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Cancer Policy Monitor: March 8, 2022

Biden Announces Reignited Cancer Moonshot

–Brandon Leonard, MA

President Biden announced during a February 2 White House event that he is reigniting the Cancer Moonshot with the goal of reducing the cancer death rate by 50% over the next 25 years and improving the experience of those living with cancer. First Lady Dr. Jill Biden and Vice President Kamala Harris also spoke at the event, which was attended by AACR CEO Dr. Margaret Foti and leaders of other cancer organizations, as well as policymakers and advocates.

In 2016, then-Vice President Biden launched the original Cancer Moonshot to accelerate progress against cancer through scientific discovery, greater collaboration, and improved data sharing. The 21st Century Cures Act, passed by Congress in December 2016, provided $1.8 billion in funding for the Moonshot over seven years. Fiscal Year 2023 is the last year of Moonshot funding under the legislation.

The reignited Moonshot will be coordinated by the White House Office of Science Technology and Policy (OSTP).  Following the departure of Eric Lander, OSTP will temporarily be led by Dr. Alondra Nelson and by Dr. Francis Collins, who will serve as the president’s top science advisor. Dr. Collins had served as director of the National Institutes of Health for more than 12 years before stepping down from that role last December. Biden also announced a Cancer Cabinet including leaders from 18 federal departments, agencies, and offices that will help guide the initiative.

The relaunched Cancer Moonshot places an emphasis on topics including prevention and early detection of cancer, addressing cancer disparities, and speeding progress on cancers for which there are currently few or no treatment options. The president’s announcement also included a call to action for getting back on track with cancer screenings that were missed or delayed due to the COVID-19 pandemic. More information on the president’s Moonshot announcement can be found on this White House fact sheet. See the AACR’s statement on the president’s announcement.

Also on February 2, the President’s Cancer Panel released a new report titled Closing Gaps in Cancer Screening: Connecting People, Communities, and Systems to Improve Equity and Access. The report outlines strategies for ensuring that more Americans have access to cancer screenings and is based on a series of workshops held over the past two years. The panel’s recommendations align with the president’s remarks regarding cancer screening at the Moonshot event.

Appropriations Update from Capitol Hill

The House and Senate passed a continuing resolution (CR), which continued government funding at current levels through March 11. As the deadline approaches, negotiators are nearing an agreement on FY 22 but may need additional time beyond March 11 resulting in an additional short-term CR.

Dr. Robert M. Califf Sworn in as Commissioner of the FDA

On February 15, the Senate voted 50-46 to confirm Robert M. Califf, MD as commissioner of the U.S. Food and Drug Administration (FDA) after a lengthy nomination process. Dr. Califf previously served as FDA commissioner in 2016-2017 under the Obama administration. A cardiologist by training and leading expert in clinical trials, Dr. Califf founded the Duke Clinical Research Institute, the world’s leading academic clinical research organization. Dr. Califf has taken over from Janet Woodcock, MD, who has served as acting commissioner since January 2021. Dr. Woodcock will continue in a leadership role at FDA as principal deputy commissioner.

During his prior leadership of FDA, the AACR worked closely with Dr. Califf including a January 2016 day-long meeting with 15 prominent members of the AACR and senior officials to discuss companion diagnostics for cancer therapies, laboratory developed tests, and the regulation of next-generation sequencing-based tests.

In congratulating Dr. Califf on his confirmation, Margaret Foti, PhD, MD (hc), chief executive officer of the AACR stated, “Dr. Califf recognizes the vital importance of scientific innovation that is especially needed for the FDA to meet many of its regulatory responsibilities. We are excited about working with Dr. Califf again, as well as the talented and innovative individuals at the agency, to ensure the rapid approval of safe and effective treatments for patients with cancer.”

