National Cancer Institute (NCI) Acting Director Douglas Lowy, M.D., has accepted the recommendations of a Blue Ribbon Panel (BRP) on 10 scientific approaches most likely to make a decade’s worth of progress against cancer in five years under the Cancer Moonshot. The report was presented by the BRP to the National Cancer Advisory Board (NCAB), and it was subsequently considered and accepted by the NCAB with revisions that reflect the NCAB’s discussion. An overview of the report was published today in the journal Science.

“The bold but feasible cross-cutting initiatives in this report will improve outcomes for patients with cancer, prevent cancer and increase our understanding of cancer,” said Dr. Lowy. “NCI stands ready to accelerate cancer research in the critical areas identified by the Blue Ribbon Panel.”

In January 2016, during his State of the Union address, President Obama announced the Cancer Moonshot “for the loved ones we’ve all lost, for the families we can still save.” The NCI’s scientific road map outlined by the BRP is one component of the Cancer Moonshot’s broader effort focused on accelerating progress on the prevention, diagnosis and treatment of cancer. Under the Vice President’s leadership, a full set of recommendations for leveraging federal investments, private sector efforts, patient initiatives and more under the mission will be announced later this fall.   

The 10 transformative approaches poised for acceleration are:

• Engage patients to contribute their comprehensive tumor profile data to expand knowledge about what therapies work, in whom, and in which types of cancer.
• Establish a cancer immunotherapy clinical trials network devoted exclusively to discovering and evaluating immunotherapy approaches.
• Identify therapeutic targets to overcome drug resistance through studies that determine the mechanisms that lead cancer cells to become resistant to previously effective treatments.
• Create a national ecosystem for sharing and analyzing cancer data so that researchers, clinicians and patients will be able to contribute data, which will facilitate efficient data analysis.
• Improve our understanding of fusion oncoproteins in pediatric cancer and use new preclinical models to develop inhibitors that target them.
• Accelerate the development of guidelines for routine monitoring and management of patient-reported symptoms to minimize debilitating side effects of cancer and its treatment.
• Reduce cancer risk and cancer health disparities through approaches in development, testing and broad adoption of proven prevention strategies.
• Predict response to standard treatments through retrospective analysis of patient specimens.
• Create dynamic 3-D maps of human tumor evolution to document the genetic lesions and cellular interactions of each tumor as it evolves from a precancerous lesion to advanced cancer.
• Develop new enabling cancer technologies to characterize tumors and test therapies.

“Thanks to the coalescence of new scientific insights and technological innovations, cancer research is poised to make unprecedented advances,” said NIH Director Francis S. Collins, M.D., Ph.D. “The approaches identified by the Blue Ribbon Panel offer exceptional promise in tipping the odds in favor of cancer patients.”

In addition to the 10 scientific approaches, the road map has specific, special projects. These include a demonstration project to test for Lynch syndrome, a heritable genetic condition that increases risk of several types of cancer, to improve early detection and prevention; the establishment of a nationwide pediatric immunotherapy clinical trials network to enhance the speed with which new immunotherapies can be tested in children; exploring patient-derived organoids; and “microdosing” devices to test drug responses in living tumors.

The Cancer Moonshot scientific road map creates a vision for the future of cancer research and treatment in which:

• Patients contribute their data, obtain genomic profiling information about their tumor, learn about what treatments might work best given their tumor’s genomic profile and find other relevant information, including clinical trials that may be appropriate.
• Researchers can identify possible targets for the development of new treatments and preventive interventions, including immunotherapies, as well as learn more about how to avoid or counter drug resistance.
• Doctors have access to information that better predicts treatment outcomes and helps control patients’ symptoms and side effects.

Dr. Lowy will share the report with the Cancer Moonshot Task Force.

“NCI greatly appreciates Vice President Biden’s leadership of and passion for the Cancer Moonshot. The Vice President has galvanized the community to move forward so we can greatly improve our ability to prevent, diagnose and treat cancer,” said Dr. Lowy. “The efforts of the BRP and working group members have been extraordinary, and I thank them for their time, energy and ideas. I am confident that the cancer community will build on this effort and seize this unprecedented opportunity to accelerate progress.”