The Many Moonshots of 2016:


Leonard Zwelling

         Look out green cheese. The Earth is taking aim at the moon
and these are serious people doing the shooting.

         Of course the first moon shooter is Dr. DePinho who has been
on this space voyage since he got to Anderson in 2011 and allegedly before
that. He just needed the right combination of gullible millionaires and members
of a Board of Regents to buy into his nonsense so that he could then get a
leadership job at and wreck havoc on one of the nation’s premier institutions
of cancer care. After all, he has the know-how and he’s got the video. He knows
what everyone else doesn’t. He knows how to cure cancer and develop the drugs
to do it better than the pharmaceutical industry does and better than all the
rest of academia. Just ask him. Better yet, ask the Securities and Exchange Commission.

         Next we have Vice President Biden doing his boss’ bidding
and opening a $1 B moonshot program to advance the treatment of cancer on the
federal level. There’s a task force and strategies and well, I’m excited,
aren’t you? After all isn’t this something new? A federal program to wage a war
on cancer. What a concept! I wish I’d thought of that.

         Last week former Facebook President Sean Parker contributed
more to the moon shooting–$250 M to cancer immunotherapy research at 6
institutions. He’s going to get these guys (and gals) to work together, to
collaborate. Bulletin—they do already and more money and more collaboration is
not the answer to cancer.

         First, let’s all agree on the goal. I will keep it simple
and allude to the wisdom of my great friend Allen Lichter, the soon to be
retired CEO of ASCO. Allen said to me over another of our fabulous dinners at
Washington, DC restaurants at which he has had a martini and me a beer, “First,
nobody dies.”

         So let us start by saying that our goal is to reduce the
rate of death from cancer. Since the War on Cancer began in 1971, that decrease
has occurred a bit. It has largely resulted from a decrease in smoking and
other harmful lifestyle choices, increased screening for breast and colon
cancer, and a marked improvement in the death rate from pediatric cancer. All
this is good news. None of it is due to basic research advances. If any
research has contributed to the improvement in the overall death rate from
cancer it is clinical research and population-based cancer prevention research.

         This also means we have the capacity to decrease the death
rate even further. What if every single American followed the USPSTF
recommendations for cancer screening, stopped smoking, took drugs to eradicate
Hep C, and used sun screen appropriately? Holy cow! We could really drop the
cancer death rate and once again, no test tubes needed.

         The cancer community has now aligned itself with the
government, Silicon Valley and big pharma to convince the American people that
what is between them and a cancer cure is not less tobacco, more colonoscopies,
more mammograms, fewer illicit drugs and needle sharing, more salads and fewer
hamburgers, but more T-cell research. Hogwash! There is not one bit of evidence
that pouring billions into basic research will have a meaningful effect on the
cancer death rate. We believe it will and we should definitely increase funding
to biomedical research of all kinds. But we should also invest in math,
physics, computational biology, and chemistry as well as K through 12 public
education because those fields are as likely to yield benefits in the fight to
cure cancer as immunotherapy is.

         Remember, if we cure cancer tomorrow we only increase the
average age of Americans by 3.5 years. Everybody dies of something and mostly
it’s their own bad choices in life, adverse genetic proclivities, or bad luck.
None of these things can be solved with more money.

         These moon shots are like monkeys at typewriters (OK, give
them computers, now) seeking to write Hamlet. It could happen, but don’t bet
the banana on it. Instead, the likely answer is in some lab somewhere in the
world where one brilliant insight gives us something like the structure of DNA,
the ability to invent a CT scanner, or the development CRISPR/Cas 9 gene

         Science is a funny fickle master. Unlike political
candidates, it cannot be bought with large sums of money. The answer to cancer
is not grandiose moon shot pronouncements. It’s the opposite. Patience,
humility, and determination and the realization that having more money than
brains does not get you anything except what money can buy and money may not
yet be able to buy inspiration.

Leonard Zwelling