President Obama’s call for a new national effort against cancer – a “moon shot” – comes at a most opportune time. Cancer research has advanced significantly and now genomic analysis of individuals’ tumors can reveal the specific DNA changes that drive cancer growth.
Our patients at Dana-Farber/Brigham and Women’s Cancer Center and Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, through the Profile research project, are benefitting from this, using the powerful technique of next-generation sequencing – scanning more than 300 cancer-related genes in every patient’s tumor to look for abnormalities. In a growing number of cases, the DNA changes can be targeted by precision therapies such as designer drugs that block overactive growth pathways. Often it will take combinations of targeted drugs to halt cancer progression, and many studies of these combinations are underway.
At the same time, there’s enormous promise in the field of immunotherapy. We’ve learned how to boost the body’s natural defenses against cancer, and how to remove the molecular “brakes” that cancer cells exploit to hide from immune soldier cells and hinder their attack on tumors. Drugs that help the immune system fight cancer are coming quickly to the market, and there is promising research on related strategies such as cancer vaccines and genetic manipulation of immune cells to recognize cancer cells in the body.
Last week some of my Dana-Farber scientist colleagues and I joined a delegation of other leading cancer researchers assembled by the American Association for Cancer Research to discuss this initiative with Vice President Joe Biden’s staff. They were looking to experts to suggest some high-value, near-term actions, and we made two recommendations.
“Together – researchers, academics, insurers, pharma and government – will make this moon shot successful and alleviate the suffering of so many patients and families. This is our challenge and opportunity.”
-Barrett Rollins, MD, PhD
First, researchers are collecting enormous amounts of data from genomic tumor analysis – data that can be linked to information on how patients’ cancers respond to targeted drugs. But if we’re going to make progress we must compile data from thousands of patients with many types of cancer to help discern patterns so that we can accelerate the development of precision cancer medicine. Today, much of this information resides in unconnected databases around the country. The Office of the National Coordinator for Health Information Technology can be a central repository for these data.
Second, panels of tests such as the kind that we do with Profile, can help improve patients’ outcomes, but they are costly. Now, these expenses are mainly being covered by philanthropy and institutional funds or out-of-pocket payment by patients, but this can’t continue. We hope that Vice President Biden can address this important issue so that these tests are covered by Medicare and other third-party payers. Now is the time for insurers to step up and make cancer gene testing widely accessible.
This is an exciting time to be a cancer researcher. We’ve made so much progress and we see the promise of what’s ahead. Together – researchers, academics, insurers, pharma and government – will make this moon shot successful and alleviate the suffering of so many patients and families. This is our challenge and opportunity.
Dr. Rollins is the chief scientific officer at Dana-Farber Cancer Institute and the Linde Family Professor of Medicine at Harvard Medical School.