Ending Cancer Deaths in Young People ‘Doable’ With Budget (1)

Cancer won’t be a death sentence for most young and otherwise healthy people if a new health research program proposed by President Joe Biden becomes a reality.

“I don’t expect to end all cancer deaths, but I think eradicating a vast majority, especially in young and otherwise healthy people, is conceivable,” said Ned Sharpless, director of the National Cancer Institute, Sunday at the annual meeting. from the American Association for Cancer Research

The boost from Biden’s plan would cut what would have taken 10 to 15 years to five, he said.

Sharpless’ comments came just two days after the White House issued a $ 6.5 billion budget request to establish the Advanced Research Projects Agency for Health, or ARPA-H. The new program would be housed at the National Institutes of Health, along the lines of Pentagon and Department of Energy initiatives that paved the way for the Internet and GPS. It requires Congressional approval.

Sharpless offered some of the first comments from an NIH official about ARPA-H in response to the budget request. ARPA-H will provide the NIH with capabilities such as fast and agile procurement and dedicated authorities to manage projects in a targeted manner. The agency is well equipped to tackle ARPA-H, especially after the Covid-19 pandemic forced the agency to work in new ways to boost vaccine and drug discovery, he said.

A big boost in funding targeted research into biotech innovations would be “ transformational ” to bring new cancer therapies to patients, said Nancy Goodman, founder and executive director of Kids v Cancer, a pediatric research advocacy group. Pediatric cancer lags behind adult cancer in terms of research and therapies, she said, but investment in pre-existing programs can go a long way in helping both groups.

Goodman is launching a “biotech acceleration program” for the new ARPA-H that would streamline and fund academic research to accelerate the movement of new ideas in the actual development of drugs and therapies. She says that if the government takes charge of “doing the work the industry cannot,” the drug manufacturers can take over in the next phase.

One of her proposals is to standardize academic studies to ensure that researchers optimize their experimental drugs and therapies for use in humans, make recommendations for production, and conduct the first human clinical trials. After that, she said, the pharmaceutical industry can move in knowing there will be benefits “ once seen in a bunch of kids. ”

The US government’s success in pushing through a Covid-19 vaccine through Operation Warp Speed ​​demonstrates the power of a marriage between the private sector and academic research, she said. The NIH already has programs that can be scaled up that aim to accelerate the production of drugs that inhibit proteins associated with cancer development and that stimulate cancer genomics.

Defined goals

The link between cancer and aging makes eradicating all cancer deaths an unrealistic goal in the short term. According to Sharpless, the goal should rather be to end cancer in young people.

“When I think about the tragedy of cancer, I think about people I really knew,” Sharpless said. He named a six-month-old who died of a very rare, fast-growing brain and spinal cord tumor and a young mother with metastatic breast cancer who wanted to live for a few more years to see her children attend college.

“Even that modest goal was one we couldn’t achieve,” he said.

It’s time to define more precisely what it means to “end cancer as we know it,” he said. “I believe this is a place for solid statistics, as opposed to hazy, ill-defined goals.”

Halving cancer mortality from its peak in the 1990s, when it was about 215 deaths per 100,000 population, would indicate that researchers are on the right track. That rate has steadily declined to about 149 deaths per 100,000 in 2018, but it would take until 2040 to reach the target halfway below the historic drop of 1.8% for men and 1.4% for women.

That decrease increased to 2.4% from 2017 to 2018, but it would take until 2031 to halve the mortality rate.

“That’s not good enough,” said Sharpless. “But if we continue to accelerate this decline by leveraging all of our new tools in prevention history and new therapies, I think we can achieve that by 2026.”

That requires an average reduction in cancer mortality of about 4% per year, which he says is not the result of a single breakthrough, but requires a concerted effort that brings together many complex parts.

Early detection

One way to use a vehicle like ARPA-H is to conduct a large national survey or a series of studies for early detection testing for multiple cancers. Researchers would use blood-based screening tests to find early cancer in healthy adults, which could aid cancer diagnosis, screening, and treatment.

ARPA-H will target other disease groups, but Sharpless said he expects cancer to be a big part of that $ 6.5 billion effort. The NCI is the largest of the NIH’s 27 institutes and centers.

“To put that in perspective, the full moonshot of cancer, which was truly a transformative initiative, was $ 1.8 billion. So this is way bigger than that, ”he said. The Biomedical Innovation Act 21st Century Cures Act (Pub. L. 114-255) provided that money as one of several specialty funding sources that led to 240 new programs and initiatives. That money will expire in 2023, and Sharpless said he doesn’t expect ARPA-H to catch the moonshot, but expand in other directions.

“ARPA-H, as envisioned, could be better suited to different types of projects because of new capabilities,” he said, adding an important question to figure out what will work well with the ARPA-H format versus the ongoing programs at the NCI . “

– With the help of Fawn Johnson

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