The COVID-19 pandemic has led to dramatic adjustments in cancer care delivery and cancer research. To examine these changes, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop, Innovation in Cancer Care and Cancer Research in the Context of the COVID-19 Pandemic, in July 2021. Workshop speakers considered the lessons learned from these adaptations in order to improve the delivery of high-quality cancer care and the conduct of cancer clinical trials in the post-pandemic era. This Proceedings of a Workshop highlights presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

The National Academies of Sciences, Engineering, and Medicine held the workshop Applying Big Data to Address the Social Determinants of Health in Oncology on October 28?29, 2019, in Washington, DC. This workshop examined social determinants of health (SDOH) in the context of cancer, and considered opportunities to effectively leverage big data to improve health equity and reduce disparities. The workshop featured presentations and discussion by experts in technology, oncology, and SDOH, as well as representatives from government, industry, academia, and health care systems. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Sharing knowledge is what drives scientific progress - each new advance or innovation in biomedical research builds on previous observations. However, for experimental findings to be broadly accepted as credible by the scientific community, they must be verified by other researchers. An essential step is for researchers to report their findings in a manner that is understandable to others in the scientific community and provide sufficient information for others to validate the original results and build on them. In recent years, concern has been growing over a number of studies that have failed to replicate previous results and evidence from larger meta-analyses, which have pointed to the lack of reproducibility in biomedical research. On September 25 and 26, 2019, the National Academies of Science, Engineering, and Medicine hosted a public workshop in Washington, DC, to discuss the current state of transparency in the reporting of preclinical biomedical research and to explore opportunities for harmonizing reporting guidelines across journals and funding agencies. Convened jointly by the Forum on Drug Discovery, Development, and Translation; the Forum on Neuroscience and Nervous System Disorders; the National Cancer Policy Forum; and the Roundtable on Genomics and Precision Health, the workshop primarily focused on transparent reporting in preclinical research, but also considered lessons learned and best practices from clinical research reporting. This publication summarizes the presentation and discussion of the workshop. Table of Contents Front Matter 1 Introduction 2 Transparency and Trust 3 Approaches to Cultivate Transparent Reporting in Biomedical Research 4 Lessons Learned and Best Practices 5 Checklists and Guidelines 6 Toward Minimal Reporting Standards for Preclinical Biomedical Research 7 Stakeholder Opportunities for Promoting Transparent Reporting Appendix A: References Appendix B: Background Discussion Document: Selected Guidelines for Transparent Reporting Appendix C: Workshop Agenda

The oncology careforce faces challenges as population growth in the U.S. contributes to increases in the number of patients diagnosed with cancer. Significant advances in cancer research, screening and diagnostic practices, and treatment have led to the age-adjusted declining mortality rate from cancer. However, as the field continues to develop and advance, cancer care has become more complex than ever before. There is a growing concern regarding the U.S. health care system's capacity to deliver high-quality cancer care to the increasing number of patients. The National Academies convened a workshop on February 11-12, 2019 to explore trends in cancer care and identify opportunities for improvement in the rapidly developing oncology careforce. Discussions at the workshop primarily focused on trends in demographics, the careforce, and oncology practice, as well as implications for the future of cancer care and strategies to improve the organization and delivery of cancer care. Opportunities to change policy and leverage technologies in oncology were also identified. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

The National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a public workshop, Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum, on February 13 and 14, 2017, in Washington, DC. The purpose of this workshop was to highlight the current evidence base, gaps in knowledge, and research needs on the associations among obesity, physical activity, weight management, and health outcomes for cancer survivors, as well as to examine the effectiveness of interventions for promoting physical activity and weight management among people living with or beyond cancer. Workshop sessions also reviewed the opportunities and challenges for providing weight management and physical activity interventions to cancer survivors. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

