publication date: Nov. 4, 2016

Cancer Moonshot Research Dollars Must Go to NCI—Not NIH—Groups Say

By Matthew Bin Han Ong

Nearly 50 cancer-related organizations urged Congressional leaders to ensure that funds slated for research in the National Cancer Moonshot Initiative go directly to NCI—as opposed to NIH or any other federal entity.

The letter, dated Nov. 3, was authored by One Voice Against Cancer, a broad coalition that convenes on national funding and policy issues in oncology.

“It is … imperative that funding provided for Cancer Moonshot research be specifically directed to NCI,” the letter states.

The word “specifically” in this letter is rich in subtext.

The document responds to what insiders describe as efforts by top NIH leadership to channel the moonshot research dollars away from NCI control. Capitol Hill sources say that in recent weeks, prominent cancer scientists and activists have been working to counter this offensive by NIH officials.

The Office of the Director of NIH controls several trans-NIH programs, including the Precision Medicine Initiative and the BRAIN Initiative. However, the moonshot, being specific to cancer, is different from these broad initiatives and should therefore be managed by NCI, several of the institute’s supporters say.

NIH officials said they are not lobbying for the funding to go to NIH instead of NCI.

“The [OVAC] letter does not say, as suggested, that the funding is going anywhere but NCI,” NIH officials said in a statement to The Cancer Letter. “NIH does not lobby Congress. The only proposal that has been put forward is in the president’s FY2017 budget, which requests that Congress appropriate funds for Cancer Moonshot directly to the NCI.”

The groups that signed the OVAC letter include the American Society of Clinical Oncology, the American Association for Cancer Research, the American Cancer Society Cancer Action Network, the Association of American Cancer Institutes, and Friends of Cancer Research.

The stakes are nontrivial—$680 million, which President Barack Obama’s budget has designated for the cancer research portion of the moonshot. Congress did not provide funding for the moonshot in existing appropriations bills for fiscal 2017 (The Cancer Letter, Sept. 23).

It is unknown how much the moonshot will receive, but negotiators are optimistic that the initiative will be funded through the 21st Century Cures Act after the short-term continuing resolution expires in December.

The 21st Century Cures Act, which aims to expedite drug development and modernize clinical trials, calls for about $8.5 billion in additional funding for NIH over five years. Lobbyists say the final amount could likely be lower—about $6 billion—but an expected $1 billion to $2 billion increase in appropriations for NIH would make up the difference in fiscal 2017.

Ultimately, it will be up to appropriators to decide who should spend the moonshot research funds.

“The importance of Congress funding the Cancer Moonshot Initiative as soon as possible by enactment of the 21st Century Cures Act in 2016 is without question,” the OVAC letter states. “Waiting until next year to act is not an option for cancer patients and their families.”

The letter can be downloaded here.

The letter is widely seen as the latest episode in NIH-NCI turf wars, which began in the run-up to enactment of the National Cancer Act of 1971. Three weeks ago, when the fiscal 2018 NCI Bypass Budget failed to appear on an originally scheduled date, Washington insiders immediately attributed NCI’s failed effort to publish the document to an incursion by NIH leadership.

The document remains unpublished.

In his introduction to the stalled Bypass Budget, a summary of which was obtained by The Cancer Letter, NCI Acting Director Doug Lowy mentions NCI’s scientific leadership of the moonshot and the institute’s mandate to set the national agenda for cancer research (The Cancer Letter, Oct. 14).

“As coordinator of the National Cancer Program, NCI seeks and supports new ideas to understand and intervene in the cancer process, from the earliest stages to the most advanced,” Lowy wrote. “The Cancer Moonshot aims to accelerate progress against cancer, accomplishing a decade’s worth of advances in just 5 years.

“As part of this effort, a Blue Ribbon Panel of experts and cancer advocates from around the country identified specific opportunities poised to accelerate research progress and formalized a set of 10 bold, yet feasible, recommendations to the National Cancer Advisory Board.”

NCI has the expertise and experience to carry out the panel’s recommendations, the OVAC letter states.

“NCI is the scientific thought leader behind the Cancer Moonshot and the scientific recommendations in the Blue Ribbon Panel report,” the letter states. “Directly funding the Cancer Moonshot at NCI will ensure that research recommended in the Blue Ribbon Panel report will proceed without delay.”

Three major oncology organizations contacted by The Cancer Letter said they support funding NCI to carry out the moonshot’s research goals:

• American Society of Clinical Oncology:

“ASCO has been encouraged by the work of the Cancer Moonshot Initiative and is pleased with the recommendations of the Blue Ribbon Panel and the reports issued recently by the Cancer Moonshot Task Force and Vice President Joe Biden,” said Richard Schilsky, ASCO’s chief medical officer. “Robust and sustained federal funding is critical to advancing the vision to accelerate progress against cancer expressed in each of these reports.

“Through letters, meetings, and congressional briefings, ASCO has advocated vigorously for increased funding for both the NCI and the U.S. biomedical research enterprise more broadly. NCI has played a pivotal role in virtually every major cancer prevention, detection, and treatment discovery. ASCO will continue to call on Congress to provide additional funding to the NCI to jumpstart and sustain the Cancer Moonshot Initiative.”

• American Association for Cancer Research:

“The AACR is deeply grateful to Vice President Biden for his passion and dedication to the success of the National Cancer Moonshot Initiative, for now is the time to support and build upon the spectacular discoveries in cancer science that will lead to further exciting breakthroughs against cancer,” said AACR President Nancy Davidson, director of the University of Pittsburgh Cancer Institute. “We also congratulate the leadership of the NCI for spearheading many of these vitally important efforts, including the exceptional stewardship of the National Cancer Moonshot Blue Ribbon Panel, which in record speed resulted in the development of ten innovative recommendations for transforming the future of cancer research, treatment, and prevention in all populations.

“These remarkable efforts, which underscore the extraordinary opportunities that exist today in cancer research, more than justify the President’s budget request for significant resources to fund the Moonshot Initiative, especially if we are to meet Vice President Biden’s inspiring goal of achieving a decade’s worth of advances in five years.

“Clearly, if we are to make significant inroads against cancer and respond without delay to the recommendations in the Blue Ribbon Panel Report, the Moonshot Initiative will require robust, sustained, and predictable funding increases for the NCI. The 21st Century Cures Bill offers a novel model for providing supplemental research dollars to the NCI. It will allow the Institute to support and oversee the Panel’s recommendations for projects that are poised to speed the conquest of cancer. Failure to seize upon this momentum for accelerating progress and for making a positive difference for cancer patients and their loved ones is simply not an option.”

• American Cancer Society Cancer Action Network:

“The Moonshot offers an historic opportunity to accelerate the pace and progress of cancer research in this country,” said Chris Hansen, president of ACS CAN. “The NCI—as it has for more than 40 years—is best poised to maximize that potential and achieve the Moonshot’s goals of improved prevention, detection and treatment for years to come. We hope that Congress acts swiftly to provide NCI with the necessary resources to fully implement the Blue Ribbon Panel report recommendations.”

• Association of American Cancer Institutes:

“AACI and its 96 cancer centers firmly believe in the goal of the Cancer Moonshot—to make a decades worth of progress in 5 years,” Barbara Duffy Stewart executive director. “We joined nearly 50 other cancer organizations in asking Congressional leaders to not delay and enact the 21st Century Cures Act in the 114th Congress.”

Copyright (c) 2017 The Cancer Letter Inc.