Cancer deaths in the United States have fallen by a little over one-third since the 1990s, according to the American Association for Cancer Research’s 2026 Cancer Progress Report. Keith Flaherty, MD, the group’s president and director of clinical research at the Massachusetts General Hospital Cancer Center, discussed the findings with Targeted Oncology.
He credits a mix of prevention, earlier detection and better therapy, built on public investment in research that began in earnest in the 1970s. Over the same stretch, the 5-year survival rate after an initial diagnosis has climbed from about 50% to 71%.
Survival with advanced disease
The figure Flaherty singles out concerns metastatic cancer in the most common solid tumors. From the mid-1990s to the mid-2020s, 5-year survival rose from about 17% to 36%. He likes that number because it leaves out gains from prevention and screening, so it points to what treatment itself has changed. The encouraging part is that people with advanced disease are benefiting, not only those caught early.
He was just as direct about the gaps. Progress has been uneven across cancer types and across molecularly defined subgroups, and some patients are not yet seeing much improvement.
The year in new drugs
The FDA approved 11 new cancer therapies in the past year, nearly all of them molecularly targeted. Researchers have been matching drugs to a tumor’s molecular drivers for about 20 years, Flaherty said, and the pace has picked up.
Two approvals stood out to him. One was the first PROTAC, a molecule that degrades its target rather than merely blocking it. Many more are in trials, and he sees the class as a step-function gain in the targets doctors can reach. The other was daraxonrasib (Rasonque), which targets all forms of RAS, mutated or not. In metastatic pancreatic cancer it doubles survival, which Flaherty said no earlier approach had managed. Around 25% of patients with cancer have KRAS mutations, and nearly all pancreatic tumors carry one, so a pipeline of KRAS drugs is now moving through trials.
There were other firsts. A PD-1 antibody won approval in ovarian cancer; about 60% of patients with cancer now have a type for which such antibodies are approved. CAR T-cell therapy was approved for marginal zone lymphoma.
Blood tests and vaccines
Flaherty pointed to circulating tumor DNA tests as the nearest to routine use. Increasingly sensitive assays can detect residual cancer after surgery, he said, identifying many people whose disease will return. That could let doctors act before any scan shows a problem, though trials are still working out what to do with a positive result. Multicancer early detection tests are further back, with room to improve sensitivity.
He also noted the first positive phase 3 trial of a personalized neoantigen vaccine, built from the mutations in a patient’s own tumor. The data have not yet been presented at a conference.
Prevention and funding
About 40% of cancers arise from modifiable risk factors. Smoking still accounts for just under 20% of all cancers, though adult smoking is now just below 10%, the lowest on record since the mid-20th century. Obesity contributes substantially, and Flaherty said researchers are watching GLP-1 drugs but are early in understanding their effect. HPV vaccination is also showing results, and about 7.5% of cancers worldwide are HPV-related.
On policy, he said Congress held NIH budgets essentially flat rather than accepting proposed cuts of 20%. But a proposed Office of Management and Budget rule could add a nonscientific review step to grants already approved, and the US Preventive Services Task Force has not met in a year and a half.
Flaherty’s own summary was “lots of reason for optimism, but a lot of work remains.” Patients curious about targeted treatments, blood-based testing or prevention should talk to their doctor about what applies to their cancer type and stage.
Sources
- 2026 AACR Report Highlights Advances and New Directions in Cancer Treatment | Targeted Oncology – Immunotherapy, Biomarkers, and Cancer Pathways
- AACR Report Highlights Gains in Cancer Survival and Prevention | Targeted Oncology – Immunotherapy, Biomarkers, and Cancer Pathways
- ESMO 2026 Preview: Late-Breaking Studies to Watch Across Tumor Types | Targeted Oncology – Immunotherapy, Biomarkers, and Cancer Pathways
Photo: EgorovaSvetlana (CC BY-SA 4.0)
