The "MOONSHOT", Part 2

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My friends Brad and Dave have just left, after a very pleasant visit that was far too short.  Both are accomplished birders (they expanded my “life-list” by nearly 6% - from 102 to 108).  They also are enthusiastic desert explorers and general naturalists, and so my wonderful little jeep got plenty of exercise. And in addition, Dave always comes bearing many bottles of excellent wine, and Brad provides multiple peanut butter cookies of a quality unexperienced by me since my mother hung up her apron long ago.  Needless to say, I invited them back!

But then I started thinking about the “Moonshot” – and realized I have very little left to say.  As many have said, this is a propitious moment to multiply our efforts to cure “cancer”.  Here is a short list of why:

1)       Largely owing to such genome-wide investigations as ENCODE and The Cancer Genome Atlas (both of which I have written about previously}, we are aware of the diversity of “cancer”, and have formed an appreciation of how difficult conquering “it” will be.  So much so, in fact, that I will stop using the quotation marks and take it as given that you are aware that what we have called “cancer” is many separate, but closely related, diseases.

2)      Also, resulting from research into the significance of our “junk” DNA, we are beginning to get a handle on how our genes are controlled – turned on, turned off, muted and modified.  Most cancers are the result of genes behaving badly; this new knowledge may – should -  help us correct their behavior.

3)      Progress is being experienced all along the front lines.  Immunotherapy, personalized therapy, early detection, increased understanding of environmental factors – it almost seems as though each of these, and more, are only lacking a swift kick in the butt to take off.  Note that money will help, but more than money is needed.

4)      Available technology of ridiculously sophisticated complexity has come on line.  To cite the one that has generated the most squawk, the CRISPR Cas9 will let us “edit” our very genes!  This is an inconceivably powerful weapon for good.  And, yes, it can be scary.

5)      And finally – we still are rich enough to afford one more Moonshot.

So, go get ,em, Joe!!   (Joe Biden, that is.)

My one remaining worry – a big one – is that future increases in funding will be distributed to researchers following current practice – peer-group review.  I have railed against this procedure several times previously; I feel that it inculcates excessive caution, incrementalism and delay, while simultaneously suppressing creativity.  I think we need a top-down approach, with one person or maybe two completely in charge.  My history may be faulty, but a am fairly certain that’s how we beat Hitler to the atomic bomb, and Russia to the moon.  So here, off the top of my balding head, are a few suggestions.

First, don’t give the money to the NCI or NIH.  Instead, create a new entity – call it NCA, for the National Cancer Agency – and put someone like Joe Biden in nominal charge.  Joe is an experienced and adept politician; Joe not only knows where all the bodies are buried, he also knows where they stacked the shovels!  Someone like Joe is indispensable in dragging ideas through government and into fruition.

However, entrust scientific decisions to someone who is broadly abreast of what’s going on, and can make hard decisions.  This person must be an accomplished scientist, but have attributes of an effective administrator.  Previously I have suggested Dr.  Soon Shiong: read about him here:

http://ljb-quiltcutie.blogspot.com/2014/12/the-richest-guy-in-la-and-also-most.html

Or maybe somewhere there is another hyperactive genius polymath who would be even better.  But, whoever is selected, put him or her totally in charge.  No committee votes, no peer reviews.  Top down.  Sounds like a horrible job, doesn’t it, but I would bet that there are plenty of qualified adrenalin junkies who would love it.  Another top candidate might be Jennifer Doudna of U.C., Berkeley, who is riding the CRISPR express full blast into parts unknown and hitherto undreamed of:

http://www.nature.com/news/genome-editing-revolution-my-whirlwind-year-with-crispr-1.19063

And, of course, give her/him an advisory panel – maybe the heads of the half-dozen top cancer labs in the country: Sloan Kettering, Fox Chase, M.D. Anderson, Fred Hutch, etc. , etc.  Let them rotate, perhaps.  But it should be clear that this panel is advisory only; where the money goes is entirely the responsibility of the Cancer Czar.  At least then we would know who to blame!

Okay, I started this by saying I had little to say, then wrote two pages, 750 words.  Imagine how long this would have been if I’d had some ideas!

And thanks to any of you who read this far; your dedication does you credit.  Right, Dave?