publication date: Oct. 21, 2016

Biden Delivers Task Force Report—Five Moonshot Goals in Cancer

By Matthew Bin Han Ong

Vice President Joe Biden and the National Cancer Moonshot Task Force published their final reports Oct. 17, summarizing the moonshot’s achievements, and outlining five strategic goals and action plans for the years to come.

The two reports conclude the 2016 National Cancer Moonshot Initiative, and the Obama administration’s efforts to develop a national conversation on cancer research.

“I gladly am going to be accepting this report, and, more importantly, I’m looking forward not only to laying the ground work for the next administration to pick up the baton and run with it, but I know that Joe and Jill [Biden] and I and Michelle [Obama] will all continue to be involved after we’ve left this office in making sure that this works,” President Barack Obama said at a press conference Oct. 17.

The reports are a culmination of Biden’s vision for achieving a decade’s worth of progress in cancer research in 5 years—an overview of ideas and priorities drawn from Biden’s roundtables with oncology leaders over the past 9 months.

The task force, consisting of Biden’s staff and officials from over a dozen government agencies and departments, directs the federal government to focus on the following goals:

• Catalyze new scientific breakthroughs

• Unleash the power of data

• Accelerate bringing new therapies to patients

• Strengthen prevention and diagnosis

• Improve patient access and care

The report—38 pages of policy positions and public-private partnership proposals—follows the NCI Blue Ribbon Panel’s scientific recommendations, published Sept. 7 (The Cancer Letter, Sept. 9).

The task force report and Biden’s executive report can be downloaded here.

On the same day, the task force announced 36 initiatives and commitments from government agencies and private organizations.

These include identifying promising technologies at the U.S. Patent and Trademark Office, promoting HPV vaccines via the Centers for Disease Control and Prevention, and precision medicine longitudinal studies at the Department of Defense.

NCI will be collaborating with Amazon Web Services and Microsoft to build a cancer genomic data cloud model through the institute’s Genomic Data Commons and Cancer Genomic Cloud Pilots.

“What we’re now doing is releasing a report—the results of the last eight months of really intensive work by Joe and Jill, but also a terrific team,” Obama said at the Oct. 17 press conference. “And what they’ve done is to mobilize researchers, scientists, doctors, hospitals, tech companies, as well as philanthropies and patients advocacy organizations, and traveled around the country and internationally in order to really figure out, how are we going to get this thing to achieve a serious impact?

“Because of Joe’s really active engagement with Congress, this has strong bipartisan support. And we are hopeful that the already significant funding stream that goes to NIH and other government agencies is significantly supplemented and directed by the work that Joe and Jill have done.”

A year ago today, Biden announced he would not run in the 2016 presidential race, and said he only regrets not being able to preside over the “end of cancer as we know it.” Biden’s son, Beau, died in May 2015 after being diagnosed with stage IV glioblastoma. He was 46.

President Barack Obama announced the moonshot in his final State of the Union Jan. 12 (The Cancer Letter, Jan. 15).

“When Barack Obama asked me to head up this moonshot, there are some skeptics out there who said, ‘Well, here we go again.’ [President Richard] Nixon declared a ‘War on Cancer’ in 1971, but there is a big difference,” Biden said at The White House Oct. 17, addressing government personnel, oncology leaders, and the press. “In 1971, President Nixon’s interest and concern was real and genuine, but he had no army, he had no resources, no clear strategy existed to win.

“But 45 years later, after decades and decades of funding, new research, training scientists and physicians, treating millions of patients—because of so many of you, we now have powerful, new technologies and tools. We have an army, and with this moonshot, a clear strategy, a road ahead.”

“Great job. Thank you, everybody.”

It is unknown whether Congress will fully fund the vice president’s initiative. The president’s budget proposal slates $1 billion for the moonshot—mostly mandatory funds—including $680 million for NIH and $75 million for FDA.

