With the signing of the National Cancer Act and the requested appropriation of $100 million for research, President Richard Nixon launched the first “war on cancer” in 1971. It was a campaign “to find a cure.” To give hope to cancer patients, Nixon asserted during a televised address that everything possible “will now be done.”
The past 40 years have brought a greater understanding of the disease's genomics and the related mortality rate has dropped by 23% since 1991, translating to more than 1.7 million deaths averted through 2012. Yet optimism about finding cures has tempered, dampened by high drug costs, lack of collaboration and unfulfilled promises.
“Let's make America the country that cures cancer once and for all,” said President Barack Obama, receiving a round of applause during his final State of the Union address. Obama tasked Vice President Joe Biden with spearheading a new “moonshot” approach to fighting cancer. Biden said he would break down silos that prevent data-sharing and ultimately, “make a decade worth of advances in five years.”
Last week, some of that work began. The National Cancer Institute said it would launch a database this summer that contains information about genetic mutations and cancer treatments. Data will come from as many as 50,000 patients and clinical-trial participants in the Therapeutically Applicable Research to Generate Effective Treatments program, as well as the Cancer Genome Atlas.
“There's never going to be (just) one cure,” said Dr. Julie Vose, president of the American Society of Clinical Oncology. Cancer is thousands of different diseases. Presentations and treatment can vary from patient to patient. Vose warned that it's “impossible to generalize treatments to all patients with cancer.”
To that end, ASCO issued a timely policy statement last week noting how the personalized nature of cancer treatment has resulted in a flood of clinical pathways—protocols that guide which treatment should be chosen for a patient's specific diagnosis. The administrative burden of managing those pathways “is at a breaking point,” experts say.
Also at a breaking point are the overwhelming costs of conducting clinical research, comparing existing therapies and the steep prices that preclude some patients from affording life-saving treatment.
The number of Americans taking at least $100,000 worth of prescription drugs annually from 2013 to 2014 tripled, according to Express Scripts. High-cost cancer medications were partly to blame.