The announcement follows reported results from HARMONi-GI1, a randomized phase 3 trial conducted in China and sponsored by Akeso, which developed ivonescimab. Akeso reported in August 2026 that ivonescimab plus chemotherapy improved overall survival compared with durvalumab plus chemotherapy at an interim analysis. The trial also met its key secondary endpoints for progression-free survival and objective response rate. Detailed results were scheduled for presentation on October 25 as a late-breaking Presidential Symposium abstract at the European Society for Medical Oncology 2026 Congress. The Chinese study provides the stated rationale for testing ivonescimab in a U.S. population, but those reported results do not establish efficacy in American patients.

EA2251 will enroll people with advanced biliary tract cancer and assess ivonescimab, an investigational bispecific antibody designed to target PD-1 and VEGF. PD-1 blockade is intended to support antitumor immune activity, while VEGF blockade is associated with anti-angiogenic effects. Ivonescimab is designed to combine these actions in a single molecule and to display cooperative binding, including higher affinity to PD-1 in the presence of VEGF. The drug is not approved in the United States. Besides overall survival, EA2251 will measure progression-free survival, objective response rate, duration of response, disease control rate and safety. The investigators designed the study to generate evidence that could support a submission to the U.S. Food and Drug Administration seeking approval of ivonescimab plus chemotherapy for advanced biliary tract cancer.

The comparator regimens reflect the first-line treatment framework established in the United States. Gemcitabine and cisplatin became the standard first-line chemotherapy for advanced biliary tract cancer more than a decade ago. Results from the phase 3 TOPAZ-1 and KEYNOTE-966 trials, published in 2022 and 2023, respectively, established the benefit of adding durvalumab or pembrolizumab to that chemotherapy. The announcement nevertheless describes prognosis as poor and identifies a need for better options. Biliary tract cancer is a group of rare, aggressive gastrointestinal cancers that includes gallbladder cancer and intrahepatic, perihilar and distal cholangiocarcinoma. These cancers may cause few clear symptoms in their early stages and are therefore often diagnosed after the disease has spread, when curative surgery may no longer be possible.

EA2251 will be conducted through the National Cancer Institute’s National Clinical Trials Network, with participation from Alliance for Clinical Trials in Oncology, NRG Oncology and SWOG Cancer Research Network. This national collaboration is intended to support recruitment across thousands of U.S. clinical sites, an important advantage for enrolling a large trial in a rare cancer. The National Cancer Institute, part of the National Institutes of Health, is funding the study. Summit Therapeutics, which is developing ivonescimab in the United States and other countries through a partnership agreement with Akeso, will supply the drug and provide financial support under a collaboration agreement with ECOG-ACRIN. The current announcement describes a planned trial and its methods; it does not provide results showing whether ivonescimab improves survival, progression-free survival or response in the U.S. population.

Subject of Research: Randomized phase 2/3 trial of ivonescimab plus chemotherapy for advanced biliary tract cancer

Article Title: ECOG-ACRIN announces a national trial of ivonescimab for first-line treatment of advanced biliary tract cancer

Article References: ECOG-ACRIN announces a national trial of ivonescimab for first-line treatment of advanced biliary tract cancer. Original publication (Bibliographic details unavailable.)

Image Credits: AI Generated

DOI: Not provided

Keywords: biliary tract cancer, ivonescimab, phase 2/3 trial, PD-1, VEGF, chemoimmunotherapy, overall survival, ECOG-ACRIN, National Cancer Institute, announces, national, trial

The trials are designed to determine whether that laboratory activity can be translated into a useful clinical strategy, rather than to establish efficacy at their outset. Ultra-high-risk multiple myeloma is an aggressive form of blood cancer in which patients often have poor outcomes despite existing treatments, including bone marrow transplantation, and the cancer frequently returns after treatment. CAR T-cell therapy is already an option for some patients whose myeloma has recurred, but the proposed trial asks whether a second agent can improve the activity of those engineered immune cells.

Opaganib will be given after CAR T-cell therapy, with the aim of helping the modified cells continue attacking the cancer. Yubin Kang, M.D., an OU Health hematologist-oncologist and chief of Hematology, Bone Marrow Transplant and Cellular Therapy at OU Health Stephenson Cancer Center, said the research is needed because patients in this high-risk group continue to fare poorly with current care. CAR T-cell therapy takes a patient’s T cells and genetically modifies them so that they can recognize and attack cancer cells before the cells are returned to the patient.

In the planned OU studies, opaganib is intended to alter the environment in which the CAR T cells operate. According to the University of Oklahoma, opaganib blocks SK2, a protein that appears to act as a brake on the immune system’s cancer-fighting T cells. When SK2 was absent or blocked in mice, the T cells multiplied more effectively and killed myeloma cells better.

The trial hypothesis is therefore specific: administration of opaganib after CAR T-cell infusion may support sustained cellular activity in patients with ultra-high-risk disease. The studies will test that hypothesis directly; the grant award itself provides no clinical evidence that the combination is effective. In mouse models receiving both opaganib and CAR T-cell therapy, tumors were controlled better and for longer than in comparison groups, the University of Oklahoma reported.

These observations led to the human research program. “Those studies led to this new grant and the opportunity to test the combination of CAR T-cell therapy and opaganib in humans,” Kang said. The distinction between the models and the planned trials is important: the animal findings supplied the rationale for the grant, but the safety, dosage and clinical effects of the sequence in people remain to be evaluated. The Phase 1b trial is the first of the two stages.

It is planned to enroll as many as 18 patients with ultra-high-risk multiple myeloma. According to the grant description, investigators will evaluate the safety of administering opaganib after CAR T-cell therapy and determine the appropriate dosage for subsequent study. This initial stage therefore addresses whether and at what dose the combination can be administered under a clinical-trial protocol.

The planned Phase 2 stage will enroll up to 21 additional patients and seek early evidence of effectiveness. Because this is a small, grant-funded program, its results will be preliminary; the source does not describe a randomized comparison or establish whether either stage can demonstrate that the combination is superior to other treatments. Opaganib is being developed as a combination agent for multiple treatment settings, including oncology.

Mark Levitt, chief scientific officer at RedHill Biopharma, said prior preclinical and clinical work has indicated that opaganib can reduce cancer-cell survival proteins such as c-Myc and Mcl-1. The company, which is partnering with OU on the trials and will supply opaganib, described those observations as evidence that the drug may have a role in combination treatment for multiple myeloma. “Opaganib has shown promise in preclinical studies as a potential combination therapy in a number of oncology and other indications,” Levitt said. The OU project will examine the drug in a defined sequence with CAR T-cell therapy in ultra-high-risk myeloma.

It will not, by itself, resolve the broader question of whether opaganib is effective across other cancers or disease indications. The project will also test a new local manufacturing workflow at OU. Cells currently sent by the university to an out-of-state company require four to six weeks for genetic engineering and cost nearly half a million dollars, according to Kang.

He said OU believes it can manufacture CAR T cells on campus in six to nine days for less than $100,000. These production times and costs are the university’s stated expectations for the new facility, not results already demonstrated in the planned trials. Kang also said the infrastructure created for the project could potentially support other cellular-therapy studies in the future.

Miltenyi Biotec, which developed the CAR construct used in the program, is helping enable local production by supplying good manufacturing practice-grade lentiviral vector for CAR T-cell manufacturing on the CliniMACS Prodigy system. The collaboration combines three elements of the planned trial: OU’s campus manufacturing operation, Miltenyi’s lentiviral vector and CAR construct, and RedHill’s provision of opaganib. The source describes this as a coordinated effort to translate the preclinical combination into human trials.

It does not report that the complete workflow has yet been clinically validated or that the projected six-to-nine-day production time has already been achieved. The overall question is whether opaganib can safely follow CAR T-cell therapy and provide an early clinical signal consistent with the improved tumor control seen in mice. The Phase 1b study will address safety and dose selection, while the Phase 2 study is intended to look for early effectiveness evidence in an additional group of patients.

