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Commentary

How We Can Win the War on Cancer

We are proud to join Vice President Joe Biden and Dr. Jill Biden in their commitment to end cancer as we know it through the work of a new nonprofit, the Biden Cancer Initiative. The Biden Cancer Initiative will convene experts from around the world to work alongside the vice president and Dr. Biden to gather and analyze the best ideas about how to address some of the biggest barriers to progress in the fight against cancer. Those barriers include lack of data standards in treating cancer, lack of data sharing in the research and development enterprise, lack of patient input and participation in clinical trials, and research and disparities in the access to care and treatment based on cost, socioeconomic status, and geographic disadvantages.

In all its work, the Biden Cancer Initiative will bring a sense of urgency to our cancer research and care efforts and introduce ideas to reinvent our culture of research and care for the 21st century. The Biden Cancer Initiative will complement and accelerate, not duplicate, the work of the scores of cancer foundations that exist today by addressing the institutional and structural issues that slow down progress in fighting all forms of cancer.

In President Barack Obama’s 2016 State of the Union address, he called on Vice President Biden to lead a new, national “Cancer Moonshot” to dramatically accelerate efforts to prevent, diagnose, and treat cancer—to achieve a decade’s worth of progress in five years. By the end of the administration, the Cancer Moonshot had launched a series of coordinated efforts that incentivized bold, creative, and disruptive approaches to conducting cancer research, promoting prevention, and addressing critical needs in cancer care. These efforts leveraged talent and expertise across disciplines and sectors and ensured rapid dissemination of information to the broader cancer research and care community to accelerate progress.

Ultimately, these efforts capitalized and built upon the progress made throughout the last decade to accelerate biomedical research, leverage data and technology, and improve the nation’s access to first-rate, affordable health care. In addition to driving this progress in both the public and private sectors, Vice President Biden also helped lead the effort to pass the 21st Century Cures Act that provides $1.8 billion over seven years for the Cancer Moonshot’s scientific priorities.

Initiatives begun under the Cancer Moonshot at federal agencies have continued, including those at the National Cancer Institute with additional funding through the 21st Century Cures Act, as will efforts started across the country in private companies, foundations, and hospitals.

The Biden Cancer Initiative fulfills the Bidens’ promise to dedicate themselves to the fight against cancer in the interest of patients and their families and friends, which is, quite literally, all of us.

As Vice President Biden tells it, we are not starting a new War on Cancer, we are trying to end the one we have been fighting for more than 40 years. The progress in every aspect of our lives since 1971, when President Richard Nixon declared the War on Cancer, is truly astounding. Booking travel, investing, seeing your grandchildren, watching a movie, following breaking news are all literally available within arm’s reach with a smartphone. But to get access to your medical records, to clinical trial data, to research data, and to patient outcomes almost requires a court order. It is not just an embarrassment, but a deadly reality, that health care and medical research are one of the last sectors to join the 21st century.

Consider this: Our system of federally funded university-based research dates to World War II. From that time to now, the process of grant reviews and funding, the nature of the grants, and the kind of people and universities funded has changed little. Huge annual conferences to exchange knowledge and release papers—totally suited to the age before computers—are still the norm despite the instant transmission of knowledge in every other field. Failures are well hidden because they are seldom published or discussed, dooming other researchers and countless patients to be in experiments that some already know will fail. Good outcomes are hardly easier to find, since searching electronic medical records—designed to enable billing—to find health outcomes is time-consuming and frustrating. The sad truth is that most electronic health systems cannot communicate with the other electronic health systems. It is not that there aren’t exceptionally bright people dedicating their lives and careers to finding new answers and wanting to deliver new hope to patients—it is just that the system is not designed to allow them to do so with great efficiency or speed.

These problems do not result from failures of science or medical technology; they result from our failure to change our cancer research system to match the times. In the launch of the Cancer Moonshot, and in today’s launch of the Biden Cancer Initiative, Vice President Biden addressed these failures and promised to do two things: inject a sense of urgency into our cancer enterprise and change the culture of our research and care systems in a decidedly non-partisan way. We could not agree more with this approach.

The interests of patients drive all the changes we need to make. The Bidens know firsthand the difficulty of communicating complex medical data from one institution to another, as they experienced this with the care of their son Beau in his valiant battle against brain cancer. They understand the difficulty patients have in finding an appropriate clinical trial when standard treatments have run their course. There are few parts of the system—from hospitals to doctors’ offices to pharmaceutical companies and university research centers—that truly demonstrate they put patients first. Yet patients hold the key to the information we need. They are the first to know if their needs are being met and can offer valuable feedback to guide medical research and improved health care delivery—if we let them. That is why the Biden Cancer Initiative will be heavily involved with cancer foundations of all stripes and patients the world over who want to be partners in research and who want to help design care systems that promote health and healing.

Cancer is a complex disease that varies from person to person. While we have made significant progress with some cancers, the bigger battle remains, because far too many people have their lives shortened by this dreadful disease in its many forms. With today’s tools, the new decoding of our human genome, and our ability to gather and analyze huge amounts of data, we have the ability to make great strides in research in half the time it used to take. But to succeed in doubling our rate of progress we need to expand our view of what is possible based on the system we will create, not the legacy system we have now. We need to bring the best knowledge and tools we have to all communities across the U.S. We need to make sure that prevention and early detection reach all neighborhoods. We need to reduce disparities in care that still exist today. And we need to put the patient at the center of our solutions and of their own care.

There is a palpable national hunger for leadership in the fight against cancer. When Vice President Biden held the first national workshop summit at Howard University in Washington, DC for the Cancer Moonshot program on June 7, 2016, there were 400 people in attendance. But there were 7,000 people who attended 270 individual summits held in each of the 50 states and the territories of Guam and Puerto Rico. Those of us who have been working for decades to attempt to accelerate the progress against cancer knew at that moment that the cancer world was beginning to change. It is for that reason we are proud to be among the founding board members of the non-partisan Biden Cancer Initiative, and to contribute to this national and international effort to double our rate of progress in preventing, diagnosing, and treating this horrible disease.

As Vice President Biden puts it, every day, every hour, every minute counts when lives are at stake. By working together and joining forces with cancer groups, patients, doctors, and researchers across the country and the world, we can make progress that previously we could only imagine—and change the face of cancer for our and future generations.

David Agus is professor of medicine and engineering at the University of Southern California (USC) and founding director and CEO of USC's Lawrence J. Ellison Institute for Transformative Medicine. Elizabeth Jaffee is deputy director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University. Greg Simon is president of the Biden Cancer Initiative. Kim Thiboldeaux is CEO of the Cancer Support Community. Jeff Zients is former director of the National Economic Council.

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