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City of Hope, one of the largest cancer research and treatment centers in the United States, forecasts that in 2023 more Orange County residents will benefit from cancer breakthroughs, including paradigm shifts in precision medicine, AI-assisted cancer prevention and diagnostics, a cancer-stopping pill and non-traditional therapies that heal and boost survivorship.
“For years, cancer discoveries leaped ahead of access to new treatments,” said Annette Walker, president, City of Hope Orange County. “With City of Hope opening Orange County’s most advanced comprehensive cancer center, tomorrow’s discoveries are widely available to the people in this community who need them today. City of Hope breakthroughs impact more than 100 million lives around the world each year. In 2023, you’ll see many more significant medical innovations that will transform the way we prevent, treat and cure cancer, saving many more lives.”
Here are City of Hope Orange County’s top eight predictions for the future of cancer care:
Prediction #1: Increased Application of Artificial Intelligence
Harnessing cancer data through AI and other techniques will be integral to cancer advances. The National Cancer Institute alone estimates that it has more than 2.3 petabytes of cancer-related data. Predictive artificial intelligence (AI) models based on machine learning are now optimizing this and other information for everyday care for people with cancer.
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.
“Academic centers such as City of Hope are unleashing the power of machine learning predictive models. 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,” said Wendy Austin, senior vice president, operations, City of Hope Orange County.
Prediction #2: Exclusions Will Lift for Many Lifesaving Clinical Trials
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 is the year more limitations to these trials 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.
City of Hope conducts more than 800 clinical trials each year, enrolling more than 6,000 patients. These studies have led City of Hope to make breakthroughs in everything from immunotherapy, which uses a person’s genetic makeup to fight cancer, to radiotherapy machines that destroy complex tumor masses.
“At City of Hope, we offer more clinical trials than anywhere else in the region and are consistently opening new trials. 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,” said Edward S. Kim, M.D., M.B.A., physician-in-chief, City of Hope Orange County and a national advocate for expanded access to clinical trials.
Prediction #3: Blood Testing for Early Detection and Monitoring
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.
“When it comes to preventing cancer mortality, we must do better. We need to put as much focus on the earlier detection of cancer as we do on treating it,” said Cristian Tomasetti, director of City of Hope’s Center for Cancer Prevention and Early Detection.
In 2023, Tomasetti will launch a bold and comprehensive research study validating a blood test recently developed by him and colleagues at City of Hope and TGen to detect cancers early, when they are curable.
Prediction #4: Exponential Growth of Precision Medicine
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 at renowned cancer institutions like City of Hope 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,” said 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.”
Dr. Malkas emphasizes that we are entering the age of cancer subspecialties and even super-subspecialties for highly targeted care. A pioneer of personalized medicine, she has developed a novel, potentially cancer-stopping pill that targets highly specific proteins in cancer cells.
Prediction #5: Integration of advanced imaging technology, shortening treatment times
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 who need that therapy.
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, said 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 said. “The most experienced, specialized physicians will leverage this, along with AI, to potentially treat some cancers in a single treatment.”
Prediction #6: A Wider Understanding of the Importance of Integrative Medicine
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,” said 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: Philanthropic Generosity Will Fuel Lifesaving Care and Research
Cancer is on a course to be defeated by researchers who speed lifesaving discoveries from bench to bedside.
In today’s world, philanthropy often fuels these discoveries, allowing researchers to pursue multiple avenues simultaneously, getting to cures faster.
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,” said Larry Zeiber, vice president of philanthropy, City of Hope Orange County.
Prediction #8: The Democratization of Cancer Care
It is no secret that we are in a bold new era of cancer innovation and discovery, but equally as newsworthy is that we are closing the gap on who can access these breakthroughs.
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 Cal-Optima (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 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,” said Annette Morgan, chief administrative officer, City of Hope Orange County.
City of Hope Is Orange County’s Most Advanced Cancer Care
Patients at City of Hope Orange County Lennar Foundation Cancer Center receive fully integrated, multidisciplinary care — from prevention through survivorship — in one convenient location where every physician and staff member is solely focused on treating and curing cancer. They have access to City of Hope’s more than 500 physicians, more than 1,000 researchers and scientists and more than 800 Phase 1-3 clinical trials conducted at City of Hope each year. Construction has started on Orange County’s only specialty cancer hospital, opening in 2025.
City of Hope’s Orange County cancer care network also includes regional clinics in Newport Beach, Huntington Beach and Irvine. The cancer center, the regional clinics and the planned hospital will create Orange County’s largest network dedicated exclusively to cancer treatment and cures.
