Policy Investments in Biomarkers Are Changing Cancer Outcomes
Genetic variations (https://www.nydailynews.com/opinion/harold-varmus-cancer-stopped-article-1.2181020) can affect hundreds, even thousands, of genes, making every cancer different, just as every snowflake is thought to be different. Catalogs of these genetic changes allow precise redefinitions of cancers, providing new diagnostic categories. More precise classifications are influencing the kind of therapies that are used and being developed.
Since the late 1990s, U.S. Congress has made a concerted effort to increase federal funding for the National Institutes of Health’s (NIH’s) biomedical research and clinical trials. Through rare but always bipartisan largess, legislative appropriators have seen the benefits of investing in the science for precision medicine; supporting genetic-grounded, patient-centered care; and changing the quality and longevity of life for millions of people, including those with cancer diagnoses.
Funding Fuels Disease Discoveries
The federal government has the deepest pockets, and on June 30, 2022, Congress doubled down its support for health agencies when the U.S. House Committee on Appropriations passed the fiscal year 2023 Labor, Health and Human Services, Education, and Related Agencies bill. The bill provides $242.1 billion for healthcare-related funding (https://officeofbudget.od.nih.gov/), an increase of $28.5 billion (13%) above the previous year’s allocation, and dedicates $62 billion (https://appropriations.house.gov/news/press-releases/appropriations-committee-approves-fiscal-year-2023-labor-health-and-human) to NIH and its new Advanced Research Projects Agency for Health (ARPA-H).
Part of ARPA-H’s charter helps steer the course on the Cancer Moonshot initiative, including its mission (https://www.nih.gov/arpa-h/mission) to:
- Speed application and implementation of health breakthroughs from molecular to societal.
- Build capabilities and platforms to revolutionize prevention, treatment, and cures.
- Support use-driven ideas that solve practical problems to advance equity and rapidly transform breakthroughs that improve outcomes for all patients.
Politicians seek opportunities that produce tangible implications for health. Cancer resonates as a problem that may not yet be solvable but is at least manageable. Biden’s personal story of losing a son to the disease led to his commitment to find a way to “end to cancer as we know it today (https://www.whitehouse.gov/briefing-room/statements-releases/2022/02/02/fact-sheet-president-biden-reignites-cancer-moonshot-to-end-cancer-as-we-know-it/)” and use the Moonshot to discover a decade of new treatments and cures in half the time.
Biomarkers Are the Pinnacle of Patient-Centered Care
Precision oncology has given clinicians and practitioners a deeper understanding of cancer as a genomic disease. Launched in 2016, the National Cancer Institute’s (NCI’s) precision oncology program (https://www.cancer.gov/research/areas/treatment/pmi-oncology) has guided research into groundbreaking frontiers. NCI used some of the program’s funding to expand its first-in-kind Molecular Analysis for Therapy Choice (NCI-MATCH) (https://www.cancer.gov/about-cancer/treatment/clinical-trials/nci-supported/nci-match) precision medicine trial and launch a sister trial for pediatric patients with cancer (https://www.cancer.gov/about-cancer/treatment/clinical-trials/nci-supported/pediatric-match). Both trials connect patients to therapies tailored to their specific cancer variants identified through biomarker testing.
NCI also supported new immunotherapy clinical trials (https://www.cancer.gov/research/areas/treatment/pmi-oncology) testing new combinations of cell, antibody, small molecule, and radiation therapies that include sequencing tumor biomarkers, and it’s developing a consortium of research institutions to conduct (https://www.cancer.gov/research/areas/treatment/pmi-oncology) “deep immunologic characterizations of patients enrolled in immunotherapy trials.” An offshoot of that work focuses specifically on developing approaches to use tumor profiling to help overcome cancer drug resistance (https://www.cancer.gov/research/areas/treatment/pmi-oncology). NCI’s additional investments went to developing new molecular cancer models (https://voice.ons.org/news-and-views/micro-organospheres-create-molecular-model-of-patients-cancer-in-just-two-weeks) and building a national genomics database that scientists, healthcare professionals, and patients can use as a resource for cancer care.
Oncology nurses are critical leaders in the conversation about biomarkers’ application in cancer care, and ONS is supporting its members’ work with an extensive repository of nursing resources on biomarkers (https://www.ons.org/learning-libraries/precision-oncology) and precision oncology, such as an overview of the seven types of biomarkers (https://www.ons.org/genomics-taxonomy/biomarkers) that researchers and clinicians use to define more precise cancer treatment strategies.
Through formal, evidence-based practices in biomarkers and beyond, nurses remain the most trusted profession (https://news.gallup.com/poll/388649/military-brass-judges-among-professions-new-image-lows.aspx), particularly in terms of patient education. Patients and caregivers rely on their nurses to explain and navigate the intricacies of a diagnosis, including their identified biomarkers. Policy leaders also look to the oncology nurse for an understanding of how healthcare policies can best support cancer outcomes and improve survivorship.
As the lynchpin on the precision oncology care team, oncology nurses are on the front lines of patient-centered care. Parlay your prime positioning to policy and support your patients in a new way by advocating for discoveries that drive current and future practice standards. See the sidebar for ONS strategies to support you.