The White House convened the Cancer Cabinet to establish a prioritized agenda including the development of new interagency programs and collaborations and announced initial steps for the Cancer Moonshot
On February 2, 2022, President Biden reignited the Cancer Moonshot with renewed White House leadership and new ambitious goals: to reduce the death rate from cancer by at least 50 percent over the next 25 years, and improve the experience of people and their families living with and surviving cancer — and, by doing this and more, end cancer as we know it today.
Yesterday, the President and First Lady Jill Biden joined a Cancer Cabinet meeting that included senior White House officials and leadership from across federal departments and agencies of the Biden-Harris Administration. The group further defined priorities for the Cancer Moonshot agenda for 2022 and beyond, with a focus on what the Cancer Cabinet agencies can accomplish through new programs and collaborations.
“All of us are moving heaven and earth to meet the President and First Lady’s call, because we know what’s at stake,” said Dr. Alondra Nelson, head of the White House Office of Science and Technology Policy. “All across America, in every town and every county, in every city and every community, all of us know what it means to feel the pang of loss. All of us, sitting here at this table today, can conjure up the face of the person we love – dad, sister, uncle, coach, teacher, friend. That person we think about every single day. And whom we’d give everything to have by our side. Today is about all of us, honoring all of them. What’s next is doing what we can together that is more collaborative and innovative than ever before.”
Ambassador Susan Rice, White House Domestic Policy Advisor, Dr. Francis Collins, Acting Science Advisor to the President, and Dr. Danielle Carnival, White House Cancer Moonshot Coordinator also helped kick off the meeting.
As part of this meeting, the White House is announcing the following new steps as initial progress towards realizing President Biden’s vision.
Initial steps for a reignited Cancer Moonshot:
- Creating a Cancer Moonshot Scholars program to invest in the next generation of diverse, innovative cancer researchers. The Biden-Harris Administration intends to create a new early career fellowship program at the National Cancer Institute (NCI) starting in fiscal year 2023 with a focus on developing a cancer research workforce that is more representative of the United States population. The goal of the Cancer Moonshot Scholars program will be to inspire and support the next generation of world-class and diverse scientists and health innovators focused on breakthroughs that will make a difference for patients and drive progress toward the goal of ending cancer as we know it today.
- The Food and Drug Administration (FDA) is pursuing steps to significantly reduce tobacco-related morbidity and mortality in the United States as part of cancer prevention efforts. FDA is working to advance a set of tobacco product standard regulations that is intended to lower initiation, addiction, and continued use of combustible tobacco products. As part of this effort, the FDA is working on a proposed menthol product standard rule that would prohibit menthol as a characterizing flavor in cigarettes and a proposed flavored cigars product standard rule that would prohibit the use of characterizing flavors (e.g., fruit flavors, menthol) in cigars. These product standards, if finalized, would represent the most significant regulatory actions to-date to limit the death and disease toll of highly addictive and dangerous tobacco products on the market today. These product standards are anticipated to benefit the population as a whole while also advancing health equity by addressing disparities associated with tobacco product use. Tobacco use is a leading cause of cancer and death from cancer. In fact, about 30 percent of all cancer deaths in the United States are caused by smoking.
- The Department of Defense (DOD) is expanding a signature clinical research program to all DOD hospitals. As part of the Cancer Moonshot in 2016, the DOD launched the Applied Proteogenomics OrganizationaL Learning and Outcomes (APOLLO) network as a collaboration between NCI, the DOD and the Department of Veterans Affairs (VA). The goal of this collaboration is to incorporate proteogenomics into patient care as a way of looking beyond the genome, to the activity and expression of the proteins that the genome encodes. To-date, this network includes thirteen DOD and VA hospitals which started with eight cancer-specific programs, including studies in lung, breast, prostate, ovarian, pancreatic, testicular, and brain cancers, and is now expanding to all cancer types. DOD, as part of the reignited Cancer Moonshot, will now ensure that the APOLLO trial network expands to include every DOD hospital.
- The VA is initiating rulemaking to consider presumptions of service connection for nine rare respiratory cancers in relation to military environmental exposure to particulate matter. Based on a focused review of scientific and medical evidence related to exposure to fine particulate matter and the subsequent development of rare respiratory cancers, the Secretary of VA plans to propose a rule that will consider presumptive service connection for several rare respiratory cancers for certain veterans. The presumptions would make it easier for affected to Veterans obtain VA healthcare and other benefits. The cancers under consideration include: squamous cell carcinoma of the larynx, squamous cell carcinoma of the trachea, adenocarcinoma of the trachea, salivary gland-type tumors of the trachea, adenosquamous carcinoma of the lung, large cell carcinoma of the lung, salivary gland-type tumors of the lung, sarcomatoid carcinoma of the lung, and typical and atypical carcinoid of the lung.
- NCI will connect underrepresented populations to clinical trials and build capacity in cancer control research in persistent poverty areas. NCI is launching an effort to implement and evaluate multilevel and culturally tailored outreach and education interventions with the primary goal of increasing referral and ultimately, accrual of underrepresented racial and ethnic minority populations, to NCI-supported clinical trials. NCI will also support several Specialized Centers to build capacity in cancer prevention and control research and to promote the implementation of programs and practices in institutions, clinics, communities, and tribes to alleviate the health-related effects of the persistent poverty in some of these areas.