If either stage produces information useful to investigators, that information will come from a limited sample and will require further study before broader clinical conclusions could be drawn. No results are available at the time of the award announcement. The NCI-supported project, identified as award No.

R01CA293516-01A1, instead represents a planned test of whether blocking SK2 can extend the cancer-fighting activity of CAR T cells in people with ultra-high-risk multiple myeloma.

Subject of Research: Clinical trials of opaganib after CAR T-cell therapy for ultra-high-risk multiple myeloma

Article Title: OU researcher to study CAR T-cell and opaganib combination in clinical trials for ultra-high-risk multiple myeloma

Article References: OU researcher to study CAR T-cell and opaganib combination in clinical trials for ultra-high-risk multiple myeloma. Original publication (Bibliographic details unavailable.)

Image Credits: AI Generated

DOI: Not provided

Keywords: multiple myeloma, CAR T-cell therapy, opaganib, SK2, clinical trials, National Cancer Institute, Yubin Kang, cellular therapy, cancer research, OU Health, researcher, T-cell

The scale of breast cancer in the United States helps explain why clinical research investment remains so urgent. Breast cancer is the most commonly diagnosed cancer among American women apart from skin cancers, accounting for roughly one in three new cancer diagnoses in women each year. The American Cancer Society projects about 320,000 new cases in 2026. While those numbers are sobering, they sit alongside one of the most encouraging long-term trends in all of oncology: breast cancer death rates have fallen steadily since 1989, declining by 44 percent through 2023. Researchers attribute that decline to a combination of earlier detection through screening mammography, growing public awareness, and successive waves of treatment advances, many of which were validated in large, practice-changing clinical trials.

Incidence, however, tells a more complicated story. Diagnosis rates have risen by about 1 percent annually in recent years, and the increase has been somewhat steeper among women younger than 50, at roughly 1.4 percent per year. That trend has intensified scientific interest in why younger women are being diagnosed more often, and it underscores the importance of trials that address the unique needs of different patient populations, from young adults facing hereditary risk to long-term survivors managing the late effects of treatment. Today, approximately 4 million people in the United States are living as breast cancer survivors, a population whose health needs extend well beyond the end of active therapy.

The infrastructure behind much of this progress is less visible to the public than any single drug approval. The Alliance for Clinical Trials in Oncology, a member of the National Cancer Institute’s National Clinical Trials Network, unites more than 26,000 cancer specialists at 112 main institutions and 1,400 affiliated sites across the United States and Canada. More than 40,000 participants have enrolled in Alliance studies over the years, and the organization’s biospecimen repository now holds more than 1.5 million samples collected across three decades. That repository is a scientific resource in its own right, allowing researchers to ask questions about tumor biology, treatment response, and long-term outcomes that were never anticipated when the original trials were designed.

Currently, the Alliance and its partner organization Alliance Foundation Trials have eight active breast cancer trials open to patients and survivors. Together they illustrate the breadth of modern breast cancer research, which spans not only drug development but also de-escalation of therapy, survivorship care, prevention, and early detection. Several of these trials reflect a growing recognition that sometimes the most patient-centered question is not which new drug to add, but whether existing treatment can safely be shortened or reduced.

One example is a phase III study known as OptimICE-PCR, led by Sara Tolaney of Dana-Farber Cancer Institute. It focuses on patients with early-stage triple-negative breast cancer, an aggressive subtype that lacks the three receptors most commonly targeted by therapy. Many of these patients now receive chemotherapy combined with pembrolizumab, an immune checkpoint inhibitor, before surgery, and those who achieve a pathologic complete response, meaning no residual invasive cancer is found at the time of surgery, currently continue pembrolizumab for up to 27 weeks afterward. The trial asks whether observation alone can match that standard in preventing recurrence, potentially sparing responders months of immunotherapy and its associated side effects and costs.

A parallel de-escalation question is being asked in HER2-positive disease. ShortStop-HER2, led by Adrienne Waks of Dana-Farber, enrolls patients whose tumors respond completely to chemotherapy paired with HER2-targeted antibodies before surgery. The standard adjuvant course of HER2-directed therapy has long been 12 months, but prolonged antibody treatment can cause side effects, and some patients struggle to complete the full year. The trial compares six months of HER2-targeted therapy with the conventional 12-month course to determine whether the shorter duration preserves effectiveness while lightening the burden of care. Studies like these reflect a broader movement in oncology toward individualizing treatment intensity, intensifying therapy for those at highest risk and reducing it for those who may not need it.

Not all trials aim to subtract treatment; some aim to target it more precisely. AFT-70 NAVIGATE, co-led by Komal Jhaveri of Memorial Sloan Kettering Cancer Center and Gaorav Gupta of UNC Lineberger Comprehensive Cancer Center, tests a molecular residual disease-guided strategy in intermediate- and high-risk ER-positive, HER2-negative early breast cancer. Patients receive giredestrant, an investigational next-generation oral selective estrogen receptor degrader, while undergoing ongoing Signatera molecular residual disease monitoring, a blood-based test that looks for traces of tumor DNA. If molecular evidence of residual cancer appears, patients may be intensified with a CDK4/6 inhibitor. The goal is to reserve prolonged combination therapy for patients whose biology suggests they need it, rather than exposing everyone to it by default. This approach exemplifies how liquid biopsy technology is reshaping adjuvant treatment design.

Survivorship research occupies another important corner of the portfolio. The Revitalize trial, led by Maryam Lustberg of Yale University Comprehensive Cancer Center, evaluates fractional CO2 laser therapy for vaginal atrophy in breast cancer survivors. Vaginal dryness is a common consequence of menopause, but it is frequently induced or worsened by breast cancer treatments, particularly endocrine therapies such as tamoxifen and aromatase inhibitors. Because hormone-based remedies are often avoided in breast cancer patients, nonhormonal options carry real clinical significance, and symptoms like these are a major reason survivors discontinue the endocrine therapy that protects them from recurrence.

Physical function is the focus of the DEFEND study, led by Kathryn Schmitz of UPMC Hillman Cancer Center and Jennifer Ligibel of Dana-Farber. Chemotherapy can erode strength, endurance, and independence, and fatigue is among the most commonly reported and least adequately treated side effects of cancer care. DEFEND tests whether a structured exercise program delivered entirely through telehealth can help patients receiving chemotherapy maintain physical function, reduce fatigue, and prevent disability. If successful, the trial could expand access to exercise oncology services for patients who live far from specialized cancer centers or face transportation and scheduling barriers.

Prevention and early detection round out the research agenda. A trial led by Devon Noonan of Duke University School of Medicine tests a text-based smoking cessation program against a printed manual in rural cancer patients and survivors who smoke, including people with breast cancer. Continued smoking after a cancer diagnosis is associated with worse outcomes, yet rural populations face persistent barriers to cessation services, and a scheduled, gradual-reduction approach delivered by text message could reach people that traditional programs miss.

Another study, led by Marie Wood of the University of Colorado School of Medicine, addresses an emerging frontier in cancer screening: multicancer early detection blood tests. These tests, which aim to identify cancer signals in a single blood draw, are advancing rapidly, but evaluating them rigorously requires large, well-characterized reference sets of samples from people with and without cancer. By collecting and storing blood and tissue specimens from both groups, the study creates a blinded reference resource that can support the development and validation of tests intended to catch cancers, including breast cancer, at earlier and more treatable stages.

Genetic services are the subject of a trial led by Angela Bradbury of the University of Pennsylvania Abramson Cancer Center. Genetic testing for inherited cancer syndromes is an established standard of care that can guide enhanced screening and risk-reduction strategies, yet many adolescents and young adults with cancer never receive recommended counseling and testing. The study compares a digital, chatbot-enabled delivery model with standard remote genetic services to determine whether the technology can increase uptake among this population while easing demands on genetic counselors and other health care staff. Because hereditary risk information has implications for patients’ relatives as well, improving access to these services can ripple outward through entire families.

