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Among keys to curing cancer, academic medical centers loom large

Monday, February 15, 2016

The following is a comment piece featured in the The Hill, by Steven J. Corwin, M.D., president and CEO of New York-Presbyterian, Lee Goldman, M.D., MPH, dean of the Faculties of Health Sciences and Medicine at Columbia University Medical Center, and Laurie H. Glimcher, M.D., he Stephen and Suzanne Weiss dean of Weill Cornell Medicine. Read the original here.

The moonshot to cure cancer will need to enlist the nation’s academic medical centers, our most powerful incubators of medical innovation. These institutions are already developing – and putting into use –some of the most promising therapies.

Following a memorable State of the Union in which he charged Vice President Joe Biden to lead a “moonshot” to find a cure for cancer, President Obama is proposing nearly $1 billion to fund cancer research over the next two years. The moonshot initiative aims to double the rate of progress being made on promising new therapies by bringing together the top minds in the field, funding their best work and sharing the results with the world. If the Obama administration needs a model for how this can be accomplished, it can turn to the nation’s academic medical centers, which are already bringing next-generation treatments to patients across the country.  

We now know that cancer develops as a result of environmental factors, lifestyle choices, and genetics—and that no two cancers are exactly alike. Our understanding of the genetic landscape has increased exponentially over the last decade, leading to a promising new field: precision medicine. Bringing together clinicians, scientists and data engineers, among others, precision medicine is a highly personalized approach to care in which doctors examine the genetics of the patient and the mutations caused by the disease in order to develop and identify the best possible treatment options.

Though precision medicine remains a relatively young field, it is already yielding impressive results in the fight against cancer at academic medical centers. In New York City, genetic tests are helping oncologists tailor treatment plans that are specific to each unique patient. Over the past two years, sequencing data from the PIPseq program—which identifies the molecular drivers of an individual child’s cancer—has been used for many high-risk cases. In addition, a new DNA sequencing test known as EXaCT-1 recently received approval from the New York State Department of Health. Both tests have been extremely useful in guiding therapy in a very high percentage of children and adults. 

Immunotherapies – a promising approach to cancer treatment designed to boost the body's natural defenses – represent another highly effective option made possible at academic medical centers through gene sequencing. This approach enlists the patient’s immune system to slow the growth of, halt or even shrink existing tumors previously considered treatment-resistant. Early results in this rapidly evolving field are remarkably promising, and we are just beginning to see what these kinds of therapies can do. To cite just one example, new immunotherapies have increased the one-year survival rate for patients with metastatic melanoma from less than 10 percent to more than 60 percent. 

Developments like these are possible thanks, in large part, to the hubs of innovation at academic medical centers. These centers provide high-quality patient care to diverse populations, perform research to find the next generation of treatments and therapies, and train promising young physicians and scientists who will bring their ideas and findings to institutions across the world.  

Now is the time to support academic medical centers so that they can maximize their ability to advance this important initiative. Federal funding for NIH research and the training of tomorrow’s physicians needs to be increased, in order to support the research initiatives being discussed and to meet the growing need for researchers and clinicians.  

If we’re going to get serious about curing cancer, we need an all-hands-on-deck approach. Insurers — public and private — can help by recognizing the tremendous benefits of these therapies and opening them up to a wider range of patients. Philanthropists have laid the groundwork for so many discoveries, and we will need their vision and generosity going forward. Technology is a major driver of innovation in care and will continue to be one of the strongest assets in finding better treatments. And if we’re really going to “make a decade worth of advances in five years,” as Biden says, we’ll need a new generation of physicians and scientists who can continue to push boundaries and unleash new breakthroughs in science.  

Academic medical centers are already hard at work bringing together essential components in the fight against cancer. Working with government, industry and other stakeholders, academic medical centers will step up to the moonshot challenge and transform care for patients with cancer.