Lawmakers Discuss Plans for Authorizing ARPA-H

On February 8, the House Energy and Commerce Subcommittee on Health held a hearing on “ARPA-H: The Next Frontier of Biomedical Research.” ARPA-H, as envisioned by the Biden Administration, would fund high-risk, high-reward research projects proposed and coordinated by term-limited program managers. Supporters have suggested this model could bring revolutionary approaches to prevent, diagnose, and cure diseases such as cancer, Alzheimer’s, and diabetes and promote new technologies and platforms that could address challenges across a wide a variety of diseases. 

One area of discussion in the hearing centered on the best place for ARPA-H to be housed. The Biden Administration has requested that ARPA-H be housed within the NIH. However, Health Subcommittee Chair Anna Eshoo’s legislation, the ARPA-H Act, would establish ARPA-H as an independent agency within HHS but outside of the NIH. 

The AACR will continue to monitor developments on ARPA-H. Watch the hearing.

AACR Releases Report on the Impact of COVID-19 on Cancer Research and Patient Care

The AACR released its Report on the Impact of COVID-19 on Cancer Research and Patient Care on February 9. The report details the burden of the pandemic on the cancer community and stresses the importance of unwavering support for cancer researchers, health care workers, and patients with cancer.

The report is the result of the AACR’s efforts to educate policymakers and the broader public about the impact of COVID-19 on cancer research and patient care. It underscores the remarkable contributions of cancer researchers in developing vaccines against the virus that causes COVID-19; the importance of robust, sustained, and predictable annual funding increases for the NIH and NCI, the Food and Drug Administration, and the Centers for Disease Control and Prevention; and the need to increase telemedicine use across the cancer care continuum. The report features the stories of survivors of cancer and how they continue to navigate the clinical care landscape during the pandemic. Two members of the United States Senate, Senator Amy Klobuchar (D-MN) and Senator Roy Blunt (R-MO), also shared their perspectives. Additionally, this report calls attention to the urgency of strengthening the nation’s public health infrastructure and the health care workforce.

At the virtual briefing, AACR CEO Margaret Foti, PhD, MD (hc), provided welcome remarks and presented a video featuring highlights of the report. The briefing ended with a live panel including AACR President (2020 – 2021) Antoni Ribas, MD, PhD, FAACR; Ana María López, MD, MPH, MACP, FRCP; and three survivors of cancer, Wenora Johnson, Allyson Pile, and Larry Saltzman, MD, to discuss their experiences being diagnosed and treated with cancer during the COVID-19 pandemic.

To read more about the report, please see this article in the Cancer Research Catalyst, the official AACR blog. To view the full report, along with videos featuring the cancer survivors who shared their stories, please visit this page.

AACR Holds Seventh Annual Early-career Hill Day

-Marc B. Johnson, MPP

On March 3, AACR held its seventh annual Early-career Hill Day (ECHD), which brought together AACR associate members to advocate for increased funding for the National Institutes of Health (NIH) and National Cancer Institute (NCI). This event is an important opportunity for early-career investigators to engage in advocacy at the federal level and educate lawmakers on the progress and promise in cancer research. This year’s virtual Hill Day included 36 participants, the largest group to date, from 20 states and the District of Columbia. Participants held over 70 meetings with congressional offices, speaking with members and staff about their research and the importance of increased funding for NIH and NCI. This year, participants asked Congress to complete FY22 appropriations without delay and continue to prioritize medical research by providing at least $46.4 billion for NIH’s base, as passed by the House; provide an increase of at least $432 million for the NCI in FY22, as passed by the House; and support another robust funding increase for NIH in FY23, including at least $7.766 billion for the NCI, as recommended in the NCI Director’s Professional Judgment Budget.

In conjunction with the Hill Day, ECHD participants and the AACR led a National Day of Action, encouraging early-career scientists and others in the cancer research space to communicate with their members of Congress via email or social media in support of increased NIH and NCI funding. Dozens of messages and pictures were shared on Twitter, Facebook, LinkedIn, and other social media platforms accompanied by the hashtags #AACRontheHill and #FundNIH.