Viewed together, these eight trials sketch the trajectory of the field. Treatment is becoming simultaneously more effective and more tailored, with immunotherapy de-escalation, shortened antibody courses, and molecular residual disease-guided intensification all under formal evaluation. Care is extending beyond the tumor to encompass sexual health, physical function, and behavioral risk factors. And the tools of early detection, from multicancer blood tests to digitally delivered genetic services, are being tested with the same rigor once reserved for drugs. The nearly 1,900 breast cancer publications the Alliance has produced from its studies testify to how much evidence this cooperative model has generated, and each new trial depends on the patients, families, and investigators willing to participate. Their contributions remain the foundation on which the next generation of breast cancer advances will be built.

Subject of Research: Breast cancer clinical trials advancing treatment, prevention, and early detection research

Article Title: Breast Cancer Awareness Month: Advancing breast cancer research through clinical trials

Article References: Breast Cancer Awareness Month: Advancing breast cancer research through clinical trials. Original publication (Bibliographic details unavailable.)

Image Credits: AI Generated

DOI: Not provided

Keywords: breast cancer, clinical trials, Breast Cancer Awareness Month, Alliance for Clinical Trials in Oncology, triple-negative breast cancer, HER2-positive breast cancer, immunotherapy, early detection, cancer survivors, National Cancer Institute, pembrolizumab, genetic testing

Ultra-processed foods, defined under the widely used NOVA classification system as industrial formulations assembled largely from substances derived from foods plus additives, flavorings, and cosmetic ingredients, now account for more than half of the energy intake among U.S. adults. Their rapid displacement of freshly prepared meals has coincided with rising rates of several chronic diseases, and observational studies have repeatedly linked high UPF consumption to elevated risks of cardiovascular disease, type 2 diabetes, and certain cancers. Colorectal cancer has been of particular interest because diet is one of its few modifiable risk factors, and because incidence in younger adults has been climbing for reasons that remain poorly understood. Yet the new analysis indicates that the processing category itself may be a poor predictor of cancer risk when the nutritional character of the foods within it is taken into account.

To untangle these relationships, the research team turned to one of the largest dietary cohorts ever assembled: the NIH-AARP Diet and Health Study. Between 1995 and 1996, 461,682 adults aged 50 to 71 years completed a detailed food frequency questionnaire documenting their habitual eating patterns. The researchers used these responses to estimate each participant’s intake of ultra-processed foods and then followed the cohort through 2018, a median of 18.8 years, during which incident colorectal cancer cases were identified through linkage with cancer registries. This combination of scale and follow-up duration gives the analysis statistical power that few dietary studies can match, allowing the investigators to detect even modest associations between food groups and cancer risk.

The headline result was striking in its simplicity: when all ultra-processed foods were considered together, there was no association between total UPF intake and colorectal cancer incidence. Participants who ate the most UPF overall were not more likely to develop colorectal cancer than those who ate the least. This null finding stands in contrast to the monolithic framing that has dominated public discussion of ultra-processed foods, in which the category is often treated as a single, uniformly hazardous block of the food supply. The data suggest that this framing obscures more than it reveals, because the health consequences of a food depend on what the food actually is, not merely on how it was made.

When the researchers disaggregated the UPF category into its constituent food groups, the picture changed dramatically. Higher intake of whole grains, fiber, dairy products, and calcium derived from ultra-processed sources was associated with a lower incidence of colorectal cancer, while meat from ultra-processed sources was associated with a higher incidence. In other words, an ultra-processed whole grain bread and an ultra-processed sausage sit at opposite ends of the risk spectrum despite sharing the same processing label. The associations observed within these food groups were consistent with long-standing dietary guidance for colorectal cancer prevention, which emphasizes whole grains, fiber, dairy, and calcium while recommending limits on red and processed meat.

The team also performed a substitution analysis that offers a practical takeaway for readers. Replacing 10 percent of gram weight from ultra-processed food intake with minimally processed foods was associated with a 2 percent lower incidence of colorectal cancer. While the magnitude of this effect is modest, it reinforces the value of shifting the overall balance of the diet toward fresh and minimally processed options. The result also implies that the potential benefit of reducing UPF consumption lies less in avoiding the processing category as a whole and more in the specific nutritional substitutions that such a shift typically involves, such as trading processed meats for vegetables, legumes, and whole foods.

These findings arrive at a moment when ultra-processed foods have become one of the most hotly debated topics in nutrition science and public health policy. Several countries have considered front-of-package warnings or taxation schemes targeting the UPF category, and recent dietary guidelines in some nations have begun to explicitly recommend limiting ultra-processed foods regardless of their nutritional profile. The new study does not settle that policy debate, but it does provide a caution against treating the NOVA processing category as a proxy for healthfulness. A food’s position within the processing spectrum, the data suggest, is a far less reliable guide to colorectal cancer risk than the food’s actual composition, particularly its content of whole grains, fiber, dairy, calcium, and meat.

The researchers are careful to acknowledge the boundaries of their evidence. The study cohort consisted primarily of older, white Americans, and the findings cannot be generalized with confidence to younger, more diverse populations whose dietary patterns and cancer risk profiles may differ substantially. In addition, UPF intake was measured only once, at baseline in the mid-1990s, a period when ultra-processed foods were less ubiquitous in the American food supply than they are today. As eating habits changed and new UPF products became available over the following decades, the single baseline measurement may have underestimated participants’ actual long-term intake, potentially biasing the results in unpredictable directions. Future studies with repeated dietary assessments and more diverse cohorts will be needed to confirm whether the food-group pattern observed here holds in other populations and eras.

Loftfield summarized the implications in a statement accompanying the publication: in this large population of older U.S. adults, the team did not observe an association between total ultra-processed food intake and colorectal cancer incidence, but when the investigators examined food groups such as whole grains, dairy, and meat by their UPF or non-UPF source, the associations aligned with current dietary guidance for colorectal cancer prevention, such that higher whole grain and dairy intakes and lower meat intakes were associated with lower colorectal cancer incidence. The study, funded by the Intramural Research Program of the National Cancer Institute, with authors from the United States, France, the Netherlands, Brazil, and Australia, ultimately suggests that ultra-processed foods should not be treated as a monolith. For readers seeking to reduce their colorectal cancer risk, the message is refreshingly familiar: fill the plate with whole grains, fiber, dairy, and calcium, keep processed meat to a minimum, and let the food itself, rather than its processing label, guide the choice.

Subject of Research: Association between ultra-processed food intake and colorectal cancer incidence in the NIH-AARP Diet and Health Study cohort

Article Title: Total ultra-processed food intake not linked to colorectal cancer in large US cohort study

Article References: Total ultra-processed food intake not linked to colorectal cancer in large US cohort study. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: ultra-processed foods, colorectal cancer, NIH-AARP Diet and Health Study, PLOS Medicine, National Cancer Institute, dietary risk factors, whole grains, processed meat, NOVA classification, cohort study, nutrition epidemiology, cancer prevention

The new funding marks a deliberate shift from discovery to translation. During the first phase of the Human Tumor Atlas Network, Campbell and colleagues helped establish the Lung Pre-Cancer Atlas, a cellular map of the earliest stages of lung cancer development under the leadership of Avrum Spira. That atlas catalogued, at remarkable molecular resolution, the changes that unfold in lung tissue as normal cells drift toward malignancy. The Phase II award now allows the team to convert that encyclopedic map into something a physician can actually use at the bedside: biomarkers that distinguish dangerous nodules from benign ones before a surgeon’s knife is ever considered.

