MedCity Influencers, BioPharma, Opinion

The Cancer Moonshot and beyond: What we need to succeed

U.S. government support can advance health breakthroughs and make a significant difference. I encourage you to support the creation of ARPA-H and to take specific actions to let your legislator know its importance.

In 2018, I had a personal experience that underpins the positive outlook I have for the future of cancer research and patient care and what we can accomplish to transform therapeutic options for cancer patients. I strongly believe that our industry can make its biggest impact by working together through partnerships and by supporting initiatives that fund innovation, such as the previously enacted Cancer Moonshot and the newly proposed Advanced Research Projects Agency – Health.

My story began on a fairly ordinary Saturday, on board the Acela train as I made my way home from meetings in DC. After getting up to stretch my legs, I was on my way back to my seat when I saw President Joe Biden (who was former Vice President at the time), sitting by himself.

As I passed by, I said, “Excuse me Mr. Vice President, I just want to take the opportunity to thank you for your support for the Cancer Moonshot Initiative. You championed it, and it’s great that the legislation passed.”

President Biden seemed genuinely surprised by my comment. He smiled and said, “People don’t ask me about the Cancer Moonshot. How do you know about it?” He gestured toward the empty seat opposite and invited me to sit down. We began to talk, and I explained my role as an executive in a small biotechnology company undertaking clinical trials in cancer therapeutics. He was sincerely interested.

We spent the next hour talking about the current state of the cancer research, clinical trials, where the next big strides may be made, the critical need for government-funded primary research, and my team’s experience working with the U.S. Food and Drug Administration. Our conversation was broad ranging, and I was impressed with his questions and the breadth of his knowledge about cancer research and treatment. As the Acela pulled into Wilmington, President Biden prepared to disembark and thanked me for our discussion. “Keep up the good work, and I hope your clinical trials are successful.” he said, as he shouldered his bag. There was no doubt that he was serious about improving the prognoses for patients diagnosed with cancer.

During his last days as Vice President, President Biden had been instrumental in advocating for the Cancer Moonshot, formally known as the “21st Century Cures Act.” This legislation authorized $1.8 billion in funding over the course of seven years to accelerate cancer research to advance therapeutics, prevention and care, and it was enacted with rare bipartisan support, passing both chambers of Congress with landslide votes. The Cancer Moonshot was highly personal for President Biden, who had lost his oldest son to glioblastoma the year before.

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A Deep-dive Into Specialty Pharma

A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.

In fewer than five years, the Cancer Moonshot has funded more than 240 research projects and 70 programs and consortiums. Its 10 research priorities all point toward greater data sharing and collaboration, with specific foci around improving immunotherapy, advancing childhood cancer research, mapping tumors, expanding cancer prevention and early detection, addressing drug resistance, engaging with patients, collecting and sharing cancer data, and collaboration and outreach.

The type of foundational research funded through the Cancer Moonshot benefits the entire industry, even those companies that are not direct recipients of funding. It’s a bit like seeding grass shoots: when the seed is spread, it’s hard to know which will grow. Without primary research, it’s risky for companies to invest limited resources into a promising technology or treatment. For the small companies that are increasingly driving oncology innovation, primary research is critical to transforming innovative ideas into marketplace products that can change patients’ lives.

Since 2016, cancer care has evolved rapidly, with sequencing and editing innovations that have created significant developments in the areas of CRISPR- and CAR-T based therapies and immune checkpoint inhibitors. In this highly innovative environment, we are shifting from a one-size-fits-all, trial-and-error approach toward a targeted approach that gets the right treatment to the right patient at the right time.

Within that context, it was gratifying to hear President Biden, in his first major address to Congress, call for the creation of an Advanced Research Projects Agency – Health, to be housed within the National Institutes of Health. ARPA-H would be modeled after DARPA, the Defense Agency Research Projects Agency, which is responsible for the development of emerging technologies for use by the military. Our everyday lives have been shaped by DARPA in profound ways we may not even realize. DARPA developed the first computer mouse, a prototype of the Internet, and GPS systems, to name just three.

The goal of ARPA-H would be to drive transformational innovation in health research and to speed the application and implementation of health breakthroughs in cancer, diabetes, and Alzheimer’s. The idea is that the work enabled by ARPA-H would change our everyday lives and our health in profound ways, just as DARPA has done. The proposal released in April called for a 2022 budget of $6.5 billion, demonstrating a serious commitment to this effort.

U.S. government support can advance health breakthroughs and make a significant difference. As an example, my company recently entered a collaboration with the NCI who will conduct a phase 2 trial with our drug in thymoma, a rare cancer with no currently approved treatments. Because fewer than 500 cases of thymoma are diagnosed annually, clinical trial enrollment can be challenging. Our company doesn’t have the resources to manage such a clinical trial. Yet, for the patients with cancer of the thymus, access to treatment is a critical need. Our partnership with the NCI will shorten the trial timeline and, if successful, will ultimately get much-needed treatment to patients sooner.

Our story is the story of many small companies and researchers with promising innovations that aim to transform what it means to receive a cancer or an Alzheimer’s diagnosis or to be diagnosed with diabetes. While we have made great strides over the past five years, we’re only beginning to realize the future of cancer care. Shouldn’t we speed those innovations and work together to improve the lives of patients? I encourage you to support the creation of ARPA-H and to take specific actions to let your legislator know its importance.

Photo: Main_sail, Getty Images

Robert Fallon is President, CEO and co-Founder of Promontory Therapeutics . He is a highly respected leader with decades of global transactional and strategic leadership. He is former Chairman & CEO of The Korea Exchange Bank, a large publicly traded company, and prior to that he ran all of Asia-Pacific for JP Morgan Chase. He holds a BA in Mathematics from Ohio University, and an MBA from Harvard Business School. Mr. Fallon also serves as Chairman Emeritus of The Council on International Educational Exchange (CIEE) and is a member of The Council on Foreign Relations.

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