The public health burden from lung cancer is substantial: it is the second most commonly diagnosed cancer and the leading cause of cancer-related deaths in the United States. Given the individual and population health burden of lung cancer, especially when it is diagnosed at later stages, there has been a push to develop and implement screening strategies for early detection. However, many factors need to be considered for broad implementation of lung cancer screening in clinical practice. Effective implementation will entail understanding the balance of potential benefits and harms of lung cancer screening, defining and reaching eligible populations, addressing health disparities, and many more considerations. In recognition of the substantial challenges to developing effective lung cancer screening programs in clinical practice, the National Academies of Sciences, Engineering, and Medicine held a workshop in June 2016. At the workshop, experts described the current evidence base for lung cancer screening, the current challenges of implementation, and opportunities to overcome them. Workshop participants also explored capacity and access issues; best practices for screening programs; assessment of patient outcomes, quality, and value in lung cancer screening; and research needs that could improve implementation efforts. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda Appendix C: Glossary

Immunotherapy is a form of cancer therapy that harnesses the body's immune system to destroy cancer cells. In recent years, immunotherapies have been developed for several cancers, including advanced melanoma, lung cancer, and kidney cancer. In some patients with metastatic cancers who have not responded well to other treatments, immunotherapy treatment has resulted in complete and durable responses. Given these promising findings, it is hoped that continued immunotherapy research and development will produce better cancer treatments that improve patient outcomes. With this promise, however, there is also recognition that the clinical and biological landscape for immunotherapies is novel and not yet well understood. For example, adverse events with immunotherapy treatment are quite different from those experienced with other types of cancer therapy. Similarly, immunotherapy dosing, therapeutic responses, and response time lines are also markedly different from other cancer therapies. To examine these challenges and explore strategies to overcome them, the National Academies of Sciences, Engineering, and Medicine held a workshop in February and March of 2016. This report summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda Appendix C: Glossary

Though cancer was once considered to be a problem primarily in wealthy nations, low- and middle-income countries now bear a majority share of the global cancer burden, and cancer often surpasses the burden of infectious diseases in these countries. Effective low-cost cancer control options are available for some malignancies, with the World Health Organization estimating that these interventions could facilitate the prevention of approximately one-third of cancer deaths worldwide. But these interventions remain inaccessible for many people in the world, especially those residing in low-resource communities that are characterized by a lack of funds ? on an individual or societal basis ? to cover health infrastructure and care costs. Few guidelines and strategies for cancer control consider the appropriateness and feasibility of interventions in low-resource settings, and may undermine the effectiveness of these efforts. For example, interventions that are designed for high-resource settings may not account for important considerations in low-resource settings, such as resource constraints, infrastructure requirements, or whether a community has the capacity to deliver downstream cancer care. Patients in resource-constrained communities continue to face delayed diagnoses of cancer, potentially resulting in the diagnosis of later stage cancers and worsened patient outcomes. In addition, social stigmas, geopolitical issues, and cultural norms may limit access to cancer care in certain communities. Recognizing the challenges of providing cancer care in these settings, the National Academies of Sciences, Engineering, and Medicine developed a workshop series examining cancer care in low-resource communities. This report summarizes the presentations and discussions from the first workshop, which focused on cancer prevention and early detection. Table of Contents Front Matter Workshop Summary Appendix A: Statement of Task Appendix B: Workshop Agenda

Despite advances in the delivery of high-quality cancer care and improvements in patient outcomes in recent years, disparities in cancer incidence, care, and patient outcomes persist. To examine opportunities to improve health equity across the cancer care continuum, the National Cancer Policy Forum and the Roundtable on the Promotion of Health Equity hosted a public workshop, Promoting Health Equity in Cancer Care, on October 25 and October 26, 2021. This virtual workshop featured presentations and panel discussions on topics that included: opportunities to improve equitable access to affordable, high-quality cancer care; strategies to identify and address the intersectionality of structural racism and implicit bias in cancer care delivery; the potential for quality measurement and payment mechanisms to incentivize health equity in cancer care delivery; and clinical practice data collection efforts to better assess and care for people living with and beyond cancer. This publication summarizes the presentation and discussion of the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Childhood cancer is an area of oncology that has seen both remarkable progress as well as substantial continuing challenges. While survival rates for some pediatric cancers present a story of success, for many types of pediatric cancers, little progress has been made. Many cancer treatments are known to cause not only significant acute side effects, but also lead to numerous long-term health risks and reduced quality of life. Even in cases where the cancer is considered curable, the consequences of treatment present substantial long-term health and psychosocial concerns for children, their families, their communities, and our health system. To examine specific opportunities and suggestions for driving optimal care delivery supporting survival with high quality of life, the National Cancer Policy Forum of the Institute of Medicine and the American Cancer Society co-hosted a workshop which convened experts and members of the public on March 9 and 10, 2015. At this workshop, clinicians and researchers in pediatric oncology, palliative, and psychosocial care, along with representatives from the U.S. Food and Drug Administration, National Cancer Institute, Children's Oncology Group, pharmaceutical companies, and patient advocacy organizations, discussed and developed a menu of options for action to improve research, quality of care, and outcomes for pediatric cancer patients and their families. In addition, parents of children with cancer and pediatric cancer survivors shared their experiences with care and provided poignant personal perspectives on specific quality of life concerns and support needs for children and families across the life spectrum. This report summarizes the presentations and discussion of the workshop. Table of Contents Front Matter WORKSHOP SUMMARY Appendix

