opinion | Biden may block the launch of his cancer moonshot

In his last year as Vice President,

Joe Biden

Launched “Cancer Moonshot” to expedite the treatment of the disease. It was short-lived, but he helped negotiate a deal easing the regulation of successful drugs and medical devices in Congress.

In February, President Biden revived the initiative, setting a goal of reducing cancer mortality by at least 50% over the next 25 years. This is ambitious but achievable given how fast scientific knowledge and treatments are advancing. There are other Biden policies, however, at odds with the goals of this one.

Just last week, two pharmaceutical breakthroughs were announced that could save thousands of lives each year and redefine cancer care. Yet the tax hikes and drug-price controls that the Biden administration is doing would discourage private investment that has distributed these potential cures.

total annual cancer The death rate has dropped by 27% in the past two decades. This progress has been partly due to preventive screenings such as mammograms and lower rates of smoking. But recent advances have come from new therapies that target specific tumor biomarkers—often a mutated gene or protein—and immunotherapies that harness the immune system to fight cancer. Some biomarkers are unique to individual patients, but scientists have identified some 160 that are shared by certain subsets of cancer patients. For example, mutations in the KRAS gene have been found in non-small cell lung, colorectal and pancreatic cancers.

Cancer innovations have been accelerating as research and investment accrue over many years. danger of death Cancers fell by about 2% annually from 2015 to 2019, compared to 1% annually during the 1990s. This is set to drop even more rapidly in the coming years as treatments for stubborn cancers that resist chemotherapy and radiation become available.

While common cancers such as prostate and breast cancer have nearly 100% survival rates, drug makers and biotech startups are increasingly investing in rare and aggressive forms of the disease. about two-thirds The 2,335 trials launched globally last year focused on new treatments for rare cancers with small patient populations. These include glioblastoma, which killed Biden’s son Beau.



Immunotherapy Jamperley, which targets cancers caused by a rare genetic disorder known as mismatch repair deficiency, or DMMR, that are less responsive to chemotherapy and radiation. Food and Drug Administration Gemperly was granted accelerated approval last August, as it demonstrated promising results in patients with recurrent or advanced colorectal, small-intestine and colon tumors due to DMMR.

But could Zemperly work for other rare cancers? Researchers at Memorial Sloan Kettering Cancer Center, with funding from GlaxoSmithKline, decided to test the drug on a small group of patients with advanced rectal cancer caused by DMMR. The genetic disorder is responsible for 5% to 10% of the 45,000 rectal cancers diagnosed annually.

Oncologists were blown away by the results reported last week in the New England Journal of Medicine: all 12 patients Receiving the drug resulted in complete remission after six months of treatment. No one needed surgery, chemotherapy or radiation. While some may resume, the 100% success rate is phenomenal even for a small trial.

Doctors are hopeful that Zemperly may help some patients with pancreatic cancer, which can also be caused by DMMR and is usually punishable by death. Follow-up research and trials often show that the benefits of treatments extend to cancers other than the cancers for which they were initially developed. Similarly, Merck Keytruda—which treats metastatic melanoma, non-small cell lung cancer, Hodgkin lymphoma and bladder cancer—becomes blockbusters among many other therapies.

Profit is a dirty political term nowadays, but it is one that funds research and provides incentives for drug manufacturers to study how approved drugs can help different classes of patients.


Treatment of breast-cancer Enhertu is a monoclonal antibody that binds to a chemotherapy drug. Breast cancers are now classified as HER2-positive or -negative, based on whether they have an abnormal number of proteins that cause cells to multiply too rapidly. Not so long ago, HER2-positive breast-cancer patients had a higher risk of recurrence and death. But their survival rates have improved dramatically over the past two decades, thanks to HER2-targeted immunotherapies including Enhartu, which the FDA approved in 2019.

Most patients are classified as HER2-negative. Many people actually have small amounts of HER2, and doctors are increasingly describing them as “low HER2” to potentially treat them with Enhertu. Although the concept is not universally accepted, it may soon be.

Last week in partnership with AstraZeneca

Daiichi Sankyo

20 reported that Enhertu reduced the risk of death by 36% in patients with metastatic breast cancer with low HER2 and by half for the subset that were hormone-receptor negative. These results blow the results of other metastatic breast-cancer treatments out of the water. Oncologists estimate that Enhartu can reduce disease progression for half of patients now classified as HER2-negative, or about 40% of all breast-cancer patients. They are also hopeful that the mechanism of the drug could be applied to other difficult-to-treat cancers.

These treatment successes are not happening because of government programs. This is happening because pharmaceutical companies have invested decades and hundreds of billions of dollars in drug research and development. it usually takes 10.5 years And $1.3 billion To bring a new drug to the market. about 95% Cancer medicine fails.

This is important to keep in mind as Mr. Biden and Democrats in Congress push to “negotiate” Medicare – that is, cap-drug prices and raise taxes on corporations and investors. To reward shareholders for their investment risk and encourage future investments, drugmakers need to make large profits from successful drugs. Capital is mobile.

Mr. Biden’s proposal to increase top marginal personal income tax rates, including capital gains, would penalize venture capitalists who seed biotech startups that conduct the most early-stage research on cancer drugs and are often used by large drugmakers. are acquired. At the same time, their proposed corporate global minimum tax would increase the cost of intellectual property, which is often taxed at lower rates overseas.

There aren’t many things to celebrate these days, but biotech innovation is one. Let’s hope the president doesn’t kill his own cancer moon.

Ms. Finlay is a member of the Journal’s editorial board.

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