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March 3 — The scientific agenda for the White House moonshot cancer initiative should be ready by the summer, the NIH director said March 2.
During a public health summit, Francis S. Collins laid out a tentative agenda for the initiative, which aims to double the rate of progress in new cancer therapies. President Barack Obama announced the initiative during his final State of the Union address. Obama proposed a budget of nearly $1 billion to start the initiative, $680 million of which would fund new grants through the National Institutes of Health
“Moonshot, after all, sounds like an engineering project and we already did that. This is, in fact, much harder.”
“Why is this special? It is because the coalescence of scientific opportunities—many of them just coming along in the last three or four years— has put us at an inflection point,” Collins said, adding that there is an “opportunity to really push the accelerator down” through a collective effort that combines innovative science, new collaborations with clinical trial participants, working between public and private sectors.
As the NIH director, Collins said he has spent a fair amount of time with Vice President Joe Biden over the last few months, who is leading the initiative and who first used the term “moonshot” for the cancer initiative. Collins acknowledged that moonshot wasn't the most apt metaphor to describe the initiative, adding that the vice president would agree.
“Moonshot, after all, sounds like an engineering project and we already did that. This is in fact much harder,” Collins said.
Because cancer consists of hundreds of diseases, all of which present their own challenges, the moonshot initiative won't have one uniform, singular goal. But during the Milken Institute's public health summit, Collins presented seven major themes that he expects to be in the moonshot initiative:
In terms of prevention, he said the initiative will pursue cancer vaccines, but there may be other avenues of prevention as well.
For early detection, he said some scientists believe they can develop tests to screen for early signs of cancer using simple blood tests. He said these tests would be both more sensitive and more specific than what is available now. “And it might work for things like pancreatic cancer, where we currently do quite poorly,” he said.
Because cancer is a disease of cells, he said, single-cell analysis is important because there's constant evolution going on within that tumor, which consists of immune cells as well as vascular cells.
“Right now we grind up the tumor and we basically look at the average of what’s there,” he said. “If we really want to understand the cancer, look cell by cell by cell and the ability to do that has emerged very recently and in very powerful ways that has yet to be applied to this disease.”
Collins said that 10 or 15 years ago, there was skepticism about the outcomes in studying cancer immunotherapy, but advances in research have made it the “hottest thing in cancer you can imagine.”
“We are really learning how to activate the immune system to go after cancer, which is after all, carrying around foreign antigens,” Collins said, adding that therefore “it ought to be something the immune system can see.
For pediatric cancer, he said, great progress has been made in pediatric leukemias and many lymphomas, both of which are blood cancers. But he said there needs to be more improvements in pediatric solid tumors.
“People have great ideas on that and what we could be doing,” Collins said.
In terms of data sharing, the NIH director said, “We will not succeed in taking advantage of this time of opportunity unless we figure out how all of the data being generated from many different clinical trials and other kinds of research studies will be made accessible. We need to knock down those silos and basically deal with resistance to that by providing appropriate carrots and sticks so that this kind of opportunity for big data in cancer is not just something we talk about but something that we do.”
Exceptional opportunities refers to a proposed special fund for what Collins described as “out-of-the-box ideas” that could find ways to prevent and treat cancer.
Collins made his remarks as part of a session titled Public Health, Medical Research and the Cancer Moonshot: A Collaboration to Change the World.
“We have a chance here to do something exceptional. So don’t be put off by the moonshot moniker, or the fact that you might have heard someone say this in 1971 and it didn’t go that well,” he said, referring to President Richard Nixon's War on Cancer. Without overpromising, he said the science is ready to “come to some pretty exciting things,” adding that “it would be too bad not to just jump in there and do it.”
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More information on the NIH's part of the cancer moonshot initiative is available at http://www.cancer.gov/research/key-initiatives/biden-cancer-initiative.
More information on the overall initiative is available at https://www.whitehouse.gov/the-press-office/2016/02/01/fact-sheet-investing-national-cancer-moonshot.
More information on the Milken Institute's public health summit is available at http://www.cvent.com/events/2016-milken-institute-public-health-summit/agenda-c7c74713178e42eb8856c85942f19e17.aspx.
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