Biden delivered the speech on the 60th anniversary of Kennedy’s moonshot speech, speaking from the late president’s museum and library. It was a less-than-subtle effort to convince Americans that the goal of eradicating cancer is not hopelessly out of reach.

“I believe we can usher in the same unwillingness to postpone, the same national purpose that will serve to energize and measure the best of our skills, to end cancer as we know it, and even cure cancer once and for all,” Biden said, borrowing phrases from Kennedy’s address.

Still, the anti-cancer effort, initially launched in the final year of the Obama administration and frequently touted by Biden on the campaign trail, has faced setbacks and struggles under his administration, and researchers hoped the presidential infusion of energy would set it on a better trajectory.

During Monday’s event, Biden announced he was naming Renee Wegrzyn, a top executive at Ginkgo Bioworks, a biotech firm, as the first director of a new agency called the Advanced Research Projects Agency for Health, or ARPA-H. Established in March to fund health innovation, it is modeled after the Pentagon’s DARPA program, which has boosted high-risk, high-reward breakthroughs like GPS and the internet.

Previously, Wegrzyn was a program manager at DARPA, where her work included research into how to respond to pathogens such as infectious diseases.

Biden on Monday also signed an executive order for a biotechnology initiative that the White House hopes will make the U.S. less dependent on foreign countries for the tools and raw materials needed for medical progress.

“It’s not enough to invent technology that saves lives,” Biden said. “We need to manufacture advanced biotechnologies here in the United States. Today’s actions are going to ensure that America leads the world in biotechnology and biomanufacturing, creating jobs and strengthening the supply chain.”

The administration’s drive to create ARPA-H has been controversial among some research scientists, who worry the new agency could divert funding from the National Institutes of Health.

And the moonshot effort, which is headed by Danielle Carnival, has been hampered by a lack of staff, resources and people in key positions at government health agencies, according to several cancer advocates and experts who are familiar with the situation and spoke on the condition of anonymity to avoid fraying relationships with the White House.

In a post in May, Sarina Neote, director of public affairs at American Society for Biochemistry and Molecular Biology, warned, “There will be no medical breakthroughs or revolutionary discoveries without sustained investments in basic scientific research. We urge policymakers to prioritize, not plunder, funding for NIH.”

Biden’s top science adviser, Eric Lander, who was initially tapped to oversee the moonshot, abruptly left the administration after he acknowledged mistreating and demeaning subordinates. The administration was criticized for not requesting any new funding to get the retooled moonshot off the ground.

And key positions — including the director of the National Cancer Institute, the head of the new ARPA-H research organization and a top presidential science adviser — have been empty for months. But now, the administration has tapped people for all three roles, fueling hope the moonshot efforts will accelerate.

“So far, the moonshot has been an inside game, without a lot of resources and people in critical positions,” said Greg Simon, who was executive director of the cancer moonshot in 2016, when Biden oversaw it as vice president. “This is the beginning of the outside game.”

While still nascent, the effort has already shown some benefits, experts say.

The cancer initiative, which was formally relaunched by Biden in February, has held numerous meetings in recent months with the administration’s “cancer cabinet” — officials throughout the government who are working on anti-cancer initiatives — as well as advocates and industry representatives.

Simon praised the administration’s focus on ARPA-H, saying that it will pioneer a crucial role that no other health agency can handle. NIH, which focuses on basic research, “can’t transform itself into a development agency that prioritizes technologies and cures,” he said.

The new agency “is the beginning of an effort to tie the work of NIH to the needs of the population by making leaps and technological forays that NIH is not set up to do,” Simon added. Congress has approved $1 billion for the new agency.

Cary Gross, director of the Cancer Outcomes, Public Policy and Effectiveness Research Center at the Yale School of Medicine, said one part of Biden’s efforts, while not technically party of the moonshot, could make a big difference — a cap of $2,000 per year on out-of-pocket prescription drug costs for Medicare beneficiaries.

