Aiming High in the Fight to End Cancer

Joydeep Goswami discusses working on the Cancer Moonshot initiative with Vice President Joe Biden’s new task force

 

Humankind’s first step toward reaching the moon was believing we could get there.

We’re now working toward a cancer-free future with the same optimism and drive. A major effort to help achieve this goal was launched earlier this year when President Barack Obama called on Vice President Biden to lead a national “Moonshot” initiative to understand, treat, and eventually eliminate cancer—and Thermo Fisher Scientific is contributing to the mission.

On October 17, 2016, Biden’s task force announced an initial set of activities to support the goals of the Cancer Moonshot project, including forming a team to create a Blood Profiling Atlas Pilot. Thermo Fisher is proud to have been chosen as part of this team of representatives from government, academia, and the private sector who will work together to create an open database for liquid biopsies to accelerate the development of safe and effective blood profiling diagnostics.

Joydeep Goswami, president of clinical next-generation sequencing and oncology and one of Thermo Fisher’s leaders on the Blood Profiling Atlas Pilot team just returned from a press conference in Washington, DC, with Vice President Biden and the rest of the team. Joydeep shares his thoughts on this exciting new project at the forefront of the efforts to end cancer.

How did it feel to be a part of the first Cancer Moonshot Task Force press conference?

It was truly an honor to have had the opportunity. I was impressed to see how many people were at the event. It represented a wide community of people from academia, hospitals, the FDA, regulatory agencies, and government agencies—but also advocates providing support for patients going through cancer, as well as cancer survivors.

What also impressed me was Vice President Biden’s personal touch and the commitment he’s putting into the program. Clearly this isn’t just about doing a nice thing. The vice president was obviously personally affected by his son succumbing to the disease. I think he has taken a lot of time to learn about the various efforts going on in different parts of the country and internationally. One of the first efforts was actually to reach out to and coordinate with international groups trying to target cancer and introduce better treatment options. 

This is a war we’ve been waging for 45 years. So what’s changed?

President Nixon declared war on cancer in 1971, and here we are again. Vice President Biden addressed this pretty directly: He said, “Look, there’s a big difference between that war and the Cancer Moonshot project. While the war on cancer in 1971 was well-intentioned and had the right spirit to it, the reality was that it was a war waged without the right firearms.”Back then, we knew very little about cancer. We still thought it was one disease. We didn’t have much scientific evidence before we declared that war so while it brought a lot of attention to cancer, and spurred a lot of scientific discovery, it really didn’t succeed. It was perhaps a little too early to have such major goals.

So 45 years may seem like a long time, but the good news is that a lot of things have happened since then. Of course, there have been advances in science, like the Human Genome Project, and advances in sequencing. But advances in our ability to handle data. The coordination between different countries in this effort has given us a set of tools, and a basis to be fighting this war in very different ways from how it was done previously.

There are skeptics who say, “It’s been done before and you guys just didn’t get anywhere.” The vice president’s response to that was, “but things are different this time, and I think there’s humility from what we’ve learned. There’s also an understanding that we have better tools to grapple with and handle the disease.”

With so much attention on cancer in terms of funding and activities, why the Moonshot project?

Vice President Biden and Greg Simon [Cancer Moonshot Executive Director] brought up a really interesting point: while there are research activities going on, the problem is that everyone starts the process of discovery almost from ground zero. So researchers might be learning a lot of stuff that could be really helpful to the next person who’s looking into the same problem and might be funded by the same agency, but it’s not being shared. And even if it’s a different agency, ultimately the money’s all coming from the US government or other governments. The goal should not be to publish papers or to see who’s the first to publish. The goal must be to actually do something about the disease. So part of what the Cancer Moonshot project is really aiming to do is make some of this data public through the right channels, so that researchers can make advances more quickly rather than starting from ground zero every time.

The project coordinates academics, oncologists, medical personnel, the FDA, pharmaceutical companies, and of course companies such as ours, encouraging us to share under the right kind of environment—where IP is protected, and no one is losing the economic value of an invention or discovery—to accelerate the pace of discovery and not to waste money. So it’s about efficiency in terms of getting there faster, but also effectiveness in terms of finding the right cures. 

Can you tell us more about the approach the task force is taking?

