22 TuftScope 􀂰􀀀􀀦􀁁􀁌􀁌􀀀􀀒􀀐􀀑􀀒􀀀􀁳􀀀􀀶􀁏􀁌􀁕􀁍􀁅􀀀􀀑􀀒􀀌􀀀􀀩􀁓􀁓􀁕􀁅􀀀􀀩􀀩
INSIGHT
MD Anderson Takes a Giant Leap for
Mankind
Ariel Lefland
Forty-one years ago, President Nixon signed what became
know as the war on cancer: the National Cancer Act of 1971.1
Fifty years ago, President John F. Kennedy famously challenged
the United States to go to the moon. “We choose to go
to the moon in this decade and do other things, not because
they are easy, but because they are hard, because that goal
will serve to organize and measure the best of our energies
and skills, because that challenge is one that we are willing to
accept, one we are unwilling to postpone, and one which we
intend to win, and the others, too.”2 Inspired by JFK’s 1962
speech at Rice University, the University of Texas MD Anderson
Cancer Center has proposed its own “Moon Shots Program”
to significantly decrease the mortality rate of cancer in
this decade. The ambitious and innovative project is putting
MD Anderson at the forefront of cancer research so that cancer
can be better prevented, treated and detected.
In the past forty-one years, cancer research has come
a long way. Researchers and doctors have discovered that
cancer is a complex disease with many forms and multiple
causes. The American Cancer Society estimates that there will
be 11.3 million cancer survivors in the United States by 2015,
but cancer is still one of the most devastating diseases. This
decade alone, 100 million people worldwide are expected to
die from cancer. The mortality rate of cancer exceeds that of
cardiovascular disease, tuberculosis, HIV and malaria combined.
In a published statement, the MD Anderson Cancer
Center calls its new program “an unprecedented effort to dramatically
accelerate the pace of converting scientific discoveries
into clinical advances that reduce cancer deaths.” The
program looks to directly impact patients; MD Anderson’s
president, Ronald A. DePinho, M.D. believes we have many
of the techniques and instruments needed to fight cancer systematically
“with the precision of an engineer.” 3
Moon Shots is focusing on developing effective drugs and
personalized therapies through molecular techniques. A new
Center for Co-Clinical Trials will study animal and cell models
from MD Anderson’s large tissue repositories to profile
the mutations and proteins responsible for the onset of certain
cancer types.4 Researchers at Johns Hopkins University
School of Medicine in Baltimore have noted that molecular
markers such as DNA mutations, alterations in gene expression
or alterations in protein function have been associated
with all types of cancer.5 These markers can be used to detect
and monitor cancer. A news release published earlier this year
by MD Anderson also points to the importance of genomics
in cancer suppression. Researchers found that Grb2 controls
an important cell-signaling pathway involved in FGFR signaling.
The research helps to explain why mutations in the
gene sequence may promote cancer formation and growth.6
Genomics is a powerful tool for doctors when choosing
appropriate treatments for patients and is becoming a more
affordable technology. Knowing key gene sequences can help
determine whether or not a patient will benefit from a specific
therapy. 7 The Moon Shots Program has a single platform to
unify all of its research teams, emphasizing clinical genomics
and bioinformatics. The initiative will also look to implement
policies to prevent cancer and promote early screening and
detection.
The Moon Shots Program will initially target eight cancers
through six moon shot teams. Acute myeloid leukemia
(AML) and its precursor myelodysplastic syndrome (MDS),
chronic lymphocytic leukemia (CLL), melanoma, lung cancer,
prostate cancer and triple-negative breast and ovarian
cancers were chosen based on current knowledge of prevention,
treatment, survivorship, the probability of reducing the
number of deaths and the strength of assembled teams.8
Myelodysplastic syndromes are a group of malignant diseases
affecting blood cells. Fifty percent of patients suffering
from MDS develop AML, the most common form of leukemia
in adults. Approximately 16,000 Americans each year
are affected by AML and MDS; however, no curative therapy
exists for patients with MDS. The Moon Shots Program
aims to identify the molecular mechanisms that drive MDS
to become AML in order to develop inhibitors of this process.
