Can the Cancer Moonshot Work? Complicated Factors Are in Orbit
With a new president, what happens to the Cancer Moonshot? And how likely is it to succeed, anyway?
When President John F. Kennedy called for an initiative in 1961 to get the United States to the moon by the end of the decade, it galvanized an industry and inspired a nation.
Can the same happen with cancer?
In January 2016, President Barack Obama announced a “Cancer Moonshot” to achieve a decade’s worth of progress in cancer prevention, diagnosis and treatment in five years.
The initiative, led by Vice President Joe Biden, was given $1.8 billion over the next seven years as part of the 21st Century Cures Act that passed Congress with bipartisan support in early December. This secures the project’s future under a new administration.
It’s a shot in the arm, cancer researchers say, but may not be enough.
After all, cancer is much more complex than traveling to outer space.
“Cancer is too complicated to be solved by a moonshot. This analogy implies that everything is available, the technology is all there, and all we need to do is assemble it. That’s not going to be the case,” says Ted Lawrence, M.D., Ph.D., Isadore Lampe Professor and chair of radiation oncology at the University of Michigan.
“Although the extra support is certainly very welcome, we’re not going to cure cancer with $1.8 billion over seven years. So what’s going to happen when people ask for results?”
Regardless of the funding, a greater value of the Moonshot might lie in the collaborations it’s fueling, says Daniel F. Hayes, M.D., Stuart B. Padnos professor of Breast Cancer Research at U-M’s Comprehensive Cancer Center.
“Is $1.8 billion enough? I don’t think this is going to collapse 10 years of research,” Hayes says. “But what’s already happening is people are talking together who didn’t used to. I’m not sure the money is going to be as important as the galvanizing impact.”
For example, 20 institutions representing government, academia and industry have come together as part of the Moonshot’s Blood Profiling Atlas. The initiative will aggregate raw data sets from circulating tumor cells, circulating DNA and other assays and make these large pools of data freely available to qualified researchers.
The project will also involve sharing sample preparation and handling protocols from multiple groups to create best practices and standards.
Hayes and Lawrence agree that great strides have been made in recent years to improve cancer care.
“This is an amazing time for cancer research,” Lawrence says. “We have so many discoveries that are translatable. The science has exploded and we need to take advantage of it to take it to the next level of treatment.”
Recent discoveries have given researchers an understanding of how cancer cells differ from normal cells, and how to harness the immune system to attack cancer. Thanks to new treatments stemming from this knowledge, some patients with melanoma or lung cancer are now cured of their disease.
But there is plenty more work to do.
“If you hear people say we haven’t made advances in cancer, we have,” Hayes says. “But if you hear people say we’ve made enough advances, let me tell you about my patients with metastatic breast cancer.”
‘Catch up and keep up’
Even though the Moonshot funding gives cancer research a crucial boost, sustained funding is needed, Hayes and Lawrence say.
Since 2005, flat funding for the National Cancer Institute has meant a 20 to 25 percent decrease in its actual buying power. That means limited ability to fund new, bold ideas from cancer researchers.
“The wedge between flat funding at the National Institutes of Health and rising inflation is what’s stopping progress,” Hayes says. “We cannot let that flat funding continue. We need to catch up and keep up.”