A long-held goal in oncology has been to develop therapies that target the specific abnormalities in each patient's cancer rather than simply treating cancers based on the tissue of origin. In the past decade, advances in technology have enabled researchers to relatively quickly and inexpensively determine, in minute detail, the genetic makeup of tumors. Although relatively few targeted cancer therapies are currently available in the clinic and it is not yet clear whether all cancers are driven by genetic changes that can be targeted, there is widespread optimism in the cancer community that this new ability to assess the genetic abnormalities in tumors will ultimately lead to better cancer treatments and improved patient outcomes. Policy Issues in the Development and Adoption of Biomarkers for Molecularly Targeted Cancer Therapies is the summary of a workshop convened in November 2014 by the Institute of Medicine's National Cancer Policy Forum to discuss recent trends in the development and implementation of molecularly targeted cancer therapies and explore potential policy actions to address specific challenges. This report highlights the presentations and discussions at the workshop. Table of Contents Front Matter Workshop Summary Appendix: Workshop Statement of Task and Agenda

In recent years, patients' out-of-pocket costs for cancer care have been rising rapidly. These costs include health insurance deductibles, coinsurance, and copayments for covered services, as well as services that are not covered by insurance. Many cancer patients are especially vulnerable financially because their illness and/or treatment impedes their ability to work, with some patients losing employment altogether. Even with insurance, cancer patients often experience financial hardships, such as going into debt, depleting all assets to pay for cancer treatment, and personal bankruptcy. Although many elements contribute to the cost of cancer care, one important component is the cost of new cancer drugs, which has been escalating rapidly in recent years. To explore the issue of cancer drug costs and patient access to affordable, appropriate drug therapies, the Institute of Medicine's National Cancer Policy Forum convened a workshop on ensuring patient access to affordable cancer drugs in June 2014. Affordability was considered from both individual and societal perspectives. The workshop featured discussion panels as well as invited presentations from clinicians, researchers, representatives from the health insurance and pharmaceutical industries, and patient advocates. Ensuring Patient Access to Affordable Cancer Drugs summarizes the presentation and discussion of the workshop.

To examine the potential role of companion animals as sentinels of relevant, shared environmental exposures that may affect human aging and cancer, the National Cancer Policy Forum held a workshop in collaboration with the Forum on Aging, Disability, and Independence and the Standing Committee on the Use of Emerging Science for Environmental Health Decisions to explore this promising and underutilized pathway for research. Presentations and panel discussions covered the current state of the science and pathways for accelerating research, along with opportunities and challenges for using this novel translational approach to exposure science to advance human health. This Proceedings of a Workshop outlines the presentations and discussions that occurred during the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda Appendix C: Biographical Sketches of Planning Committee Members and Workshop Speakers

