10 Cancer Moonshot Blue Ribbon Panel recommendations embraced by NCI

When 28 distinguished individuals convened earlier this year to help shape the scientific mission at the National Cancer Institute (NCI) of Vice President Joe Biden's National Cancer Moonshot Initiative, they were given five months to draft guidelines to accelerate cancer research, prevention and care. On Wednesday, the National Cancer Advisory Board approved the Blue Ribbon Panel's 10 recommendations.

"In a very limited amount of time we were able to come together to address important topics to help Vice President Biden's mission to make a decade's worth of advances in cancer prevention, diagnosis and treatment in just five years," said Blue Ribbon Panel member, María Elena Martínez, PhD, Sam M. Walton Endowed Chair for Cancer Research at University of California San Diego School of Medicine and co-lead of the Moores Cancer Center's Reducing Cancer Disparities research program. "My hope is that not just the National Cancer Institute, but other organizations and industry as well, take these recommendations to heart and contribute to moving these guidelines forward."

Martínez co-chaired the Implementation Science Working Group, which was tasked with drafting recommendations that improve cancer outcomes by identifying and testing methods that more effectively implement evidence-based interventions for cancer prevention, risk assessment, screening and early detection, and prognosis, treatment and survivorship.

"In some areas of cancer research, be it prevention or treatment, we actually have evidence of what works," said Martínez. "A lot of research goes behind these guidelines. In some populations, specifically those that do not have the means to get to a physician, to get to a hospital, who don't have health insurance, these guidelines don't get implemented. Some of it has to do with educating the community, making sure they are part of the implementation of these guidelines and that they're at the forefront of moving this forward."

The group recommended expanding use of proven prevention and early detection strategies to further address tobacco cessation, colorectal cancer screening, vaccination for the human papillomavirus (HPV) and screening for hereditary cancer syndromes. This recommendation has the potential to impact large populations through prevention strategies.

In the United States, only 50 to 60 percent of people are screened for colorectal cancer; the figure drops to 20 to 30 percent among low-income individuals, said Martínez. HPV vaccinations rates are worse, with only 40 percent of age-eligible girls and 20 percent of age-eligible boys completing the recommended vaccine dosage.

"The bold but feasible cross-cutting initiatives in this report will improve outcomes for patients with cancer, prevent cancer and increase our understanding of cancer," said Douglas Lowy, MD, NCI acting director. "NCI stands ready to accelerate cancer research in the critical areas identified by the Blue Ribbon Panel."

The final 10 Blue Ribbon Panel recommendations are:

• Engage patients to contribute their comprehensive tumor profile data to expand knowledge about what therapies work, in whom, and in which types of cancer.
• Establish a cancer immunotherapy clinical trials network devoted exclusively to discovering and evaluating immunotherapy approaches.
• Identify therapeutic targets to overcome drug resistance through studies that determine the mechanisms that lead cancer cells to become resistant to previously effective treatments.
• Create a national ecosystem for sharing and analyzing cancer data so that researchers, clinicians and patients will be able to contribute data, which will facilitate efficient data analysis.
• Improve understanding of fusion oncoproteins in pediatric cancer and use new preclinical models to develop inhibitors that target them.
• Accelerate the development of guidelines for routine monitoring and management of patient-reported symptoms to minimize debilitating side effects of cancer and its treatment.
• Reduce cancer risk and cancer health disparities through approaches in development, testing and broad adoption of proven prevention strategies.
• Predict response to standard treatments through retrospective analysis of patient specimens.
• Create dynamic 3-D maps of human tumor evolution to document the genetic lesions and cellular interactions of each tumor as it evolves from a precancerous lesion to advanced cancer.
• Develop new enabling cancer technologies to characterize tumors and test therapies.