Reinvigorating the Cancer Moonshot with empowered patients
The Biden administration has made various organisational and financial efforts to kick-start a renewed push against cancer. Ben Hargreaves looks at how the Moonshot initiative has been restarted and how CancerX aims to bring together various partners to promote innovative work to reduce cancer deaths.
In 2016, the US White House launched the ‘Cancer Moonshot’ effort. The initiative was initially led by then Vice President Biden, after he lost his son Beau to brain cancer in 2015. Shortly into his initial term, President Biden renewed the Cancer Moonshot, with the aim to reduce the death rate from cancer by at least 50% over the next 25 years. Alongside this goal, the White House stated that it also wanted to improve the experience of people and families living with and surviving cancer.
Supporting the broader objectives of the Moonshot was the creation of a ‘Cancer Cabinet’, which is made up of individuals, healthcare providers, and leaders across the sector to take action in five key priority areas:
- Close the screening gap
- Understand and address environmental exposure
- Decrease the impact of preventable cancers
- Bring cutting-edge research through the pipeline to patients and communities
- Support patients and caregivers
As part of this collective action, the White House also announced the creation of ‘CancerX’, a public-private partnership launched by the Department of Health & Human Services. The plan for this organisation is to act as a ‘national accelerator’ to boost innovation in the fight against cancer. One such way this will be carried out is through a push into greater adoption of digital tools. Another major part of the movement is to address the inequality of health access, outcomes, and economic disparities associated with cancer.
Returning to the Moonshot
As part of the efforts to reinvigorate the Moonshot programme, the White House has made several announcements in 2023. This involved appointing members to a National Cancer Advisory Board, which guides the National Cancer Institute (NCI) on setting priorities for the national cancer research programme. Six individuals with experience within cancer research were appointed at the beginning of the year to fulfil this role. The White House also revealed the inaugural cohort of ‘Cancer Moonshot Scholars’, who would be provided with funding to concentrate on projects to increase prevention and early detection efforts for patients from underrepresented populations, create new cancer treatments, and conduct research into hard-to-treat cancers.
Outside of forming and curating expertise, the Biden-Harris administration also provided $115 million to three projects that are working on research in support of the Moonshot. Two of the awards will go towards developing new ways to treat cancer. Rice University will use the funds to develop a minimally invasive implant to sense and respond to specific doses of medicine, helping the body to better respond to cancer treatments. The second project sees the University of Missouri work on the development of bacteria that are able to specifically target tumours. The additional project is led by Georgia Institute of Technology and aims to understand the cellular profiles unique to cancer cells.
A major part of the action to propel the relaunch of the Moonshot was the creation of CancerX. In June 2023, the organisation stated that its founding members were composed of over 90 companies that had partnered with the organisation to realise the goals of the Moonshot. By September, this number had increased to over 125 members. In respect of the efforts to make cancer treatment and care more equitable, CancerX will leverage digital solutions that are able to improve the lives of all people with cancer.
CancerX announced in September the creation of a steering committee, comprised of 12 industry members, to provide support and oversight to achieve the Moonshot’s goals. In addition, the committee will have representation from various government agencies, serving in non-voting observer roles.
One of the most recent members to join forces with CancerX is the Patient Empowerment Network (PEN), which is a virtual non-profit set up to aid health literacy, equity, and treatment outcomes for cancer patients. In terms of how the organisation fits into the CancerX effort, PEN noted the importance of having each cancer patient be able to access information needed to engage in shared decision-making.
Speaking to pharmaphorum, Tracy Rode, executive director of PEN, explained the network’s purpose, and how this dovetails with the aims of CancerX: “We know there is a tremendous impact of social determinants of health in survival of a cancer diagnosis, particularly access to local care and financial resources. We have aggressive goals to reach more patients, earlier in their cancer journey and all the way through their post-treatment survivorship, to help them increase their knowledge and confidence to act. PEN’s cancer education programmes help create actionable steps to allow patients and care partners to be more confident in their discussions with treatment providers.”
Rode outlined the efforts of PEN’s programmes, which involve helping enable patients and care partners to navigate barriers that could impact access to care, allowing them to “ask the right questions, at the right time.” Rode stated that the programmes aim to:
- Help underrepresented patients overcome barriers/bridge gaps in care, access clinical trials, understand biomarkers and testing, and access easy-to-understand, medically-vetted education for their entire cancer journey, from diagnosis through post-treatment/survivorship wellness. The programmes will soon address early detection and end-of-life.
- Offer direct support through Empowerment Leads, volunteers who are survivors, or care partners. They offer personal experiences through online videos, as well as direct contact options. This provides those going through cancer the opportunity to get answers to non-medical questions, as well as have the support of someone who has walked that road. They also offer a closed Facebook Group and X (Twitter) patient chat channel.
- Deliver training in online literacy for the technologically inexperienced, both through partner organisations and directly to patients via self-paced training.
- Assist care partners in supporting, understanding, and participating in their patients’ cancer treatment decisions.
- Share strategies with healthcare providers to help them learn to better communicate with patients and engage patients in decision-making about their treatment and desired outcomes.
- Based on the National Cancer Institute’s cancer experience map, where the patient voice is considered and incorporated into treatment decisions, engagement strategies, and behavioural goals.
One of the overarching objectives of PEN is that providing such information can contribute to health equity – the concept that all patients should get the care they need to achieve the best health outcome, regardless of where they live, their race, ethnicity, education level, or language spoken. This was also stated as a major aim on the founding of CancerX. Rode said that PEN’s work in this area involves helping patients to feel connected with resources to aid understanding, and also to collaborate with healthcare professionals to promote shared decision-making.
“PEN works to help all patients embrace their role in shared decision-making by providing educational content; our data shows it leads to action and more confident communication with their medical team [...] Patients who are active in their care decisions have been shown to have better treatment outcomes,” Rode concluded.