The clinical problem the team is attacking is both common and consequential. Lung adenocarcinoma is the most frequently diagnosed form of lung cancer and remains a leading cause of cancer death worldwide, even as smoking cessation programs, low-dose CT screening, targeted therapies and immunotherapies have improved outcomes for many patients. Screening itself has created a new challenge: as more people undergo CT scans, radiologists increasingly find so-called ground glass nodules, faint hazy areas that can represent early adenocarcinoma, precancerous change, inflammation or old scars. Telling these possibilities apart is notoriously difficult, and the stakes of guessing wrong run in both directions.

A nodule that is actually indolent may trigger an invasive surgical resection, exposing a healthy patient to the risks, pain and anxiety of a major procedure. A nodule that is quietly progressing toward invasive cancer, meanwhile, may be watched for too long, and the window for curative early intervention can close. Campbell’s team describes the goal as eliminating this guesswork through a multimodal strategy that reduces false-negative rates, ensuring earlier and more targeted intervention while minimizing overtreatment. To do so, the investigators have assembled a multidisciplinary group spanning pulmonology, pathology, cancer biology, imaging science and data science at Boston University, Roswell Park Comprehensive Cancer Center in Buffalo, the University of Colorado Anschutz, and the University of California, Los Angeles.

Central to the project is a new generation of sampling technology. Robotic-assisted bronchoscopy systems use steerable, computer-navigated instruments that can travel deep into the peripheral lung and reach small nodules that conventional bronchoscopes struggle to access. The team will systematically evaluate how well these emerging platforms perform on part-solid ground glass nodules, which are small, hazy and less dense than solid nodules and are therefore harder to reach and harder to sample. A biopsy is judged successful when it retrieves enough tissue to yield a definitive answer, whether cancer, precancer or benign, and the proportion of such definitive results is known as the diagnostic yield, the key metric for whether a biopsy platform is worth using at all. Because of the physical properties of these nodules, a substantial fraction of current biopsies come back inconclusive, leaving patients and physicians without an answer and often facing repeat procedures or surgery.

To build one of the largest cohorts of part-solid nodule biopsies assembled to date, interventional pulmonologists at Roswell Park, led by co-principal investigator Nathaniel Ivanick, MD, and at Boston Medical Center, led by co-investigator Ehab Billatos, MD, will collect biopsy specimens across the participating centers. Every sample will then be reviewed by co-principal investigator Daniel Merrick, MD, a pathologist at the University of Colorado who specializes in the earliest stages of lung cancer, ensuring that the histological ground truth against which the biomarkers are calibrated is read by an expert in precisely the lesions the project targets.

Imaging will provide a second, independent stream of evidence. William Hsu, PhD, at UCLA, will lead automated quantitative image analysis that extracts advanced radiomic features from CT scans, measuring characteristics of the nodule itself, the surrounding lung tissue and the lung as a whole. The team will determine which of these features best predict whether a given biopsy will produce a usable diagnosis. That predictive capability could change clinical practice before any molecular test is run: if a scan can forecast, in advance, which nodules are likely to yield inconclusive biopsies, physicians could choose which nodules to sample, select the most appropriate tool, and plan a route to diagnosis that requires fewer procedures overall.

The molecular layer of the project will be directed by co-principal investigator Sarah Mazzilli, PhD, assistant professor of medicine at Boston University and Director of the BU Spatial Biology Core. Biopsy material, which is inherently limited in quantity, will be profiled using spatial transcriptomics, a technology that maps which genes are active in each histological region of a tissue sample rather than averaging signals across the whole specimen. These spatially resolved molecular profiles will be integrated with CT imaging features and artificial intelligence-based risk scores to build models capable of diagnosing cancer even in biopsies that pathologists judged inconclusive, and of predicting which nodules are likely to progress toward invasive disease.

Mazzilli emphasized the precision the approach demands. Each biopsy is tiny, she noted, so every piece of tissue has to count. Her team has built a pipeline to optimally preserve and process each sample, profile it, and map gene activity across it at near single-cell resolution, allowing the earliest molecular signs of cancer to be pinpointed even when they are not yet distinguishable under the microscope. Just as important, she added, every profile generated will become part of a public atlas, so that researchers everywhere can apply their own novel methods to better understand how lung cancer begins and how it might be targeted for intervention before it becomes lethal.

The broader context for the work is the Human Tumor Atlas Network itself, a National Cancer Institute initiative to construct three-dimensional atlases of the dynamic cellular, morphological and molecular features of human cancers as they evolve from precancerous lesions to advanced disease. By anchoring its biomarker development in that atlas framework, the Boston University-led consortium hopes to do more than refine the management of a single nodule type. If the integrated models perform as intended, the project could establish a template for how large-scale molecular atlases are converted into clinical decision tools, transforming early-stage lung cancer management so that patients with aggressive tumors receive immediate treatment while healthy individuals are spared the anxiety and physical toll of unnecessary procedures. The research is supported by the National Cancer Institute of the National Institutes of Health under Award Number U01CA313003, and its content remains the responsibility of the investigators rather than the National Institutes of Health.

Subject of Research: Translating the Lung Pre-Cancer Atlas into multimodal biomarkers for managing lung ground glass nodules

Article Title: Grant awarded to BU-led team targeting early lung cancer detection

Article References: Grant awarded to BU-led team targeting early lung cancer detection. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: lung cancer, ground glass nodules, Human Tumor Atlas Network, Lung Pre-Cancer Atlas, biomarkers, robotic-assisted bronchoscopy, spatial transcriptomics, radiomics, early detection, lung adenocarcinoma, Boston University, National Cancer Institute

The biology underlying the approval is rooted in one of the most consequential discoveries in modern cancer genetics. DNA mismatch repair is a cellular quality-control system responsible for correcting errors that arise when DNA is copied during cell division. When the genes encoding this machinery, most commonly MLH1, MSH2, MSH6, or PMS2, are defective or silenced, errors accumulate in stretches of repetitive DNA known as microsatellites, producing a state called microsatellite instability. The resulting tumors carry an exceptionally high burden of mutations, and those mutations are translated into abnormal protein fragments that the immune system can recognize as foreign. This neoantigen-rich environment explains why dMMR tumors respond unusually well to immune checkpoint inhibitors, drugs that release the molecular brakes, such as the PD-L1/PD-1 axis targeted by atezolizumab, that cancers use to evade immune destruction. Paradoxically, however, dMMR tumors are less sensitive to fluoropyrimidine-based chemotherapy, the historical backbone of adjuvant treatment, leaving a critical therapeutic gap that the ATOMIC trial was designed to close.

Colorectal cancer remains the second leading cause of cancer-related death worldwide, and stage III disease, in which cancer has spread to nearby lymph nodes but not to distant organs, represents a pivotal and potentially curable stage. For decades, the standard adjuvant treatment for all patients with stage III colon cancer, regardless of molecular subtype, has been chemotherapy with a fluoropyrimidine combined with oxaliplatin, typically delivered as the FOLFOX regimen. Yet even with this treatment, a substantial proportion of patients experience recurrence, and the diminished sensitivity of dMMR tumors to fluoropyrimidines meant that this subgroup derived comparatively limited benefit from the existing standard. That unmet need provided a strong scientific rationale for a biomarker-driven approach, one that would match the distinctive immunogenicity of dMMR tumors with an agent capable of exploiting it, rather than treating all stage III colon cancers as a single, uniform disease.

The ATOMIC trial enrolled 712 participants between September 2017 and January 2023 across the United States and in Germany, a scale of accrual that investigators attribute to the infrastructure of the National Cancer Institute’s National Clinical Trials Network. Patients with stage III colon cancer and confirmed mismatch repair deficiency were randomized to receive either standard adjuvant chemotherapy alone or chemotherapy combined with atezolizumab. The trial was designed with disease-free survival as its primary endpoint, while overall survival and safety were designated as secondary endpoints, a structure that enabled a comprehensive assessment of both the efficacy and the tolerability of integrating immunotherapy into the adjuvant setting, where patients have already been rendered surgically disease-free and treatment is intended to prevent relapse rather than shrink measurable tumors.

