Cancer ‘Moonshot' Scientific Agenda Released

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By Jeannie Baumann

Sept. 7 — The White House cancer “moonshot” initiative to accelerate new therapies and prevention strategies took a big step forward Sept. 7 with the release of an advisory panel report that lays out the scientific agenda for the effort.

The report includes recommendations for data sharing, patient-focused initiatives and emerging therapies involving the immune system. The National Cancer Advisory Board, the presidentially appointed advisory board to the National Cancer Institute, part of the National Institutes of Health, received the report from its blue ribbon panel at a Sept. 7 meeting.

NCI Acting Director Douglas Lowy said during a Sept. 7 press call that the institute “embraces” the blue ribbon panel's report.

“Today we’ve taken a big step forward in the goal to make a decade’s worth of progress in preventing, diagnosing and treating cancer in five years, ultimately striving to make huge gains and improve the outlook for cancer patients,” Lowy said. “The blue ribbon panel has laid out a bold but feasible scientific proposal.”

The NCI plans to adopt some of the recommendations in fiscal year 2017, which begins Oct. 1.

First of Three Reports

The report culminates the work of the 28-member blue ribbon panel, which the NIH appointed in April to develop the scientific agenda (10 LSLR 08, 4/15/16).

It's the first of three reports that will shape the direction of the initiative. The intergovernmental Cancer Moonshot Task Force will release its own report “likely in mid-to late October,” task force director Greg Simon said at the NCAB meeting. Vice President Joe Biden, who is leading the initiative, is expected to release his own report at the same time as the task force.

Both Simon and the leaders of the blue ribbon panel said that the moonshot initiative doesn't encompass the entire cancer enterprise, either in the private sector or at the NCI.

“We’re trying to reach out and pull out the things that are really moonshot leaps,” Simon told the NCAB members. “Every now and then, you need to stop and say, ‘What can we do if we take a leap, rather than if we go step by step over a long period of time?'”

10 Recommendations

Tyler Jacks, co-chairman of the blue ribbon panel and director of the Koch Institute for Integrative Cancer Research at the Massachusetts Institute of Technology, said the panel's charge was to assess the science and evaluate which opportunities were “ripe for acceleration.” The report lists 10 recommendations:

  •  enlist patients in a network so they can pre-register for clinical trials and contribute their tumor profile data;
  •  organize a clinical trials network for immunotherapy—an emerging area of treatment that trains the immune system to attack the tumor—and ultimately develop immunotherapy-based vaccines;
  •  launch interdisciplinary studies to delineate mechanisms that lead cancer cells to become resistant to previously effective treatments;
  •  create a national cancer data ecosystem to collect, share and interconnect data sets;
  •  improve understanding of the abnormal fusion proteins that result from a chromosomal abnormality and drive many pediatric cancers;
  •  support research to accelerate development of guidelines to manage patient-reported symptoms to improve the quality of life and adherence to treatment regimens;
  •  implement evidence-based approaches to encourage broader adoption of human papillomavirus vaccination, colorectal cancer screening and tobacco cessation;
  •  conduct retrospective analyses of biospecimens from patients treated with standard of care to develop better treatment plans;
  •  create a human tumor atlas that catalogs genetic lesions and cellular interactions in tumors at all stages of disease development; and
  •  support development of new technologies to accelerate testing of therapies and tumor characterization.

“As we envision what the moonshot will look like, it will not feel like business as usual,” Jacks said.

NCI Implementation Talks Underway

Dinah Singer, co-chairwoman of the blue ribbon panel and director of the NCI Division of Cancer Biology, said the institute already has discussed the implementation plan for adopting the panels' recommendations, “with the intent of beginning as soon as FY 17 to fund some of those recommendations or parts of the recommendations that are feasible to fund in this fiscal year.” The NCI will then develop a rollout plan for all of the recommendations.

“The rate of that obviously will depend on the kind of appropriations that we see from Congress,” Singer said during the press call. “Even in the absence of any appropriation, we will be able to begin some of the implementation, but the rate obviously would be greatly enhanced with the kind of funding that the vice president has been talking about.” The White House proposed $755 million in mandatory funds for new cancer-related research activities at both the NIH and the Food and Drug Administration as part of the proposed budget for fiscal year 2017.

Singer said the recommendations won't get equal funding, but they will get equal attention.

Policy Issues Not in Report

The blue ribbon panel also identified policy issues that members believed needed to be addressed. But those topics—which include coverage and reimbursement, privacy and consent, delivery of care, clinical trials, pediatric drug development and new research funding models—don't appear in the report.

Singer said during the NCAB meeting that because its focus was the scientific agenda, the blue ribbon panel forwarded its policy recommendations to the task force. Simon said they will be part of the task force report that comes out this fall.

“Implementation of the blue ribbon panel recommendations—especially the clinical ones and the patient-related ones—will depend on the extent to which the task force is able to address some of the barriers that were identified,” Singer said during the NCAB meeting.

The advocacy groups Friends of Cancer Research, American Association for Cancer Research, Personalized Medicine Coalition and American Society of Clinical Oncology all praised the blue ribbon panel's report.

“If the broader cancer research community is to implement the innovative and exciting scientific ideas that were announced today by the Blue Ribbon Panel, it is going to require that Congress provide the NCI with robust, sustained, and predictable funding increases,” said Jon Retzlaff, the American Association for Cancer Research managing director of science policy and government affairs. “By implementing the Blue Ribbon Panel’s recommendations, which are all poised for acceleration, we will make a major difference for cancer patients and their loved ones.”

To contact the reporter on this story: Jeannie Baumann in Washington at jbaumann@bna.com

To contact the editor responsible for this story: Randy Kubetin at rkubetin@bna.com

For More Information

A summary of the report is at http://src.bna.com/ins.

More information on the NCAB meeting is at http://deainfo.nci.nih.gov/advisory/ncab/0916/agenda.pdf; an archived webcast of the Sept. 7 meeting will be available at https://videocast.nih.gov/PastEvents.asp?c=94.

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