that often discriminate against older and sicker patients, people of diverse ethnicities and genders, and because many follow-ups are often required, those with limited access to transportation.

“You’ll see us opening more trials this year that are specifically tailored for people of color, who have traditionally been excluded from trials. It makes sense to have our study populations look like the real-world cancer population. That’s just good science and will open trials to a wider range of patients,” says Edward S. Kim, M.D., MBA, physician-in-chief, City of Hope Orange County.

Prediction #3: Blood Testing for Early Detection

Novel blood tests, assisted by complex classification algorithms, will unlock clues to cancer and become the solution for detecting various types of cancer as well as monitoring patients. Today, only four types of cancer—breast, cervical, colorectal and lung—have screening tests recommended for use by the U.S. Preventive Services Task Force.

“We need to put as much focus on the earlier detection of cancer as we do on treating it,” says Cristian Tomasetti, Ph.D., director of City of Hope’s Center for Cancer Prevention and Early Detection.

In 2023, Tomasetti will launch a comprehensive research study validating a blood test developed by him and colleagues at City of Hope and TGen to detect cancers earlier when they are curable.

Prediction #4: Precision Medicine’s Exponential Growth

Cancer is not one disease but hundreds of diseases. Each person’s cancer is unique; the best treatment is highly personalized for the individual patient. That’s the crux of precision medicine.

Physician-scientists understand that they must explore the individual’s genetic makeup and develop personalized therapy treatments to address each cancer.

“This approaching paradigm will shake up the biopharmaceutical field because everyone is going to be treated with a unique cadre of drugs,” says Linda Malkas, Ph.D., professor in City of Hope’s Department of Molecular Diagnostics & Experimental Therapeutics. “Every patient will be treated as if they have a rare cancer requiring unique drug therapy.”

We are entering the age of cancer subspecialties and even super-subspecialties for highly targeted care, Dr. Malkas says. A pioneer of personalized medicine, she has developed a novel, potentially cancer-stopping pill that targets highly specific proteins in cancer cells.

Prediction #5: Advanced Imaging Tech Integration

The use of advanced imaging technology is shortening treatment times for patients and providing physicians with real-time views of tumors. This means more precise radiation treatment to patients.

Magnetic Resonance Imaging Guided Linear Accelerators (MR-LINAC) and RefleXion radiation technology could soon achieve the evasive goal of delivering tumor-destroying radiation in “real time” to multiple tumors, says Percy Lee, M.D., medical director of Orange County & Coastal Region Radiation Oncology, who practices at City of Hope Orange County Lennar Foundation Cancer Center in Irvine.

“The MR-LINAC coming this year to our cancer center will further allow us to personalize each treatment to each patient, shortening the number of treatments, minimizing side effects and improving treatment outcomes,” Lee says. “The most experienced, specialized physicians will leverage this, along with AI, to potentially treat some cancers in a single treatment.”

Prediction #6: Integrative Medicine’s Growth

Acupuncture, meditation, and cannabis were once considered far from the standard for cancer care. However, new evidence shows that chronic stress can hinder cancer recovery and even lead to a worse quality of life.

Clinicians will increasingly recognize the benefits of combining the best of Western medicine with integrative therapies such as mind-body techniques and acupuncture, backed by research findings.

“We don’t always have to think about a prescription as a first option,” says Richard T. Lee, M.D., medical director of integrative medicine, City of Hope. “This year, you’ll see wider recognition of the importance of this field, driven by patient interest.”

Dr. Lee is studying the impact of plant-based therapies, including mushrooms and cannabis, to help cancer patients. City of Hope is one of the few cancer centers in the country with an integrative oncology program.

Prediction #7: Generosity

In 2022, City of Hope’s philanthropic community contributed more than $200 million to advance treatment innovation and cures for cancer.

“We saw great momentum in 2022. Donors recognized their gifts had an impact that could not wait. Philanthropy has often powered the latest advances, and in 2023, it will be vital for accelerating transformational change,” says Larry Zeiber, vice president of philanthropy, City of Hope Orange County.

Prediction #8: Cancer Care Democratization

The California Cancer Care Equity Act, signed into law in 2022, requires Medi-Cal managed care plans, which cover many of California’s most vulnerable people, to provide access to NCI-designated cancer centers.

Additionally, a new contract between City of Hope and CalOptima Health (Orange County’s Medi-Cal plan) will bring about expanded local access. The changes greatly impact the one-fourth of Orange County residents—approximately 900,000 people—who rely on Cal-Optima Health for medical coverage.

“Cancer breakthroughs only make a difference if the patients who need them have access to them. This year, we are closer to City of Hope’s vision of democratizing cancer care,” says Annette Morgan, chief administrative officer, City of Hope Orange County.

Previously published in the Feb. 20 issue of Orange County Business Journal

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