The fiscal 2017 appropriations does not include funds for the moonshot, but advocates are optimistic lawmakers will, once the continuing resolution expires in December, support the initiative through appropriations or the 21st Century Cures Act, a broad-based effort to modernize clinical trials and streamline drug development, passed by the House in 2015 (The Cancer Letter, Sept. 23).

“The vice president and Dr. Jill Biden have shown us how profound grief can give way to transformative change,” Ellen Sigal, chairperson and founder of Friends of Cancer Research, said to The Cancer Letter. “He has bought us all together towards one goal and that’s to make a difference for all patients. Faced with overwhelming sadness they resolved to channel their sorrow into bold action.

Sigal played a key role as a convener and advocate for the 21st Century Cures Act, and in formulation of the moonshot’s goal to consolidate FDA’s oncology portfolio. Richard Pazdur, director of the FDA Office of Oncology and Hematology Products, is currently acting director of the agency’s newly-formed Oncology Center of Excellence (The Cancer Letter, July 1).

“The report released by the vice president, paired with the recently released Blue Ribbon Report, which I was so proud to be an author of, puts forth a bold framework and sets the precedent for what collaborative innovation should look like,” said Sigal, who delivered the opening keynote at the Oct. 17 announcement. “With these new initiatives, as well as many programs, like the FDA Oncology Center of Excellence, already underway, Vice President Biden has led the way to accomplish the full challenge of the Moonshot.”

Biden has galvanized the entire cancer research and patient care community into action, said Nancy Davidson, president of the American Association for Cancer Research.

“During the past year, the entire cancer research and patient care community have come together in ways rarely seen before, and these efforts have resulted in a robust and comprehensive list of innovative proposals and approaches for transforming the ways we will prevent and treat cancer,” said Davidson, who is also director of the University of Pittsburgh Cancer Institute. “In view of all of the extraordinary scientific opportunities that exist today for making major advances against cancer, it will be extremely disappointing if the Obama administration leaves office in January without having secured significant funding and support for the initiatives and programs that have been recommended to advance the National Cancer Moonshot Initiative.”

The task force report would not only help accelerate the discovery of new cancer treatments, but also expand patient access to promising treatments, said Daniel Hayes, president of the American Society of Clinical Oncology.

“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,” Hayes said in a statement Oct. 17. “The vice president and Task Force approached their work through a wide lens that puts central focus on the millions of Americans who face a cancer diagnosis each year—by highlighting policies and efforts that would foster scientific breakthroughs and treatments for patients, make better use of data, strengthen prevention and diagnosis, and improve access to care.

“ASCO is particularly pleased that the Cancer Moonshot Task Force report details a commitment by FDA ‘to improve the use of science-based, clinically relevant eligibility criteria to allow greater patient access to clinical trials while maintaining patient safety.’ As specifically noted in the report, ASCO and Friends of Cancer Research are working with the FDA to change eligibility criteria to enable broader participation on clinical trials and ensure that trial participants are more reflective of the cancer patient population. This recommendation, alone, could dramatically increase the knowledge we could gain from scientific inquiry and the efficiency of clinical trial accrual, while also expanding patient access to cutting-edge intervention.

“ASCO also appreciates that Vice President Biden and the Task Force highlight the need to make it easier for patients and providers to access and share healthcare information. Oncology practices are struggling with timely access to healthcare data—whether they are across town, in different states, or right next door to one another. Oncologists routinely care for patients with complicated cases in which radiation therapy, surgery, chemotherapy, imaging, and pathology must all be carefully coordinated to ensure the highest quality care. In addition to the efforts outlined in the reports, it is vital for Congress to enact legislation to ensure widespread interoperability is achieved, including addressing information blocking.

“Implementing the far-reaching vision of progress described by Vice President Biden and the Cancer Moonshot Task Force will take both committed effort and funding. In addition to sustained funding increases through the regular appropriations process, achieving the goals of the Cancer Moonshot requires a boost in funding from Congress. We call on Congress to come together in the upcoming lame duck session to pass a $2 billion appropriations increase for NIH and an additional boost in funding for NCI to support the Moonshot initiatives.”

Copyright (c) 2017 The Cancer Letter Inc.