About the Cancer Moonshot℠
The Cancer Moonshot, initially funded through the 21st Century Cures Act passed in 2016, rests on a solid foundation of scientific research. By focusing on areas of cancer research that are most likely to benefit patients as a result of new investment, the Cancer Moonshot has brought together a large community of patients, advocates, researchers, and clinicians who are dedicated to advancing research to improve the lives of people with cancer, those at risk, and their loved ones.
Today, that community is building on the Cancer Moonshot’s momentum, to deliver on even bolder goals: to reduce the cancer death rate by half within 25 years and improve the lives of people with cancer and cancer survivors. This next phase of the Cancer Moonshot, kickstarted in 2022 by President Biden with new goals, emphasizes the role that Americans themselves can play in this effort—by getting back to cancer screenings missed during the pandemic, quitting smoking, and even participating in research—and how agencies across the federal government can work together to further support these goals.
Since the launch of the Cancer Moonshot in 2016, remarkable progress has been made. NCI has supported more than 250 research projects that achieved the original Cancer Moonshot goals of accelerating discovery, increasing collaboration, and expanding data sharing among the research community. These projects are delivering important insights into the mechanisms that drive cancer and have identified candidates for new cancer treatments, as well as new approaches to preventing and detecting cancer. Although funding for the initial Cancer Moonshot, through the 21st Century Cures Act, extends only through fiscal year 2023, NCI is committed to continuing to support the most promising ongoing research projects to completion.
A new phase of the Cancer Moonshot
The initiatives of the initial Cancer Moonshot launched in 2016 have laid the foundation for new programs and progress described in this article in Nature Medicine.
New Cancer Moonshot Research Goals
As the Cancer Moonshot continues, NCI is focusing on activities that support bold goals:
Include more people in expanded and modernized cancer clinical trials
Clinical trials are the way new cancer prevention, screening, and treatment approaches are evaluated, and they are a fundamental part of how cancer drugs and devices are developed and brought to patients. By including people from all backgrounds in clinical trials, we can ensure that new approaches to preventing and treating cancer work for everyone.
Today, only a small percentage of people with cancer participate in clinical trials. In large part, this is because trials are often designed with overly broad exclusion criteria, and participation can be burdensome for patients. Substantially increasing the number of people who participate in NCI-sponsored clinical trials is an ambitious undertaking, but it is necessary to develop new prevention, diagnosis, and treatment approaches more quickly.
Increase the pipeline of new cancer drugs
NCI invests heavily in opportunities to speed delivery of cancer drugs and vaccines to prevent and treat cancer, including cancer types for which progress has been limited. To fuel sustained progress that serves the needs of people with cancer and those at risk of cancer, we must increase the number of meritorious investigator-initiated research proposals we fund. Doing so will help build a deeper understanding of cancer’s complex biology, which can stimulate new strategies to prevent, screen for, diagnose, and treat cancer. We also aim to increase investment in the NCI Experimental Therapeutics (NExT) program, our flagship program that moves promising drugs and interventions from early-stage discovery to selection of candidates for clinical trials to Food and Drug Administration review and approval.
Ensure access to current and new standards of cancer care
The field of implementation science develops and tests how people access care, including methods aimed at ensuring interventions that are proven to be effective through research—and go on to become the standard of care—are accessible to anyone seeking cancer care in their community. NCI will expand research in this area to better understand and address barriers that prevent the uptake of effective approaches, and how to overcome those barriers, so that all people benefit equitably from cancer research advances.
Enhance diversity in the cancer research workforce
A vibrant biomedical research workforce, made up of professionals with diverse perspectives, is essential to address the formidable challenges presented by cancer. NCI will introduce new programs to attract scientists of diverse backgrounds to cancer research and improve their inclusion in training environments. See Cancer Moonshot Scholars below.
The White House invites organizations, companies, and institutions to share actions they plan to take as part of the mission to end cancer as we know it. People with direct experience with cancer are encouraged to share ideas and stories of inspiration. Visit whitehouse.gov/cancermoonshot to share.
New and Upcoming Cancer Moonshot Programs
Several initiatives have already been launched or will soon launch that will address the goals of the next phase of the Cancer Moonshot:
Major trial to evaluate multi-cancer detection tests
Multi-cancer detection blood tests may provide less-invasive tools for early detection of cancer and improved health outcomes. The NCI Multi-Cancer Detection (MCD) Test Vanguard Study is a 4-year pilot study that will enroll 24,000 people ages 45 to 70 to inform the design of a much larger randomized controlled trial involving about 225,000 people. The study will evaluate whether the benefits of using MCD tests to screen for cancer outweigh the harms, and whether they can detect cancer early enough to reduce deaths.
The Vanguard study will be conducted through the NCI Cancer Screening Research Network (CSRN), a new network of organizations to include health care systems, practice-based networks, academic institutions, and consortia of researchers. Members of existing clinical trial networks such as NCI’s National Clinical Trials Network and the NCI Community Oncology Research Program may also participate. Funding opportunities to develop the CSRN and the Vanguard study will be released in late 2022, and NCI will begin recruiting volunteers for the study in 2024.
Cancer Moonshot Scholars
Cancer Moonshot Scholars is an early-career grant program with a focus on developing a cancer research workforce that is representative of the US population. The program aims to improve the diversity of the applicant pool for NCI R01 grant funding. The program will provide grants to early-stage investigators from underrepresented groups to support the next generation of diverse, world-class scientists and health innovators.
NCI intends to fund at least 45 early-stage investigators in initial rounds beginning in 2023, with project periods of up to 5 years, investing approximately $135 million.
Telehealth research centers
The NCI Telehealth Research Centers of Excellence (TRACE) program aims to determine whether the use of telehealth can improve cancer-related care and outcomes across the cancer control continuum. A centerpiece of the program will be a trial to evaluate how telehealth—used broadly during the COVID-19 pandemic—practiced in a real-world clinical environment may improve patient access, quality of care, patient-provider communication, and health outcomes for people of all ages and all socioeconomic and geographic backgrounds.
NCI is investing $23 million in the program over 5 years (2022-2027) to four academic research institutions. Each center will focus on an overarching cancer-focused telehealth research theme that will frame their studies and will work with local clinical practices in their areas to support the studies.