The White House announced a $1 billion initiative Feb. 1 to jumpstart the national cancer moonshot program—an ambitious proposal first announced by President Barack Obama during his final State of the Union address.
Vice President Joe Biden, whose son Beau died of brain cancer in May 2015 at age 46, is leading the program, which aims to achieve a decade’s worth of progress within the next five years.
The $1 billion announcement establishes a game plan for how the funds will be spent: the moonshot initiative will begin with $195 million in cancer research at NIH in fiscal 2016, according to the White House. The fiscal 2017 budget will propose to allocate $755 million in mandatory funds for new cancer-related research activities—$680 million for NIH and $75 million for FDA. The remaining $50 million is expected to go to the Departments of Defense and the Veterans Affairs through funding Centers of Excellence.
Further details on the funding are expected to become available Feb. 9 when the president’s budget proposal is released.
The $75 million infusion for FDA includes a proposal to create a new Oncology of Center of Excellence.
According to the White House: “The FDA will develop a virtual Oncology Center of Excellence to leverage the combined skills of regulatory scientists and reviewers with expertise in drugs, biologics, and devices. This center will expedite the development of novel combination products and support an integrated approach in:
• “Evaluating products for the prevention, screening, diagnosis, and treatment of cancer;
• “Supporting the continued development of companion diagnostic tests, and the use of combinations of drugs, biologics and devices to treat cancer; and
• “Developing and promoting the use of methods created through the science of precision medicine.”
In an October 2015 editorial, Ellen Sigal, chair and founder of Friends of Cancer Research, called on Congress to update FDA’s structure to better reflect 21st century science.
“By investing in the FDA, and through the creation of a new Center of Excellence of Oncology, the administration has taken a significant step that we hope will enhance the FDA’s ability to execute their vital role in translating scientific discovery into new therapies for patients,” Sigal said in a statement Feb. 1.
The FDA Centers of Excellence would improve coordination between FDA medical product centers, Sigal said. The centers would also facilitate and expedite the development of novel combination products, support integrated product evaluation, and promote precision medicine methods.
The moonshot’s priorities include promoting enhanced data sharing, which involves pooling together oncology bioinformatics data banks and making that data more accessible and interoperable across research platforms (The Cancer Letter, Jan. 22).
“Almost every cancer center keeps a database of information—genetic history, medical records, and tissue banks—that might hold the key to improving certain cancer therapies,” Biden wrote in a blog post Jan. 27.
“Allowing researchers and oncologists to tap into this treasure trove of information is absolutely vital to speeding up the pace of progress toward a cure. If we ensure this data is interoperable and accessible for scientists, researchers, and physicians, the consensus is that we can absolutely speed up research advances, improve patient care, and get ourselves closer to a cure.”
On Feb. 1, Obama and Biden convened a working group, officially called the White House Cancer Moonshot Task Force, which consists of the heads of the executive branch departments, agencies and offices, including the HHS, NIH, NCI and the Department of Defense, among others. The task force members will oversee the execution of the program, with funding and administrative support from NIH.
The task force is charged with reaching out to external stakeholders to produce a detailed set of findings and recommendations to: “(a) accelerate our understanding of cancer, and its prevention, early detection, treatment, and cure; (b) improve patient access and care; (c) support greater access to new research, data, and computational capabilities; (d) encourage development of cancer treatments; (e) identify and address any unnecessary regulatory barriers and consider ways to expedite administrative reforms; (f) ensure optimal investment of Federal resources; and (g) identify opportunities to develop public-private partnerships and increase coordination of the Federal Government’s efforts with the private sector, as appropriate.”
Input will be critical to the success of the moonshot, NIH Director Francis Collins said.
“There was a lot of energy in the room—the kind that comes with a shared desire to make a positive difference in people’s lives and the awareness that the United States has the brainpower and determination to do it,” said Collins Feb. 2, referring to the first meeting of the task force which was presided over by the president and vice president. “We are, indeed, a nation of innovators.”
