What the Next Phase of the National Cancer Moonshot Initiative Means for Oncology Nurses

October 11, 2017

In one bold declaration during his final State of the Union Address in 2016, President Barack Obama raised our hopes to a singular goal—ending cancer as we know it—as he announced the National Cancer Moonshot Initiative, now called the Biden Cancer Initiative. Grounded in real research with tangible results, the intent was not even that daring: it was more realistic. Eradicating cancer, now understood to be many different aspects of the same disease, in five years was unlikely, but rather the goal was to achieve in five years what previously would take a decade.

What the Moonshot Initiative Has Achieved So Far

It began with a listening tour by Vice President Joe Biden. He and his staff toured several cancer institutions, met with research scientists, asked questions, and held meetings to discuss the possibilities. At almost every meeting, ONS had a representative at the table (https://obamawhitehouse.archives.gov/node/352601), adding the expertise of an oncology nurse to the conversation.

The Blue Ribbon Panel and Working Groups

During this time, the National Institutes of Health (NIH) convened an ad hoc committee, known as the Blue Ribbon Panel (BRP), on which experts sat to evaluate and recommend to authorities such as the National Cancer Advisory Board on potential research opportunities that could meet the initiative’s goals.

One BRP member was former ONS president and University of North Carolina (UNC) Lineberger Comprehensive Cancer Center and professor in the School of Nursing at UNC Chapel Hill Deborah Mayer, PhD, RN, AOCN®, FAAN. Her addition, as the only oncology nurse on the panel, helped to remind experts of the need for patient-centered, evidence-based research when thinking about next steps to treatment and care.

It was a rigorous process, and a committee structure was created (https://www.cancer.gov/research/key-initiatives/moonshot-cancer-initiative/blue-ribbon-panel/all-working-group-reports.pdf) to delve deeper into a variety of areas.

“The panel considered more than 1,600 ideas submitted by the broader cancer community through a dedicated website, email, and other routes. Some working groups created subgroups with focused expertise in particular areas to carefully craft their recommendations. As the working groups narrowed in on their specific recommendations, the chairs of multiple groups also met to discuss cross-cutting themes and to merge similar topics into joint recommendations.”

Ultimately, the BRP developed 10 areas for concentration (https://www.cancer.gov/research/key-initiatives/moonshot-cancer-initiative/blue-ribbon-panel/all-working-group-reports.pdf). Some were more specific than others, but all were intended to carry the movement forward with definite ends through dedicated programs.

  1. Establish a network for direct patient involvement.
  2. Create a translational science network devoted exclusively to immunotherapy.
  3. Develop ways to overcome cancer’s resistance to therapy.
  4. Build a national cancer data ecosystem.
  5. Intensify research on the major drivers of childhood cancers.
  6. Minimize cancer treatment’s debilitating side effects.
  7. Expand use of proven cancer prevention and early detection strategies.
  8. Mine past patient data to predict future patient outcomes.
  9. Develop a 3D cancer atlas.
  10. Develop new cancer technologies.

Additionally, seven working groups developed areas of concentration driving the panel’s priorities (https://www.cancer.gov/research/key-initiatives/moonshot-cancer-initiative/blue-ribbon-panel/all-working-group-reports.pdf), and each has its own detailed report.

The Question of Funding—and a Future as the Biden Cancer Initiative

While the Moonshot Initiative was under way, the political question of how to pay for it was being debated in Washington, DC. Should Congress allocate funding for this project? What were the timelines, budgets, and results? Which government agency would take the lead? Was it a one-time infusion of federal dollars, or would this require subsequent funding?

After the 2016 presidential election, the Moonshot was left in limbo. Although both parties had campaigned on supporting the goals of Moonshot, it was uncertain if then-president-elect Trump would agree to funding such a massive endeavor. And frankly, without the deepest of pockets to jump start Moonshot, it was unlikely the program would be able to get going. However, since Joe Biden had been a U.S. senator for more than 30 years, in a rare bipartisan effort, the chamber gathered its members and allocated $1.8 billion over seven years to what it renamed the Biden Cancer Initiative and wrapped in a single piece of legislation called the 21st Century Cures Act, which passed in the December 2016 lame duck session after the November presidential election.

Housed in the newly created Biden Foundation, the Biden Cancer Initiative (https://bidencancer.org/sites/default/files/uploads/biden_cancer_initiative_press_release_final_june_26_2017.pdf) aims to “develop and drive implementation of solutions to accelerate progress in cancer prevention, detection, diagnosis, research and care, and to reduce disparities in cancer outcomes.” The foundation will work with cancer centers, educational institutions, nonprofit organizations, healthcare providers, patient advocates, corporations, and interested citizens to achieve its goal (https://bidencancer.org/sites/default/files/uploads/biden_cancer_initiative_press_release_final_june_26_2017.pdf) of changing how “systems collaborate to take on cancer, with the patient as the focus. The Initiative will be a major convening force in driving new actions and collaborations toward ending cancer as we know it.”

It’s been 18 months since the Biden Cancer Moonshot Initiative was announced. Much has been done, but there is much more to do. But no one put it better than former Vice President Joe Biden himself (https://www.ons.org/newsroom/news/ons-president-elect-and-ceo-attend-cancer-moonshot-panel-vice-president-biden), when he said, “I can tell you, on behalf of my family, what an overwhelming debt of gratitude we owe our nurses.”

ONS’s Perspective

ONS continues to be a vital part of this effort. Moonshot work is pervasive in the U.S. government, within several agencies, including the NIH, Centers for Disease Control and Prevention, and the U.S. Food and Drug Administration. ONS members have real-world experience in treating patients with cancer. Our role in this important project is meaningful and sought after. And since its creation, the Biden Cancer Initiative has had an impact in research, patient education, and treatment.

Perhaps now, more than ever, the role of the oncology nurse in health care is absolute. ONS members have a unique opportunity to make a real difference in public policy with a powerful advocate. It’s incumbent on nurses, as the most trusted healthcare providers, to make your voices heard. ONS will be doing that very thing in Washington, DC.

Copyright © 2017 by the Oncology Nursing Society. User has permission to print one copy for personal or unit-based educational use. Contact pubpermissions@ons.org for quantity reprints or permission to adapt, excerpt, post online, or reuse ONS Voice content for any other purpose.