“If that was the only thing that happened in the first six months of the moonshot, that is a tremendous win,” Gross said.

Gross urged the leaders of the moonshot and ARPA-H “to lean into the idea that there are many prohibitively expensive [drugs] that are on the market that we do not have adequate understanding of their risks and benefits.” He said the administration should come up with a plan to research how well the drugs perform in actual patients, who tend to be older and sicker than participants in clinical trials.

“I think most patients don’t recognize how much uncertainty” surrounds the drugs’ effectiveness, he said.

Edward Abrahams, president of the Personalized Medicine Coalition, an advocacy group that focuses on targeted therapies and other treatments, praised the new executive order designed to ensure that cutting-edge biotechnologies — including cellular therapies critical for cancer treatments — are manufactured in the United States. And he welcomed the announcement of a major clinical trial launched by the National Cancer Institute to test so-called liquid biopsies, blood tests use to detect cancer at its earliest stages.

“These ideas are something the federal government can do to move the needle forward,” he said.

Ellen Sigal, chair of Friends of Cancer Research, said Monday’s steps, along with the new leaders at key agencies, suggest the moonshot effort, along with the current pace of scientific innovation, “could truly change what a cancer diagnosis means for patients.”

But some experts urged the administration to take a broad view of the moonshot, including finding ways to help cancer patients based on what is already known.

Otis Brawley, a professor of oncology and epidemiology at Johns Hopkins University, said about 20 percent of the 600,000 annual cancer deaths in the United States could be avoided if disparities were reduced so that people with a high school education received the same help with prevention, diagnosis, screening and treatment as those with a college education.

“I am not anti-treatment, but we are much more interested in finding early treatments than in trying to prevent cancer in the first place,” Brawley said.

Biden has become a strong advocate for cancer research, with much of his inspiration coming after the death of his son Beau from brain cancer in 2015. His efforts were at times deeply personal — he has used his own connection with cancer to speak with others, frequently on the campaign trail — and at times political, as he turned it into a cause he sought to address with new federal policies.

“Everywhere we go, people share their stories, literally in grocery stories, airports, rope lines,” he said on Monday.

Biden’s anti-cancer efforts also provided a rare moment of bipartisanship in Washington. Biden worked closely with Republicans — including Senate GOP Leader Mitch McConnell (R-Ky.) — to win passage of the 21st Century Cures bill. It was one of the last pieces of legislation that Barack Obama signed as president, and McConnell also announced that the Senate would rename the law’s cancer program after Biden’s son, an emotional moment that caused Biden to tear up from the presiding officer’s chair in the Senate chamber.

“He’s known the cruel toll this disease can take,” McConnell said of Biden. “But he hasn’t let it defeat him.”

Biden for years had used Beau’s death to speak about, and advocate for, cancer initiatives. He has talked more openly in recent months about the possibility that his son’s cancer resulted from his military service near toxic burn pits in Iraq and Kosovo. Last month, with bipartisan support, he signed the PACT Act, new legislation that provides additional coverage for veterans who, like his son, were exposed to toxic burn pits during their military service.

During his trip to Massachusetts, Biden also appeared with state Attorney General Maura Healey, who is the Democratic gubernatorial nominee and is running against Geoff Diehl, a Trump-backed former state lawmaker. Healey participated with Biden in a photo line at the Kennedy Library.

And while Biden invoked President Kennedy’s aspiration for the moon, also on his mind was Edward M. Kennedy, the late Massachusetts senator and longtime Biden ally who died of the same brain cancer as Beau.

Just after landing in Boston, Biden spoke about Sen. Kennedy campaigning for him during Biden’s first Senate race, in 1972. Later, he reflected on the Kennedys helping him after his wife and daughter died in a car crash shortly after the election.

“Your family was there for me,” he said to Caroline Kennedy, the late president’s daughter who introduced Biden. “And I’ll never forget it.”

https://www.washingtonpost.com/politics/2022/09/12/biden-cancer-moonshot/