Cancer ‘moonshot’ has lofty new goal, halves deaths in 25 years

Pathologist and cancer researcher Michael Becich has two criteria for setting goals: they should be measurable, and they should lofty, even if that means they border on unattainable. Becich told the journal Nature: “By trying to hit a lofty goal, we start to measure ourselves against that. And what gets measured gets done.”

United States (US) President, Joe Biden, announced on February 2 that he would renew the US Beau Biden Cancer Moonshot Initiative — a $1.8-billion cancer research programme that began five years ago and was slated to run for another two — with a fresh target of decreasing cancer deaths by at least 50 per cent in the next 25 years. Becich saw a goal, albeit a lofty one, that he could get behind. “Here’s a politician trying to understand the science,” he says. “And I applaud him for what he wants to do with it.”
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For Becich, who works at the University of Pittsburgh in Pennsylvania, and other cancer researchers, that’s a welcome change. For decades, they have been tethered to unrealistic political promises. In 1971, former president Richard Nixon aimed for cancer to be cured in five years. In 2016, then-vice-president Biden declared that the moonshot would achieve ten years of cancer research in only five years — a target that Becich considers worthy, but too subjective and difficult to measure. Even now, as researchers hope the renewal of the programme will come with a fresh influx of funds — Biden has yet to say how much — it will take years to determine whether the first five years has met that original target.

Congress awarded the moonshot’s first $1.8 billion over seven years. Although this sounds like a dazzling sum, it constituted a relatively small annual investment, says epidemiologist Cary Gross at Yale School of Medicine in New Haven, Connecticut. The funds amounted to a yearly increase of only about 5% to the budget of the US National Cancer Institute (NCI), which funds moonshot programmes. “What was conveyed to the public with great excitement was that we’re going to reshape the way we do cancer research,” says Gross. “They said, ‘we’re going to revolutionize everything: you were getting $100, now we’re going to give you $105.’”

Still, the NCI found room to launch more than 240 projects covering a wide spectrum of cancer research. Moonshot programmes are studying therapies that stimulate the immune system to fight paediatric cancers, and are compiling 3D atlases of tumour cells as they progress from precancerous lesions to advanced disease. There are programmes to address disparities in access to health care, and to improve the implementation of best clinical practices after they have been identified in clinical trials. And the NCI built data-sharing infrastructure, such as the Cancer Research Data Commons, to maximize the use of the generated data — a crucial way to amplify the impact of moonshot programmes, says Gross.

Despite the moonshot’s achievements, it will be difficult to determine whether the programme has delivered on Biden’s initial pledge to accomplish ten years’ worth of progress in five. At a December meeting of the National Cancer Advisory Board, NCI deputy director Dinah Singer said that moonshot programmes had already yielded 1,212 publications, 14 supported patents and 22 clinical trials.