Last Monday, the White House announced the formation of its Cancer Moonshot Task Force, a follow-up to President Obama’s State of the Union exhortation to “make America the country that cures cancer once and for all.” At the time, the president’s announcement elicited snickers from many on the right concerned about expansive government programs that promise more than they can deliver.
But conservatives who worry about the government’s role in combating cancer are missing a key part of the picture: When it comes to making big gains against cancer, it’s not about central planners generating solutions from whole cloth; it’s about making sure nothing gets in the way of the cutting-edge treatments that are already within our reach. Conservatives can play an important part in the cancer moonshot by helping to keep it focused on its key task.
Powerful new cancer treatments verge on science fiction.
Cancer cells cloak themselves from the body’s immune system. We can now strip that cloak away with drugs called “checkpoint inhibitors.” We can also genetically modify hunter-killer T cells and send them, like predator drones, to attack tumors. Based on research showing that genetic screening could detect early-stage cancer in pregnant women, Illumina just launched a company called Grail to develop and commercialize a test to detect circulating tumor DNA, potentially identifying at-risk patients before they show any clinical symptoms. The earlier we can detect cancer, the more easily we can cure it.
But enormous challenges still loom.
For instance, fewer than 5 percent of cancer patients participate in clinical trials, which are usually incredibly expensive and time-consuming and fail more than 90 percent of the time.
We desperately need a new “gold standard” for testing promising cancer medicines – a system that uses the latest advances in artificial intelligence, statistics, and powerful diagnostic platforms to rapidly identify and test promising combinations of drugs in the patients who are most likely to respond.
Very few institutions have committed to the kind of massive, routine data sharing that we need to make rapid strides against cancer.
Another key challenge is to get researchers, companies, and academic medical centers to embrace robust data sharing. Universities use prominent journal articles as a yardstick for tenure, salary, and promotion — encouraging researchers to hoard, not distribute, data. There’s also a complex web of privacy regulations at the state and federal levels that discourages data sharing, or provides a ready-made excuse for avoiding it. As a result, everyone pays data sharing lip service, but very few institutions have committed to the kind of massive, routine data sharing that we need to make rapid strides against cancer.
Vice President Joe Biden — tasked by President Obama to lead the moonshot efforts — is already making a difference through the call to arms he has issued from the bully pulpit.
#share#A large coalition of pharma and biotech companies, along with academic cancer centers and community oncologists, have agreed to test more than 60 medicines in different immunotherapy combinations, attacking up to 20 tumor types in early-stage trials through the National Immunotherapy Coalition. They call the program Cancer Moonshot 2020.
The NIC aims to use the latest diagnostics tests, including next-generation genomic and proteomic sequencing, to match 20,000 cancer patients with combination immunotherapies that match their particular disease profiles. The goal is to achieve “durable, long-lasting remission for patients with cancer.” It’s the largest immunotherapy trial network of its kind. This is the first time that a major private insurer has agreed to cover next-generation sequencing for cancer patients. (The insurer is Independence Blue Cross.) If this effort is successful, the NIC will help rewrite the rules for rapidly developing and testing novel combination treatments for cancer.
If we fail to engage, we lose the opportunity to articulate a conservative vision for what government can do well.
Biden’s call for routine data sharing is also shaking up the status quo, drawing long overdue attention to a complex system that claims to protect patient privacy but often operates against the wishes of cancer patients, who are overwhelmingly eager to share their data. Government is well positioned to tackle this problem, because it regulates human-subject research and pays for much of the underlying research and patient care (through Medicare).
In short, the opportunity is certainly there to make big strides against cancer quickly.
Conservatives should take Biden’s promise to “clear the way” of regulatory hurdles for scientists and researchers at face value, and help him find the right walls to knock down.
Critics have correctly noted that the engineering problem implied by the “Moonshot” phrase is wrong. Cancer research isn’t rocket science; it’s orders of magnitude more complicated.
But they’re nitpicking when they should be engaging. They should join with Biden and call for government to pare back or repeal costly and ineffective regulations that slow research, empower patients to control their own data, and commit federal agencies to moving towards a nimble, 21st-century framework for rapid cancer-drug development.
It’s easy to become cynical about government when it tries to do too much. But if we fail to engage, we lose the opportunity to articulate a conservative vision for what government can do well: direct public resources more efficiently and effectively, provide the right incentives for unleashing entrepreneurship and innovation, and set a regulatory framework that empowers patients and their physicians to make informed decisions about the risks and benefits of new technologies.
It might take decades, but the battle against cancer is one America can win. Conservatives shouldn’t be on the sidelines in that fight.