Biden’s Moonshot Initiative Aims to Halve Cancer Deaths by 2047. How?

The White House is calling on the health and science community to put all hands on deck to reduce cancer death rate by at least 50% over the next 25 years and in so doing, “end cancer as we know it today.”

President Joe Biden revamped the Beau Biden Cancer Moonshot Initiative, which he led during his last year as vice president under the Barack Obama administration.

Nearly 2 million new cancer cases are expected to be diagnosed and more than 600,000 deaths are expected in 2022. But with renewed investment in cancer prevention, detection, and treatment, the administration said it’s possible to reduce cancer deaths by at least half in the next two decades.

“It’s bold, it’s ambitious, but it’s completely doable,” Biden said.

The moonshot program, named for Biden’s eldest son, who died of brain cancer in 2015, began five years ago and was slated to continue for two more.

Congress in 2016 allocated $1.8 billion to support the moonshot initiative over a seven-year-period. There is $400 million left for 2022 and 2023. But the relaunch did not include any new funding.

The sweeping plan calls on experts to put their heads together to accelerate scientific discoveries, increase data sharing and institutional collaboration, and ameliorate cancer care in underserved segments of society.

“The Biden administration re-upping the moonshot really tells us as cancer researchers how committed the administration is to what we do and the difference we make in the lives of cancer patients,” Kevin Haigis, PhD, chief scientific officer at Dana-Farber Cancer Institute and associate professor of medicine at Harvard Medical School, told Verywell. “What we see as cancer researchers is a real, concrete, long-term commitment to curing cancer through research.”

The Plan to Curtail Cancer Deaths

The moonshot blueprint calls for a “cancer cabinet,” in which representatives from 19 federal departments and agencies collaborate to set and achieve goals for improving cancer detection and prevention.

In 2016, then-Vice President Biden organized a panel of top cancer researchers and health providers to inform the new initiative. Deborah K. Mayer, PhD, RN, a professor at the University of North Carolina School of Nursing, was tapped to be the nurse representative on the panel. Mayer said she was impressed then by Biden’s ability to forge partnerships and encourage collaboration in cancer care.

“Having all those different agencies around the table will be very helpful in reducing barriers to care,” Mayer told Verywell.

Unlike the previous iteration of moonshot, the reinvigorated plan goes beyond research to support practical medicine, like promoting screenings and improving electronic records access.

The first step in reducing cancer deaths is to minimize the number of cancer cases. The White House announced a call to action to make up for the more than 9.5 million cancer screenings that were missed due to the COVID-19 pandemic.

Improved at-home testing capacity and expanded access to community health centers during the pandemic can make it easier to test for diseases like cervical cancer and colon cancer.

Some of the moonshot programs have found new ways to catch cancer early on—a key tool for effectively treating it. “Five years ago, detecting many cancers at once through blood tests was a dream,” the White House said.

Now, blood tests can aid in the diagnosis of many cancers and new “liquid biopsies” show promise in detecting DNA fragments from dozens of cancers in the blood.

Still, screening all Americans for various cancers is no small task. Haigis said that energy is better invested in developing therapeutics that allow cancer patients to live longer, fuller lives. Extending the life expectancy of individuals living with cancer also decreases the death rate.

“Early detection is more of a pie in the sky type of approach to reducing the cancer death rate,” Haigis said. “I would say a more realistic route to reducing the death rate, especially in that short amount of time—25 years—is by turning cancer into a chronic disease rather than a disease that results in death.”

Making Strides in Personalized Therapeutics

Projects funded by the National Cancer Institute are investigating ways to prevent cancer from the outset. The COVID-19 pandemic ushered in practical mRNA vaccine technology that had long been in development. This platform may be used to train the immune system to stop cancer cells when they first appear, as they do when used against viruses.

Cancer patients may receive a treatment like chemotherapy and radiation, which broadly target quickly multiplying cells. Now, researchers are making strides in immunotherapies, which use the immune system to attack cancerous cells. Such approaches will allow providers to more directly target cancerous growths and minimize damage to other tissues.