The results, recently published in The New England Journal of Medicine, were striking. Adding atezolizumab to standard adjuvant chemotherapy reduced the risk of cancer recurrence or death by fifty percent, a magnitude of benefit rarely achieved in the adjuvant treatment of gastrointestinal malignancies. After three years of follow-up, 86.3 percent of patients who received the combination remained disease-free, compared with 76.2 percent of those who received chemotherapy alone. In practical terms, the immunotherapy combination translated into roughly one additional patient in ten remaining free of cancer three years after surgery, an absolute improvement with profound implications for a disease in which recurrence after stage III diagnosis frequently presages incurable metastatic spread. The ten-percentage-point separation between the curves, sustained over years, provided the evidentiary foundation on which the regulatory decision was built.

Leadership of the Alliance for Clinical Trials in Oncology framed the approval as both a clinical and an institutional milestone. Evanthia Galanis, MD, DSc, Group Chair of the Alliance, said that the approval of atezolizumab for patients with stage III dMMR colon cancer is a significant milestone for patients and for the organization, noting that the ATOMIC trial demonstrates the potential of introducing immunotherapy earlier in the course of cancer treatment, when the disease is still potentially curable, with the goal of preventing recurrence and increasing the number of patients who can be cured. She added that the trial also demonstrates the power of the National Cancer Institute’s National Clinical Trials Network to conduct large, definitive trials that answer important questions in cancer management and translate those findings into a new standard of care, and that the results show what is possible when investigators across the country come together around a common goal.

Frank A. Sinicrope, MD, the Alliance Study Chair for ATOMIC and a Professor of Oncology and Clinical Investigator of the Mayo Foundation at the Mayo Clinic Comprehensive Cancer Center, emphasized the clinical and scientific significance of the findings. He said the results provide compelling evidence that immunotherapy can play an important role in reducing the risk of recurrence and death after surgery for patients with stage III dMMR colon cancer, and that the FDA approval is an important step in bringing the benefits demonstrated in the trial into routine clinical practice. He also underscored a broader principle that is increasingly shaping oncology: the approval reinforces the importance of understanding the molecular characteristics of a patient’s tumor and using that information to guide treatment. He expressed gratitude to the patients and investigators who made the study possible and helped establish the new treatment regimen.

The trial’s execution reflected a public-private partnership model that has become central to modern cancer drug development. ATOMIC was sponsored by the National Cancer Institute, part of the National Institutes of Health, and led by the Alliance within the NCI-funded National Clinical Trials Network. Genentech provided support to the study through a Cooperative Research and Development Agreement with the NCI, an arrangement that allowed an academic-public consortium to evaluate a commercial immunotherapy agent in a biomarker-defined population while retaining the scientific independence and broad accrual capacity characteristic of network trials. The Alliance itself unites more than 26,000 cancer specialists at 112 main institutions and nearly 1,500 affiliates across the United States and Canada, and also serves as a leading research base for the NCI Community Oncology Research Program, enabling practice-changing trials to reach patients in both academic centers and community settings.

The broader implications extend well beyond a single drug approval. ATOMIC adds to a growing body of evidence that mismatch repair deficiency is one of the most predictive biomarkers in oncology, a molecular signature that reliably identifies patients likely to benefit from checkpoint blockade across disease stages and tumor types. By moving immunotherapy from the metastatic and locally advanced settings into the adjuvant treatment of early-stage colon cancer, the trial demonstrates that immune checkpoint inhibition can prevent recurrence, not merely control established disease, and that earlier intervention may increase the number of patients who are ultimately cured. The approval also validates the strategy of biomarker-driven trial design, in which a molecularly defined subgroup is studied prospectively rather than discovered retrospectively, and it reinforces the value of disease-free survival as an endpoint capable of supporting regulatory decisions when the biological link to overall survival is well established.

For patients, the practical consequence is a new standard of care: those diagnosed with stage III colon cancer will now undergo molecular testing for mismatch repair status as a routine part of treatment planning, and those whose tumors are dMMR will be eligible to receive atezolizumab alongside fluoropyrimidine and oxaliplatin chemotherapy after surgery. The full description of the clinical trial is available through ClinicalTrials.gov under identifier NCT02912559, and the primary results were published by Sinicrope and colleagues in The New England Journal of Medicine in March 2026. As immunotherapy continues its migration earlier into the treatment course of cancers with recognizable immune vulnerabilities, the ATOMIC trial and the approval it produced stand as a template for how large cooperative-group studies, molecular diagnostics, and public-private collaboration can converge to convert fundamental insights about tumor immunology into tangible gains in survival.

Subject of Research: Adjuvant immunotherapy with atezolizumab for stage III deficient DNA mismatch repair colon cancer based on the phase III ATOMIC trial

Article Title: Alliance announces FDA approval of atezolizumab based on results from the Phase III ATOMIC trial for patients with Stage III dMMR colon cancer

Article References: Alliance announces FDA approval of atezolizumab based on results from the Phase III ATOMIC trial for patients with Stage III dMMR colon cancer. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: atezolizumab, colon cancer, dMMR, microsatellite instability, immunotherapy, ATOMIC trial, adjuvant chemotherapy, FDA approval, clinical trial, Alliance for Clinical Trials in Oncology, National Cancer Institute, disease-free survival

RACE21, funded by the National Cancer Institute through its Youth Enjoy Science initiative, was designed to fill a well-documented gap. Historically, cancer workforce development has concentrated on graduate and professional students, leaving undergraduates with little exposure to oncology research before they commit to a career path. The program, run through UAB’s Center for Community OutReach Development in partnership with the O’Neal Comprehensive Cancer Center and the university’s Cancer Biology undergraduate major, set out to change that by offering year-round, multi-year mentored research experiences rather than the short summer internships that dominate the field.

The numbers from the program’s first five years are striking. RACE21 recruited 78 undergraduate students, of whom 51 have already graduated, achieving a 98.5 percent graduation rate that far exceeds the national four-year institutional average of roughly 52 percent. Scholars worked across 43 faculty-led laboratories spanning 23 clinical and research departments, delivered more than 100 presentations at local, national, and international scientific meetings, and co-authored 53 peer-reviewed publications. Approximately 80 percent of alumni are now continuing their education in graduate school, medical training, or positions in cancer research or healthcare.

Recruitment itself became a lesson in how scientific talent finds its way into the pipeline. The program cast a wide net through academic advisors, honors college directors, student organizations such as the Minority Association of Pre-Health Students and the Black Undergraduate Medical Association, campus flyers, and social media. Yet by the second year, word-of-mouth referrals from current participants had emerged as the single most effective recruitment strategy, a finding consistent with research showing that peer relatedness and social support shape persistence in STEM. Applicants submitted transcripts, recommendation letters, and personal statements describing their goals in areas ranging from basic cancer mechanisms to epidemiology and clinical oncology.

Selection favored students with a GPA of 3.5 or higher, clear professional goals, and evidence of community engagement, though prior research experience was not required. Once admitted, trainees were matched individually with mentors based on their stated interests, and mentors were vetted for active funding, recent publications, and mentoring track records. Trainees could reapply annually for up to four years, with each year building on the last: foundational engagement during the pandemic-constrained first year, introduction to research culture and the BioBridge outreach camp in year two, financial literacy and scientific communication in year three, and leadership, entrepreneurship, and advanced research in years four and five.

The technical skills students acquired read like a syllabus for modern cancer biology. Participants described hands-on experience with cell culture, animal models, flow cytometry, immunohistochemistry, Western blotting, gel electrophoresis, and computational and bioinformatics approaches. Just as importantly, they learned that science is iterative. One scholar noted that repeating Western blot experiments helped them get better results after each attempt, while another reflected that even when projects fail, they still love research enough to keep trying. That resilience, the evaluation found, is as much a workforce competency as any laboratory technique.

