Life-Years Saved Captures Gains—and Gaps—in Blood Cancer Treatment

Over the past several decades, advances in blood cancer treatment have transformed outcomes for many patients, turning once-fatal diseases into conditions that can be treated, controlled, or, in some cases, cured. However, measuring the impact of that progress can be challenging. Traditional measures such as 5-year survival capture an important snapshot of outcomes, but they may not reflect the full effect of therapies that allow patients to live for decades beyond diagnosis or treatment.

A retrospective analysis published this month in Blood Advances examined “life-years saved” as a way to quantify the impact of advances in blood cancer therapy, tracing changes in survival across hematologic malignancies over time.¹ At the same time, the analysis highlights differences in progress between diseases and persistent disparities in outcomes across patient populations, underscoring the importance of both therapeutic innovation and access to care.

In an interview with Targeted Oncology^TM, E. Anders (Andy) Kolb, MD, pediatric hematologist/oncologist and president/CEO of Blood Cancer United, explained the rationale for using life-years saved to evaluate progress in blood cancer, what the analysis reveals about advances across hematologic malignancies, and the need to pair continued innovation with equitable access to treatment.

Targeted Oncology: What prompted you and your colleagues to look at “life-years saved” as a way of measuring progress in blood cancer?

Andy Kolb, MD: First of all, I think it is very useful and easy to translate a year of life saved into real life and what that means for a patient. That was the main driving force behind this; we wanted to create a terminology that spoke to patients and their families. But when you think about how cancer progress is evaluated in the United States—and we've seen this with the Cancer Moonshot, with reporting from American Cancer Society—we look at population-based mortality rates: the number of people that die each year because of a specific type of cancer.

Population-based [cancer] mortality rates in the United States have been going down [steadily] since 1991,² and that's remarkable progress. Most of that progress, however, is due to screening programs, early detection programs, and cancer prevention. Fewer people smoke, so fewer people are getting smoking-related cancers. Lung cancer mortality in particular has dropped significantly since the Surgeon General first alerted people to the risks, people listened to smoking cessation education programs, and then [received] cancer screening. The broad application and use of Pap smears, mammography, lung cancer screening, colon cancer screening, skin cancer screening—all of these have helped us identify some of the most devastating, high-mortality cancers earlier so that they can be treated, [thus] improving survival rates. Those programs have been a remarkable success in the United States in helping reduce mortality rates.

The problem is that blood cancers have a few unique features. One, the incidence is increasing with our aging population,³ so there are more blood cancers today than there were in 1991. Two, improvements in blood cancer mortality are due almost exclusively to the development of innovative new therapies. Screening and prevention programs have not improved survival rates significantly…so we wanted to make sure that for blood cancers in particular, the metric life-years saved reflected the development and access to innovative new therapies.

What does this metric capture that traditional measures such as 5-year survival do not?

A 5-year survival rate is a time-bound metric that can be measured in the context of a clinical trial, but a lot of things can happen after year 5. Patients can have recurrence of their disease. Patients can suffer life-limiting or life-ending [adverse events] from their treatment. Life-years saved continues to measure survival well beyond the confines of that clinical trial, and it also acknowledges that…we equate 5-year survival in many diseases to a cure, but a cure isn't always achievable. It's not even always the goal. The very first precision medicine ever approved, imatinib [Gleevec] for chronic myeloid leukemia [CML],⁴ isn't a curative therapy for most patients. But patients who get imatinib for CML can live a normal life, have a lifespan that that is the same as anybody else without the disease. So, cure and 5-year survival aren’t necessarily the goal of new therapies; [the goal] is a normal and healthy life, and that's what we want to measure with the life-years saved analysis.

What were some of the most significant findings from the analysis, and what were your reactions to the data?

The analysis was very validating. When we look back, we see these incredible reflections in the inflection points. In the 1960s, we see inflection for patients with Hodgkin [lymphoma]: when we started using multi-agent combination chemotherapy and radiation therapy, survival improved. The number of life-years saved started to increase dramatically for patients with Hodgkin lymphoma. Similarly, for acute lymphoblastic leukemia, in the late 60s [and] early 70s, we see an inflection around the time that we started using multi-agent chemotherapy and prophylaxis against central nervous system leukemia.

Then, in the 1990s, we see one of the most profound inflection points in the late 90s when rituximab [Rituxan] was approved for patients with non-Hodgkin lymphoma.⁵ We see an inflection for patients with CML when imatinib was approved…. So, we see this stable life-years saved, and then with the approval of those drugs, we see the number of life-years tick up very quickly. [This is] remarkable progress for these diseases.

For chronic lymphocytic leukemia and multiple myeloma, we see more gradual improvement as there have been moderately effective therapies, but an increasing number of effective therapies over time have improved survival significantly for those patients. But the other thing we learn when we look back is that there are diseases like acute myeloid leukemia [AML] where we have seen no inflection, or maybe only just recently we're starting to see some improvement in survival... It shows the incredible challenge that we have: despite all that we know about AML, we have failed to identify effective therapies that give us those proportional inflection points that we've seen for the other blood cancers.

The analysis shows that the benefits of progress have not been distributed equally, with persistent survival disparities by race. What do you see as the biggest drivers of these gaps, and where should the field focus its efforts to close them?

It was sobering to look at our analysis and see that Black patients haven't benefited the same as White patients. Though we are narrowing the gap, there is still a lot of work to do across diseases. And this isn't just blood cancers; this is for all cancers, so there continue to be racial and ethnic barriers in our healthcare system that we need to address as aggressively as possible. There are also geographic barriers as therapies become more complex and more expensive and patients that simply can't access them, either because of proximity to a major medical center or because of cost and insurance coverage. We need to think very seriously as a country about how we solve these problems. Patients' ability to access effective therapy should never be determined by race or address. We need to address this as an urgent need, and study effective therapies to mitigate the impact of these disparities.

What needs to happen beyond drug development to ensure patients treated in community settings can benefit from the progress captured in the analysis?

I mentioned how much we learned and how validating it was to look back and see these moments with inflection points representing major progress. I think it's also sobering to think that, as we look forward, progress is not guaranteed. Those life-years that we have given patients are not guaranteed if patients don't have access and improvements for diseases like [myelodysplastic syndrome] and AML. Continued improvement for patients with myeloma is also not guaranteed if we don't continue to fund the next generation of…innovative therapies.

We need to make sure that we maintain the integrity of the peer review process. We need to ensure that we, as a country, continue to be a leading funder of cancer research and drug development—not just in the academic world, but that we can continue to retain and support innovative biotech and drug development ventures out there. Most importantly, we need to make sure that patients have access to and can afford these innovative therapies. If we don't have systems that get the most effective therapies to the patients who need them, we will not realize the potential of the number of years of life that we can save moving forward.

REFERENCES

1. Chang DC, Eisfeld AK, Greenberger LM, Kolb EA. Life-years saved by advances in blood cancer therapy: a retrospective analysis. Blood Adv. Published online September 1, 2026. doi:10.1182/bloodadvances.2026019813

2. Siegel RL, Kratzer TB, Giaquinto AN, Sung H, Jemal A. Cancer statistics, 2025. CA: A Cancer Journal for Clinicians. 2025;75(1):10-45. doi:10.3322/caac.21871

3. Krok-Schoen JL, Fisher JL, Stephens JA, et al. Incidence and survival of hematological cancers among adults ages ≥75 years. Cancer Med. 2018;7(7):3425-3433. doi:10.1002/cam4.1461

4. Cohen MH, Williams G, Johnson JR, et al. Approval summary for imatinib mesylate capsules in the treatment of chronic myelogenous leukemia. Clin Cancer Res. 2002;8(5):935-942.

5. Harrison AM, Thalji NM, Greenberg AJ, Tapia CJ, Windebank AJ. Rituximab for non-Hodgkin's lymphoma: a story of rapid success in translation. Clin Transl Sci. 2014;7(1):82-86. doi:10.1111/cts.12111