Special Edition
February 2016

Barbara Duffy Stewart, MPH, is executive director of the Association of American Cancer Institutes

Commentary Overview

* AACI serves as the rallying point for academic cancer centers—breaking down silos, facilitating cooperation, and enhancing cancer centers' ability to work together.

* Vice President Joe Biden has identified "unprecedented levels of cooperation" among leading cancer centers as a major goal of the National Cancer Moonshot.

* AACI's programming, including its annual meeting and Clinical Research Initiative, provides a solid foundation for achieving the vice president's goal of significantly greater shared effort among cancer centers.
About AACI Commentary

As part of AACI's efforts to feature the work and views of its member centers, AACI has launched AACI Commentary, a quarterly editorial series. Written by cancer center leaders, each edition will focus on a major issue of common interest to the nation's cancer centers.



Breaking Down Silos: AACI Cancer Centers and the National Cancer Moonshot

BY BARBARA DUFFY STEWART, MPH

The Association of American Cancer Institutes (AACI) represents 95 academic cancer centers that excel in cancer research, clinical care and education. AACI serves as the rallying point for academic cancer centers—breaking down silos, facilitating cooperation, and enhancing cancer centers' ability to work together. These institutions house more than 20,000 scientific, clinical and public health investigators who work collaboratively to translate promising research findings into new approaches to prevent and treat cancer. AACI also plays a central role in ensuring synergy exists among its members, the government--particularly the National Cancer Institute (NCI)--and the private sector, from small biotechnology firms to large pharmaceutical companies.

Sixty-six of NCI's 69 designated cancer centers are AACI members, including all 45 NCI-designated comprehensive cancer centers. These centers coordinate the majority of NCI-supported cancer research and clinical investigation while providing substantial local support to augment these efforts.

A key element of AACI's mission is helping cancer centers keep pace with the changing landscape in science, technology and health care. AACI does this by gathering and sharing best practices, providing a forum for cancer center leaders to address common challenges and explore new opportunities, and collaborating with the NCI. AACI also supports a "corporate roundtable" to facilitate collaborations between cancer centers and industry.

With this deep experience in promoting cooperation among cancer centers, AACI is poised to make a significant contribution to the National Cancer Moonshot, led by Vice President Joe Biden and announced by President Barack Obama in his final State of the Union address in January 2016.

In a blog post following the president's announcement, Vice President Biden flagged two overarching action items: Increase resources, and, "Break down silos and bring all the cancer fighters together—to work together, share information, and end cancer as we know it."

Elaborating further, the vice president said the government's initiative would "encourage leading cancer centers to reach unprecedented levels of cooperation, so we can learn more about this terrible disease and how to stop it in its tracks."

AACI's programming provides a solid foundation for achieving the vice president's goal of significantly greater shared effort among cancer centers. For example:

AACI hosted its largest-ever annual meeting last fall in Washington, DC. More than 340 cancer center directors and executive level administrators convened with leaders of national cancer research and advocacy groups, industry, and government health agencies. The meeting featured panel discussions on a number of topics including understanding and developing immunotherapy programs, improving cancer care through innovative health information technology, evaluating emerging areas of cancer research, cancer survivorship and cancer center shared resources.

The AACI Clinical Research Initiative (CRI), a forum for clinical research leaders to share information and to advocate for improving the national clinical trials enterprise, will hold its 8th annual meeting in July in Chicago. Last year, the meeting convened more than 200 clinical research office leaders and medical directors. Attendees discussed how cancer centers manage the challenges of working with new clinical trial designs, such as basket and umbrella trials. Presentations touched on how these trials differ from other cancer trials, the benefits and risks for patients, screening patients using molecular tumor boards and the use of a centralized institutional review board to facilitate regulatory compliance.

With more than 500 subscribers, the CRI listserv provides a unique opportunity for AACI members to seek and get answers to a broad range of clinical research questions and to learn about best practices from their peers. For example, in response to members' queries about electronic regulatory binders, several members who have successfully implemented the binders hosted a webinar to describe their success. Similarly, in response to questions about the NCI-MATCH clinical trial, AACI hosted a conference call to discuss the general structure of the trial, coordination of patient activities, and collection of samples. NCI-MATCH-related conference calls will continue in 2016

The AACI Physician Clinical Leadership Initiative (PCLI), a forum for cancer center clinical operations physician leaders, aims to establish and share best practices addressing the following cancer center interests: Quality oversight and standardized approaches to care; clinical operations and optimal utilization of resources and technology; financial management and clinical services reimbursement; and, impact of clinical research on clinical services and trial enrollment.

In a letter to the vice president sent on behalf of the association by AACI President George J. Weiner, MD, AACI signaled its full support for the vice president's call to revolutionize the sharing of medical and research data. AACI cancer centers are a primary source for the generation, collection and use of molecular, clinical and outcomes data. Dr. Weiner stressed that steady, predictable funding for the National Institutes of Health and NCI is vital as cancer centers work to share data and improve information systems and communication across the cancer continuum. Streamlining regulatory oversight of these efforts, while also protecting patient privacy, is central to optimizing progress.

"A coordinated cancer moonshot will allow us to accelerate our research progress, thereby reducing the pain and suffering caused by cancer, for current and future generations," Dr. Weiner wrote. "The nation's cancer centers look forward to working with the president and vice president to move these general concepts from the drawing board to the launching pad."

Representing 95 of North America's premier academic and free-standing cancer centers, the Association of American Cancer Institutes is dedicated to reducing the burden of cancer by enhancing the impact of the nation's leading cancer centers.