NCI’s Acting Director: Data-Sharing, Immunotherapy, and the Cancer Moonshot Initiative
The national Cancer Moonshot initiative, led by Vice President Joe Biden, was established to accelerate the progress in cancer outcomes, including prevention, diagnosis, and treatment. First introduced in January 2016, the initiative is focused on moving cancer research forward in a meaningful way by encouraging greater cooperation between cancer research institutions and increasing data-sharing for that purpose, said Douglas R. Lowy, MD, Acting Director, National Cancer Institute (NCI), at the 2016 American Association of Physicists in Medicine annual meeting in Washington, DC.
The Moonshot Federal Task Force, a first-of-its-kind task force, will work with various federal agencies, including the FDA, the NCI, and the National Institutes of Health (NIH), and with help from a Blue Ribbon Panel of experts, to achieve key cancer-related milestones, according to Dr Lowy. The Blue Ribbon Panel includes top cancer experts who will provide access to the best available science in oncology.
Data-sharing is at the forefront of the Cancer Moonshot initiative that can break down barriers between institutions and help fast-track the exchange of knowledge toward the translation into clinical practice. Dr Lowy highlighted several NCI-sponsored projects related to data-sharing efforts, including the Cancer Imaging Archive, an open-access archive for deidentified imaging data. The Cancer Imaging Archive currently houses information from 33,000 patients with cancer and 67 data sets, of which 21 have been matched to genetic mutations linked to cancer found in The Cancer Genome Atlas (TCGA).
He introduced the Genomic Data Commons, a repository for publicly available annotated cancer research. “For the NCI, one of the ways in which we are reflecting the importance of data sharing is through the development of the Genomic Data Commons, whose long-term goal is to have annotated patient-level clinical data and various -omics in it,” Dr Lowy said.
The Genomic Data Commons will include data from NCI-supported clinical trials, and will provide opportunities for others to add their annotated cancer information. This repository includes approximately 14,000 cancer specimens from TCGA and the pediatric version, TARGET.
In fact, Foundation Medicine, a genomic research company, agreed to add 18,000 cancers to the Genomic Data Commons, with an analysis of approximately 350 genes, Dr Lowy reported. “We look forward to this being just the first of many such contributions, whose, by increasing the size and annotation of the database, that it will become progressively more useful for the cancer research community,” he said.
Immunotherapy and Combination Therapy
Several proposals from NCI include NIH leadership in various areas of cancer research. “One important area in cancer treatment is to increase immunotherapy trials and combination trials, which include chemotherapy, radiation therapy, and other kinds of approaches. Immunotherapy has found a place in areas where we really don’t have, if you will, contemporary treatment,” Dr Lowy said. He highlighted the example of the PD-1 immunotherapy nivolumab (Opdivo), which has demonstrated superior efficacy over standard chemotherapy in metastatic melanoma.
In addition, a drug formulary developed from multiple companies at NCI can help facilitate the study of combination therapy: several companies have already expressed interest in providing their investigational and FDA-approved drugs for use in combination treatments that involve drugs from more than a single company, according to Dr Lowy.
“We think that this will drastically shorten the turnaround time from thinking about doing a trial to actually being able to initiate it,” Dr Lowy emphasized.
Prevention and Screening
Research proposals for cancer prevention, screening, and implementation are a large part of the moonshot initiative. Dr Lowy discussed developing preventive interventions against infectious and noninfectious targets, as well as creating tests that use body fluid samples (eg, urine, blood, saliva) to screen for cancers. “I suspect that in the next few years we will be successful at least with some of these fluids, such as urine with bladder cancer, or saliva, perhaps, with lung cancer,” Dr Lowy said.
“We think that this investment at this time in cancer really stands a very high probability of paying very big rewards both in the area of increased understanding of cancer and also for benefits for patients, and the benefits will go from the area of preventing cancer to treating it to survivorship,” Dr Lowy concluded.