Start the day smarter.Get all the news you need in your inbox each morning.It’s realistic to dramatically cut cancer death rates, several experts said, based on the recent pace of advances and their expectations for the next few years.However it will also require radical change.Right now, effective treatments and early detection tools aren’t reaching all patients who could benefit.Pioneering technologies could be advanced faster with better trial design, more collaboration and improved data collection.
And people aren’t making the lifestyle changes that could make as much difference in their cancer risk as quitting smoking has over the last quarter-century.Tuveson, who also directs the Cold Spring Harbor Laboratory Cancer Center in New York, sees three major areas where federal attention can make a dramatic difference: “Having enough money, having the right technologies and having the right therapies.” The biggest technological advances are expected in areas like liquid biopsies that promise to diagnose a range of cancers with a blood test, long before a tumor becomes visible on a scan.
Even more advances are coming in the area of immunotherapy, which has already proven transformative for many patients with melanoma and lung and blood cancers.
Daring to say ‘cured’: Two patients declared ‘cured’ of leukemia, a decade after innovative treatment that has transformed blood cancer care David Arons, CEO of the National Brain Tumor Society, said he hopes the moonshot’s extra attention will finally move the needle on cancers like brain tumors and pancreatic cancer that have seen no improvements in decades.”We can’t leave these populations behind, just because brain cancer is the most treatment-resistant, recalcitrant, stubborn cancer on the planet,” said Arons, noting that glioblastoma is what killed Biden’s son Beau.The President hasn’t yet put any financial promises into his plan.While public attention from Biden is helpful, advocates say it will take real money to make the kind of advances he wants.”To drive innovative cancer research will take new dollars, because even today’s dollars are not keeping up with inflation,” said Arons.
Funding is needed for technological and medical advances, but also for spreading information, screening and treatments to more people, said Electra Paskett, the founding director of the Ohio State University Center for Cancer Health Equity.”We have to figure out how to get what we know out to the people who need it,” she said.The timing is right for Biden’s initiative because advances in recent years have deepened the understanding of cancer, from its genetics to the role of the immune system, said Dr.Laurie Glimcher, president and CEO of the Dana-Farber Cancer Institute in Boston.
“There’s been a huge number of exciting discoveries,” she said.Biden’s goal is great, but patients don’t have time to wait a quarter century, said Kathy Giusti, the founder and chief mission officer of the Multiple Myeloma Research Foundation.Cancer deaths fell about 27% between 1999 and 2019, but still, about 1.8 million Americans are diagnosed every year and 600,000 die from it annually.Cancer is expected to soon surpass heart disease as the nation’s biggest killer and its incidence is increasing, even among young adults.
Rather than just a long-term target, Giusti wants more milestones along the way that people can use to judge the moonshot’s effectiveness.”To me, it’s all about the need for speed,” she said.
“The science and technology blow my mind and yet it’s taking too long.” Treatment advances could be sped up, Giusti said, with better public-private collaboration, more effective use of patient data to rapidly determine what works and what doesn’t, and delivering those advances to more people sooner.”I was glad (Biden) said ‘urgency’ so many times, but what does that really look like?” To provide easier access to cutting-edge treatments, the Affordable Care Act, which provides insurance to millions of Americans, should considers all major cancer hospitals “in-network,” Aron said.The war against cancer: 50 years after the US declared war against cancer, the fight continues.These are the 10 biggest victories.Now, too often, people have to fight to get coverage at the hospitals that can best serve them, he said.Those hospitals also have the most access to clinical trials which can provide hope and extra time for patients who are otherwise out of options.
