Is Biden’s cancer ‘moonshot’ initiative just creating new ‘silos’?

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It’s ironic that Vice President Joe Biden’s cancer “moonshot” initiative’s promise to break down existing silos to accelerate cancer research and discovery seems to be creating a whole new set of silos.

(In this context, the vice president has been using the term “silo” to refer to the various entities in the cancer enterprise that have been working in isolation from one another, rather than collaboratively. Playing on the moonshot metaphor, he may also be occasionally alluding to the chambers that hold guided missiles prior to firing.)

{mosads}Last week, I attended the American Society of Clinical Oncology (ASCO) annual meeting in Chicago, which, according to the society, is “the largest gathering of cancer doctors focused on groundbreaking clinical research advances and the most promising treatments in patients.”

The meeting boasted more than 35,000 attendees, of whom about 6,000 attended the vice president’s talk regarding initiatives related to moonshot.

“This year, [ASCO’s meeting theme] is harnessing the collective wisdom of oncologists around the world to put patients at the center of research and care. That’s exactly what I’m trying to do in the cancer moonshot, and it matters,” Biden said.

That’s encouraging because when the initiative was originally introduced by President Obama in January at the State of the Union address, Obama said, “Let’s make America the country that cures cancer once and for all.”

Biden reiterated moonshot’s four critical priorities:

  • Significant new federal investment in cancer research;
  • Enhanced sharing of research and patient data;
  • Increased use of team-based approaches harnessing various medical and scientific disciplines; and
  • New approaches to developing and recruiting for clinical trials.

He noted that his vision of making data-sharing a reality, the importance of developing a new mindset stressing “a lot more openness — open data, open collaboration and above all, open minds,” and mentioned a new initiative launched that day by the National Cancer Institute (NCI).

But there seemed to be a silo-like disconnect for some of us who also attended two earlier related sessions at ASCO.

One was a presentation by the NCI’s National Cancer Advisory Board’s moonshot blue-ribbon panel that did not fully present the scope of the initiative beyond its own role, but did invite questions from the audience.

When I asked who was being invited to the upcoming National Cancer Moonshot Summit to be held June 29 at Howard University, James H. Doroshow, NCI’s director of cancer treatment and diagnosis, said he did not know, but assumed it was being handled through the vice president’s office.

I also inquired about press coverage at the event, noting that one of the first moonshot venues held at the University of Pennsylvania’s cancer center had been restricted to reporters selected by the White House, according to a Penn public affairs representative.

It was also unclear if the other federal agencies involved in moonshot had complementary blue-ribbon panels doing similar work.

To many of us in the cancer-centric community, most of moonshot has seemed to revolve around the NCI orbit, often without adequate reminder of the larger context. This was reflected anecdotally by a number of ASCO attendees who were mostly aware only of NCI’s involvement.

This overarching perspective was also absent during a press briefing on the initiative that did include one of the NCI’s blue-ribbon panelists but no one representing the moonshot’s overall effort — the Cancer Moonshot Task Force — and focused largely on ASCO’s contributions.

And the best opportunity at the conference to learn more about the upcoming summit and its invitation process was later that afternoon when Vice President Biden spoke, but unfortunately he left without taking any questions.

This piece was updated on June 13, 2016 at 9 a.m.

Rosenthal is an independent journalist who covers issues, controversies and trends in oncology as special correspondent for MedPage Today. He is the founder of the National Cancer Institute Designated Cancer Centers Public Affairs Network, and helped organize a number of national medicine-and-the-media conferences. The opinions expressed belong solely to the author.

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