Cancer Moonshot℠ Progress
In the four short years since the Cancer Moonshot was launched, remarkable progress and scientific accomplishments have been made. To date, NCI has invested over $1 billion in Moonshot funding, supporting over 240 research projects across more than 70 cancer science initiatives. That investment has led to many important insights tied to the Moonshot’s key research priorities.
Below are a few featured projects that highlight some of the progress that has been made to date, as a result of the Cancer Moonshot. Across all of these initiatives are the cross-cutting themes of reducing health disparities, increasing data sharing, and creating new collaborations and partnerships.
Moonshot-supported groups are working to expand the benefits of immunotherapy and discover new immune targets for cancer treatments through research networks that address challenges in the development of immunotherapies for adults and children with cancer.
The Immuno-Oncology Translational Network (IOTN) was created to improve immunotherapy for adults. Research supported by IOTN has led to insights into the responses of ovarian cancers to immunotherapy and into the use of immunotherapy in certain types of head and neck cancers.
The Pancreatic Cancer Microenvironment Network (PaCMEN) is focused on understanding the pancreatic tumor microenvironment to find vulnerabilities that could be exploited by immunotherapies. In one study, researchers discovered that tumor-associated immune cells block the action of a chemotherapy drug given to patients with pancreatic cancer.
Advancing Childhood Cancer Research
Although significant progress has been made in reducing death due to childhood cancer, it remains the leading cause of death from disease among children. Several of the Cancer Moonshot initiatives focus specifically on childhood cancers because the type of cancer and the response to treatment is often different in children than adult patients with cancer.
The Pediatric Immunotherapy Discovery and Development Network (PI-DDN) is working to advance preclinical immunotherapy research for children and adolescents with cancer to overcome major barriers that have hindered the development of effective immunotherapies for these patients. A recent study supported by PI-DDN suggested that some children with B-cell acute lymphoblastic leukemia that recurs or resists treatment may benefit from certain immunotherapy drugs, such as blinatumomab (Blincyto) or inotuzumab (Besponsa).
Rare cancers—including all pediatric cancers—are harder to study and are a greater burden on the patient. My Pediatric and Adult Rare Tumor Network (MyPART) is made up of researchers, patients, family members, advocates, and health care providers who want to help find treatments for children and young adults who have rare cancers. The network has developed a pipeline for biospecimen collection and analysis, created a strong communication platform with patients and patient advocates, and established several new specialized rare tumor clinics around the country.
To implement the Blue Ribbon Panel’s recommendation to intensify research into drivers of childhood cancers, NCI created the Fusion Oncoproteins in Childhood Cancers (FusOnC2) Consortium. The consortium’s researchers have developed a number of novel cancer models to study these rare cancers and have made significant advances in understanding how each fusion affects the protein’s function and localization in the cell. One of the research teams has made breakthroughs in understanding the biological consequences of the fusion oncoprotein that drives synovial sarcoma. These novel insights could inform the development of new therapies for this highly aggressive and rare cancer.
The Blue Ribbon Panel recommended generating human tumor atlases that describe the cellular, structural, and molecular characteristics of human cancers over time. Creating a comprehensive human tumor atlas requires collaboration and expertise across disciplines as well as new technological advances to make the mapping of tumors possible. The Human Tumor Atlas Network (HTAN) has collaboratively developed best practices for tissue and biospecimen collection and storage, standard methods for data collection and quality control, and policies for sharing data and samples. One team of HTAN investigators has developed novel imaging technologies to generate data sets for biological discovery and to create multidimensional cancer atlases. This method is also being used to study the effects of SARS-CoV-2 infection.
Expanding Cancer Prevention and Early Detection
The Cancer Moonshot is supporting research to reduce cancer risk and cancer disparities through the expanded use of proven strategies for cancer prevention and early detection.
