NOT ‘BUSINESS AS USUAL’|
Biden Inspires ‘Moonshot’ Cancer Effort at NIH
Putting his considerable political capital behind fresh opportunities to make progress against cancer, Vice President Joe Biden is to run “mission control” at an NIH and National Cancer Institute-led “moonshot” effort, said President Barack Obama at his Jan. 12 State of the Union address.
Two days later, NIH director Dr. Francis Collins and NCI acting director Dr. Doug Lowy briefed reporters on fuels for the rocket, including recent success with immunotherapy; lowered costs of genetic sequencing, which will permit faster finer and cheaper analysis of the genomic glitches that lie behind the hundreds of diseases known as cancer; the promise of scalable, effective cancer vaccines based on abnormalities in specific tumors; and an aggressive “combination therapy” approach, to “hit [cancer] with everything we’ve got,” Collins said.
“This coalescence of events suggests there is a pathway here,” he added. “And we have a very motivated and passionate individual to lead us…He will build a bold, coherent and milestone-driven program. This is the moment to pull out all the stops.”
Lowy said that the mortality rates for most cancers have gone down in the past 20 years and applauded the recent $2 billion addition to NIH’s FY 2016 appropriation, NIH’s biggest increase in more than a decade. “This is building on strength,” he stated.
“The notion of a moonshot should be seen as aspirational and not business as usual,” Lowy said. The Biden-led effort will enable faster progress, he predicted. “The opportunities are enormous at this time.” But he cautioned that no cure is expected within the next few years.
Lowy also announced creation of a Genomic Data Commons to debut at midyear, housing data for up to 50,000 patients. It will include detailed genomic analysis and annotation of how patients have responded to various therapies. It will rely not just on NCI trial results, but other sources as well, largely due to Biden’s influence in the philanthropic community, he said.
“We believe the vice president can enhance this effort,” Lowy added. “This kind of database has enormous potential.”
Biden, who lost his son Beau to brain cancer last year, has been a keen advocate for cancer research, meeting with more than 200 scientists recently to learn where opportunities against the disease may lie.
His advocacy, rooted in a 36-year Senate career prior to becoming vice president, is seen as assuring more robust private-public partnering and a willingness to share data on an unprecedented scale.
Collins said that NIH’s 2-year record of success with the Accelerating Medicines Partnership, which he chairs, is evidence of NIH’s ability to navigate public-private partnerships in unique and effective ways. “People were skeptical at first,” he said, “but we are now quite excited about that model.”
Lowy emphasized, “Patients are absolutely critically important to any initiative. Having more people on clinical trials is a really key issue and can be improved. People all over the country need access to the latest and best treatments.”
Lowy predicts the Biden-led effort will improve basic scientific understanding of the immune system, which is key to creating vaccines, and will boost combination therapies “that might come in various guises—chemotherapy and immunotherapy, or immunotherapy plus radiotherapy…Having more funding will make it possible to explore more avenues more quickly. We have much more to learn about the immune system through basic research. We could have new and important clues not only for cures, but also for prevention.”
Noted Collins about the precise new classes of drugs such as helped put former President Jimmy Carter’s cancer into remission, “We have educated immune cells to go to college, now it’s time to take them to graduate school, where we can explore even finer details.”
Noting that Biden is calling for a decade of advances within 5 years, one reporter asked Collins how NIH would know when that milestone was met.
“It’s not like turning a crank and getting a predictable result,” he explained. “Science is not like that. We are not talking about just a little tweak here or there. This is expected to have a major impact.”
Asked what the biggest obstacle facing the moonshot is, Collins responded, “Based on my 23 years [at NIH], I can tell you that it won’t be an absence of ideas or talents. It will be a limitation of resources. But we have a very energized, remarkably creative group of scientists here who are champing at the bit and will rise to the occasion. Given the vice president’s support and leadership, I think this is going to be amazing.”