Resistance to current medications is a major barrier in
finding an effective cure for MDS. Understanding why AML/
MDS becomes resistant to intervention is a major goal for
this moon shot team so that outcome in patients can rapidly
be improved.9
CLL is the most common form of leukemia seen in the
United States and Europe. The prognosis for patients with
CLL can range, making it a challenge to treat.10 Its genetic
makeup can be studied easily in detail because it flows in the
bloodstream.11 Out of the eight cancers under study in the
program, CLL is closest to being cured. Researchers hope to
create a “gene map” to determine risk factors, new drug combinations
for personal therapies and new screening methods.
Lung cancer is the leading cause of cancer-related deaths
in the United States. 220,000 people per year are diagnosed
with lung cancer in the US, and it kills approximately 160,000
Americans each year. Its most common cause, tobacco smoking,
however, is also its most preventable cause of death.
Detecting lung cancer too late is also a leading cause of poor
prognosis in lung cancer patients.6 Better detection methods
and educational programs can make a huge impact on the
number of lung cancer cases and deaths due to lung cancer
Ariel Lefland is the Researech Highlights Editor of TuftScope.
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2. Kennedy, J. F. (n.d.). Address at Rice University on the Nation’s
Space Effort, September 12, 1962 – John F. Kennedy Presidential
Library & Museum . John F. Kennedy Presidential Library
& Museum . Retrieved October 12, 2012, from http://www.jfklibrary.
org/Research/Ready-Reference/JFK-Speeches/Addressat-
Rice-University-on-the-Nations-Space-Effort-September-
12-1962.aspx
3. UT MD Anderson Cancer Center launches unprecedented
Moon Shots Program. (2012, September 20). Cancer Treatment
and Cancer Research. Retrieved October 12, 2012, from http://
www.mdanderson.org/newsroom/news-releases/2012/ut-mdanderson-
cancer-center-launches-unprecedented-moon-shotsprogram.
html
4. Engineering & Biotechnology News. (2012, September 24).
News Highlights: MD Anderson aims for the moon. Genetic
Engineering & Biotechnology News. Retrieved October 12,
2012, from http://www.genengnews.com/gen-news-highlights/
md-anderson-aims-for-the-moon/81247376/
5. Sirdansky, D. (2002). Emerging molecular markers of cancer. Nature
Reviews Cancer, 2(3), 210-219. Retrieved October 12, 2012, from
http://www.nature.com/nrc/journal/v2/n3/full/nrc755.html
6. Anderson Cancer Center. (2012, June 21). Grb2 holds powerful
molecular signaling pathway in
check. Cancer Treatment and Cancer
Research. Retrieved October 12, 2012,
from http://www.mdanderson.org/
newsroom/news-releases/2012/grb2-
holds-powerful-molecular-signalingpathway-
in-check.html
7. Falco, M., & Hellerman, C. (2012, September 21). Launching a
new war on cancer. CNN Health. Retrieved October 12, 2012,
from http://www.cnn.com/2012/09/21/health/cancer-program/
index.html
8. About . (n.d.). MD Anderson Moon Shots Program | The Time
is Now. | End Cancer. Retrieved October 12, 2012, from http://
cancermoonshots.org/about/
9. Leukemia (AML/MDS) . (n.d.). MD Anderson Moon Shots Program
| The Time is Now. | End Cancer. Retrieved October 12,
2012, from http://cancermoonshots.org/moon-shots/leukemiaaml-
mds/
10. Leukemia (CLL). (n.d.). MD Anderson Moon Shots Program
| The Time is Now. | End Cancer. Retrieved October 12, 2012,
from http://cancermoonshots.org/moon-shots/leukemia-cll/
11. Beyond the boundaries: the moon shots to cure cancer.
(2012, September 20). YouTube – Broadcast Yourself..