The program’s quantitative evaluation relied on a mixed-methods design with careful statistical treatment. Attitudes toward cancer biology research were measured with a ten-item scale adapted from a validated survey, and because the scores were ordinal and non-normally distributed, the analysts used Wilcoxon signed-rank tests with rank-biserial correlations as effect sizes and bias-corrected bootstrap confidence intervals. Among 27 matched pre-post pairs, total attitude scores rose significantly, with a large effect size of 0.51. When items were grouped by construct, the strongest gains appeared in Interest, with moderate-to-large shifts in perceived Value and Self-Efficacy, while Commitment changed least, largely because students arrived already deeply committed, producing ceiling effects that limited measurable growth.

Community outreach proved to be an unexpected engine of professional development. RACE21 scholars facilitated BioBridge, Alabama’s first summer STEM camp focused on cancer biology for rising ninth-grade students, reaching more than 170 teenagers. An analysis of 50 open-ended reflections from four cohorts, summarized in a word cloud of the most frequent terms, revealed seven dominant themes: student engagement, teaching and learning, mentorship and leadership, STEM content, communication skills, impact, and program identity. Scholars reported that explaining cancer biology to fourteen-year-olds sharpened their ability to translate complex science for public audiences, a competency the program’s leaders now consider important enough to make mandatory for future trainees.

Mentorship operated at multiple levels simultaneously. Faculty research mentors guided experimental design and career development, program staff provided advising, and a near-peer structure allowed senior undergraduates to support newer ones, a culture students described as tight-knit and uplifting. All surveyed scholars from the third and fourth cohorts reported enjoying their work with faculty mentors, and 97 percent agreed they had sufficient mentor support to accomplish their research goals. Alumni have gone on to medical school, doctoral programs, NIH post-baccalaureate fellowships, dental and optometry schools, and research positions, with several earning Goldwater and Fulbright awards along the way.

The authors are candid about limitations. Selection bias is inherent in a program admitting high-GPA applicants who often arrive with strong science identities, and the adapted attitude scale, while internally consistent, has not undergone full psychometric validation; ceiling effects constrained what the rating scales could detect. Non-significant findings, they caution, should not be read as absence of program influence but as a sign that highly motivated students leave little room on the scale. The deeper lesson may be that for students already inclined toward science, the decisive ingredient is sustained, authentic exposure: longitudinal mentorship, real publications, real conferences, and the chance to teach the next generation. As a scalable model for building the cancer workforce of 2035 and beyond, RACE21 makes a compelling case that the pipeline should begin far earlier than graduate school.

Subject of Research: Evaluation of the RACE21 undergraduate cancer research and education training program at the University of Alabama at Birmingham

Article Title: Building the cancer research workforce through implementation of the RACE21 undergraduate cancer research and education program

Article References: Johnson, M. S., Haynie, K. C., Shevde, L. A., & Wyss, J. M. (2026). Building the cancer research workforce through implementation of the RACE21 undergraduate cancer research and education program. Discover Education, 5(1), Article 1127. https://doi.org/10.1007/s44217-026-02251-w

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02251-w

Keywords: cancer research, RACE21, undergraduate education, STEM workforce, mentorship, Youth Enjoy Science, National Cancer Institute, science communication, BioBridge, health disparities, student persistence, UAB

The urgency underlying the agenda was captured early by Chyke Doubeni, MD, MPH, Chief Health Equity Officer at The Ohio State University Wexner Medical Center. Established prevention and screening strategies, he told attendees, have the power to eliminate nearly half of all cancer deaths, yet barriers continue to prevent many Americans from accessing these opportunities. Doubeni warned that new screening technologies carry transformative potential for cancer detection, but that their value will not be realized equitably unless the fragmented delivery processes that risk deepening existing disparities are addressed. His framing set the tone for two days of discussion in which scientific optimism was repeatedly tempered by structural realism: the tools exist, the evidence exists, and the remaining challenge is one of delivery, coverage, and trust.

That tension between knowledge and access was echoed by Darcie Green, Executive Director of Latinas Contra Cancer, who argued that the field knows more than it ever has about preventing cancer, lowering risk, and finding disease earlier, but that too much distance remains between what is known and what people can actually access and benefit from. Green called for closing that distance by bringing excellent care and patient navigation within reach and by engaging patients and communities in shaping the systems meant to serve them. Jody Hoyos, MHA, Chief Executive Officer of the Prevent Cancer Foundation, described how rapidly the paradigm is shifting: cancer prevention is no longer only about avoiding risk, she said, but about using better science, smarter screening, and earlier detection to find cancer before it becomes life-threatening. She added a practical caveat that resonated through the meeting—patients are demanding less invasive and more accessible options, and uptake will only improve if the field responds to that demand.

Day one of the summit focused on broad, population-level strategies, spanning public health infrastructure, tobacco cessation, vaccines against cancer-causing infections, emerging blood-based tests, and artificial intelligence-driven efficiencies in screening programs. Speakers emphasized that these interventions, deployed at scale, represent the clearest near-term opportunity to bend the cancer mortality curve. Mishellene McKinney, MHA, RN, OCN, Vice President of Clinical Programs at Kaiser Foundation Health Plan and Hospitals, offered an integrated delivery perspective, explaining that value-based care models can proactively engage people in prevention and screening through personalized outreach and evidence-based approaches. As both health plan and care provider, Kaiser Permanente, she said, recognizes preventing cancer as a critical part of overall care and is committed to making screening more accessible, equitable, and effective for members and surrounding communities.

The second day shifted to system-level solutions for meeting individual screening needs, particularly among higher-risk populations. Discussions covered hereditary risk assessment, follow-up diagnostics after abnormal findings, out-of-pocket costs, and continuity of care across the full cancer journey. Lisa Schlager, Vice President of Public Policy for FORCE: Facing Our Risk of Cancer Empowered, stressed that cancer risk is not one-size-fits-all: age, family history, genetics, and environmental and lifestyle factors all shape an individual’s probability of disease. Screening and prevention strategies, she argued, should be tailored so patients receive the most appropriate care for their risk profile, and public policies must evolve so patients can access the right interventions at the right time—an approach she said would improve outcomes, save lives, and reduce healthcare costs simultaneously.

Continuity of care emerged as one of the summit’s most persistent themes. Brandon Leonard, MA, Vice President of Government Affairs at LUNGevity Foundation, identified the central systems challenge as ensuring that patients move seamlessly from initial screening through follow-up diagnostics, treatment, and survivorship care. From a policy standpoint, he called for eliminating access barriers by guaranteeing that screening and diagnostics are covered for all eligible patients without burdensome cost-sharing or utilization management requirements. Molly Guthrie of Susan G. Komen reinforced the point with a concrete legislative record: Komen’s Center for Public Policy has led the introduction of, and helped pass, dozens of state bills to remove barriers standing in the way of affordable, accessible breast imaging. Gaps remain, she cautioned, and laws must continue to evolve so that all patients can obtain the screening they need without financial burden—a goal requiring collective action at both state and federal levels.

Disparities in screening access and experience received pointed attention, including for communities often overlooked in mainstream cancer control conversations. Scout, PhD, Executive Director of The LGBTQIA+ Cancer Network, identified medical mistrust as one of the biggest screening barriers for LGBTQIA+ people, citing recent data showing that this barrier has grown notably worse for 75 percent of that population within the last 18 months. Simple, low-cost interventions—welcoming signage, inclusive badges, visible signals of affirmation—can counteract that mistrust, Scout argued, while medical offices that fail to take such steps actively perpetuate disparities. The observation underscored a recurring summit message: equity in cancer screening is built or lost in thousands of small, everyday clinical interactions, not only in federal legislation.

