Forbes August 8, 2022
MIT Professor Tyler Jacks has made a mark in cancer work not only by his research but his ability to bring different organizations together.
Through his leadership, Break Through Cancer has spurred a first-of-its-kind collaboration of five of the top cancer research centers in the world: Dana-Farber Cancer Institute, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, MIT’s Koch Institute for Integrative Cancer Research, The University of Texas MD Anderson Cancer Center, and Memorial Sloan Kettering Cancer Center.
The effort, funded with $250 million of help from the family of Richmond, VA businessman William H. Goodwin, is committed to reducing the day-to-day barriers to cross-institutional collaboration such as contract negotiations, data sharing, intellectual property, and authorship policies.
President Biden’s Cancer Moonshot, requiring collaboration across the U.S. government agencies, is up against many of those same problems. I recently spoke to Jacks at his office in Cambridge, Massachusetts on how he sized up the effort. He knows well about then Vice President Biden’s 2016 Moonshot efforts, having been a co-chair of a Blue-Ribbon Panel to advise on the effort.
First, he said, is the importance of quantifying the battle. “Having specific goals and an action plan for cancer is important. Having a strategy about how to approach the cancer problem is equally important. The fact is that the White House was motivated to do that in the setting of Cancer Moonshot 1.0 and re-initiate the effort in 2.0 lends ready comparisons to our efforts in Break Through Cancer,” Jacks said.
“I like the fact that they have included in 2.0 a goal of reducing cancer mortality in 25 years by 50%. Putting a stake in the ground and measuring success against it is sensible,” he said. “I also strongly support several of the specific areas that have been identified in 2.0, including earlier detection. We know that cancer is a particularly challenging disease when it gets to the advanced stages. After it is spread, it's much more difficult to treat. And so, the earlier one can detect the disease, the greater the chances of success.”
Focal points are important because of the availability of new technologies to find cancers at earlier stages, Jacks said. “Some of them are based in blood screening technologies that are becoming available now. They're not perfect yet, but they're going in the right direction. Other technologies that are being developed, including better assessment of imaging technologies using, for example, artificial Intelligence and machine learning.”
Jacks also noted the importance of a new Biden effort that’s been launched at Break Through Cancer: learning from every patient. “When we think about clinical trials and what information is gathered in the setting of such trials, frequently there's not enough information learned. The patient is given the drug, and some period of time elapses. One ultimately determines whether the patient responded or not. And that is often the limit of the information gained. In fact, that period between giving the drug and assessing the outcome, lots of things were changing.”
Sometimes the drug was doing what it was designed to do. Sometimes it failed to do so. Sometimes the body was responding in this way, and other times responding in that way. But you lose all that Information unless you look. Bu stressing the need to learn from every patient, they mean to apply the best scientific methods that are available to us today, which are increasingly more precise and increasingly more specific, and for which the resolution is better than ever — or sensitivity to assess these changes is better than it's ever been,” Jacks said.
He encouraged current Moonshot leaders to put resources into early detection and treatment. “Moonshot 2.0 calls out one approach that I'm quite excited about –immune-based approaches at the earlier stage, specifically, the potential for vaccines, even more specifically, mRNA based vaccines. I'm excited about the prospect of building vaccines that can reduce an individual’s risk or prevent the cancer altogether.
Jacks also called out the need for wider accessibility to improving treatments across all society strata – “not just at the high-end medical centers, but in the community setting as well. Access to the latest developments is very, very important. And this is a frustration of mine. We create the latest advances (yet they) are frequently unavailable to people who have different types of coverage and different types of health care in cancer.”
“I think we need to make sure that the community setting, where a lot of these patients are being treated, has access to newest technologies. We need to have the payers to support the use of those tests. When such tests are approved, there should be no impediment to any patients having access to having them. Unfortunately, there is often a problem here.”
Payers, such as insurers, he said, “put into the system various impediments that block the ability of the physician or the patient to access those tests, thereby denying the individual drugs that could benefit them, including drugs that are quite potent.”
One takeaway from his experience with the 2016 Moonshot was the opportunity for the kind of wider exchanges and collaboration in the cancer field that now guides Break Through Cancer, where Jacks helps five elite groups combine forces. “I liked the fact that we were gathering experts, and thinking about a plan and developing more specific ideas as a collective effort about what we wanted done,” he said.
In turn, he believes, the current Moonshot leaders might well turn to established teams such as his own multi-institution grouping at Break Through Cancer in search of relatively quick advances. “They might then build off those (existing) structures to expand the activity through follow-on funding,” Jacks said.
“I believe there's a real value in the approaches that we're taking — team based, strategically driven, with proper oversight and with experts from wherever they might be located,” he said.