Retrieved October 12, 2012, from http://www.youtube.com/
watch?feature=player_embedded&v=7Nnzt_J31Jo
12. Lung. (n.d.). MD Anderson Moon Shots Program | The Time
is Now. | End Cancer. Retrieved October 12, 2012, from http://
cancermoonshots.org/moon-shots/lung/
13. Ackerman, T. (1992, September 21). ‘Moon Shots’ endeavor
gives cancer patients hope. Houston News, Sports, Business, and
Entertainment – The Houston Chronicle at Chron.com – Houston
Chronicle. Retrieved October 15, 2012, from http://www.
chron.com/news/houston-texas/article/Patients-express-hopein-
MD-Anderson-Cancer-Moon-3885155.php
14. Prostate. (n.d.). MD Anderson Moon Shots Program | The Time
is Now. | End Cancer. Retrieved October 12, 2012, from http://
cancermoonshots.org/moon-shots/prostate/
15. Breast & ovarian. (n.d.). MD Anderson Moon Shots Program
| The Time is Now. | End Cancer. Retrieved October 12, 2012,
from http://cancermoonshots.org/moon-shots/breast-ovarian/
each year. Moon Shots aims to use new smoking prevention
programs to reduce tobacco use by 15% among youth and
adolescents. The program also wants to use molecular profiling
to increase the number of patients cured with early-state
and locally advanced lung cancer by 10-20%.12
Melanoma is the most severe form of skin cancer. The
survival rate for most patients with advanced melanoma is
two years; Moon Shots aims to make it over 3-5 years. There is
an exciting new therapy in which a patient’s immune system
cells are trained to attack the cancer cells. T cells are collected,
exposed to antigens found on tumor cells and then injected
back into the patient.13 Whether or not this therapy can be
used successfully for long-term remission remains to be seen.
Prostate cancer is the most common cancer and the
second leading cause of death in men in the US. Currently,
one in six men gets prostate cancer; incidence is expected to
increase with the age of the male population. Researchers aim
to develop screening techniques and tools to identify molecular
targets to prevent unnecessary treatment and extend the
lifetimes of patients not benefiting or responding to current
therapies.14
The final group of cancers targeted
by the program are triple
negative breast and ovarian cancers.
Breast and ovarian cancers are the
most lethal and aggressive forms of
cancer in women. It is estimated that 229,000 women will be
diagnosed with breast cancer and approximately 40,000 will
die from breast cancer in 2012. Out of 22,280 diagnosed cases
of ovarian cancer in the US per year, 15,000 women will die.
Both are associated with BRCA1 and BRCA2 breast cancer
genes. Mutations in these genes increase the likelihood that
the cancer will develop. The moon shots team’s goal is to identify
women and families at risk for these cancers and develop
programs to decrease their risk for breast and ovarian cancers.
The team is also studying animal models for potential new
drug targets.15
The Moon Shots Program recognizes the great advances
cancer research has made in the past forty-one years; however,
it also recognizes that we still have much to learn in order to
be able to wage a successful fight against cancer. The program
is ambitious, but it also serves to raise confidence in the scientific
community. As MD Anderson’s president noted, the tools
needed to fight cancer already exist. The $3 billion dollar project
set to launch in February 2013 is structured to use these
tools in a systematic and unified way. It aims at a dramatic
reduction in mortality by not only finding genetic targets but
also by creating programs for better screening methods, earlier
detection, and improved allocation of resources. The fight
against cancer will certainly not be an easy battle to win, but it
is a challenge MD Anderson intends to win.
REFERENCES:
1. The War on Cancer, 40 years later. (2011, December 20). Insight.
Retrieved October 15, 2012, from http://blog.dana-farber.org/
insight/2011/12/the-war-on-cancer-40-years-later/
“…the tools needed to fight
cancer already exist.”