Genetic risk and the promise of precision prevention figured prominently as well. Tuya Pal, MD, a clinical geneticist at Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, and Vice-Chair of the NCCN Guidelines Panel for Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, emphasized that access after testing is what actually saves lives. People with inherited genes that elevate cancer risk have tremendous potential to benefit from screening, she noted, but it is not testing alone that improves outcomes—rather, it is accessing appropriate care based on the results. To reap the benefits of genetic testing, the field must ensure that all individuals can obtain recommended screening and preventive measures once a result is in hand. Her comments reframed the national conversation about expanding genetic testing, warning that testing capacity without downstream care is a hollow victory.

Speakers also grappled with how to translate accelerating scientific progress into practical, responsible care. Ernest Hawk, MD, MPH, Head of Cancer Prevention and Population Science at The University of Texas MD Anderson Cancer Center, acknowledged that the science of cancer prevention and screening has advanced remarkably, and that translating that evidence into clinical tools for risk assessment, evidence-based screening programs, and practice standards has already helped save countless lives. Looking ahead to innovations such as multicancer detection tests moving closer to clinical practice, he urged balance: enthusiasm for their potential must be weighed against careful consideration of potential harms, costs, and implications for population health, until rigorous evidence demonstrates meaningful improvements in outcomes. Elisa M. Rodriguez, PhD, MS, of Roswell Park Comprehensive Cancer Center, added a patient-centered dimension from her own experience delivering cancer risk information: people do not simply want a risk score or percentage, she said—they want actionable information on what they can do to help protect themselves from developing cancer.

The summit also featured remarks from NCCN’s Chief Medical Officer, Renuka Iyer, MD, and Chief Scientific Officer, Nancy L. Lewis, MD, MBS, FACP, with panels moderated by Clifford Goodman, PhD, a consultant in health care technology and policy, and a series of presentations showcasing effective screening and prevention strategies in action. Attendees could pick up copies of the free NCCN Guidelines for Patients on screening and prevention—covering breast cancer screening and diagnosis, colorectal screening, genetic testing, lung cancer screening, and prostate cancer screening—all available in English and Spanish at NCCN.org/patients through funding from the NCCN Foundation. The organization’s next convening, the annual Patient Advocacy Summit on December 3, 2026, also in Washington, D.C., will turn to advancing family-centered cancer care, examining gaps in government support, awareness of assistance programs, and caregiver information. For a field that can already prevent roughly half of cancer deaths with tools in hand, the summit’s collective message was clear: the next frontier is not discovery, but delivery.

Subject of Research: Cancer prevention and screening policy, equity, and access discussed at the NCCN Oncology Policy Summit

Article Title: Cancer prevention and screening takes center stage during DCSummit convened by NCCN

Article References: Cancer prevention and screening takes center stage during DCSummit convened by NCCN. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: NCCN, cancer prevention, cancer screening, health equity, National Cancer Institute, CDC, genetic testing, early detection, health policy, patient advocacy, multicancer detection tests, screening disparities

The study, led by Ingrid Jacobson of the Rural Cancer Institute in Staples, Minnesota, together with colleagues affiliated with several US medical institutions, set out to answer a question that had been surprisingly underexplored: does loneliness function as a population-level indicator associated with variation in cancer mortality between communities? While individual-level studies have previously linked loneliness and social isolation to cancer incidence and survival, the authors note that little to no research had examined this relationship at the community scale, where public health surveillance and intervention decisions are actually made. By shifting the analytical lens from the individual to the county, the researchers aimed to determine whether loneliness could serve as a practical signal for identifying communities at elevated risk.

Methodologically, the investigation drew on two large, publicly available data sources. Cancer mortality came from the National Cancer Institute’s State Cancer Profiles, which provides five-year age-adjusted, all-site cancer mortality rates per 100,000 population covering 2018 through 2022. Age adjustment is a critical technical step in this kind of comparison, because counties differ substantially in the age structure of their populations; without it, a county full of retirees would appear to have a cancer problem simply because cancer risk rises with age. Loneliness, meanwhile, was measured using 2022 County Health Rankings data capturing the percentage of adults who report subjective feelings of loneliness, a self-reported measure that reflects the psychological experience of perceived social disconnection rather than the more objective condition of living alone.

To isolate any independent contribution of loneliness, the researchers merged these data with a battery of covariates from the County Health Rankings system, spanning sociodemographic characteristics, health behaviors, and rurality as classified by the US Department of Agriculture’s rural-urban continuum codes. The analysis proceeded through a series of general linear models, beginning with unadjusted estimates and progressively adding controls. In the crude, unadjusted analysis, the association between county-level loneliness and cancer mortality was pronounced: each unit increase in the percentage of lonely adults was associated with a beta coefficient of 1.88 in the age-adjusted mortality rate, a relationship that was highly statistically significant with a p-value below 0.001.

The more consequential result, however, emerged from the fully adjusted models. When the researchers controlled simultaneously for sociodemographic factors, health behaviors, and rurality, the association between loneliness and cancer mortality was attenuated but persisted, with the coefficient falling to 0.88 while remaining statistically significant at p < 0.001. In practical terms, this means that roughly half of the raw association can be explained by the fact that lonely counties also tend to have other characteristics linked to cancer deaths, such as higher smoking prevalence, lower educational attainment, or economic disadvantage. Yet a substantial, independent signal remains, suggesting that loneliness captures something about community health that conventional covariates do not fully absorb.

The authors report that the sociodemographic and health covariates in their models were differentially associated with cancer mortality, meaning some factors carried more explanatory weight than others. This pattern is consistent with a broader epidemiological literature. Prior work has documented strong geographic inequalities in cancer mortality across US counties tied to social determinants, and umbrella reviews have established socioeconomic status as a robust correlate of cancer outcomes. Behavioral pathways are also well characterized: tobacco smoking remains a dominant driver of cancer incidence and death, alcohol consumption contributes to a measurable share of cancer mortality, insufficient sleep has been linked to cancer risk, and rural populations face documented disparities in risk factors and screening access. Loneliness may plausibly intersect with several of these pathways, influencing health behaviors, delaying care-seeking, or reflecting underlying community resource deprivation.

The new county-level findings also dovetail with individual-level evidence that has accumulated over the past decade. A cohort study of Finnish middle-aged men found that loneliness and social isolation were associated with increased cancer incidence, and a 2025 systematic review and meta-analysis published in BMJ Oncology examined the impact of loneliness on cancer mortality among patients. Research using SEER-Medicare data has shown that isolation affects survival among non-Hispanic Black women diagnosed with breast cancer, and a Colombian cohort study identified loneliness as a predictor of mortality in cancer patients. What the new study adds is the ecological perspective: the observation that the burden of cancer death is geographically patterned alongside the burden of loneliness, which matters for how health departments allocate attention and resources across communities.

At the same time, the study’s design imposes important interpretive limits that the authors themselves acknowledge by framing the work as an ecological analysis. Ecological studies examine groups rather than individuals, so the finding that lonely counties have higher cancer mortality does not prove that lonely individuals are more likely to die of cancer, nor that loneliness causes cancer deaths at all. This is the classic ecological fallacy problem: correlations observed at the aggregate level may not hold, or may hold for different reasons, at the individual level. Residual confounding is another concern, since no model can fully adjust for every characteristic that distinguishes one county from another, and cause-of-death data themselves carry well-documented limitations, including under-recording of certain conditions. The five-year mortality estimates and the single-year loneliness measure also come from different windows, complicating any causal sequencing.

Nevertheless, the policy context gives the findings real weight. Loneliness has been formally recognized as a health issue in leading medical journals, and the 2023 US Surgeon General’s advisory on the epidemic of loneliness and isolation called for social connection to be treated as a public health priority. Legislative and governmental responses have followed at multiple levels, including a proposed National Strategy for Social Connection Act in the US Senate, a Combating Loneliness Act in the House, resolutions in New Jersey, California community college districts, and Thurston County in Washington, and earlier national initiatives in the United Kingdom and Japan. If county-level loneliness is indeed a usable indicator of cancer mortality risk, as the study suggests, it could be incorporated into public health surveillance systems alongside measures like smoking prevalence and screening rates, helping to identify communities where social connection interventions might yield the greatest health returns.