Data-sharing remains critical to making advances, said Dr.Larry Norton, a breast cancer specialist at Memorial Sloan-Kettering Cancer Center in New York City, Making data truly useful requires patients to volunteer their information, hospitals to share it with companies and government and computer systems that can speak to each other.Regulatory changes will also be needed to make data-sharing possible, and that’s where having the support of the White House and the Cancer Cabinet Biden has promised to establish could make a significant impact, he said.”A well coordinated national effort, headed by and supported by a Cancer Cabinet, especially one that actually has resources could make an enormous difference,” Norton said.When Özlem Türeci entered the field of cancer immunotherapy 30 years ago it was a research backwater.Most other experts thought the immune system had nothing to do with cancer.
But time has proven her right.The COVID-19 pandemic has given the company she co-founded with her husband the opportunity to show the world what they’ve learned over those decades.
Their company, BioNTech, created in collaboration with Pfizer, one of two incredibly successful COVID-19 vaccines.They are using the same mRNA technology to fight cancer recurrences, treating patients who have had their tumors surgically removed, but might still have lingering cells that could cause trouble later.So far, they have completed early trials in personalized vaccines and ones that are more generic.”These vaccines are safe, well tolerated and have clinical activity … we have seen very strong immune responses which were unprecedented,” Türeci said.
They are now investigating the same approaches in later-stage trials in melanoma and colon cancer in combination with other immunotherapies.Türeci said Biden’s initiative could make a profound difference in the future of cutting-edge research like hers, providing more funding at a key moment in the development and helping the public understand that harnessing the immune system offers the promise of helping to end cancer as we know it.
“Not only the scientific community, but also the general public has learned about the power of the immune system (during the pandemic) the power of immune therapies and that harnessing them can make a difference,” Türeci said From cancer to COVID: German scientist Özlem Türeci was focused on cancer at BioNTech, then came COVID-19.It was her ‘duty’ to help develop a vaccine.But public hesitation has stalled progress with previous vaccines.As of 2017, only about half of American teenagers had received the HPV vaccine, which prevents cervical cancer and some head and neck cancers.
“We have a vaccine that can prevent up to six cancers and people won’t get it, they won’t give it to their children,” said Ohio State’s Paskett.
Lifestyle changes like getting more exercise, reducing alcohol, eliminating tobacco, maintaining a healthy weight will clearly prevent cancer, she said.
But “those are very difficult things.” Access remains a huge issue, too – and one Biden plans to highlight in the moonshot program.Sometimes problems just need a little more attention and creative solutions, Paskett said, citing the example of a clinic in Appalachia where she and her colleagues helped institute colon cancer screening.At first, she said, clinic workers said they couldn’t do it because they only had 10 minutes to spend with each patient.But Paskett and her colleagues explained the importance of colon cancer screening, helped them obtain and mail out stool-sample kits, and follow up with anyone who tested positive.Recently, someone from the clinic called her office to tell her about a patient who had 10 polyps removed during a colonoscopy – likely preventing colon cancer.”You have kicked cancer in the rear!” Paskett told them.And it didn’t require a huge amount of money or any regulatory changes, just some guidance to work out a better process.
Equity also involves the people delivering the care, Dana-Farber’s Glimcher said.
“When a patient has cancer, it’s scary enough,” Glimcher said, “but if you go into a hospital where nobody looks like you, it gets even harder.” America has an urgent need for Black doctors: ‘It’s hard to be what you can’t imagine’ Norton, of Sloan-Kettering, said he was “deeply moved” by the personal stories the President, First Lady and Vice President offered about their brushes with cancer.They all talked about the importance of putting patients at the center of care.”That all by itself as a principle can make an enormous difference,” Norton said.But the cancer death rate won’t come down without tremendous effort on many fronts, he said, making an analogy to building an airplane.
The plane won’t fly unless all the parts work – in this case, the basic science has to be turned into medicines that can be tested and proven effective, and then delivered equitably to patients.”It’s the whole picture, the whole airplane we have to make run,” he said.Contact Karen Weintraub at [email protected] and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare.
The Masimo Foundation does not provide editorial input.This article originally appeared on USA TODAY: Can Biden’s ‘Cancer Moonshot’ succeed? It’s possible, experts say, but it will take more than words.