“Right now, we have immunotherapies that are very effective, but they’re very effective for a small number of people,” Haigis said. “What we really need to do is to branch out in the number of different immunotherapies that we have available to patients.”

Bolstering developments in machine learning, tumor genotyping, blood-based biomarkers, and health records systems, can help scientists to create more personalized treatments for cancer patients.

The administration’s call to address barriers to collecting and sharing data may further expedite discoveries. For example, through the Human Tumor Atlas Network, scientists can map the changing characteristics of cancers over time.

A focus on combatting the most common cancers—including breast, lung, prostate, and colorectal cancers—can improve outcomes for many cancer patients. But investment in better understanding, diagnosing, and treating more rare cancers can make a big impact, too.

“Meaningful progress may be in understanding how a rare cancer develops—that might apply to a lot more cancers,” Mayer said. “What we learn everywhere may apply in places that we can’t even imagine.”

While working to cut death rates with novel diagnostic and therapeutic technologies, Mayer said it’s important to draw on existing knowledge about cancer prevention will help minimize cancer incidence in the long-term.

People who work with cancer have long known the risk factors of some of the most common cancers, including behavioral factors like smoking, unbalanced diets, and a lack of exercise.

“If we applied what we know today, we would be well on our way to that goal. The problem is that we do not systematically implement the things that we know would make a difference,” Mayer said.

Reducing Disparities

Efforts to expand health services to hard-to-reach communities during the pandemic through at-home screenings, mobile testing sites, and bolstering community health networks has reduced barriers to care in myriad ways. Drawing on these approaches can make cancer care more equitable.

“The pandemic that has affected everything we do, from the way that we treat patients, the way the hospital operates, and the way we think about approaching cancer treatments and cures,” Haigis said.

In research, too, collecting samples for trials without participants needing to travel could improve diversity across race, gender, region, and resources.

Even when cancer screenings and treatments are available, having the means to access them can be the key difference in outcomes. The Affordable Care Act expanded health-insurance access to tens of millions of Americans. Still, prescription drugs can be prohibitively expensive, and costly treatments and lifestyle adjustments that come with a cancer diagnosis can exacerbate disparities.

Healthcare, Mayer said, is “notoriously slow” at adapting to change. But the introduction of telehealth during the pandemic shifted the way many health professionals provide care, and may become a permanent fixture, she said.

In addition to cancer research and treatment, minimizing risk factors for cancer could have long-term effects. The Environmental Protection Agency, for instance, might consider how environmental pollutants disproportionately impact people living in certain regions or with lower incomes.

Reducing disparities and keeping the patient top of mind when providing care and developing new diagnostics or treatments will remain important in coming years, Mayer said.

“It’s not just about the disease, it’s about the person with the disease,” she said. “And if we don’t keep that in mind, it can be really problematic. You can reduce the death rates, but if their quality of life isn’t maintained, what are we doing?”

Making Moonshot Feasible

Clinical trials and cancer centers are expensive to run. To continue funding cancer research, Biden urged Congress to pass the Advanced Research Projects Agency for Health program. It seeks $6.5 billion in seed funding to improve the government’s capacity to speed research to improve human health and will focus initially on diseases like cancer and Alzheimer’s.

It isn’t yet clear exactly how much funding is required to accomplish the moonshot’s objectives, nor whether Congress will provide it. In the meantime, residual funds can support research.

Cutting cancer deaths in half in just 25 years is an ambitious goal, worthy of a title that references John F. Kennedy’s campaign to put a man on the moon, Haigis said. He said he’s encouraged by the number of people bringing ideas and expertise to cancer research from various fields.

“Cancer is not a simple problem—that’s why we haven’t cured it in the past 50 years,” Haigis said. “We’re certainly not going to cure it in the next 25 years, but there are obvious places for us to go and it requires expertise from all areas of science and technology.”