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Vice President Biden Releases Final Report on Cancer Moonshot Initiative Before Leaving Office Vice President Joe Biden delivered the Cancer Moonshot Initiative ’ s report , which presented the Task Force and Blue Ribbon Panel ’ s plans and recommendations , as well as the vice president ’ s strategic plan for transforming cancer research and care .
In his address , Vice President Biden reviewed the accomplishments of the Cancer Moonshot Initiative ’ s first year , which involved the development of the Precision Medicine Initiative Cohort Program and the Genomic Data Commons . These included :
• establishing the U . S . Patent and Trademark Office ’ s ( USPTO ) Cancer Moonshot Challenge to use intellectual property datasets to map and identify trending cancer technologies , enabling more precise funding and policy decisions regarding promising new treatments
• harnessing the power of artificial intelligence to improve cancer and disease diagnosis through the U . S . Department of Defense ’ s Joint Pathology Center , which digitized and made available its repository of more than 34 million unique pathology samples
• launching a pilot project from the National Endowment for the Arts ( NEA ) that will develop therapeutic art programs within designated cancer centers and health facilities at the state level
• launching the Department of Defense ’ s ( DoD ) longitudinal study to enhance our understanding of the biologic underpinnings of cancer , using the vast amount of data housed within DoD ’ s cancer registry and serum repository
He also detailed plans for the second year and beyond , including :
• strengthening interactions among agencies and engaging additional partners in support of multidisciplinary basic cancer research
• creating a high-quality performance status tracking system for cancer patients during therapy and longterm follow-up
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• creating a shared resource of linked clinical datasets
• developing predictive computer algorithms to rapidly develop , test , and validate predictive preclinical models
• modernizing eligibility criteria for clinical trials
• identifying and implementing culturally and linguistically appropriate cancer education and outreach efforts
• building collaborative relationships with the private sector and academia
Some of the new partnerships and commitments that will help achieve these goals include a collaboration between the National Cancer Institute ( NCI ), Amazon Web Services , and Microsoft to build a sustainable model for maintaining cancer genomic data in the cloud . The information will be available to researchers through the NCI ’ s Genomic Data Commons and Cancer Genomics Cloud Programs . In addition , the DoD is establishing a new study to transform the understanding of the biologic basis of cancer using its cancer registry database and biologic sample collection that includes approximately 250,000 samples .
The report also detailed the Blood Profiling Atlas , a pilot project in which representatives from government , academia , and pharmaceutical and diagnostic companies are partnering to develop blood tests – known as liquid biopsies – that can more accurately detect and monitor cancer . The group of 20 stakeholders includes companies developing the blood tests ( including Foundation Medicine , Epic Sciences , Personal Genome Diagnostics , and Guardant Health ), as well as pharmaceutical companies ( including AstraZeneca , Eli Lilly , Novartis , Pfizer , and Roche ). Seven Bridges Genomics is creating the website and Cloud-based software that will be used for the project ’ s data sharing . These companies will work closely with the FDA and NCI .
These new commitments will need to be supported by donations for research and data-sharing partnerships designed to make data more accessible for doctors , researchers , and patients . Vice President Biden also called for new funding mechanisms to encourage “ high-risk , high-reward research .”
Sources : The White House press release , October 17 , 2016 ; The Washington Post , October 17 , 2016 ; Forbes , October 17 , 2016 .
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AABB Releases Clinical Practice Guidelines on Red Blood Cell Transfusion and Storage The American Association of Blood Banks published in the Journal of the American Medical Association new clinical practice guidelines for red blood cell ( RBC ) transfusion thresholds and storage .
Based on a review of 31 randomized clinical trials ( comprising 12,587 participants ) in which patients were randomized to receive transfusion at either restrictive thresholds ( transfusion not indicated until the hemoglobin level of 7-8 g / dL ) or liberal thresholds ( 9-10 g / dL ), the guidelines recommend more restrictive transfusion thresholds for adult patients :
• Transfusion is not indicated until the hemoglobin level is 7 g / dL . This is recommended for hospitalized adult patients who are hemodynamically stable , including critically ill patients , rather than when the hemoglobin level is 10 g / dL ( strong recommendation , moderate quality evidence ).
• A restrictive RBC transfusion
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threshold of 8 g / dL is recommended for patients undergoing orthopedic surgery , cardiac surgery , and those with preexisting cardiovascular disease ( strong recommendation , moderate quality evidence ).
These more restrictive thresholds were not associated with higher rates of adverse clinical outcomes , including 30-day mortality , myocardial infarction , cerebrovascular accident , rebleeding , pneumonia , or thromboembolism . However , the authors noted that these recommendations do not apply to patients with acute coronary syndrome , severe thrombocytopenia , and chronic transfusion-dependent anemia .
In a review of 13 randomized controlled trials ( comprising 5,515 participants ) evaluating clinical outcomes of fresher blood ( storage length < 10 days ) or standard-issue blood ( used within the licensed dating period ), the guideline authors determined that fresher blood did not improve clinical outcomes . Based on these data , the guidelines recommend that patients , including neonates , should receive standard-issue RBC units rather than limiting patients to transfusion of only fresh RBC units ( strong recommendation , moderate quality evidence ). ●
Source : Carson JL , Guyatt G , Heddle NM . Clinical practice guidelines from the AABB : Red blood cell transfusion thresholds and storage . JAMA . 2016 October 12 . [ Epub ahead of print ]
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