Moonshot 2.0 Looks to Focus on Caregivers, Learn From Patients


Danielle Carnival, PhD, spoke at the National Comprehensive Cancer Network Policy Summit on Friday.

The Biden administration’s reboot of the Cancer Moonshot Initiative, also called Moonshot 2.0, has clear goals: to reduce cancer deaths by 50% in 25 years and to “improve people’s and their families’ experience of living with cancer and fighting it.” to survive”.1

To do that, you have to go beyond traditional measures of success and really learn from patients and caregivers living with cancer, Danielle Carnival, PhD, Cancer Moonshot coordinator in the White House Office of Science and Technology Policy, told the National Comprehensive Cancer congregation on Friday Network Policy Summit in Washington, DC.

Over the past 20 years, Carnival says, the age-adjusted cancer mortality rate has fallen by about 25%, helped by breakthrough advances in treatments, prevention tools like the human papillomavirus vaccine, and improved use of screening that can remove lesions that are precancerous and a sharp decline in long-term cigarette use, “particularly among young people.”

Carnival, which was involved in the first Moonshot initiative in 2016, said it created 70 new partnerships and drove passage of the 21st Century Cures Act, invested $1.8 billion in research and the FDA’s decision timeline for new therapies optimized. “Despite advances in extending life and saving lives, cancer is still the number two killer in America,” she said. “We lose more than 600,000 Americans to cancer each year and 1.8 million families are devastated by a cancer diagnosis each year.”

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But many problems remain. Cancer is often diagnosed late. Too little is being done to prevent cancer. “We have strong inequalities in access to diagnosis, access to treatments and trials, and inequalities in outcomes,” Carnival said.

“We don’t know enough about how to target treatments to the right patients,” she said, and good strategies for developing treatments are lacking for many types of cancer, including childhood cancers.

Worst of all: “We leave most patients and caregivers alone with the disease and its consequences, including the chances of survival, and do not learn from the experiences of most patients.”

These experiences include dealing with treatments that are too toxic and too unaffordable, insurance processes that are impossible to control, and survival plans that may be incomplete or nonexistent.

Tackling that list — addressing the medical, financial and emotional burdens of cancer through assistance with diagnosis, treatment and survival — represents a “collective agenda” for Moonshot 2.0, Carnival said.

To address this agenda, the administration has created an interagency “cancer cabinet” that includes representatives from HHS, the CDC, the Department of Veterans Affairs and the Environmental Protection Agency, among others. In mid-September, President Joe Biden named former biotech executive Renee Wegrzyn, PhD, to head the Advanced Research Projects Agency-Health, or ARPA-H, which will take on the bolder, riskier projects that the National Institutes of Health don’t typically pursue.2 Alongside those moves, Carnival said, Biden signed a bioengineered manufacturing executive order to ensure products are made in the United States.

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One of those efforts includes a large clinical trial, she said, which “if successful, will identify effective blood tests to detect one or more types of cancer so we can reach more people with early detection and get them into a pipeline to follow up.” and diagnosis.”

Such steps will help close the “screening gap” that keeps some populations not receiving their cancer diagnosis until it reaches later stages.

Broader parts of the Biden administration’s agenda, such as reducing out-of-pocket expenses for Medicare beneficiaries, “will affect tens of thousands of cancer patients who could reduce their prescription drug costs by thousands annually,” Carnival said. Prevention efforts include new funding to clean up Superfund sites and $200 million in CDC grants for cancer prevention programs that “reach every state, U.S. territory, and tribal organization.”

Private sector efforts and partnerships are also working to improve equity in screening. Carnival listed projects across the country, including mobile and home screening projects and the development of new tools in collaboration with pharmaceutical companies and groups that include the American Cancer Society and the National Minority Quality Forum.

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In response to a question, Carnival said pre-approval and reimbursement challenges are definitely part of the agenda.

Carnival said the administration wants to hear from those directly affected by cancer and has set up a website, whitehouse.gov/cancermoonshot, with links for patients and families to insert written or video testimonies.

“The goals and priorities for the Cancer Moonshot must be communicated by individuals with direct experience of cancer. So please share your stories of inspiration and knowledge,” she said. The Moonshot relaunch featured stories from 3 people with direct experience of cancer, “and those 3 people happen to be the President, First Lady and Vice President of the United States. This is personal to them.”

references

  1. Fact Sheet: President Bien is relaunching Cancer Moonshot to end cancer as we know it. press release. The White House. February 2, 2022. Accessed September 21, 2022. https://bit.ly/3w14Ofg
  2. Klein E. What Joe Biden knows that nobody expected of him. New York Times. September 18, 2022. Accessed September 21, 2022. https://www.nytimes.com/2022/09/18/opinion/biden-invention-arpa-h.html



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