The National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop in March 2021 to examine the existing evidence base on how the Patient Protection and Affordable Care Act (ACA) has altered the landscape of cancer prevention and care delivery in the United States. The workshop featured presentations and discussions reviewing the effects of the ACA on people at risk for or living with cancer and providing insight into remaining policy challenges that could inform future efforts to improve and support the delivery of high-quality cancer care across the care continuum. This publication provides a high-level summary of the discussions presented during the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Cancer treatment can lead to an array of significant short- and long-term physical, psychosocial, and socioeconomic consequences for patients and their families. To examine the opportunities to prevent and mitigate the adverse effects of cancer treatment, the National Academies of Sciences, Engineering, and Medicine hosted a virtual workshop, Addressing the Adverse Consequences of Cancer Treatment, in November 2020. This workshop was convened by the Academies' National Cancer Policy Forum in collaboration with the Forum on Aging, Disability, and Independence. Workshop presentations and discussions described the range of adverse effects that patients with cancer may experience across the life course, and highlighted potential strategies to improve quality of life for cancer survivors and their families. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

There is a void in evidence-based information for making informed decisions on how to optimize care for older adults, particularly those 80 years and over. Because older adults are vastly underrepresented in clinical trials, there is a dearth of information about the appropriate use of drugs in this population. Yet older adults have higher rates of comorbidities and simultaneous use of multiple medications than the general population, and are the majority users of many medications. Additionally, age-related physiological and pathological changes, particularly for adults 80 years of age and older, can lead to significant differences in the pharmacokinetics (PK)2 and pharmacodynamics (PD)3 of a given drug compared to the general population. On August 5 and 6, 2020, the National Academies of Sciences, Engineering, and Medicine hosted a workshop titled Drug Research and Development for Adults Across the Older Age Span. The workshop was designed to examine the challenges and opportunities in drug research and development for older adult populations, explore barriers that impede safety and efficacy studies in these populations, and share lessons learned for better understanding clinical pharmacology for populations over age 65. This publication summarizes the presentation and discussion of the workshop. Table of Contents Front Matter 1 Introduction 2 Inclusion of Older Adults in Clinical Trials: An Evolving Landscape 3 Overcoming Key Barriers 4 Alternative Study Approaches 5 Strategies for Engaging Older Adults in Clinical Research 6 Clinical Trials in the Era of COVID-19 and Beyond 7 Reflections and Key Takeaways Appendix A: References Appendix B: Workshop Agenda Appendix C: Speaker Biosketches

Digital health encompasses a broad array of tools and strategies with the goals of advancing research, increasing health care access and quality, and making care more personalized. It encompasses health content, digital health interventions, and digital applications, such as communication tools connecting patients and clinicians (e.g., secure email in the patient portal, text, chat, video visit), remote monitoring tools, clinical decision support tools, and systems for exchanging health information. Patient-facing tools, tools for clinicians, and systems to facilitate research and care improvement are all part of this diverse landscape, and each raises unique opportunities and potential challenges. To examine key policy issues for the effective and safe development, implementation, and use of digital health technologies in oncology research and care, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a virtual workshop in collaboration with the Forum on Cyber Resilience. The workshop, Opportunities and Challenges for Using Digital Health Applications in Oncology, held on July 13-14, 2020, convened a broad group of experts, including clinicians and researchers; patient advocates; and representatives of federal agencies, health professional societies, health care organizations, insurers, and the pharmaceutical and health technology industries. Many workshop speakers found the opportunities presented by digital health tools to be particularly compelling for oncology; however, capitalizing on these opportunities necessitates careful attention to the design, implementation, and use of digital health technologies. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

