September 22, 2016 by Douglas R. Lowy, M.D.
Cancer, like many other diseases, doesn’t exist within the geographic borders of any single country. Its burden is felt around the world and that burden is growing in many countries. According to the most recent estimates, worldwide, there were approximately 14 million new cancer cases in 2012. And that number is expected to swell by an additional 10 million cases over the next two decades.
In April, while speaking alongside Pope Francis at a Vatican event, Vice President Biden stressed the role that biomedical research can—and, indeed, must—play in addressing the impact of cancer and other diseases on global health.
“We stand on the cusp of unprecedented scientific and technological changes that were once unimaginable breakthroughs,” he said. “But we cannot forget that real lives and real people are at the heart of and the reason for all that we do.”
On that day, the Vice President called on the international community to build on the momentum of the Cancer Moonshot effort, asking leaders from across the globe to commit to making renewed and focused investments in cancer research, including increasing patient access to the latest treatment opportunities provided through research studies and increasing researchers’ access to patient data.
Earlier this week, in conjunction with the 71st session of the United Nations General Assembly in New York, we took concrete steps toward establishing international collaborations that can help bring us closer to achieving this goal.
Pursuing Progress on Multiple Fronts
On September 19, I was privileged to join NIH Director Francis Collins, M.D., Ph.D., White House Director of the Office of Science and Technology Policy John Holdren, Ph.D., Health and Human Services Secretary Sylvia Burwell, and senior health leaders from Japan and the Republic of Korea in a trilateral meeting to discuss potential collaborative efforts around cancer prevention and screening, targeted therapy, data sharing, and other research efforts intended to reduce the cancer burden.
Importantly, this meeting directly followed from meetings earlier this year between President Obama and the prime ministers of Japan and Korea in which he asked them to be part of the Cancer Moonshot.
Also in New York, we joined with other NIH leaders to announce the signing of a series of Memoranda of Understanding (MOU) with several countries focused on improving cancer treatment and data sharing involving proteogenomics research—that is, studies that use data from gene- and protein-based analyses to drive treatment decisions.
Specifically, the MOUs—which cover 14 institutions in 7 countries—will greatly expand the number of patients participating in NCI’s Applied Proteogenomics OrganizationaL Learning and Outcomes (APOLLO) consortium. The consortium will provide genomic and proteomic profiling of patients with lung cancer within the U.S. Department of Defense and Veterans Administration health systems, with the goals of deepening our understanding of cancer and enabling researchers to more rapidly and accurately identify therapies based on each patient’s unique proteogenomic profile.
The MOUs between NCI/NIH and research institutions and state governments in Australia, for example, will open research studies to an expected 8,000 American and 50,000 Australian patients by 2021.
In addition to Australia, proteogenomics MOUs were signed with research institutions in Canada, Germany, China, Korea, Taiwan, and Switzerland.
The United Nations General Assembly meetings also offered an opportunity to discuss other potential collaborations with health leaders from many countries.
Perhaps foremost among these opportunities are those intended to help translate important research findings on prevention, cancer control, and treatment into policy and practice changes in low- and middle-income countries (LMIC). In most of these countries, cancer incidence and mortality rates are increasing, but the countries often lack the resources and infrastructure to address the problem in a systematic way.
As part of this effort, NCI has developed a research framework that will establish a network of Regional Centers of Research Excellence that will support partnerships between high-income countries and LMICs. The partnerships will help plan and design regional hubs to coordinate basic, translational, clinical, and population science research on specific issues relevant to each LMIC.
For example, centers would be established to help build a pathology-based cancer registry to study breast, uterine, and cervical cancers in Bangladesh and a country-wide, clinic-based method to prevent and control breast and oral cancers in India. Other countries involved in this program include Vietnam, South Africa, Mexico, Guatemala, Costa Rica, Colombia, and several others.
Taking Advantage of Unparalleled Opportunities
Our national investment in biomedical research and advanced technologies has created this moment, one in which we have an unparalleled opportunity to rapidly increase our understanding of this collection of disease we call cancer and, importantly, develop innovative ways to prevent, diagnose, and treat them.
By expanding our outreach and finding new and innovative ways to take advantage of relationships that span borders—among researchers, industry, governmental and non-governmental health organizations—we can accelerate progress in a way that, at one time, many might have considered to be impossible.
In doing so, we can continue to transform how we think about cancer, approaching it not as something to be feared, but something we understand well and know how to prevent and treat effectively—not just in wealthier nations, but in all nations.