Biden’s final ‘cancer moonshot’ report outlines progress and hurdles

Vice President Biden is expected to tell President Obama on Monday that the administration’s “cancer moonshot” effort infused new urgency in the fight against the disease but that formidable challenges remain, including a lack of coordination among researchers, an “antiquated” funding culture and unacceptably slow dissemination of important information about new treatments.

The final moonshot report, which Biden is scheduled to deliver in an Oval Office meeting, lists an array of promising new government and private actions designed to accelerate progress. It also includes a letter to the president describing in personal terms the impact of the death of Biden’s son Beau from brain cancer in May 2015, as well as recommendations on how to score research breakthroughs and improve patient care over the next five years.

During his son’s illness, Biden wrote, he and his wife, Jill, had numerous meetings with oncologists and researchers. They came away convinced that “even if we couldn’t save our own son, the science, medicine and technology are progressing faster than ever to save countless other sons and daughters.”

Yet while the field may be at “an inflection point” — because of increased understanding of cancer biology and new opportunities created by an explosion of genetic and other data — barriers to progress remain, he said.

He took aim at incentives that reward scientists for individual successes rather than team efforts that “can lead to new answers and new solutions.” He complained that problems recruiting and retaining patients for clinical trials can cause costly delays. And he said it takes too long for cutting-edge treatments developed at the nation’s premier cancer centers to reach the community oncologists who treat most patients.

To overcome those and other obstacles, Biden called for new funding mechanisms for research, especially the work sponsored by the National Cancer Institute, to encourage “high risk, high reward research.” He also called for improved access to clinical trials, intensified efforts to reduce cancer disparities, and enhanced prevention and screening efforts. Initiatives to address some of the issues are underway, but more needs to be done, he said.

Monday’s scheduled meeting between Biden and Obama, to be followed in the afternoon by a Biden address to cancer researchers, advocates and patients, comes almost a year after the vice president announced that he would not run for president. At the time, he called for “an absolute national commitment to end cancer,” and in January, Obama named him head of the cancer moonshot, with a goal of making a decade’s worth of progress in just five years.

Now, as the end of the administration approaches, Biden faces a big piece of unfinished business: trying to persuade a lame-duck Congress to approve additional funding for efforts for the current fiscal year, which began Oct. 1.

The administration, researchers and patient groups have been pressing Congress to approve about $700 million for cancer initiatives. “With all the momentum in 2016, if you are unable to show something for these new ideas, it will be very difficult to all of a sudden build up from the ground floor next year,” said Jon Retzlaff, managing director for science policy and government affairs for the American Association for Cancer Research.

Prospects may be brightening, supporters say. Republican leaders have indicated that passage of “21st Century Cures” legislation, which could be a vehicle for the money, is a top priority.

Even if the money is approved, a significant portion of the cancer community will remain skeptical. For one thing, they say much more money is needed for cancer research than what the administration is seeking.

“The moonshot is a lot of rhetoric and a lot of meetings,” said Vinay Prasad, an oncologist at the Oregon Health and Sciences University. He said that researchers need much greater understanding of cancer’s basic biology to make substantial progress — and that’s something that he said requires funding of at least $100 billion over 20 years.

But supporters of the moonshot effort say that it has encouraged researchers and the public that cancer might someday be vanquished.

“I think the moonshot is a wonderful, visionary effort,” said Drew Pardoll, director of the Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University.

Biden’s efforts have involved encouraging new public-private partnerships in the fight against the disease that will kill an estimated 600,000 people this year. New commitments in the vice president’s report include millions of dollars of donations for research, as well as data-sharing partnerships designed to make it easier for doctors, researchers and patients to access data.

For example, the National Cancer Institute is expected to announce Monday a new partnership with Amazon Web Services and Microsoft to build a model for maintaining cloud-based cancer genomic data, meaning on a network of servers, to aid researcher access. The Defense Department is expected to announce a new study to use 250,000 blood and tissue samples from members of the armed forces to try to identify markers that could point to cancer. And the ride-sharing companies Lyft and Uber said they would take steps to help cancer patients get to their doctor appointments and treatments.

As for the moonshot’s future with a new administration, Democratic presidential nominee Hillary Clinton has said that she would like to continue it and would welcome Biden’s advice. Donald Trump, the Republican nominee, hasn’t commented on the matter. Biden said recently that he’d like to remain active, but not from inside the government.

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