Vice President Joe Biden launched a “moonshot” initiative Friday to hasten a cure for cancer, aiming to use his final year in office to break down barriers in the medical world he says are holding back progress on eradicating the dreaded disease. ( PERHAPS HE COULD ENGAGE BRAIN BEFORE OPENING WELL INTENDED MOUTH- YOU SEE THIS CAUSES ECSTACY AMONG THE CONSPIRACY THEORISTS INCLUDING BIG PHARMA AND GOV)
Biden chose Penn Medicine’s Abramson Cancer Center in Philadelphia as his venue to call attention to the institute’s pioneering efforts on immunotherapy, in which a patient’s own immune system is deployed against cancer cells. After touring the facility’s Center for Advanced Cellular Therapeutics, Biden sat down with doctors, researchers and academics to discuss recent advances.
“You’re on the cusp of some phenomenal breakthroughs,” he said. “In my terms – not your medical terms – we are at an inflection point in the fight against cancer.”
With barely a year left, Biden has yet to lay out exactly what he’ll do that hasn’t been done in the half century since President Richard Nixon declared war on cancer. But Biden said in addition to pushing for more funding, he would use his influence to “break down silos” he says are pervasive throughout the sprawling and fragmented world of cancer
Since declaring his “moonshot” in October, Biden has been searching for answers about what’s holding back a cure, with all the meticulousness of a physician diagnosing disease. His conclusion: The hold-up, in large part, lies in the cancer world itself.
Meeting with scientists Friday, Biden recalled his grandfather’s adage that the world has three kinds of politics: church politics, labor politics and regular politics.
“I hope you’re not offended, but there are four kinds of politics in America. There’s cancer politics,” Biden said. He deemed that particular flavor even more vexing than the rest.
But Jim Greenwood, CEO of BIO, which represents the biotech industry, said there’s a reason why organizations developing treatments must keep some information to themselves.
“There are prioprietary interests, and the model for developing drugs in the U.S. is done by the private sector,” Greenwood said. “That means competition, and there’s a lot of benefit to that.”
Still, Biden has described a system in which competition, territorialism and “stove-piping” of information leave researchers and their discoveries cloistered in their own corners. His campaign this year will work to encourage more data-sharing about patient data and treatment outcomes.
“My hope is that I can be a catalyst, to oversimplify it, to get everybody on the same page,” Biden said.
A key focus will be promising advances such as immunotherapy. At the cancer center Biden visited Friday, researchers are exploring what’s known as chimeric antigen receptor technology, in which a patient’s immune cells are engineered outside of their body to hunt for tumors, then infused back into the patient’s body. The White House said 250 patients have been treated with the approach, with early promising results.
Another priority for the vice president is to further “precision medicine,” which personalizes treatments based on the genetic makeup of a patient’s tumors. Cancer researchers who met with Biden recently said he was intrigued by the possibilities for improving prevention and early detection.
Biden planned to continue the effort next week by convening global cancer experts at the World Economic Forum in Davos, Switzerland. Then he’ll chair a series of meetings with Cabinet secretaries in about ways to boost federal funds.
For Biden, the emotional undertones of his mission are difficult to avoid. After his 46-year-old son, Beau Biden, died from brain cancer in May, Biden entered a period of painfully public mourning, followed eventually by his decision not to enter the presidential race.
“This is still a blow that he’s still recovering from,” said former Sen. Ted Kaufman, a Biden confidante for many decades. “He’s in his problem-solving mode. He’s more comfortable in this area because of his desire to eliminate this thing that caused him so much damage.”
When Biden, in a Rose Garden speech, announced a bid “to cure cancer,” eyebrows were raised. Some wondered whether Biden was unduly raising expectations.
“I’m an eternal optimist, but I’m not going to go around saying we’re going to cure cancer in five years. That’s just not realistic,” said Dr. George Demetri, a Harvard Medical School professor and researcher at the Dana-Farber Cancer Institute who met with Biden’s staff.
Biden acknowledged that some cancers can’t be cured, insisting he wasn’t naive. But he said he thought it was possible to double the rate of scientific advances.
