The US National Cancer Plan and Cancer Moonshot goals

I’ve been reading quite a bit lately about the National Cancer Institute (NCI)’s response to the Cancer Moonshot goals. This Nature news article covers it succinctly. In it, they quote Dr. Monica Bertagnolli, who heads the NCI. At the AACR meeting last week, she said: “Doing more of what we have today is not enough … We need much more to cover the last mile.” To achieve the Cancer Moonshot goal of halving the cancer death rate in 25 years, cancer death rates should decline by an average of *2.7%* a year. Currently, we are at *2.3%* decline, which is encouraging, but we can, and should, do better — for each individual patient and for overall population health. How do we get there?

The NCI published an ambitious National Cancer Plan to accompany their Cancer Discovery publication which outlines key levers and opportunities for change. Some of the initiatives that I’m particularly excited about include:

💡Targeted diagnostic testing: E.g., Increase Low Dose Chest CT (LDCT) testing uptake (especially for individuals who have a history of smoking; reduce disparities in use of LDCT testing.

💡Novel treatments: E.g., KRAS mutations have long been known as driver mutations in many cancers. In fact, as a scientist, my colleagues and I used to work with a number of KRAS-mutant genetically engineered mouse models as that was the best way to model human cancer. We’ve made progress in the last decade with a number of molecules targeting KRAS mutants, but there’s a number of mutations for which there’s yet to be a targeted therapy in market.

💡Equity of preventative, diagnostic, and care access: A number of initiatives here, and I think we need to do more research in establishing where we’re not adequately serving patient populations.

💡Maximizing insights from health data: Simply put, information that is being collected both at points of care (e.g., EHR, labs, claims data) and for research (e.g., -omics data) are not being fully utilized to accelerate research and clinical development today. This is an investment we can put in place today, that would have long-term return for science, medicine, and population health.

Each of those levers would be an impactful change that would have us meet and, dare I say, exceed (!!!) the Cancer Moonshot goals. I encourage everyone reading this to think about how we make some of these opportunities a reality.