NCI director: ‘Committed and collective action’ required to achieve Moonshot goal
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CHICAGO — “Committed and collective action” will be required if a key goal of the Cancer Moonshot — reducing cancer mortality by at least 50% in 25 years — will be met, the NCI director told ASCO Annual Meeting attendees.
“We won’t succeed if we stay in our silos, and we won’t succeed by pointing fingers,” Monica M. Bertagnolli, MD, FACS, FASCO, said during remarks at the meeting’s opening ceremony. “We have to find new ways to work together, taking full advantage of everyone’s collective resources, expertise and experience.”
An NCI analysis showed a 50% age-adjusted decrease in cancer mortality by 2047 can be achieved through further modest but sustained annual reductions. The average annual decline in cancer mortality would need to be 2.7% instead of the current 2.3%, Bertagnolli said.
“This might seem relatively easy given the favorable trajectory we have seen in mortality in recent years, but you all know that it most certainly is not,” she said. “It would take committed, collective action from all of us, including societal changes much beyond the medical community.”
As Healio previously reported, HHS in April released the National Cancer Plan, which includes eight goals and strategies to prevent cancer, reduce related mortality and improve the lives of people living with the disease.
“You, the cancer research and clinical care community, will see your work reflected in these goals,” said Bertagnolli, who announced in November that she had been diagnosed with early-stage breast cancer. “But they were designed to guide not only NCI and not only ASCO members, but also everyone we need if we are going to accomplish them — from government leaders all the way to individual private citizens.”
Bertagnolli expanded on each objective during her remarks at ASCO.
Prevent cancer
Widespread adoption of proven strategies to reduce cancer risk are needed, such as tobacco cessation, maintaining a healthy weight, and reducing sun exposure and alcohol intake, Bertagnolli said.
“These are things each of us can commit to, but we need so much more — a fundamental understanding of what drives early carcinogenesis and more accurate management of inheritable and environmental risk factors, and many more prevention-focused clinical trials,” she said.
Detect cancers early
“Cancer is a gradual process,” Bertagnolli said. “We must address it before it causes trouble. But we also can’t overreact so our treatments are worse than the disease. Again, we need better fundamental understanding of cancer biology, new diagnostics and more clinical trials.”
Develop effective treatments
“We must have effective treatments for every person and every cancer, with minimal side effects,” she said. “For some cancers, we have made tremendous progress. For others, not so much. Succeeding for one gives us confidence that — with renewed dedication and persistence and commitment — we can succeed for all.”
Eliminate inequities
Strategies must be implemented to eliminate disparities in access to screening, prevention, treatment and survivorship care, Bertagnolli said.
“I don’t believe there is anything more tragic than seeing great harm to people not because we don’t have ways to help, but because life-saving options are just not available to them,” she said.
Deliver optimal care
“We need to create a learning health system that prioritizes prevention, reduces morbidity and mortality, and improves the lives of cancer survivors,” Bertagnolli said. “Inefficiencies, excessive costs, barriers to access and, above all, complacency, must be eliminated.”
Maximize data utility
“We can create conditions such that secure sharing of privacy-protected health data is standard practice throughout research,” Bertagnolli said. “How much knowledge do we still have locked away in clinical trial databases, electronic health records and research laboratories? We no longer have excuses for not sharing data because technology exists that can allow us to honor the wishes of our patients for data use and to combine analyze and visualize data from many different sources. We still lack a commitment to this goal.”
Optimize the workforce
“We need to nurture a cancer care and research workforce that is diverse, reflects the community we serve, and meets the needs of all people with cancer and those at risk for cancer,” she said.
Engage every person
Every person with cancer or at risk for cancer should have an opportunity — if they wish to do so — to participate in research or otherwise contribute to the collective knowledge base, Bertagnolli said. Barriers to participation must be eliminated, she added.
“We lament the fact less than 10% of [patients with cancer] in the United States participate in clinical trials,” she added. “We agonize over issues related to informed consent, responsibility for data security and intellectual property.
“The answer, however, is to listen to our patients,” she added. “They are demanding more access to clinical trials and more use of their data. We must make this possible. I am convinced by my own experience that if we just honor the wishes of people whose data we need, we will make tremendous progress.”
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Bertagnolil MM. NCI director’s remarks. Presented at: ASCO Annual Meeting; June 2-6, 2023; Chicago.
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