The evidence base for such interventions is itself maturing. Meta-analytic work has identified effective approaches to reducing loneliness, and randomized trials have tested internet-based self-help programs with human or automated guidance, one-to-one peer support in mental health services, home-based interventions for older adults, and neighborhood-level efforts to build social connectedness. Telemedicine is also being explored as a tool for expanding access to care in isolated communities, which is particularly relevant given the rurality adjustments in the new analysis and the rural focus of the research team itself. None of this establishes that reducing loneliness would lower cancer mortality, a question that would require longitudinal and interventional study designs. But the study’s central message is difficult to ignore: the communities where Americans report feeling most alone are also the communities where cancer is most lethal, and a public health apparatus that tracks one but not the other may be missing an important part of the picture.

Subject of Research: The association between county-level loneliness and cancer mortality rates in the United States

Article Title: Loneliness is correlated with cancer mortality in US counties: an ecological analysis

Article References: Jacobson, I., Swenson, A., Schroeder, Z., McGovern, E., Northrup, G., & Swenson, W. (2026). Loneliness is correlated with cancer mortality in US counties: an ecological analysis. Supportive Care in Cancer, 34(10), Article 1016. https://doi.org/10.1007/s00520-026-11258-w

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11258-w

Keywords: loneliness, cancer mortality, ecological study, public health, social determinants of health, social isolation, County Health Rankings, National Cancer Institute, rurality, cancer epidemiology, health surveillance, United States

The study, led by Sara A. Flores, Rachelle Brick, and Sallie J. Weaver of the National Cancer Institute’s Healthcare Delivery Research Program, together with Michelle Doose of the institute’s Behavioral Research Program, examined a unique natural experiment. Following the release of the standards, the NCI funded 18 supplemental research projects across the country with a twofold mission: to assess how well existing survivorship services and programs aligned with the new standards, and to identify the barriers and facilitators that shape implementation. Because each project team independently developed its own approach to measuring alignment, the resulting portfolio offered researchers an unprecedented window into how the field actually operationalizes the standards when left to its own devices.

To make sense of this diversity, the research team conducted a systematic synthesis of the measurement tools used across the funded projects. Trained abstractors applied a standardized codebook to extract detailed characteristics at both the project level and the measure level, including which specific national standards were assessed, what types of data were collected, which methods were used, and who the respondents were. Fourteen of the 18 projects ultimately contributed materials to the analysis, yielding a total of 91 distinct measurement tools spanning surveys, interview protocols, environmental scan protocols, and variables drawn from electronic health records and administrative data.

The first striking finding concerns which parts of the standards attracted the most measurement attention. The 2024 National Standards are organized into three domains: policy, processes, and evaluation and assessment. When the researchers categorized the 91 tools, they found that the overwhelming majority, 82.4 percent, addressed the health system process standards, which describe how survivorship care should actually be delivered to patients. By contrast, only 31.9 percent of tools addressed health system policy standards, which concern the organizational structures and commitments that underpin survivorship programs, and a mere 15.4 percent addressed the evaluation and assessment standards, which call on systems to monitor and improve their own performance.

This imbalance matters because the three domains are conceptually interdependent. Policy standards create the institutional scaffolding, such as leadership support and dedicated resources, that allows process standards to be implemented sustainably. Evaluation standards, in turn, generate the feedback loops that tell a health system whether its processes are working and for whom. A measurement landscape dominated by process checks risks producing a skewed picture of alignment, one in which a cancer center might appear to be delivering survivorship services while lacking the governance and self-assessment infrastructure to sustain or improve them. The authors suggest that this pattern likely reflects both the relative concreteness of process standards and the practical difficulty of writing tools for abstract organizational commitments.

The second major finding concerns the depth of measurement rather than its breadth. When the team classified what each tool actually captured, they found that 72.5 percent assessed the existence or occurrence of care elements, essentially yes-or-no questions about whether something happens. Does the program have a survivorship care plan? Was a referral made? Did a visit occur? Far less commonly captured was the quality or degree to which a standard was met, or how care processes actually unfolded in practice. This distinction is fundamental to quality measurement. Knowing that a service exists says nothing about whether it is timely, appropriate, equitable, or responsive to patient needs, and the study’s findings suggest that the field’s current toolkit is far better at detecting presence than at judging performance.

The methodological diversity documented in the study is itself informative. The 91 tools ranged from validated patient-reported outcome instruments to bespoke interview guides and electronic health record queries, reflecting the absence of any shared, ready-made measurement approach at the time the standards were released. This kind of grassroots innovation is valuable, but it comes at a cost: without common operational definitions, findings from one health system cannot be directly compared with those from another, and the field cannot aggregate local insights into a national picture of survivorship care quality. The problem echoes well-documented challenges in hospital accreditation research, where measuring the effects of complex, system-level interventions has proven notoriously difficult, and in quality measurement more broadly, where misalignment across state and regional measure sets has long hampered comparison.

The study’s implications reach beyond survivorship care into the broader science of implementation. Implementation researchers have long argued that strong measurement infrastructure is a prerequisite for learning health systems, in which care delivery continuously improves through the systematic collection and use of data. The NCI supplement portfolio demonstrates both the promise and the peril of funding implementation pilots ahead of measurement standardization. On one hand, the projects generated a rich, ground-level understanding of how diverse cancer care delivery settings interpret the standards and what barriers they face. On the other hand, the heterogeneity of the resulting tools means that synthesizing those insights requires exactly the kind of labor-intensive coding exercise this study performed, and some information may resist aggregation altogether.

The authors point toward several concrete opportunities for strengthening the measurement foundation. Chief among them is the development of shared operational definitions for each standard, phrased concretely enough to be applied consistently across settings that range from large academic cancer centers to community oncology practices. Such definitions would need to accommodate legitimate variation in how survivorship care is organized while preserving the core intent of each recommendation. The team also highlights the value of measures that move beyond existence checks toward assessments of quality and fidelity, drawing on established frameworks for evaluating health care quality and on growing experience with electronic clinical data standards that make process measurement more feasible at scale.

For the growing community of cancer survivors and the clinicians who care for them, the stakes of this seemingly technical work are substantial. Survivorship care encompasses surveillance for recurrence, management of late and long-term treatment effects, attention to psychosocial wellbeing, and coordination among many providers, often over decades. Standards that exist only on paper cannot close the well-documented gaps in how this care is delivered, and gaps that cannot be measured cannot be systematically addressed. By mapping how the first wave of implementation projects measured alignment with the 2024 National Standards for Survivorship Care, this study provides the field with an honest self-portrait: a committed and creative research community that has, so far, been measuring the easiest things most often. The path forward, the authors argue, lies in building the shared measurement infrastructure that will let every cancer care setting see clearly where it stands, and where it needs to go, in serving the millions of Americans who live beyond a cancer diagnosis.

Subject of Research: Measurement of alignment with the 2024 National Standards for Cancer Survivorship Care across NCI-funded implementation projects

Article Title: Measuring uptake of the 2024 national standards for survivorship care: Insights from National Cancer Institute funded pilot projects

Article References: Flores, S. A., Doose, M., Brick, R., & Weaver, S. J. (2026). Measuring uptake of the 2024 national standards for survivorship care: Insights from National Cancer Institute funded pilot projects. Journal of Cancer Survivorship. https://doi.org/10.1007/s11764-026-02130-1

Image Credits: AI Generated

DOI: 10.1007/s11764-026-02130-1

Keywords: cancer survivorship, survivorship care standards, National Cancer Institute, quality measurement, health care delivery, implementation science, electronic health records, care processes, health systems, measurement infrastructure, cancer care quality, patient-reported outcomes