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 WhatIs.com, 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 JNCCN.edmgr.com.