Overview of the AACR Clinical and Translational Cancer Research Think Tank meeting.

On January 17–18, 2010, the American Association for Cancer Research (AACR) hosted a Think Tank meeting in San Francisco that brought together a group of clinical and translational research thought leaders to identify the most promising scientific priorities and opportunities for the future of this field. This meeting was held over 2 days and included specific presentations on key areas such as animal models; the impact of genomics on personalized cancer therapy; innovative clinical trial design; imaging strategies, controversies, and opportunities; and biomarkers and companion diagnostics. Breakout sessions focused on research, information sharing, standardization, validation, regulatory issues, and education. The overall goal of this gathering was to provide a forum for thoughtful input and discussion about the strategies needed to help catalyze progress in the field of clinical and translational cancer research. A number of key issues were discussed over this 2-day period, and several opportunities and barriers were identified. The group reached a general consensus regarding the following needs: (i) establishment of a national database to provide access to clinical trials data, biomarker data, and educational information for researchers, providers, decision makers, and the public; (ii) additional support for team science in the academic, private, and governmental sectors; (iii) mechanisms for sharing data and approaches more effectively; (iv) education of the research, advocacy, anddecision-maker communities about the current and future challenges of clinical and translational cancer research; (v) involvement and engagement of survivors and advocates in supporting team science and clinical/translational research in general; (vi) biomarkerdriven clinical practice for both cancer prevention and treatment; and (vii) outreach and involvement of the pathology community, especially in the area of biomarker development to help establish better standards and adopt new science. An ongoing challenge in the field is to develop the most effective strategies for using biomarkers and companion diagnostics to effectively direct the care of cancer patients who are undergoing treatment with targeted therapies. The group also viewed the lack of appropriate funding as the primary challenge in translational research, followed by clinical trial design and the cost-effectiveness of cancer prevention. Dr. Susan Desmond-Hellmann gave the keynote address at a meeting entitled "Accelerating Innovation: Oncology Translational Research." She reviewed the progress in the field and remarked on certain guiding principles that will be critical for the future. She stated that rituximab, trastuzumab, and imatinib mesylate are 3 drugs that have changed cancer medicine because they each address a major unmet need, are based on biomarker-driven patient selection, can extend survival, and arewell toleratedbypatients. Shenoted that the barriers that currentlymake cancer research so slow, expensive, inefficient, and uncertain must be addressed if additional similar products are to be developed. Going forward, she noted that the most important metric for success should be predictability; specifically, cancer researchers have not gone far enough to decrease uncertainty, and this is a technical challenge that needs to be overcome. Currently, the ultimate failure rate for the development of new cancer drugs is exceedingly high. Enormous resources are expended to get a drug candidate from the point of basic discovery to the preclinical testing stage and finally to the patient. Primarily, the current paradigm for drug development does not effectively rule out poor drug candidates early on in their development. Over the next decade, cancer researchers must strive to better understand the biologic drivers of cancer and explore novel approaches to bench-tobedside research. To build the next generation of nimble, flexible investigators, today’s leaders must value, espouse, and teach new methods and models for research that stress the importance of translational research. The Think Tank meeting included some very productive breakout sessions inwhich recommendationsweremade to improve the effectiveness of clinical/translational research overall. Each groupwas chargedwithdefining toppriorities, summarizing the state of the science, identifying obstacles and challenges, and recommending new directions and opportunities for progress. Five breakout groups discussed the following areas: