Promising the Moon!

Margaret Tempero
Search for other papers by Margaret Tempero in
Current site
Google Scholar
Full access

Last year, President Obama surprised me during his State of the Union address by introducing a precision medicine initiative, which I thought was pretty cool. This year I almost fell off my chair when he announced the “moonshot” program to accelerate cancer research, putting Vice President Joe Biden, who lost his son to brain cancer, in charge. It's about time!

In preparing to write this editorial, I looked up the definition of “moonshot” on, a very trustworthy Web site, I'm sure. The robotics glossary defined it like this: “A moonshot, in a technology context, is an ambitious, exploratory, and ground-breaking project undertaken without any expectation of near-term profitability or benefit and also, perhaps, without a full investigation of potential risks and benefits.” Yikes! I hope that's not what the President is thinking!

I calmed down a bit when I found Google's definition, which it has applied to some of Google's inventions: “A moonshot 1) addresses a huge problem, 2) proposes a radical solution, and 3) uses breakthrough technology.” Right! That sounds better. Cancer is a huge problem and we definitely have breakthrough technology poised for action. But how do we get to “radical solutions”?

It's hard to find out exactly what the moonshot plan proposes. The 2017 budget does include an infusion of about a billion dollars ($755 million plus some existing funds) into federal agencies, presumably to increase grant support to worthy scientists. And, as with all new and innovative programs, a task force of stakeholders will be assembled, who will be charged with hashing out the process of moving forward.

I think this new investment is sorely needed. We all know that with a flat budget, the NCI dollars are effectively decreasing because of inflation. We have pleaded for more funds for a long, long time. But is this a one-time investment or can we expect to see this kind of additional funding sustained? I sincerely hope for the latter. A billion dollars sounds like a lot of money, but considering the many areas of need, the cost of clinical trials, and the required investment in technology and infrastructure, it may not go as far as you'd think.

And how in the world will we prioritize among competing interests? A few years ago, the Recalcitrant Cancer Research Act was passed, holding the NCI accountable for investment and progress in cancers with the highest mortality rates—basically those cancers with a 5-year survival rate of 15% or less. It wasn't an appropriations bill, so no new money was involved. But maybe the moonshot program is an opportunity to provide more targeted investment for the malignancies that are difficult to diagnose early and equally difficult to treat. That makes a lot of sense to me.

So let's not waste any time on this. We need to get started. Please put on your spacesuit and buckle up. We're ready to launch!

What do you think? Please submit correspondence (include contact information) to

Dr. Tempero is a Professor of Medicine and Director of the UCSF Pancreas Center, and the editor-in-chief of JNCCN. Her research career has focused on pancreatic ductal adenocarcinoma, especially in the area of investigational therapeutics.

Dr. Tempero has served on the ASCO Board of Directors and as ASCO President. She co-directed the AACR/ASCO Methods in Clinical Cancer Research and taught this course and similar courses in Europe and Australia. She was founding Chair of the NCI Clinical Oncology Study Section (CONC) and served as a member and chair of the NCI Board of Scientific Counselors Subcommittee A. She is on the External Advisory Boards of the Pancreas SPOREs at Mayo Clinic and at UAB/Minnesota and the GI SPORE at the University of Arizona. She is, or has been, on the Scientific Advisory Boards of the Lustgarten Foundation, the Pancreatic Cancer Action Network, the V Foundation, The Alberta Canada Cancer Board, and the EORTC. She served as a member of the Oncology Drug Advisory Committee for the FDA.

She has served as Deputy Director and Interim Director for the UNMC Eppley Cancer Center. She is Chief Emeritus of the Division of Medical Oncology at UCSF and served as Deputy Director and Director of Research Programs at the UCSF Helen Diller Family Comprehensive Cancer Center.

The ideas and viewpoints expressed in this editorial are those of the author and do not necessarily represent any policy, position, or program of NCCN.

  • Collapse
  • Expand
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 256 15 1
PDF Downloads 38 3 1
EPUB Downloads 0 0 0