Cancer Moonshot

Optical imaging plays key role in new US attack on cancer.

01 October 2016

Optical imaging technologies will play a key role in the US “Cancer Moonshot” initiative, a program led by US Vice President Joe Biden.

With an initial $1 billion allocated over the next two fiscal years, the Cancer Moonshot will marshal a multidisciplinary effort across government agencies and research organizations to make anti-cancer therapies available to more patients and improve the technologies used to detect and diagnose the disease.

As photonic technologies — notably optical imaging — are already being exploited in cancer diagnosis and treatment, the US National Photonics Initiative (NPI) created a Cancer Moonshot Task Force to join in the effort. In June, the task force published its initial recommendations for how new optical technologies could contribute to early detection and effective intervention in cancer treatment.

In a white paper titled “A Brighter Future: Achieving the Goals of the Cancer Moonshot through Adoption of New and Enhanced Technologies and a Transformed IT Health System,” the NPI also details a commitment made earlier by members of the task force to leverage more than $3 billion in annual investments from the scientific community, technology developers, hospitals, and patient advocacy groups for early detection technologies of the most aggressive cancers.

Lauren Leiman, senior director of external partnerships at the White House Cancer Task Force, said the NPI Task Force would contribute to the goal of making “a decade of advances in cancer prevention and diagnosis, as well as in treatment and patient care, in five years.”

FUNDING AND BIG DATA SUPPORT

The NPI document makes three strategic recommendations toward that goal. The first is more funding over the next five years for clinical studies using already existing non-invasive and minimally invasive imaging technologies and their companion molecular tests for early detection of cancer, particularly breast, colon, and gastric cancers where current optical imaging modalities have large potential.

Another involves expanded funding for new imaging approaches, through coordinated public and private investments. It calls for a focus on low-cost but highly precise early-detection instruments and diagnostic assays; new predictive models using image analyses and machine learning techniques; and scalable, reproducible treatment protocols.

The third NPI recommendation is development of a shared IT infrastructure capable of supporting the large amounts of data generated by new imaging modalities and other photonics-based techniques, along with secure cloud-based data storage to make them available to more people. Such a national infrastructure would give patients, doctors, and researchers access to quantitative diagnostic medical data and enable more rapid reporting of patient outcomes.

It would also facilitate the key financial reimbursement decisions affecting the entry of new technologies.

The NPI task force is one of 26 public-private partnerships involved in the Cancer Moonshot. “I believe that the future of advances against cancer now lies in the intersection of these relationships,” Leiman said. “Combining resources and hearing from across all of the stakeholder universe is vital.”

FIVE-YEAR GOALS

SPIE Fellow Alan Willner, chair of the NPI Steering Committee, noted that advancements in optics and photonics technologies as well as high-sensitivity molecular diagnostic tests are essential for ushering in next-generation tools that will benefit patients. “The NPI looks forward to continuing to engage with a broad array of stakeholders who can define and exploit opportunities that will significantly impact efforts to achieve the National Cancer Moonshot Initiative goals,” he said.

Outlining the NPI strategy, Tom Baer, chair of the NPI Cancer Moonshot Task Force, commented that the US “war against cancer” has so far led to a limited number of significant, but narrow victories.

“For some cancers, several of the technologies needed to improve this picture already exist and are installed in hospitals and clinics,” Baer said. “In these cases, what is now needed are robust instrument calibration techniques to ensure site-to-site reproducibility of imaging measurements; technicians and radiologists trained in computer-aided quantitative measurement; and an IT infrastructure scaled to allow quantitative 2D and 3D image files to be routinely available for comparison.”

However, an attack on certain other cancers currently awaits the development of suitable technologies to diagnose and treat them. Baer noted that more effective early detection technologies for ovarian, brain, and prostate cancers still need to be developed, along with multi-parameter imaging techniques to simultaneously assess both the physiology of a tumor and its biological activity, such as its use of oxygen, a key aspect of cancer growth now being studied by optical means.

“The good news is that we can make significant strides within the next five years by effectively utilizing existing technologies and leveraging new investments to stimulate development of low-cost, precise, early-detection technologies and treatment protocols,” Baer said.

The NPI white paper commented specifically on ovarian cancer, where the lack of early-detection methods coincides with an absence of available biomarkers that would guide therapeutic intervention. New quantitative imaging diagnostic technologies and a series of coordinated clinical trials are critical to detecting the earliest signs of this cancer, and better identifying the molecular signatures for effective drug treatment in its early stages. (Read more about cancer research recognized with the 2016 SPIE President’s Award.)

A similar opportunity lies in the current lack of imaging methods able to detect cancer-positive lymph nodes without excision and subsequent biopsy. An emerging solution is based on near-infrared fluorescence imaging technologies, offering a low-cost, point-of-care method to assess the tumor load at the molecular level in the lymphatic system prior to the node’s removal.

Read the NPI white paper.


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