“The administration also released the first details of the initiative, calling for $680 million in NIH’s FY2017 budget to support seven scientific areas ripe for advancement.
“To share the news, the National Cancer Institute Acting Director Dr. Doug Lowy and I fielded many questions from the public during a Twitter chat using #CancerMoonshot, where it was apparent that we weren’t the only ones excited about the effort.
“One of the most-asked questions was how can people get involved to help shape the initiative. To be clear, stakeholder input will be critical to the success of the National Cancer Moonshot and there will be numerous opportunities in the coming months to share your ideas and input. I encourage you to sign up for updates on the NCI Cancer Moonshot web page to stay apprised of the latest developments.”
The new infusion of funds comes at a crucial point in cancer research, the American Society of Clinical Oncology said.
“With the current explosion of new cancer science, diagnostic tests, and treatments, there is no better time for this bold commitment to reduce the human suffering and loss of life that cancer inflicts on millions of Americans each year,” ASCO said in a statement. “ASCO applauds the president for taking this important step toward making the ‘moonshot’ vision a reality and for outlining a comprehensive approach to speed advances in cancer prevention, diagnosis and treatment that addresses critically important issues, such as patient access to care, federal funding, and information technology and interoperability of electronic health records.
“ASCO stands ready to offer its full support to the ‘moonshot’ initiative and looks forward to working with Vice President Biden as he leads this unparalleled and essential effort to accelerate the rate of progress in the fight against cancer.”
ASCO, along with the American Association for Cancer Research and other oncology organizations, has been in meetings with Biden to discuss the evolution of bioinformatics and other goals for the moonshot program.
“The AACR very much appreciates the Obama administration’s continued commitment to providing significant federal funding increases in the fight against cancer, and we look forward to next week’s release of the president’s budget for additional and more specific information,” said AACR CEO Margaret Foti.
“The AACR, and its 35,000 laboratory researchers, physician-scientists, other healthcare professionals, and patient advocates who constitute our membership, stands ready to work with Vice President Biden’s ‘Cancer Moonshot Task Force’ to provide valuable insights and creative thinking about how to further reduce cancer incidence and mortality.”
In 2015, members of Congress from both parties have acted in support of biomedical research, said Mary Woolley, president and CEO of Research!America.
“The president told Majority Leader [Mitch] McConnell and Speaker [Paul] Ryan that assuring resources for research, cancer in particular, is one of his five priorities for working across the aisle this year,” Woolley said. “His FY17 budget proposal—scheduled for release next Tuesday—will reportedly request additional dedicated funding for the moonshot and for combating substance abuse.
“There is every reason to be optimistic, but we can’t take anything for granted.”
A recent public opinion survey by Research!America showed that 50 percent of Americans favor a tax increase to fund cancer research. Thirty-eight percent disagree and an additional 12 percent are not sure.
Two-thirds of Democrats, 67 percent, and more than a third of both Republicans (at 38 percent) and independents (39 percent) support a tax increase, and support is particularly strong among Americans ages 18 to 49.
Of those who favor a tax increase, more than half (57 percent) say they are willing to pay up to $50 per year in taxes (60 percent of Republicans, 58 percent of independents and 54 percent of Democrats) and 28 percent are willing to pay even more. This finding applies across all age groups.
“Americans understand that we must turbo-charge our investments in cancer research in order to make significant headway in our battle against this insidious disease,” Woolley said. “Our new survey finding illustrates that individuals across the political spectrum view the ‘moonshot’ initiative as an all hands on deck endeavor that is worthy of taxpayer support.
“With significant advances in immunotherapy and genomics, it is incumbent upon candidates and elected officials to tell potential voters whether they support increased funding for research to find cures for cancer and other diseases,” Woolley said. “It’s time to put research to work to find solutions and cure what ails us; we call on all policymakers and those who aspire to be, to speak out for and act to make research for health a number one national priority.
“We urge President Obama to include sufficient funds to support the ‘moonshot’ initiative in his FY17 budget proposal.”