Molecular and cellular events that drive premalignant progression are on the verge of being comprehensively characterized, according to a special report published in Cancer Prevention Research (doi:10.1158/1940-6207.CAPR-15-0406). The report lays out a brief agenda for the immediate future of cancer prevention research, including early detection.

The report was authored by world-renowned leaders in cancer prevention research, including a Nobel laureate, 3 past-presidents of the American Association for Cancer Research (AACR), the president-elect of AACR, the editor-in-chief of Cancer Prevention Research, members of the AACR board of directors and Cancer Prevention Committee, and the chief executive officer of the AACR. Coauthors came from academia, the pharmaceutical industry, the AACR, and the National Cancer Institute.

Developing approaches to prevent cancer requires understanding the molecular and cellular events that cause normal cells to become precancerous and progress to fully invasive cancers. A new era in cancer prevention is being heralded by recent discoveries of what drives cancer development, including new understandings of the sequence of genomic events and the inflammatory tumor microenvironment, including stroma and immune-cell regulation.

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The report highlights many key recent advances, including genomic technical advances that allow for single-cell sequencing and support the creation of a Pre-Cancer Genome Atlas (PCGA); successful randomized, controlled clinical trials of chemopreventives, including a breakthrough trial in familial adenomatous polyposis; validated first genomic markers for early detection of colon and lung cancers; and promising genomic leads for pancreatic and ovarian cancers based on new liquid-biopsy technology and big-data analytics.

In persons with genes that predisposition them toward cancer, studies of the biology of their tumors has recently established paradigm-changing therapy and prevention, including early detection. Efforts are being made toward implementing clinical use of such proven approaches as HPV vaccines, which can prevent the essential cause of a major global cancer burden.

“We stand at the edge of a new frontier that will include comprehensively characterizing the molecular and cellular events that influence cancer development” wrote Scott M. Lippman, MD, director of the University of California San Diego Cancer Center in an AACR blog post about the report.

“The technology and science are evolving rapidly and herald a new era of precision medicine and immune-oncology in cancer prevention that will require new paradigms for implementation into clinical practice.”