Accelerating Colorectal Cancer Screening and follow-up through Implementation Science (ACCSIS) is working to build the evidence base on multilevel interventions to increase rates of colorectal cancer screening, follow-up, and referral to care—especially in underserved groups, including racial and ethnic minority populations and people living in rural or difficult-to-reach areas.
The Implementation Science Centers in Cancer Control (ISC3) were developed to expand the use of proven cancer prevention and early detection strategies, especially among underserved, rural, and minority populations. The six implementation science centers collectively provide leadership for implementation science across and beyond the other Moonshot initiatives.
The Cancer Center Cessation Initiative (C3I) was created to help cancer centers build and implement sustainable tobacco cessation treatment programs for patients with cancer. More than 50 NCI-Designated Cancer Centers have added smoking cessation programs. These centers refine electronic medical records and clinical workflows to ensure routine delivery of evidence-based tobacco cessation treatment services. Many of the cancer centers have found success in helping people with cancer quit smoking by implementing counseling sessions, point-of-care treatment, or decision support tools combined with institutional buy-in.
Addressing Drug Resistance
The Cancer Moonshot has created the Drug Resistance and Sensitivity Network (DRSN), a framework for collaborative research to tackle the complexities of treatment resistance and to share data with the cancer research community. The transdisciplinary network is developing new experimental models for studying drug resistance in tumors, investigating mechanisms of drug resistance in cancer, and designing innovative approaches to exploit the sensitivity of cancer cells to specific treatments. A DRSN research team identified an adaptive feedback mechanism that drives resistance to KRAS inhibitor drugs. The study highlighted the potential importance of combining inhibitors that target multiple nodes of the same pathway.
Engaging with Patients
The Moonshot is modernizing how patients are involved in clinical cancer research by establishing patient-centric networks to improve outreach and engagement.
Through the NCI Comprehensive Oncology Network Evaluating Rare Central Nervous System Tumors (NCI-CONNECT), patients with rare tumors of the central nervous system can learn more about their cancers, find referrals to experts, participate in studies about risk factors, and learn about ongoing clinical studies. The network has established partnerships with 9 patient advocacy groups and includes 32 clinical sites across the country that provide patients access to new clinical trials for these rare tumors.
The Participant Engagement and Cancer Genome Sequencing (PE-CGS) Research Network, one of the newest Cancer Moonshot initiatives, is using direct participant engagement approaches to promote cancer genome sequencing programs for rare cancers, highly lethal cancers, cancers that occur at an early age, cancers that disproportionately affect certain populations, and cancers that are prevalent in understudied populations. One team is working to boost engagement by American Indians of southwestern tribal nations in cancer genome sequencing programs. They ultimately aim to translate this research into strategies that enhance cancer prevention and treatment in tribal communities.
Collecting and Sharing Cancer Data
The Blue Ribbon Panel recommended developing a National Cancer Data Ecosystem to enable and encourage all participants across the cancer research and care continuum to share, access, combine, and analyze diverse data. One component of the broader Cancer Data Ecosystem is already a robust central resource: The Cancer Research Data Commons (CRDC) currently provides access to 23 data sets, with more to come, and users can bring their own data to combine with the existing data to perform novel analyses through NCI’s cloud resources.
Collaboration and Outreach
A prominent goal of the Cancer Moonshot is to encourage greater cooperation and collaboration. Many of the Moonshot initiatives were designed as networks of researchers that communicate, collaborate, and share data and resources. These networks create a research community that is greater than the sum of its parts and that can conduct research that would be difficult or impossible for individual teams to do by themselves.
Beyond connecting research teams from around the country, the Cancer Moonshot has also initiated several partnerships with other federal agencies and industry leaders. These include collaborations with the Department of Energy and public–private partnerships that include FDA and pharmaceutical companies.
NCI has held many Cancer Moonshot meetings and workshops to engage the community and to share research progress, including the Cancer Moonshot Collaborative Meeting in the winter of 2019. Similarly, research progress is shared with the public during monthly Cancer Moonshot Seminar Series presentations.