Cancer progress is real: Survival hits 70% as the field turns

In a darkened convention hall in Chicago on May 31, a Harvard oncologist named Brian Wolpin stood at a podium and in a voice that sounded as if he was reading from the phone book, recited a set of numbers that brought a roomful of cancer doctors to their feet for 42 seconds. Adam Feuerstein, a biotech correspondent for the health news site Stat who has covered cancer conferences like this for two decades, said he had never witnessed anything like it. The applause lasted so long that Wolpin, caught off-guard, ad-libbed: “That time was not built into my talk.”

What Wolpin had just shown attendees at the American Society of Clinical Oncology’s (ASCO) annual meeting was a simple line graph: a drug called daraxonrasib had nearly doubled median overall survival in a 500-patient trial of a form of previously treated advanced pancreatic cancer. ASCO’s chief medical officer Julie Gralow termed the result not a home run but a “grand slam.” Toronto oncologist Jennifer Knox called it a “game changer.”

Wolpin received such a rapturous response at ASCO because pancreatic cancer is among the most pernicious and treatment-resistant cancers in existence, killing more than 50,000 Americans a year, among them Supreme Court Ruth Bader Ginsburg. The cancer has a five-year survival rate in the low teens.

Wolpin, who began his career in the mid-2000s at the world-class Dana-Farber Cancer Institute, told The Bulwark: “I think I saw several patients that first year of fellowship who had pancreatic cancer, and they all died in like three months. It’s not supposed to happen here, right? You’re supposed to have figured this out.” For decades after President Richard Nixon declared a “war on cancer,” deaths continued to mount and medical progress on many cancers remained all too limited.

But a change is well underway. The US death rate from cancer has fallen 34 percent from its 1991 peak through 2023, and the five-year relative survival for all cancers combined reached 70 percent for people diagnosed between 2015 tto 2021, up from 50 percent in the 1970s. And while daraxonrasib got the standing ovation, it was only the loudest moment in a week — and a decade — of steady, compounding victories over cancer.

The immune system, turned up

One major driver of the shift is immunotherapy. Rather than attacking a tumor directly as conventional chemotherapy does, these treatments use a patient’s own immune system to hunt and kill cancer cells. You can see immunotherapy’s powerful effects through the story of former President Jimmy Carter, who was diagnosed in 2015 at age 90 with metastatic melanoma that had spread to his liver and brain. That should have been a sign for newspaper editors to update their planned obituaries immediately; yet after being treated with the immunotherapy drug pembrolizumab, as well as surgery and radiation, Carter watched his tumors vanish and managed to live another decade.

And scientists keep pushing the frontier further. Moderna and Merck reported that the combination of a personalized mRNA vaccine — the technology behind the Covid shots, retrained on each patient’s own tumor — and an immuontherapy drug (pembrolizumab) reduced the risk of recurrence or death for high-risk melanoma by 49 percent after five years. In a small, early Memorial Sloan Kettering trial of a similar vaccine appeared to help some pancreatic cancer patients stay cancer-free longer after surgery. Seven of the eight patients who responded to the vaccine were still alive four to six years later, with a larger trial now underway.

A Memorial Sloan Kettering trial of a similar vaccine in 2024 kept pancreatic cancer at bay in patients whose immune systems responded to it. And for blood cancers, a single infusion of reengineered immune cells — called CAR T-cell therapy — has begun producing something that looks close to a cure: Emily Whitehead, the first child with cancer ever treated with CAR T, is now more than a decade cancer-free and attending college. (I wrote in more detail about immunotherapy and CAR T last year.)

From treatment to prevention

And scientists’ ambitions are growing, from treating cancer to stopping it before it starts. Last week, a team led by the Francis Crick Institute’s Charles Swanton reported that a blood test measuring 14 proteins, combined with basic risk factors like age, smoking, and lung disease, could help identify people likely to develop lung cancer years before diagnosis. They also found an intriguing clue from an older drug trial: An anti-inflammatory drug seemed to cut lung cancer risk nearly in half among people with the highest inflammation levels.

This is still early evidence — not yet a blood test and prevention treatment doctors can offer patients — but Swanton compared it to how statins work for heart disease. Just as cholesterol tests can predict a person’s risk of heart disease, and then statins can be given to lower cholesterol, the protein test identifies lung cancer risk and the anti-inflammatory drug reduces it.

And no story on modern medical miracles would be complete without an appearance from GLP-1 drugs, which truly do seem to do everything. A University of Pennsylvania study of more than 110,000 women, also reported at the ASCO meeting this week, found that taking GLP-1 drugs like Ozempic was associated with about 30 percent lower breast cancer incidence.

Both findings are early, so we shouldn’t expect major changes overnight. It took decades between the development of a test for LDL cholesterol levels, the introduction of statins, and the undeniable proof of heart disease prevention. But oncology is clearly moving toward catching cancer before it takes hold, just as we have with heart attacks.

Medical advances come with a literal cost. The new medicines are brutally expensive, with the average monthly price of a new cancer drug more than doubling between 2009 and 2019, while about half of surveyed American cancer patients and survivors have to take on debt to pay for treatment.

Many of those high prices will eventually fall, once patents run out and generic versions emerge. But a greater worry is that the scientific engine driving these advances is being throttled. Almost every advance I’ve mentioned can be traced back to federally funded basic research, which the Trump administration has been attacking relentlessly.

In 2025, the administration froze or canceled thousands of National Institutes of Health (NIH) and National Science Foundation (NSF) grants, while new NIH awards fell by billions of dollars. Congress later rejected the deepest proposed NIH cuts, but the damage was already real: Hundreds of NIH-funded clinical trials were disrupted, and early-career scientists became much less likely to win major grants. In saving dollars with those cuts, we risk losing discoveries that would save lives, at the very moment when cancer research is paying off.

The cost of those lives was made visceral at the ASCO meeting. In the opening address, ASCO’s outgoing president Eric Small spoke about his partner, Amy Lin, a University of San Francisco San Francisco oncologist. Lin had died in December of metastatic clear cell ovarian cancer, a deadly disease that still has few treatment options. He brought on the grief expert and author David Kessler to give a talk on compassionate end-of-life care.

Perhaps more than any other medical specialty, grief and loss have always been an inseparable, if rarely discussed, part of oncology. Brian Wolpin started his career watching pancreatic patients die within months and feeling certain it wasn’t supposed to happen at a place like Dana-Farber. The ovation he got was the sound of a room realizing he might be right — that the disease that once seemed untreatable is starting to lose its terrible power.

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