AACR Annual Meeting 2021: NCI Director Ned Sharpless Outlines Blueprint for Progress

With President Joseph R. Biden in the White House, the United States may be poised to make a major leap forward in ending cancer as we know it, Norman E. “Ned” Sharpless, MD, FAACR, director of the National Cancer Institute (NCI), said at the AACR Annual Meeting 2021 on Sunday.

But what, exactly, will that look like? Sharpless outlined several measures that could propel progress against cancer in the next few years, while acknowledging the toll that the coronavirus pandemic continues to take on public health in the United States and beyond.

Last year In the United States, more than 1.8 million cancer cases were diagnosed, and more than 600,000 people died of the disease. Sharpless has estimated that that there will be nearly 10,000 excess U.S. deaths from breast and colorectal cancer in the next 10 years due to pandemic-related delays in cancer screening and treatment.  

Still, Sharpless said, there are reasons for optimism. Cancer mortality is continuing its decline from a peak in the 1990s, thanks in part to the increased pace of drug development and approval.

“Just since 2017, there’s been a string of remarkable productivity,” Sharpless said, citing 240 new or supplementary approvals by the U.S. Food and Drug Administration, including more than 80 new medicines. “These treatments deliver improved outcomes, including some cures, and they often have fewer punishing side effects.”

Sharpless also noted progress in cancer prevention and screening, citing the dramatic reduction in cervical cancer incidence and mortality since the development of HPV vaccines.

These developments were made possible thanks to sustained federal funding for the NCI and the National Institutes of Health (NIH), Sharpless said. In the coming months and years, he expects further support from the Biden administration.

FEDERAL GOVERNMENT RENEWS FOCUS ON SCIENCE

“The new administration has a real connection to cancer,” Sharpless said. Beau Biden’s death from glioblastoma inspired his father, then-Vice President Biden, to launch the Cancer Moonshot Initiative in 2016. Vice President Kamala Harris is the daughter of a breast cancer researcher, and as a teenager, she worked in her mother’s laboratory, washing pipettes, much like many of the researchers tuned in to the Annual Meeting, Sharpless noted.

Last week, the Biden administration called for the establishment of ARPA-H—Advanced Research Projects Agency-Health—a federal entity designed to “deliver breakthroughs to find cures for cancer and other diseases.” Sharpless said the organization would likely be housed within the NIH, which would allow for rapid sharing of resources and knowledge.

With an aging population, Biden’s goal of “ending cancer as we know it” may not mean the elimination of all cancers, Sharpless said. Instead, it may mean cures for pediatric patients, or improved treatments that let parents live long enough to witness their children’s milestones.

“When I think of ending the tragedy of cancer, I think of its consummate unfairness,” Sharpless said. “Can we improve the outlook for people who are young, or otherwise healthy? I think that is doable.”

Ideas for the next wave of progress

Sharpless identified three major ideas for accelerating the pace of progress against cancer. First, he suggested the development of a large national trial of liquid biopsies for the early detection of cancers. Liquid biopsies have shown promise, and are the subject of multiple presentations at this year’s Annual Meeting. Still, Sharpless said, “They have to be evaluated at an appropriate power to fully determine whether they can accurately diagnose cancers before they become difficult to treat.”

Sharpless also recommended the allocation of significant resources to government-sponsored clinical trials in order to ensure that underserved populations, including rural communities, are reflected and can reap the potential benefits of clinical trials.

Finally, he urged a new commitment to accelerating drug discovery. The rapid development of the COVID-19 vaccines sent a signal that swift development of lifesaving drugs is possible, he said. The United States should harness technologies like machine learning and data science to speed the development of cancer therapeutics.

A BRIDGE TO THE FUTURE

In closing, Sharpless turned his focus to the scientists on the front lines of cancer research, treatment, and care. No matter what challenges the world may present, their innovation and collaboration will create the next revolution in cancer.

“What this story will really be about—the really important part—is it’ll be about all of us who work on cancer, and about our patients, and about their loved ones. And the key moments we’ll look back on, the key moments in that story, will be about meetings like this, where we come together, and we talk about what works—and what doesn’t work, frankly. And slowly—maybe not so slowly—we together make progress against malignant disease.”