More Americans die of heart disease each year than anything else, but cancer has better lobbyists.
And now it’s getting an especially powerful one: Vice President Joe Biden. In Monday’s State of the Union address, President Obama tapped Biden to lead a “moonshot to cure cancer.” The shape of this particular moonshot is still indistinct, but the basic elements are coming into focus: more federal money, better data sharing between scientists and doctors, and giving a big pair of red-tape-cutting scissors to Biden, whose son Beau died of brain cancer last May.
It's a noble goal, of course. But is the problem that there’s not enough research money (the NIH anti-cancer budget is already $5.3 billion), or that it’s not going to the right place? Or perhaps, that cancer is just a really, really tough biological hombre? “It’s the most complex disease known to mankind,” says Jon Retzlaff, policy director for the American Cancer Research Association, a group that publishes several cancer journals and pushes out information about new treatments. “We are making major progress on certain cancers, but overall there are many cancers such as lung and pancreatic where the survival rate has not improved that much in the past decade.”
Retzlaff met with Biden’s people last week. He anticipates that the NIH will get as much as a 7 percent budget boost in the president’s budget, which comes out in February. That’s enough for 39,000 cancer researchers and technicians, Retzlaff says. “We need to see progress in every area of cancer,” he says. “That’s going to take focused efforts over the long term.”
Research alone won't be enough. One idea is to have Medicare cover genetic cancer screens, something now only covered by a few top-shelf insurance plans. That might take an Apollo-sized line-item, but it will also yield tons of genetic data that might give clues about potential drug targets and other treatments. More genetic information about who has which kinds cancer mutations will also help drugs work better; many current cancer therapies only work on 80 percent of patients because of individual genetic variation.
An injection of federal dollars into cancer trials and research could also be a boon to some biotech firms. Jeff Galvin, CEO of American Gene Technologies in Rockville, Md., says Biden should look for “shovel-ready” cancer therapeutics,like the road and bridge projects that were part of the Obama administration’s 2009 economic stimulus package. “If he raises the profile of stuff already going on,” Galvin says. “He’s going to look like a genius.” AGT is developing gene therapies using HIV-derived lentiviruses to treat liver and breast cancer, HIV, and Parkinson’s disease, but the firm is still in the early days of research. Its first clinical trial is supposed to kick off this year.
As with most medical treatments, curing cancer---or even just driving down death rates from various cancers---will take a lot longer than the last few months of the Obama administration.
In fact, the NIH is in the middle of another cancer-fighting program launched at last year’s State of the Union. The National Institutes of Health Precision Medicine Initiative, a $215 million big data project, is collecting medical records, biopsies, data from smartphones or wearable sensor devices, and information about diet, substance abuse, and disease symptoms. The NIH estimates it will take three to four years to secure 1 million volunteers for the study.
With all the focus on clinical trials and data collection, at least one NIH program officer says perhaps some of the new attention and money should be focused on answering fundamental questions of how cancer works. “You can throw a ton of money at these new emerging agents, and some are interesting, like immunotherapy,” said the officer, who spoke on the condition that his name would not be used. “They don’t all fail, but the majority fail. The effort should not be on more clinical trials, but to providing funds for research community to develop new ideas and understand why you become resistant.”
A few cancer patients and their families trekked to the Capitol to watch the president’s speech on Monday night. Advocacy groups looking for more money for specific cancers: breast, lung, etc., will likely be jockeying for position. But Claire Snyder, a cancer outcomes researcher at Johns Hopkins School of Medicine, says Biden’s cancer “moonshot” needs to think about people and how they are live with cancer, a disease that can take years from diagnosis to death. “We need to be making sure we are taking care of the patient and not just giving them drugs,” she says. As a talking point, it's not as good as "find a cure," but it's still pretty solid.
