The United States will have to make a fundamental shift in how it conducts cancer researcher and delivers cancer treatments to accomplish goals established under the federal cancer "moonshot" initiative, according to a report published Tuesday in The Lancet Oncology.
The National Cancer Institute launched the cancer moonshot initiative under former President Barack Obama. The initiative focuses on finding a cure for cancer.
For the report, more than 50 leading U.S. cancer physicians who are part of The Lancet Oncology Commission on Future Research Priorities in the USA created a five-year roadmap for the cancer moonshot initiative. The physicians in the report outline 13 priority areas with measurable goals and target deadlines for the United States to accelerate cancer research using about $2 billion in cancer research funds provided under the 21st Century Cures Act.
Cliff Hudis, CEO of the American Society of Clinical Oncology and a co-author of the report, said the report translates recommendations issued in 2016 by the Cancer Moonshot Blue Ribbon Panel into "clear milestones, metrics, and measures that could be assessed."
Elizabeth Jaffee—co-chair of The Lancet Oncology commission, deputy director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, and president-elect of the American Association for Cancer Research—said the report focuses on "prevention, a new model for drug discovery and development, a vast expansion of patient access to clinical trials, and an emphasis on targeted interventions to improve cancer care for underserved groups, specifically children, cancer survivors, and minority groups."
The physicians in the report recommended that the United States prioritize:
- Accelerating the drug discovery process, expanding the cancer center drug pipeline, and leveraging partnerships to reduce drug development costs;
- Encouraging cancer prevention through new treatments, vaccines, and policies designed to promote healthier lifestyles;
- Expanding patient access to new drugs through participation in larger clinical trials, particularly pediatric and minority patients;
- Expanding use of radiation therapy in combination with immunotherapy for cancer that has spread;
- Identifying new and improved ways to use the body's immune system to attack cancer;
- Improving health disparities and access to care, including access to cancer treatment in underserved communities;
- Improving imaging technology to help physicians assess the effectiveness of cancer therapies;
- Improving the precision of tumor assessments to help match appropriate drugs and cancers;
- Increasing cancer screening rates and improving examinations for high-risk groups;
- Increasing the share of children and teens who are treated at large cancer centers;
- Increasing the amount of shared cancer data, including information on FDA approvals, patients, treatments, and toxic effects;
- Making progress on cancer surgery technologies; and
- Using supportive treatments, such as symptom management and palliative care therapies.
The physicians tied each of the priorities to measurable goals with target deadlines. For instance, the physicians called for U.S. researchers to collect more than 10,000 cancer specimens from patients within two to four years in an effort to improve cancer prevention.
Hudis said, "We have a rare moment now of unity, with our political forces and our general public aligned behind the goals of the moonshot effort." Hudis added, "What we have to do is deliver" (Thompson, HealthDay/Philadelphia Inquirer, 10/31; Steenhuysen, Reuters, 10/31; Diamond, "Pulse," Politico, 11/1).
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