June 29, 2016 -- Vice President Joe Biden challenged American researchers Wednesday to cram 10 years of work against cancer into 5 years by boosting clinical trials, enlisting big data, and making life-saving drugs cheaper.
Biden, who lost his 46-year-old son Beau to the disease last year, is the point man for the Obama administration’s billion-dollar “Moonshot” aimed at finding a cure. He headlined a nationwide conference on the project Wednesday vowing the federal government would help break down barriers that are hindering collaboration.
“I don’t want this to come across as somehow the federal government has the answer,” Biden said. “We don’t have the answers. We’ve got to figure out how to get out of your way, and you guys need to figure out how to get in each other’s way more.”
But he also warned that institutions that didn’t promptly report data could find their funding slashed -- and he sharply criticized the cost of some drugs.
"Treatments need to be affordable. The cost of lifesaving drugs is astronomical. We have to come up with a better way," Biden said. He said one drug, which he didn’t identify, shot up from $26,000 to $120,000 a year in 15 years.
"Tell me -- tell me -- tell me, what is the justification for that?" he asked. He acknowledged that companies may spend hundreds of millions pursuing unsuccessful leads, “but I want to raise some questions here, and I hope we get some answers.”
Biden’s remarks at Howard University were beamed to a network of 270 meetings that brought doctors, patients, and scientists together with government officials and technical experts to talk about how to speed up the search for a cure. The White House kicked off the day by announcing a list of steps it hopes will help, including using super-computers at the Department of Energy and IBM’s famed Watson to sort through the mountains of data scientists and doctors are generating.
Those machines can be used to share findings on diagnoses, treatment outcomes, gene changes, and more, said Walter Curran, MD, executive director of the Winship Cancer Institute at Atlanta’s Emory University.
“There’s no reason every patient interaction with cancer, every research project related to cancer, can’t be a learning experience for all of us,” said Curran, whose institute hosted one of Wednesday’s events.
Comedienne Carol Burnett, who introduced Biden at the conference, said she called the vice president as soon as she heard about the Moonshot to see how she could help. The two belong to a club that no one wants to join: parents who’ve lost children to cancer.
“Every day, I wake up and decide today I’m going to love my life,” Burnett said her daughter, Carrie Hamilton, told her while she was being treated for cancer. “To a cancer patient and the family affected by it, hope means everything.”
Hamilton died of cancer in 2002 at the age of 38. Burnett and Biden embraced before he began speaking.
“Carol came into my office yesterday, and it was like we’d known each other forever,” Biden said.
Nearly 1.7 million people in the United States will find out they have cancer this year, and it kills nearly 600,000 a year, according to the American Cancer Society. But the odds of survival are going up.
Richard Wender, MD, the society’s chief cancer control officer, said death rates have come down by 26% since 1991, when they were at their peak. Lung, prostate, and breast cancer deaths have fallen sharply as prevention and early detection programs have ramped up, he said.
“Unfortunately, for the cancers for which we don’t have a prevention or an early detection strategy, mortality progress has not been nearly as good,” Wender said.
The White House says the science has reached the point where an all-out effort might bear fruit, though. President Barack Obama made the “Moonshot” the centerpiece of his final State of the Union address, promising to pour $1 billion into the fight “for the loved ones we’ve all lost, for the families that we can still save.”
The administration has steered $195 million from the National Institutes of Health to the project for this budget year, and it asked Congress for another $755 million for the NIH and the Food and Drug Administration in 2017. Congress has yet to provide the requested funds, though.
That worries people like Julie Whitehead, a cancer survivor who attended the Atlanta event.
“They seem very energized, and I think that’s really terrific,” Whitehead said. “But unfortunately in this country, politics plays a really big part in funding these sort of things. We’re now getting ready to change presidents, and it could stifle a move forward.”
Bari Ross, another cancer survivor, said she came away optimistic.
“I’m hopeful that the politics don’t get in the way of the humanity,” she said.
This is not the first time the White House has been involved in a national effort to cure cancer. In 1972, President Richard Nixon declared a “War on Cancer.” That was more than 40 years ago, and cancer is still the second-leading killer of Americans.
But Greg Simon, chair of the cancer Moonshot task force, says there’s a big difference between the two.
“When we started the war on cancer, we had no weapons,” said Simon, who finished treatment for leukemia in January.
“I think that we have all the tools that we need to make progress against many, many cancers,” Simon said. He cited lab advances and those in information technology, which enable a new level of collaboration and sharing of data.
Douglas Lowy, MD, acting director of the National Cancer Institute, said “our understanding of how cancer comes about is far deeper and more profound.”
And the ability to diagnose and treat cancer is much better today, Lowy said. Patients “do better than they did before and have a better quality of life.”
A prime example is the knowledge that the human papillomavirus (HPV) causes virtually all cervical cancers, he said. His research helped develop the HPV vaccine, the first vaccine designed to reduce the risk of cancer.
Besides leading to a vaccine against cervical cancer, basic science about HPV is changing how we test for cervical cancer, Lowy said. In the next 5 years, he predicted, screening for HPV, which he called “precision screening,” will replace the traditional Pap smear, which looks for changes in the appearance of cervical cells that could be precancerous.
Another big topic at the conference was how to get more people involved in experimental treatments. Fewer than 4% of patients take part in those trials, and Biden said the administration has set up a website, trials.cancer.gov, to connect doctors with patients.
Wender said boosting participation is “a huge challenge, and it’s not a new one.”
“People fairly have asked why this effort will be different, and I think it’s in our hands to make it different,” he said.
Kim Thiboldeaux, the CEO of the worldwide nonprofit Cancer Support Community, said patients are often hesitant because of longstanding misconceptions about what participation entails. Many people fear that patients in clinical trials are merely guinea pigs, while others think they have to pay to participate, she said.
“Trials are overwhelming,” said Thiboldeaux, who attended the Washington event. “They’re intimidating and don’t meet patients where they are.” But she said her organization just launched a new program, “Frankly Speaking,” to help people navigate the process.