Because cancer takes hundreds of forms, it can’t be eradicated by any single advance. But immense progress has been made recently. Survival rates for most cancers are increasing, although the American Cancer Society still predicts nearly 1.7 million new cancer cases this year and nearly 600,000 deaths. AONTHER VIEWPOINT
War on cancer, take two
The past 40 years have brought a greater understanding of the disease’s genomics and the related mortality rate has dropped by 23% since 1991, translating to more than 1.7 million deaths averted through 2012. Yet optimism about finding cures has tempered, dampened by high drug costs, lack of collaboration and unfulfilled promises.
“Let’s make America the country that cures cancer once and for all,” said President Barack Obama, receiving a round of applause during his final State of the Union address. Obama tasked Vice President Joe Biden with spearheading a new “moonshot” approach to fighting cancer. Biden said he would break down silos that prevent data-sharing and ultimately, “make a decade worth of advances in five years.”
Last week, some of that work began. The National Cancer Institute said it would launch a database this summer that contains information about genetic mutations and cancer treatments. Data will come from as many as 50,000 patients and clinical-trial participants in the Therapeutically Applicable Research to Generate Effective Treatments program, as well as the Cancer Genome Atlas.
“There’s never going to be (just) one cure,” said Dr. Julie Vose, president of the American Society of Clinical Oncology. Cancer is thousands of different diseases. Presentations and treatment can vary from patient to patient. Vose warned that it’s “impossible to generalize treatments to all patients with cancer.”
To that end, ASCO issued a timely policy statement last week noting how the personalized nature of cancer treatment has resulted in a flood of clinical pathways—protocols that guide which treatment should be chosen for a patient’s specific diagnosis. The administrative burden of managing those pathways “is at a breaking point,” experts say.
Also at a breaking point are the overwhelming costs of conducting clinical research, comparing existing therapies and the steep prices that preclude some patients from affording life-saving treatment.
The number of Americans taking at least $100,000 worth of prescription drugs annually from 2013 to 2014 tripled, according to Express Scripts. High-cost cancer medications were partly to blame.
And profiteering from drugs is a trend that “shows no sign of slowing,” added Dr. Lee Newcomer, senior vice president of oncology, genetics and women’s health at UnitedHealthcare. To help control costs, the insurer—the largest in the country—in 2009 launched a collaboration with five oncology groups. They use a value-based payment model based on best practices and patient outcomes.
The national focus on quality and value has also bolstered interest in comparative effectiveness studies that assess the merits of new drugs. But even that research faces challenges.
A 2014 NCI analysis found that some cancer drugs are so expensive they hinder post-market trials that compare which ones work best. It’s not in the best interests of the manufacturer of a more expensive drug to provide free medication for those trials, making it necessary for a third party to finance the research. A study comparing the brand and generic versions of two prostate cancer drugs could rack up to $70 million in drug costs alone, the authors wrote. Oncologists have urged changes in federal law to allow Medicare to negotiate drug prices.
Dr. Vincent DeVita, former director of the NCI and a pioneer in oncology research, argues that the U.S. Food and Drug Administration could help by speeding up the approval process, which now can take more than two years. “The ability to innovate is gone,” DeVita said. “The FDA has become the oncologist.”
Less than 5% of adult patients participate in studies, according to ASCO. And as physicians see more patients in the changing healthcare climate, they may be too busy to discuss the option.
Most patients don’t even know to ask about studies, said Dr. Michael Seiden, chief medical officer of the US Oncology Network and McKesson Specialty Health.
In light of the challenges seen over the past 40-plus years, experts say any new approach to curing cancer, moonshot or otherwise, must get back to the basics.
Historically, clinical breakthroughs, including drugs and other therapies, have been the shiny new thing. Most recently, the pending 21st Century Cures Act aims to fast-track the most promising treatments. But the “gee whiz stuff” isn’t all there is to it, said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society.
Efforts to reduce obesity and smoking and boost access to primary and preventive care could significantly cut the cancer mortality rate. “We could do much better in coordinating our efforts in that regard,” Lichtenfeld said.
Eisenberg added that specialty cancer drugs have diverted attention from research into the chromosomal abnormalities that result in cancer variations among patients. “Basic research is not very sexy,” he said. But “if we better understood the science, we could better design the drugs.”