From survival to cure: Designing the next era of cancer leadership

At Cancer 2035: A Roadmap for the Future, hosted by the Milken Institute and the Richard Nixon Foundation, leaders gathered to reflect on the legacy of the National Cancer Act of 1971 and examine what the next era of cancer treatment progress demands.

More than five decades after the National Cancer Act of 1971 mobilized federal research and reshaped the nation’s commitment to fighting cancer, the system stands at another inflection point.

On stage, Deloitte US Board Chair Lara Abrash sat down with Kathy Giusti, founder of the Multiple Myeloma Research Foundation.

What followed was not a retrospective. It was a roadmap.

From fatal prognosis to field builder

When Kathy Giusti was diagnosed with multiple myeloma at age 37, the disease was considered 100 percent fatal. Survival was measured in three to four years. There were no drugs in development and no coordinated research ecosystem.

She did not try to become a scientist. She became an architect of change.

“My job was the business of science.”

Rather than working inside the lab, she focused on aligning others who were. She convened academics, industry leaders, regulators, and investors around a shared objective: Move faster than the disease.

The results reshaped the field:

• More than 100 Phase I and II clinical trials supported

• Genomic sequencing partnerships

• Venture philanthropy investment models

• Publicly available clinical and genomic data sets

• Five-year survival improving from 32 percent to 62 percent

This was not incremental progress. It was structural redesign.

Rare cancers cannot afford fragmentation. Critical mass must be engineered.

“If we want to solve the problem for patients, then we all need to compromise for the goal.”

Collaboration, in this model, is not goodwill. It is strategy.

Survivorship and the weight of time

The most powerful thread running through the conversation was survivorship. Not as a statistic, but as lived experience.

Giusti began journaling the day she was diagnosed. She was writing to her 18-month-old daughter because she believed she would not survive long enough to be remembered.

Thirty journals later, she reflected: “I never, ever expected to live.”

Survivorship carries gratitude and weight.

Her husband sold his company as they prepared for the possibility she would not survive and relocated to be closer to treatment. They were facing financial strain and profound uncertainty. Her twin sister donated stem cells. Her children grew up navigating life with a seriously ill parent.

Survival reshapes families. It changes identity. It requires rebuilding not just health, but life. The human dimension grounds the science in purpose.

From managing disease to defining cure

A pivotal shift discussed on stage was the movement from managing disease to defining cure.

Leaders in multiple myeloma treatment are aligning around measurable residual disease negativity sustained over time. Clean scans. Low relapse rates. Clear endpoints.

Defining cure reshapes:

• Clinical trial design;

• Regulatory pathways;

• Surrogate endpoints;

• Investment strategy; and

• Payer alignment.

It also demands coordination across government agencies, biopharma companies, technology partners, and nonprofit foundations.

Giusti was unequivocal.

“I truly 100 percent believe we will cure myeloma in my lifetime.”

When she was diagnosed, five-year survival was 32 percent. Today it is 62 percent. That trajectory reflects what becomes possible when science, capital, and collaboration move together.

The acceleration era

Science is advancing at remarkable speed:

• Earlier detection

• Circulating tumor cell technology

• Combination sequencing strategies

• AI-enabled imaging and clinical trial matching

• Real-world data integration

Artificial intelligence has the potential to transform patient identification, treatment sequencing, imaging analysis, and trialenrollment. But technology alone does not produce outcomes.

Acceleration requires aligned incentives, trusted partnerships, modernized data infrastructure, and leaders willing to act with urgency.

“Why wait? Just do it now.” said Kathy.

In cancer, time is measured in lives.

Designing the next era

The National Cancer Act of 1971 catalyzed a national mobilization of science. The next chapter requires mobilization of systems.

The first era funded discovery.
This era must redesign delivery.

Cure will not emerge from isolated breakthroughs. It will come from aligned ecosystems, shared data as public good, public-private partnership at scale, and leaders willing to move with urgency.

The dialogue between Lara Abrash and Kathy Giusti underscored a broader truth. Complex health challenges demand coordinated leadership across sectors. Scientific progress should be matched by operational discipline, regulatory clarity, financial strategy, and sustained collaboration.

Conviction matters. Belief shapes investment. Alignment accelerates discovery. Urgency drives performance.

The roadmap to 2035 is underway.

If the last half century was about launching a national fight against cancer, the next decade is about building the conditions for cure. It’s about leaders across science, policy, industry, and community working together to build healthier tomorrows.