The National Cancer Moonshot Lifts Off

A Conversation With Deborah K. Mayer, PhD, RN, AOCN, FAAN

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Just 6 months after President Barack Obama announced the establishment of a National Cancer Moonshot Initiative to accelerate the pace of research discoveries, improve patient access and care, and encourage data-sharing, dozens of new initiatives to accomplish those and other goals were rolled out at the Cancer Moonshot Summit held on June 29 in Washington, DC.

Prior to the Summit, the creation of the National Cancer Institute (NCI) Genomic Data Commons was announced at the 2016 ASCO Annual Meeting. This research data-sharing system is designed to facilitate access to genomic and clinical data among researchers.

Cancer Moonshot programs now also include the creation of the Oncology Center of Excellence at the U.S. Food and Drug Administration (FDA); a partnership between the NCI and 20 to 30 pharmaceutical and biotech companies to expedite trials of combination drug therapies; a public-private partnership among the Department of Energy, NCI, and GlaxoSmithKline to harness high-performance computing and diverse biologic data to speed drug discovery; and a new collaboration among the Department of Defense, the Department of Veterans Affairs, and the NCI to use proteogenomics to more rapidly identify unique targets and pathways of cancer for detection and intervention, among others. In addition to these actions, during the Cancer Moonshot Summit, both the American Cancer Society and the Breast Cancer Research Foundation announced they were doubling their research budgets by 2021 to $240 million and $1 billion, respectively.

Led by Vice President Joe Biden, whose son, Beau, died of glioblastoma on May 30, 2015, the Cancer Moonshot endeavors to accomplish in 5 years what would normally take 10. During his address to the hundreds of scientists, physicians, nurses, cancer survivors, patient advocates, federal officials, social workers, and members of foundations and cancer organizations, among others, watching in 270 satellite events held throughout the country, Vice President Biden said about patients with cancer, “Time matters. Days matter. Minutes matter.”

Accomplishing Its Mission

To guarantee that the Cancer Moonshot’s approaches to accomplishing its mission are evidence-based, the NCI has established a blue-ribbon panel of 28 experts in the fields of science, medicine, patient advocacy, business, and industry. The panel is charged with providing advice on the vision, proposed scientific goals, and implementation of the Cancer Moonshot and has established 7 working groups, each of which includes an additional 12 to 20 leading experts from the cancer community and industry. The working groups are developing recommendations for opportunities of progress in the areas of clinical trial expansion, enhanced data-sharing, cancer immunology and prevention, implementation sciences, pediatric cancer, precision prevention and early detection, and tumor evolution and progression.

The panel has an ambitious timeline in which to accomplish its goals. Recommendations from the blue-ribbon panel to the NCI’s National Cancer Advisory Board are due by the end of the summer, and the top 5 to 10 recommendations will be submitted to the White House by the end of the year. If accepted, funding opportunities for these proposals will be awarded by mid-2017.

We have to work together in a better way—not just in the field of research, but in our cancer care delivery system as well.
— Deborah K. Mayer, PhD, RN, AOCN, FAAN

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To learn more about the ideas being considered to expedite a decade’s worth of advances in 5 years, The ASCO Post spoke with Deborah K. Mayer, PhD, RN, AOCN, FAAN, Director of Cancer Survivorship and Professor in the School of Nursing at the UNC Lineberger Comprehensive Cancer Center in Chapel Hill, North Carolina, and a member of the Cancer Moonshot blue-ribbon panel.

Cautious Optimism

The Cancer Moonshot Initiative is generating a lot of excitement and making rapid progress in bringing together a cadre of people from diverse fields to advance cancer therapies and patient care. How optimistic are you of its success?

I am cautiously optimistic. It is going to take time to start seeing results from our efforts, but we will know 5 years from now if we have fulfilled the goal of accelerating the pace of advances in cancer.

I’m encouraged because the members of the blue-ribbon panel are very committed to helping shape the direction of how progress can be made, and we are all taking this effort very seriously. We represent many different constituencies. For example, I am the only nurse on the panel, and I know that the survivorship community is looking to me to make sure that the issues cancer survivors face are being addressed.

I am on the Implementation Sciences Working Group tasked with identifying methods for more effectively disseminating information about new approaches for cancer prevention, risk assessment, screening, prognosis, treatment, and survivorship. Our group meets regularly by conference calls to discuss what it would take to accelerate progress.

Galvanizing Stakeholders

Vice President Biden announced the launch of nearly 40 public and private sector actions at the Cancer Moonshot Summit. How was he able to galvanize so many different stakeholders to come together in this one effort?

First of all, the Vice President has galvanized many stakeholder groups to think about what could happen if we had the resources to make progress—and how we can work together to accelerate that progress. He is very well informed about the issues contributing to the delay in making more progress against cancer. Many of the barriers are being addressed by the Cancer Moonshot Task Force. If we can be successful at promoting collaborations and reduce some of the barriers, we are certain we will facilitate progress in cancer.

Also, professional advancement in the scientific/academic community is based on individual accomplishment, such as the number of articles published and grants received and not on team efforts or data-sharing, which is the antithesis of the objectives of the Moonshot. So to be successful we are going to have to shake up the notion of doing business as usual.

Another reason I think the Cancer Moonshot has been so effective in bringing people from diverse professions and interests together is that Vice President Biden is by nature bipartisan and can get a lot of different groups around a table to work together in a way they probably haven’t before. It is actually awesome to see him in action.

Funding Commitment

The National Institutes of Health (NIH) received $195 million this year for the Cancer Moonshot, and the Obama Administration has asked for another $755 million for the NIH and the FDA in 2017. However, Congress has not yet approved funding. Do you expect that the Cancer Moonshot will be fully funded?

The Vice President has told us if we bring him good recommendations to advance cancer progress he will find the money to fund the programs. He has made a personal commitment to seeing that this effort is successful, and that commitment is not going to end when he leaves office on January 20.

Pending Recommendations

Is there anything you can tell us about the types of recommendations the panel members are considering?

We plan to make our final round of 5 to 10 proposals for funding opportunities to the public by August. The NCI is planning to retain all recommendations from the seven working groups and address the other proposals in some way.

Regardless of what recommendations get funded, my particular wish for this effort is that all the professional organizations—including ASCO, the Oncology Nursing Society, the American Society for Radiation Oncology, and the American Psychosocial Oncology Society—think of this Cancer Moonshot as an opportunity to work more collaboratively around common goals and come at the intricacies of finding more effective therapies for cancer in a new way.

The truth is we have to work together in a better way—not just in the field of research, but in our cancer care delivery system as well. ■

Disclosure: Dr. Mayer reported no potential conflicts of interest.