EXTRA: The Presidential Moon Shot Task Force

EXTRA: The Presidential
Moon Shot Task Force

By

Leonard Zwelling

         A thoughtful reader has forwarded to me the announcements
from the federal government about the Task Force that President Obama has put
together to re-energize the war on cancer. I guess this is the Surge on Cancer.

         This announcement came in two parts. There was a White House
Memorandum on January 28 and a Fact Sheet on February 1.

         Here’s a brief summary (my comments in parentheses):

         Memorandum:

1. Once again we hear that cancer research is at the cusp
of a major breakthrough. (Perhaps. We shall see.)

2. The Task Force is made up of the heads of DoD, D of
Commerce, HHS, Energy, VA, OMB, National Economic Council, Domestic Policy
Council, Office of Science and Technology Policy, FDA, NCI, NIH, NSF and others
(I hope there’s a medical oncologist in the group.)

3. Designation is permitted. (So we can hope that the
heads of the agencies will do just that and get people in the room who know
about cancer.)

4. The Task Force will work with everyone. (They will be
busy.)

5. NCAB is involved.

6. Blue Ribbon panel of experts is recommended. (Again,
let’s hope there is at least one real clinical investigator in the room.)

7. The Task Force will conduct outreach. (How is that
different than the President’s Cancer Panel?)

Fact
Sheet:

1. We are at an inflection point. (Perhaps. We shall
see.)

2. $1 billion more. (That’s good! Less than CPRIT.)

3. Prevention and Cancer Vaccines are a priority. (Let’s
get everyone who needs HPV vaccine vaccinated. Let’s get all who need
mammography and colonoscopy cared for. Who is going to do that?)

4. Cancer detection is important. (Who could argue with
that?)

5. Immunotherapy-(Great idea. Let’s find out where it
works and where it doesn’t as quickly as possible, but I doubt doing
combination therapy with new immunologic agents plus targeted drugs ought to be
done in private oncology offices. Of course, the obligatory politically correct
nod to cancer disparities is in here.)

6. Genomic analysis of tumors and surrounding tissue-(Again,
who could argue with this?)

7. Data Sharing-(You better get the interoperability of
the various medical records and HIPAA under control first.)

8. FDA Oncology Center of Excellence-(The last place I
would put an oncology center of excellence is at the FDA. The regulatory
adjustments that need to be made need to come from the Congress not from within
the body that is broken to start with and under the thumb of big pharma.  This is a terrible idea.)

9. Pediatric cancer-(Again, no argument here, but
recognition of the specific needs of AYA patients and survivorship should have
been mentioned. You would think that the amazing success in the treatment of
systemic pediatric cancer would warrant a mention that it may be a different
animal than adult malignancy and thus may or may not inform the treatment of
adults.)

10.   
VP’s
Exceptional Opportunities Grants-(I smell money and corruption in the wind.
Sounds like CPRIT to me and it’s less money.)

I
welcome the money. My suspicions are that all those involved will fight over it
and we will be no further along now than we are when we start. Why? Because the
goals and the incentives are not aligned. If this is really to be a second war
on cancer, we need to get the profit motive out of it, end the intellectual
property fights, streamline access to trials, overhaul the regulatory
environment at the FDA and among the IRBs, and end rewards in academics going
to individuals.

Good
luck with that.

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