EPA Takes Strong Action to Promote Environmental Justice and Reduce Cancer Risks

-Nicholas Warren, PhD

Industrial air pollution is estimated to increase the risk of developing cancer for 74 million Americans living in nearby communities. Due to many factors including housing and economic discrimination, systemic racism, and other issues, racial and ethnic  minority communities are disproportionately near areas with high levels of industrialized pollution. Since 1990, the Clean Air Act of provides the U.S. Environmental Protection Agency (EPA) the authority to regulate 188 hazardous air pollutants to protect public health. However, the EPA itself only operates 26 air pollution monitoring stations nation-wide, and thus relies primarily on self-monitoring of air pollutants from the facilities that release them into the environment and surrounding communities. While state and local environmental agencies also occasionally monitor air pollution, facilities often receive advanced warning and alter their activities on those days.

In response to decades of serious health complaints from residents in heavily polluted communities, EPA Administrator Michael Regan has made addressing the disproportionate impacts of industrial air pollution a priority of the EPA. Following a two-month “Journey to Justice Tour,” Administrator Regan announced new plans for the EPA to directly monitor concerning air pollution and take powerful steps to protect public health, including:

  • Establishing a new Pollution Accountability Team to increase unannounced site inspections;
  • Utilizing $20 million in funding from the 2021 American Rescue Plan for grants to local communities to increase air pollution monitoring capabilities;
  • Requiring some concerning facilities to install additional monitoring devices or install pollution mitigating technology;
  • Propose a new regulation to decrease allowable ethylene oxide emissions by 2,000-fold;
  • Funding from the Bipartisan Infrastructure Law to improve water quality; and
  • Appointing a new senior advisor for environmental justice.

Additionally, in February the EPA proposed reinstating the 2016 regulations for hazardous air pollutants from power plants. These actions also follow a recent EPA-wide plan to better control pollution from PFAS carcinogens. Collectively, these are the strongest steps the EPA has taken to address the public health impacts of industrial air pollution since implementing the 1990 amendments to Clean Air Act, and will provide the greatest benefits to the some of the most marginalized communities in the country.

The PREVENT Pandemics Act Seeks to Strengthen America’s Readiness

-Nicholas Warren, PhD

Since early 2020, the COVID-19 pandemic has killed nearly one million Americans and sickened almost 80 million. As detailed in the AACR Report on the Impact of COVID-19 on Cancer Research and Patient Care, the pandemic has negatively impacted all aspects of cancer care and research, including nearly 10 million missed cancer screenings. It is clear that the United States must be better prepared for a future pandemic in order to avoid widespread disruptions to cancer research and broader society. To build the nation’s resilience, the leaders of the Senate Committee on Health, Education, Labor, and Pensions (HELP), Sens. Murray (D-WA) and Burr (R-NC), have spent more than a year developing the recently unveiled PREVENT Pandemics Act.               

The more than 200-page bill would bolster nearly every aspect of the U.S. pandemic response and public health systems. Large structural changes, such as requiring Senate confirmation for the director of the Centers for Disease Control and Prevention, creating a new public health communication advisory committee, establishing a bipartisan commission to investigate the federal response to COVID-19, and requiring national and state level exercises every five years would help ensure the response to future pandemics is better coordinated and communicated more effectively to the public. Additionally, the bill would authorize new funding programs to modernize public health data reporting systems, rebuild the public health workforce, improve genome sequencing of pathogens, strengthen the Strategic National Stockpile, support domestic manufacturing of critical medical supplies, and establish ARPA-H. The final section of the bill would direct the U.S. Food and Drug Administration to issue further guidance to increase the resilience of clinicals trials during a future pandemic, such as promoting the use of real-world data and de-centralizing trials.

The AACR has advocated for many of these provisions in letters to Congress, as well as the policy chapter and call to action of the recent COVID-19 and cancer report. In addition to strengthening responses to future pandemics, many of these policies would greatly help public health efforts for cancer prevention and early detection that would make Americans healthier.