Clinical Researcher—October 2022 (Volume 36, Issue 5)
David J. Morin, MD, FACP, CPI, FACRP, 2022 Chair of the Association Board of Trustees for ACRP
On September 12, 2022, the White House announced the National Cancer Institute’s Vanguard Study on Multi-Cancer Detection to assess the potential of biomarkers for early cancer detection and prevention. This is one component of the “Cancer Moonshot” launched in 2016 with an ambitious goal of marshalling federal resources to significantly reduce cancer deaths in the next several decades.
When we look at healthcare strategies, we have two broad options. We can prevent disease, or we can treat it. Obviously, prevention is preferrable, but requires an understanding of causation. Sometimes the cause is environmental—such as that between smoking and lung cancer. It may be biological, as seen with higher rates of diabetes in obese patients. It may be genetic, as with breast and colon cancer. Or it may be a combination of factors.
However, we still do not understand what causes many cancers and this announcement, coming on the 60th anniversary of President Kennedy’s Moonshot Address about the goal of landing humans on the moon and returning them safely to Earth, comes at a time when our understanding of genetic markers provides many potential tools to pre-identify those at risk.
The majority of cancers do not have known screening markers, and this research is needed to be sure potential biomarkers are predictive of disease, reduce mortality, do not lead to unnecessary procedures or needless worry, and are cost-effective. This will require intense study and a long-term commitment, not unlike the original Moonshot announcement. I remember watching with intense interest and fascination in the 1960s the many successes of NASA—and occasional painful failures—that eventually led to multiple successful moon landings.
One question raised in the midst of social upheaval in the 1960s was whether that money for the so-called Space Race could have been better spent on programs to help the poor. Today, it is widely recognized how the technological advancements NASA accomplished led to many products, processes, and breakthroughs that we may take for granted, but which have undoubtedly improved the quality of life for many. The Vanguard Study is the next step in a process that has the potential to directly benefit us and future generations. The focus this time is on human research with a direct potential benefit to humankind. ACRP’s mission is to support excellence in clinical research worldwide as clinical trial practitioners are a key to these efforts, along with the valued contributions of study participants.
As a practicing physician, researcher, husband, and father, there is no diagnosis wrought with more anxiety and fear than a diagnosis of cancer. It will take many years to assess the potential benefits of these technologies, but now is the time to take these bold steps.
In addition to his volunteer duties with ACRP, Morin provides patient care and serves as the Director of Research at Holston Medical Group, a multispecialty practice in Tennessee and Virginia, and is Director of the High-Risk Disease Prevention program for a Fortune 100 company.