New technologies and improved understanding of the genesis and progression of various cancers have added to the enthusiasm for potential new strategies to improve screening and early detection of cancer. Research is also under way to evaluate refinements in current screening approaches, including determining optimal screening intervals, the ages at which screening should begin and end, as well as more specific estimates of the potential risks and benefits of screening for certain populations, such as racial and ethnic minority populations and people who have elevated risk for specific cancers. However, there remain significant challenges to developing, validating, and effectively implementing new cancer screening approaches. Guidelines for screening issued by different organizations vary considerably with no clear way of deciding which guidelines are most trustworthy. There is also a need to improve access to high-quality cancer screening and follow-up care, particularly in low-resource communities and among populations who are underserved or have numerous barriers to receiving care. To examine the challenges and opportunities related to improving current approaches to cancer screening, as well as the evidence base for novel cancer screening methods, the National Cancer Policy Forum held a workshop, Advancing Progress in the Development and Implementation of Effective, High-Quality Cancer Screening, on March 2-3, 2020, in Washington, DC. This workshop convened a broad range of experts, including clinicians, researchers, statisticians, and patient advocates, as well as representatives of health care organizations, academic medical centers, insurers, and federal agencies. This publication summarizes the presentations and discussions of the workshop and highlights suggestions from individual participants regarding how to improve cancer screening. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Health literacy is a critical skill for engaging in healthy behaviors to reduce disease risk and improve health outcomes across the continuum of cancer care. However, estimates suggest that more than one-third of the U.S. adult population has low health literacy, and nearly half of all patients with cancer have difficulty understanding information about their disease or treatment. Low health literacy among patients with cancer is associated with poor health and treatment outcomes, including lower adherence to treatment, higher rates of missed appointments, and an increased risk of hospitalization. Low health literacy can also impede informed decision making, especially as cancer care becomes increasingly complex and as patients and their families take more active roles in treatment decisions. To examine opportunities to improve communication across the cancer care continuum, the National Cancer Policy Forum collaborated with the Roundtable on Health Literacy to host a workshop, Health Literacy and Communication Strategies in Oncology, July 15-16, 2019, in Washington, DC. Patients, patient advocates, clinicians, and researchers, representatives of health care organizations, academic medical centers, insurers, and federal agencies explored the challenges of achieving effective communication in cancer care. This publication summarizes the presentations and discussions of the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

On November 18 and 19, 2019, the National Academies of Sciences, Engineering, and Medicine hosted a public workshop in Washington, DC, titled Sharing Clinical Trial Data: Challenges and a Way Forward. The workshop followed the release of the 2015 Institute of Medicine (IOM) consensus study report Sharing Clinical Trial Data: Maximizing Benefits, Minimizing Risk, and was designed to examine the current state of clinical trial data sharing and reuse and to consider ways in which policy, technology, incentives, and governance could be leveraged to further encourage and enhance data sharing. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Perspectives on Current Data-Sharing Policies in Practice 3 Data-Sharing Platforms 4 Striking a Balance Between Benefit/Value and Risk/Cost 5 Data Interoperability and Platform Usability 6 Infrastructure Sustainability 7 Challenges and Disincentives for Sharing and Reuse of Data 8 Finding Value in Sharing Clinical Trial Data: Overcoming Usability and Sustainability Challenges 9 Looking Forward: Incentivizing Data Sharing and Reuse Appendix A: References Appendix B: Workshop Agenda

A hallmark of high-quality cancer care is the delivery of the right treatment to the right patient at the right time. Precision oncology therapies, which target specific genetic changes in a patient's cancer, are changing the nature of cancer treatment by allowing clinicians to select therapies that are most likely to benefit individual patients. In current clinical practice, oncologists are increasingly formulating cancer treatment plans using results from complex laboratory and imaging tests that characterize the molecular underpinnings of an individual patient's cancer. These molecular fingerprints can be quite complex and heterogeneous, even within a single patient. To enable these molecular tumor characterizations to effectively and safely inform cancer care, the cancer community is working to develop and validate multiparameter omics tests and imaging tests as well as software and computational methods for interpretation of the resulting datasets. To examine opportunities to improve cancer diagnosis and care in the new precision oncology era, the National Cancer Policy Forum developed a two-workshop series. The first workshop focused on patient access to expertise and technologies in oncologic imaging and pathology and was held in February 2018. The second workshop, conducted in collaboration with the Board on Mathematical Sciences and Analytics, was held in October 2018 to examine the use of multidimensional data derived from patients with cancer, and the computational methods that analyze these data to inform cancer treatment decisions. This publication summarizes the presentations and discussions from the second workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Rapid advances in cancer research, the development of new and more sophisticated approaches to diagnostic testing, and the growth in targeted cancer therapies are transforming the landscape of cancer diagnosis and care. These innovations have contributed to improved outcomes for patients with cancer, but they have also increased the complexity involved in diagnosis and subsequent care decisions. To examine opportunities to improve cancer diagnosis and care, the National Academies of Sciences, Engineering, and Medicine developed a two-workshop series. The first workshop, held on February 12?13, 2018, in Washington, DC, focused on potential strategies to ensure that patients have access to appropriate expertise and technologies in oncologic pathology and imaging to inform their cancer diagnosis and treatment planning, as well as assessment of treatment response and surveillance. This publication chronicles the presentations and discussions at the workshop. Table of Contents Front Matter Workshop Overview Current Diagnostic Challenges in Cancer Care Ensuring the Quality and Accessibility of Diagnostic Expertise and Technologies Quality Improvement Efforts Integration and Collaboration of Specialties Wrap-Up References Appendix A: Statement of Task Appendix B: Workshop Agenda

