Editor’s Desk

Taking shots at the cancer moonshot before takeoff

Peter Wehrwein

The Obama administration is seeking $1 billion for a cancer moonshot (the unofficial name but it seems likely to stick).

But even before the first dollar has been spent, the cancer initiative has launched a volley of opinions and critiques about its goals, organization, and scope.

Some have said a billion dollars may seem impressive but is paltry relative to the need. It's a slingshot not a moonshot in the opinion of some experts, the New York Times reported.

Meanwhile, a news piece in Science offered a peek into the infighting that might break out. Some researchers are apparently worried that "plumping up" favored NCI programs will divert money from others and that funds for investigator-initiated research could grow more slowly.

Vinay Prasad, an assistant professor at Oregon Health and Science University who has been making some waves with his research and book about medical reversals, wrote an opinion piece in the Washington Post questioning the focus on the FDA and drug approvals. Prasad wrote in the Post that a "serious moonshot" would fund science more broadly and consistently.

Ronald DePinho

Ronald DePinho

Here at Managed Care we interviewed Ronald DePinho, president of MD Anderson, for a piece about the cancer moonshot in our February issue. DePinho and his colleagues can take some credit for the moonshot moniker: The Houston, Texas, cancer center has launched "moonshots" for 13 different types of cancers.

A program at a single cancer center — even one as large as MD Anderson — and a federal cancer initiative are quite different. Still, DePinho had some takeaways. For example, he advised setting concrete goals. "You don't want to just fund activity," he told us. "You want to fund milestone-driven projects that are going to meet a particular endpoint."

Should the cancer moonshot take on skyrocketing treatment costs? DePinho tread carefully, noting that costs were complicated and, in his opinion, the private sector's interest in drug development needed to be preserved. But he held out "science-driven drug discovery" as a potential cost saver. A better understanding of cancer could, he argued, reduce the failure rate in clinical trials, which would, in turn, reduce development costs: "If 19 out of 20 drugs in clinical trials fail, you are paying for those failures as well as the 1 in 20 success."

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