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Why We Must Shift the Strategy in the War on Cancer

Cancer Guides

The problem: Financing is overly leveraged toward basic laboratory research. Funding dedicated to advancing biotech innovations showing clinical promise remains limited. This results in an insufficient quantity of technologies showing early promise entering the product development pipeline.

In 2016, the US government dedicated approximately $5 billion to the National Cancer Institute in support of cancer research activities at academic institutions in the US. The very same year, approximately 29,000 research papers were produced, 1,800 US patents covering biotech innovations were issued and 20 cancer drugs were approved by the FDA. While most of the public efforts to combat cancer have been devoted to funding research and have resulted in volumes of information, the data argues for greater support for advancing biotech innovations toward FDA approval.

The way our current war on cancer is being fought, where public dollars are almost entirely being dedicated to cancer research, is essentially unproductive.  There is a need to raise awareness on how the war on cancer is being fought and why a shift towards supporting biotech innovation is key to improving outcomes.

Background: The “war” on cancer has been raging for 40 plus years. It was officially launched in 1971 when President Nixon signed the National Cancer Act. The legislation represented a national commitment to combat cancer, which by 1970 had become the second leading cause of death in the United States. Today, cancer remains the second leading cause of death behind heart disease. While there has been major progress in our understanding of cancer, treatment for many cancers has not dramatically progressed.

What have we learned so far? First, cancer is not one disease, but hundreds of diseases. Second, cancer can strike anyone, of any age, of any socioeconomic background or ethnicity. Cancer does not discriminate. The biggest risk factor for getting cancer is aging, which means that every living being on the planet is at risk for getting cancer at some point in his or her life time. Finally, it is well understood that there is no single “cause” for cancer. Most cancers are “random” and happen because of mistakes made to the DNA during cell division. In other words, getting cancer for most people is simply due to bad luck, while for others it may be due to genetic or environmental causes.

What are we doing to combat cancer?  The US government dedicates about $5 billion annually towards cancer research activities at major academic institutions, a mere pittance compared to the $4.79 trillion that has been appropriated by the U.S. Congress to fight wars in Iraq, Afghanistan, Pakistan and Syria to protect American lives.  Since some 600,000 Americans will lose their life to cancer this year alone, while 6,900 US soldiers have died in direct combat over the past 15 years, clearly funding for combating cancer is woefully inadequate before even getting to the question of where government monies invested in combating cancer actually goes.

The limitations of Basic Research. As basic research has been key to understanding mechanisms of cancer, basic research has generated a plethora of potential solutions that could address gaps in treatment.  Yet, this research more often than not, does not lead to useful products for people. This is because research institutions are nominally involved in commercializing ideas from the laboratory into medicines used in the clinic. Too often basic research results sit on electronic shelves never to be capitalized upon. While over the past three decades, “biotechnology” has emerged as the primary vehicle for developing biomedical products, only limited public funding goes to support commercialization of promising biomedical products. Without commercialization, great ideas only remain in laboratories and never end up helping people.

The Challenge for Biotechnology. A big hurdle for the biotechnology industry is producing products that achieve desired treatment outcomes in humans. In fact, inevitably, most biotech innovations fail, while only a small handful actually succeed. Yet, this small handful potentially represent life changers for those benefiting from the innovations. Because of the high failure rate, most institutional investors steer clear of investing in biotech innovations, particularly at very early stages of advancing ideas.  As a consequence, a funding vacuum termed “the valley of death,” has become endemic for small biotech companies. The valley of death is a wasteland that few Americans are aware of its even existing, and yet is where thousands of great ideas go quietly to die, to the detriment of the public.

Why A New Narrative is Needed. The rhetorical phrase “research for the cure” has dominated the public psyche for decades, accompanied more recently by the many “races for the cure” where billions of dollars have been raised by the general public through walkathons, biking events, road races, etc. The quest for “the cure” was developed by marketers in the 1950s who sought to champion a national effort in the war on cancer. At the time, the rhetoric seemed fitting as cancer was thought to be curable, just like smallpox or polio. Further, it was assumed that the only path to finding the cure was through research, which over time came to be allocated to distinguished research institutions in the hope of discovering the cure.

Fast forward to 2017: There is no cure for cancer, research institutions do not commercialize science, and the biotech innovators who are actually responsible for addressing unmet needs in treatment are unnoticed and underfunded. Juxtapose this with the projected number of cancer deaths in 2017: 600,920. If we are to see progress as measured by lives improved and saved, we must balance funding to those who can generate useful cancer treatments.

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