The vice president and other speakers emphasized that there’s a sense of urgency that is so important to patients in this area. The whole point here is to do in five years the work that would have otherwise taken 10 years.The idea with the Cancer Moonshot project is to really get things done: to set an audacious goal, and then find ways to get there and achieve it. This is a disease that claims upwards of 600,000 lives every year in the US alone. And a lot more people are afflicted by and suffer from the disease over a long period of time. The urgency to make a difference in five years is really important.

Of course, one of the areas on the scientific side is making discoveries faster. But there are certainly other things that need to be considered in terms of how to actually encourage that innovation. For example, we need to make sure that we’re not putting barriers in the way of getting medicines or diagnostic assays to patients. It currently takes more than 10 years to get any drug into the hands of patients, so if you calculate 10 x 600,000, that’s six million patients who died while waiting for newer drugs to get to the market, given how we currently approach this area.

It’s also of the utmost importance to get the right information to doctors who don’t have it today. A startling fact is that, despite having so many clinical trials going on in oncology right now, only four percent of patients actually participate in these clinical trials. Four percent! That’s it! Clinical trials occur right now in only 10 of the 50 states in the US, which starts to then explain why only four percent of patients participate in a trial; they just can’t get into one. It’s economically very hard.

And information on trials is also very hard to come by. The Cancer Moonshot project is trying to set up ways in which it will be easier for a patient to go to a single website and get this information. So there’s work to be done in making these trials more accessible. More than 50 percent of patients are currently treated in community hospitals. They’re not the tier-one hospitals that most of us in the field know and target. The reality is that community hospitals may lack oncologists, access to the latest information, or the latest drugs and/or diagnostics. That’s part of the intent of the Moonshot. It’s not just about science; it’s about economic access, education, and training.

One more interesting point is that the Department of Defense and VA hospitals have this vast repository of samples of everyone who goes through the VA system, and now we can go back to these samples, collected over the last several years, and look for circulating tumor DNA or other protein markers. That could really be useful in accelerating some of the discoveries that we’ve been talking about in this interview.

We can compare these collected samples to the current state of individual patients, which can help us understand the disease. To be able to access and study data of clinical utility and measurability will be a huge step in the right direction.

So far we haven’t done sample databasing of this scale, and I don’t think there has been a project yet to address this, but if we can get this project going I would definitely want Thermo Fisher to be a part of that initiative and contribute resources from our end. Such an initiative could be a huge win for patients in terms of early detection and diagnosis. The biggest predictor of success in many forms of cancer is detecting it early, so if we could find ways to do that as a nation, and as part of this initiative, I think it would be a huge step forward.

How else do you see the role of our company as part of the Cancer Moonshot project?

Thermo Fisher has traditionally been focused on building tools for researchers to do what they need to get done. But now that we’re squarely in the IVD space and working with partners such as the pharmaceutical companies Novartis and Pfizer, among others, it behooves us to take much broader action. We have a part to play in terms of educating doctors, patients, and even regulatory agencies about the technologies we offer, as well as their capabilities and limits.

In thinking a little more broadly about the mission of the Cancer Moonshot project, it gives us an opportunity to have a discussion with a broader set of participants—not just researchers, but also pathologists, oncologists, regulators, some of the patient advocacy groups, and perhaps other people associated with this effort.

The initiative also lets us bring our most innovative targeted solutions against cancer to the fore, and subject them to rigorous testing by a broad set of key researchers in terms of not just performance, but also reproducibility, consistency, actionability, and cost-effectiveness. These are key parameters for a diagnostic/translational research product to make a difference in the fight against cancer, and a meaningful and far-reaching contribution to patient lives. A good initial example of this will be the cfDNA assay and data that we are sharing with the Blood Profiling Atlas Pilot.

Our platforms also have a key part to play in democratizing the availability of diagnostic solutions to all cancer patients, providing the best combination of flexibility, speed, reproducibility, and reliability to quickly process samples and provide physicians with actionable data to choose the right therapy for each individual.

For Thermo Fisher, we look forward to working with all of our partners and helping convince them to contribute data to this important initiative and helping with the transformation of clinical research. That’s a responsibility we bear. And we’ll continue to accelerate and push our R&D efforts to be able to deliver the right kinds of solutions that can really help propel these initiatives and research to help us understand and tackle cancer.

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