- The Office of Science and Technology Policy will lead an effort to provide scientific support to assess and address cancer risks from air pollution in environmental justice communities. OSTP will convene an interagency group on air quality and community health research through the National Science and Technology Council (NSTC). The subcommittee will work to accelerate research to identify inequities in air pollution exposure and inform policy decisions to address disproportionate health risks in environmental justice communities in service of cancer prevention.
Highlights of Additional Biden-Harris administration actions:
- The Centers for Medicare & Medicaid Services in February announced a national coverage determination (NCD) that expands coverage for lung cancer screening with low dose computed tomography (LDCT) to improve health outcomes for people with lung cancer, a decision aimed at improving early detection of non-small cell lung cancer. This final decision expands eligibility for people with Medicare to get lung cancer screening with LCDT by lowering the starting age for screening from 55 to 50 years and reducing the tobacco smoking history from at least 30 packs per year to at least 20 packs per year.
- The Environmental Protection Agency, in support of President Biden’s State of the Union address, announced impactful new steps to clean our air and water, which will contribute to cancer prevention, as part of the implementation of Bipartisan Infrastructure Law. This includes:
- $1 billion to initiate cleanup and clear the backlog of 49 previously unfunded Superfund sites and accelerate cleanup at dozens of other sites across the country, with work expected at more than 80 Superfund cleanup projects in the next year. Many of these legacy sites expose Americans to many contaminants that have been shown to cause an increased risk of cancer and other health effects.
- $7.4 billion for Fiscal Year 2022 in Bipartisan Infrastructure Law funding will be available to states to upgrade America’s aging water infrastructure, sewerage systems, lead pipes and service lines, and more through their State Revolving Fund programs. By this time next year, using Bipartisan Infrastructure Law funding alone, EPA will have worked with state and local governments to fund more than 400 new water projects from replacing lead service lines to improving drinking water systems. This means millions of American families will be protected from Per- and Polyfluoroalkyl Substances (PFAS) or “forever chemicals” in their water. Peer-reviewed scientific studies have shown that exposure to certain levels of PFAS may lead to increased risk of some cancers, including prostate, kidney, and testicular cancers.
- The FDA released cancer clinical trial guidances that involve addressing inequities, targeting treatments to patients, speeding progress against the most deadly and rare cancers, and learning from the experience of more patients, all central pillars of the Cancer Moonshot. These include:
- The first guidance, “Inclusion of Older Adults in Cancer Clinical Trials,” provides recommendations to sponsors and institutional review boards for including older adult patients, aged 65 years and older, in the clinical trials of drugs for the treatment of cancer. It recommends enrolling older adults in early phase studies of cancer clinical trials, if appropriate, to obtain information that better informs later phase studies. It also includes recommendations for trial design, recruitment strategies, information collection, and developing and reporting more discrete age groups to encourage enrollment of this historically excluded population.
- The second guidance for industry “Expansion Cohorts: Use in First-in-Human Clinical Trials to Expedite Development of Oncology Drugs and Biologics,” provides advice on designing and conducting trials with multiple expansion cohorts that allow for concurrent accrual of patients into different cohorts to assess safety, pharmacokinetics, and anti-tumor activity of first-in human cancer drugs. Pharmaceutical companies and researchers can use trials with expansion cohort design to assess many different aspects of a drug in a single clinical trial to efficiently expedite the clinical development of the drug.
- Finally, the “Master Protocols: Efficient Clinical Trial Design Strategies to Expedite Development of Oncology Drugs and Biologics” guidance addresses master protocol design including information on what sponsors should submit to the FDA as part of these trial design approaches. It also directs how sponsors should interact with the FDA to facilitate efficient review and mitigate risks to patients. These clinical trials can help expedite the clinical development of a drug to treat cancer because they allow more than one investigational drug or biologic, more than one disease type, or more than one patient population, to be evaluated under a single clinical trial structure.
About the Cancer Cabinet
When President Biden re-ignited the Cancer Moonshot in February 2022, he announced a whole of government response, including the formation of a Cancer Cabinet to be convened by the White House, bringing together departments agencies, and other White House components across government to address cancer on multiple fronts. These include the Department of Health and Human Services (HHS), Department of Veterans Affairs (VA), Department of Defense (DOD), Department of Energy (DOE), Department of Agriculture (USDA), Environmental Protection Agency (EPA), National Institutes of Health (NIH), National Cancer Institute (NCI), Food and Drug Administration (FDA), Centers for Medicare & Medicaid Services (CMS), Centers for Disease Control and Prevention (CDC), Office of Science and Technology Policy (OSTP), Domestic Policy Council (DPC), Office of the First Lady (OFL), Office of the Vice President (OVP), Office of Management and Budget (OMB), Office of Legislative Affairs (OLA), Office of Public Engagement (OPE), along with additional members, as needed, to help establish and make progress on Cancer Moonshot goals.