If you were one of the millions of Americans who tuned into the final State of the Union given by President Obama this past January, you know it contained references to American leadership and innovation, as well as news that has piqued the interest of researchers all over the nation. President Obama invoked the spirit of John F. Kennedy and his call to put a man on the moon by the end of the 1960’s, as he called for a new American “Moonshot” to cure cancer. This initiative stemmed from comments made by Vice-president Joe Biden after his son Beau Biden succumbed to brain cancer in May of 2015. This also comes after Congress increased medical research funding for the first time in over a dozen years.
The NIC’s goal is to make major strides and subdue cancer by the year 2020. Despite the increased national attention and focused intentions at the executive level, how realistic is the goal to cure cancer in four years?
The Moonshot is being managed by the newly established National Immunotherapy Coalition (NIC) which is comprised of academic, government, and private institutions. The NIC’s goal is to make major strides and subdue cancer by the year 2020. Despite the increased national attention and focused intentions at the executive level, how realistic is the goal to cure cancer in four years? “Cancer” is such a complex word as there are hundreds of “cancers” that possess different properties based on the tissue they originate from, and even after tumors manifest the cells that make it up are distinctly different from their parent cancer cell. Because cancer manifests in different ways within the individual to eradicate it would require a very individualized approach. The NIC has pushed the idea that many current treatment strategies deemed toxic to the body are not the way to win this fight, but rather it should be approached by immunotherapy.
The entire basis of the NIC is founded around the concept of collaboration, and the success of the Moonshot will be up to the parts of the whole. I am personally unaware of the climate of collaboration among the cancer research labs around the nation; however, I am aware of the pressure on labs to publish novel and groundbreaking work. The mentality of “paper pushing” makes labs very reluctant to share information with one another that is not previously common knowledge, for the fear of being “scooped” on a project. However, if egos are pushed aside for the broader goal of this initiative, the collaborative nature of NIC scientists could accelerate progress towards a goal faster than any previous research conducted.
Government policy will also play a huge role in how Moonshot 2020 plays out.
Government policy will also play a huge role in how Moonshot 2020 plays out. The goal described by the NIC is to diagnose and sequence 100,000 cancer patients, and assign 20,000 of them for immunotherapy treatment. To ensure this success, new trial protocols need to be established in order to streamline the process. Relying on the government has always been a frightening concept, but I do not think the President would have made such a spectacular announcement if he was not confident it could be done (right?).
The other players in this game are the big pharmaceutical companies, such as Amgen and Celgene that have the bottom-line riding on this. They are the ones who will be using newfound knowledge to manufacture these drugs, and if they can pull it off there is a lot of money in it for them, as they would control the market of next generation treatment. This gives me the confidence that they will be willing to see this project through, and the drug development phase will be funded. However, it is other aspects of funding this project that I am concerned about.
How much will this cost? When talking about saving lives, it’s nice to say that no price is too great, but that is just not viable.
How much will this cost? When talking about saving lives, it’s nice to say that no price is too great, but that is just not viable. Independence Blue Cross is a member of the NIC and is promising to cover costs for the individual sequencing, but only to its members and through reimbursement rather than upfront costs based off statements posted by the NIC. However, the cost of the basic and clinical research will be up to different sources to fund. The NIH will most likely be responsible for the distribution of funds to different labs, but the NIH will need a large budget increase in order to try to meet the demands of the Moonshot, and it’s funding ultimately rest on Congress’ shoulders. This is an extremely expensive undertaking, but if it works out like the NIC plans, it will be much cheaper than maintaining our current treatment strategies and accounting for the morbidity of the disease.
President Obama gave the metaphorical reins to Biden, and while Moonshot 2020 is technically led by billionaire Patrick Soon-Shiong, Biden can play an extremely important role as advocate for this cause. I think that with Joe Biden’s advocacy, Congress may be willing to go along with this plan for its projected four year course. However, I think that if serious gains are not made in a couple of years the political will behind this initiative will falter and the Moonshot will fall apart. My thought when first processing the Moonshot announcement was, “why now?” I realize now that political will backs up this entire project, and unprecedented coalitions have been established because finding a cure to cancer seems within reach.
The political will is there, the will of those affected by cancer is there, and if we can get the scientific will behind this project, then I have no doubt that we can see the goal through.
There are a lot of people who are skeptical of the Moonshot, and think that it is just a flashy rehashing of Nixon’s “War on Cancer” initiative. Some believe that the system doesn’t need an overabundant amount of money from the government, but rather the NIH and its budget should steadily grow year after year. Some cite the perceived flopping of the Human Brain Project in Europe as grounds for dismissing massive new scientific undertakings. However, we know much more than we did 40 years ago, a large amount of funding is better than whatever the cancer world has now, and we should look at one of the greatest scientific achievements, the Human Genome Project, as an example of what is possible if we’re determined to do something. The political will is there, the will of those affected by cancer is there, and if we can get the scientific will behind this project, then I have no doubt that we can see the goal through. I may be seen as optimistic and naïve, but maybe a little optimism is just what the cancer world needs. It is certainly a daunting task, and I am nervous to see how cohesive the unit of the NIC will behave and how all the pieces will fall into place, but I sincerely hope that I can read this piece four years from now and laugh at my worries.