Delivering high-quality cancer care to all patients presents numerous challenges, including difficulties with care coordination and access. Patient navigation is a community-based service delivery intervention designed to promote access to timely diagnosis and treatment of cancer and other chronic diseases by eliminating barriers to care, and has often been proposed and implemented to address these challenges. However, unresolved questions include where patient navigation programs should be deployed, and which patients should be prioritized to receive navigation services when resources are limited. To address these issues and facilitate discussion on how to improve navigation services for patients with cancer, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a workshop on November 13 and 14, 2017. At this workshop, a broad range of experts and stakeholders, including clinicians, navigators, researchers, and patients, explored which patients need navigation and who should serve as navigators, and the benefits of navigation and current gaps in the evidence base. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Advances in cancer research have led to an improved understanding of the molecular mechanisms underpinning the development of cancer and how the immune system responds to cancer. This influx of research has led to an increasing number and variety of therapies in the drug development pipeline, including targeted therapies and associated biomarker tests that can select which patients are most likely to respond, and immunotherapies that harness the body's immune system to destroy cancer cells. Compared with standard chemotherapies, these new cancer therapies may demonstrate evidence of benefit and clearer distinctions between efficacy and toxicity at an earlier stage of development. However, there is a concern that the traditional processes for cancer drug development, evaluation, and regulatory approval could impede or delay the use of these promising cancer treatments in clinical practice. This has led to a number of efforts?by patient advocates, the pharmaceutical industry, and the Food and Drug Administration (FDA)?to accelerate the review of promising new cancer therapies, especially for cancers that currently lack effective treatments. However, generating the necessary data to confirm safety and efficacy during expedited drug development programs can present a unique set of challenges and opportunities. To explore this new landscape in cancer drug development, the National Academies of Sciences, Engineering, and Medicine developed a workshop held in December 2016. This workshop convened cancer researchers, patient advocates, and representatives from industry, academia, and government to discuss challenges with traditional approaches to drug development, opportunities to improve the efficiency of drug development, and strategies to enhance the information available about a cancer therapy throughout its life cycle in order to improve its use in clinical practice. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Though cancer was once considered to be a problem primarily in wealthy nations, low- and middle-income countries now bear a majority share of the global cancer burden, and cancer often surpasses the burden of infectious diseases in these countries. Effective low-cost cancer control options are available for some malignancies, with the World Health Organization estimating that these interventions could facilitate the prevention of approximately one-third of cancer deaths worldwide. Effective cancer treatment approaches are also available and can reduce the morbidity and mortality due to cancer in low-resource areas. But these interventions remain inaccessible for many people in the world, especially those residing in low-resource communities that are characterized by a lack of funds?on an individual or a societal basis?to cover health infrastructure and care costs. As a result, worse outcomes for patients with cancer are more common in low- and middle-income countries compared with high-income countries. Few guidelines and strategies for cancer control consider the appropriateness and feasibility of interventions in low-resource settings, and this may undermine the effectiveness of care. Recognizing the challenges of providing cancer care in resource constrained settings, the National Academies of Sciences, Engineering, and Medicine developed a two- workshop series examining cancer care in low-resource communities, building on prior work of the National Academies. The first workshop, held in October 2015, focused on cancer prevention and early detection. The second workshop was held in November 2016, and focused on cancer treatment, palliative care, and survivorship care in low-resource areas. This publication summarizes the presentations and discussions of this workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda