In the Oval Office of the White House on Oct. 17, Vice President Joe Biden delivered the much-anticipated report of the Cancer Moonshot Task Force to President Obama. The President had requested that Biden, who lost his son Beau Biden to brain cancer, lead the new U.S. initiative against cancer in his final State of the Union address last January, and the task force was created that month.
The new report includes a framework of strategic goals and a summary of implementation activities and plans that can serve as a blueprint for future administrations. These activities and plans represent progress since the Moonshot was announced. According to Biden, more than 70 commitments have been made by different organizations this year to make strides in the fight against cancer. The Cancer Moonshot's ambitious goal is to compress 10 years of advances against cancer prevention, diagnosis, and treatment into 5 years.
Organizations within the cancer community have praised and voiced their support for the Moonshot initiative. As previously reported in Oncology Times, the administration established a Blue Ribbon Panel to make recommendations in areas of scientific opportunity to complement the task force's activities. That panel's 10 sweeping recommendations were presented to the Moonshot task force.
The Role of Healthcare Data
The new Moonshot task force report contains a personal note from the Vice President to President Obama, which emphasizes the increasingly important role of data in making progress and creating a new world of hope for cancer patients.
"There's a recognition that the cancer system of the 20th century must be reimagined for the 21st century to match the breakthroughs creating an inflection point in this fight." Biden said. "I am enthusiastic about what can be accomplished when we are united in this fight." And, he added, "Like President Kennedy challenged the nation before, let this Cancer Moonshot challenge all of us to think anew about what is possible and end cancer as we know it."
In his cover letter to the Moonshot task force accompanying the Blue Ribbon Panel report's scientific recommendations, acting NCI Director Douglas R. Lowy, MD, said, "NCI is energized and optimistic. We stand ready to build on this momentum and move forward so that we may improve the quality of life for those who are at the heart of and the reason for all that we do."
Daniel F. Hayes, MD, President of ASCO, commented, "Vice President Biden and the government-wide Cancer Moonshot Task Force have presented today a sweeping vision that, if realized, could change the face of cancer prevention, screening, treatment, and survivorship-as we know it." Especially heartening is the commitment to broader eligibility for clinical trials and efforts to improve the sharing of healthcare information, added Hayes, Professor of Internal Medicine, the Stuart B. Padnos Professor in Breast Cancer and Clinical Director of the Breast Oncology Program at the University of Michigan Comprehensive Cancer Center, Ann Arbor, Mich.
"Oncology practices are struggling with timely access to health care data," Hayes noted, "whether they are across town, in different states, or right next door to one another." He called on Congress to enact legislation to ensure widespread interoperability of healthcare data. He also called on Congress to pass a $2 billion appropriations increase for the NIH and additional funding for the NCI in the lame duck session after this November's election.
Goals for Success
To accomplish its aim of markedly speeding progress against cancer, the task force report sets forth these overarching strategic goals:
* catalyze new scientific breakthroughs;
* unleash the power of data;
* accelerate the process of bringing new therapies to patients;
* strengthen prevention and diagnosis; and
* improve patient access and care.
New activities, initiatives, and collaborations intended to implement the goals of the initiative are taking place in both the public sector and the private sector. They are extremely varied, and range from cutting-edge science to efforts to improve cancer patients' quality of life. Last June 29, Biden convened a Cancer Moonshot Summit, which sparked more than 54 new private-sector responses to accelerating the fight against cancer. As detailed in the task force report, some of the new initiatives in both the public and private sectors follow.
* Crowd-sourcing intellectual property data to guide and speed investments in innovative cancer therapies constitutes a new initiative of the U.S. Patent and Trademark Office. In September 2016, that agency launched a free, accelerated pilot program whose intention is to cut in half the time it takes to review patent applications in cancer therapy-from 2 years to less than a year.
* A blood profiling atlas pilot project has been launched with representatives from government, academia, pharmaceutical, and diagnostic companies. These companies are joining in a new partnership to create an open database for liquid biopsies in hopes of accelerating the development of safe and effective blood profiling diagnostic technologies. Many researchers believe that next-generation sequencing in plasma represents the future of precision medicine. A group of 20 stakeholders will launch the pilot project. Studies will be contributed from AstraZeneca, Eli Lilly and Company, Epic Sciences/Memorial Sloan Kettering Cancer Center, Foundation Medicine, Genentech, Guardant Health, Novartis, Personal Genome Diagnostics, Pfizer, Thermo Fisher Scientific, the University of Michigan, and the University of Southern California. The strategy of developing an open, well-curated database would be similar to that used to develop the database the FDA reviewed in clearing a next-generation sequencing cystic fibrosis test nearly 3 years ago. The blood profiling pilot project will include an Open Commons Consortium in collaboration with the University of Chicago. Seven Bridges will develop the blood profiling atlas analysis cloud, tailored to the needs of the liquid biopsy community.
* Recognizing that cancer patients' quality of life should be an active research priority, the Health and Environmental Sciences Institute, the Friends of Cancer Research, and the National Patient Advocate Foundation are collaborating to launch in 2017 the THRIVE network-the first of its kind. The THRIVE network will bring together the nearly 20 million cancer survivors to define and reduce immediate and long-term adverse effects from cancer therapies.
* The Joint Pathology Center of the U.S. Department of Defense (DoD) will explore digitizing and making available its repository of more than 34 million unique pathology samples to help improve cancer diagnosis. DoD is also establishing a new study on the biologic basis of cancer. By using the data in DoD's cancer registry database and biological sample collection, researchers will be able to investigate potentially 250,000 samples to identify new connections between the earliest signs of cancer. These findings can then be linked to the database of the U.S. Environmental Protection Agency to advance the study of the environmental factors that contribute to cancer progression.
* The NCI in June launched a drug formulary-a new public/private partnership with 20-30 pharmaceutical companies and biotechnology companies-that allows researchers to more easily license and test their existing drugs for new combinations that could be effective against different types of cancerous tumors.
* The U.S. Department of Veterans Affairs and the U.S. Department of Energy (DOE) have formed a partnership to apply the most powerful computational assets at the DOE's national laboratories to half a million veterans' records drawn from the Million Veteran Program to forge a new understanding of cancer and new patterns of treatment.
* NCI, Amazon Web Services, and Microsoft are entering into a partnership to build a sustainable model for maintaining cancer genomic data in the cloud.
* The U.S. Department of Health and Human Services (HHS) has clarified and strengthened the requirements for public release and availability of information from clinical trials. In September 2016, HHS issued a final rule for clinical trial registration and results information submission to http://ClinicalTrials.gov, which hopefully will increase the availability of trial results, avoid duplication of resources and increase public trust in the clinical trials process.
* A new project has been launched to demonstrate the quality assurance of oncology nursing navigation. The Sarah Cannon Research Institute, the Hospital Corporation of America's Cancer Institute, and the Academy of Oncology Nurse & Patient Navigators have announced a $12 million national research project to measure, standardize, and increase the role of oncology nurse navigators in ensuring patient compliance with cancer treatment plans, improving care coordination and patient satisfaction, and identifying patients eligible for cancer clinical trials.
* The FDA has established the Oncology Center of Excellence (OCE) to attain the highest level of oncology expertise and review on cancer-related new product applications. The OCE is charged with enhancing product regulatory review and communication across FDA's internal centers to accelerate the process of bringing new cancer therapies to market.
* The CDC is stepping up its efforts to promote cancer vaccines. For example, the CDC is working to increase HPV vaccination rates in boys and girls ages 11-12 to prevent HPV-related cancers.
* The EPA is partnering with the American Lung Association, HHS, the Department of Housing and Urban Development, and several industry and advocacy organizations to reduce radon-induced lung cancer, with a goal of reducing radon in 5 million homes and saving 3,200 lives annually by 2020.
* The NCI has established a new "dashboard" web site portal to make it easier for physicians and cancer patients to search for suitable clinical trials for which the patients might be eligible when they click on http://trials.cancer.gov.
* NASA and the NCI are partnering to launch a preclinical research project to evaluate the potential of particle beam radiotherapy. This collaboration will study the biologic effects of particle beam radiotherapy, which delivers a more targeted dose to cancer cells.
* Lyft and Uber ride services are expanding their efforts to provide affordable, reliable transportation to cancer patients who need to get to medical appointments. According to the new Moonshot report, one-quarter of cancer patients miss or have to reschedule appointments due to transportation issues and problems.
* Deloitte has launched the "Conquering Cancer XPRIZE," a competition which will bring together individuals and teams to spark innovative ideas for early detection of cancerous tumors.
* Atlanta's Global Center for Medical Innovation and T3 Labs are collaborating with NCI to accelerate the development of innovative new diagnostic devices from laboratory to marketplace. The project's aim is to double the speed at which new cancer diagnostics can move from bench to bedside.
* The Bristol-Myers Squibb Foundation is committing $25 million over the next 2 years to alleviate cancer inequities. As part of this effort, the foundation is earmarking a $10 million grant to bring high-quality cancer care to patients in rural and underserved areas through the use of telemedicine.
* The worldwide Cancer Support Community, a nonprofit, has launched the Frankly Speaking About Cancer Clinical Trials Program. This group hopes to reach at least 500,000 people with this educational program, which is aimed at dispelling myths and building awareness of the benefits of enrolling in clinical trials among cancer patients and their caregivers.
* Hospitals are expanding their cancer prevention efforts. The MedStar Washington Hospital Center Washington Cancer Institute in Washington, D.C., has launched the Colon Cancer Prevention in the Neighborhood Program to build awareness of this cancer and advocate for early detection. The program has distributed colon cancer tests to return for free testing to more than 1,400 residents. In Oklahoma, Mercy Hospital has doubled the number of free mammograms, diagnostic procedures, and breast health education programs provided to the uninsured and underinsured in Oklahoma City.
* Recognizing that artistic expression can help cancer patients fight their disease, the National Endowment for the Arts is designing a pilot project with its state partners to develop art programs for cancer patients with state-level designated cancer centers and health facilities.
Peggy Eastman is a contributing writer.
Five Pillars to Fight Global Cancer
Vice President Biden has traveled abroad as well as in the U.S. in his role as head of the Cancer Moonshot initiative. He has stated the importance of fighting cancer internationally as well as domestically. He has announced what he calls five pillars to change the global fight against cancer.
1. Increase the global focus on cancer prevention, and on treatment access and affordability.
2. Raise the international response to cancer to the same level of urgency brought to bear on infectious disease threats.
3. Increase research and patient data-sharing among researchers, institutions, foundations, and nations.
4. Support international standardization of data and bio-repositories, so records can be easily shared and compared with data from medical centers across the world.
5. Increase worldwide government investment in cancer research.
To learn about progress, contribute an idea or commit to a new initiative as part of the Cancer Moonshot effort, visit http://whitehouse.gov/cancermoonshot.