A bold initiative, in the face of doubts

In his State of the Union address, President Obama called for a stepped-up war on cancer, but with hundreds, even thousands, of types of cancer and an ever-increasing number of specialized therapies for them, experts say there is no true “moonshot” approach to tackling the nation’s second-leading cause of death.

The intensified research effort, which Obama said would be led by Vice President Biden, may instead be more like a swarm of fighter jets scrambling to take on numerous adversaries in a never-changing battle.

“A single approach to cancer . . . ain’t going to happen,” said Jose Basel ga, president of the American Association for Cancer Research and chief medical officer at Memorial S loan Kettering Cancer Center in New York. “Cancer, we’ve learned, is far more complex than we’ve ever imagined. Every single tumor is different.”

Yet top cancer specialists agree on several big ideas that might push the boundaries of research and therapy for the 1.7 million people diagnosed each year. Chief among them is creation of a huge database of diagnostic and treatment information from all cancer patients that clinicians and researchers would use to study different disease types and respond with specially targeted drugs.

Genomic testing has revealed that lung cancer, for example, is actually at least half a dozen kinds of cancers, said Richard L. Schilsky, chief medical officer for the American Society of Clinical Oncology. “The only waywe will learn everything thatwe continue to have to learn will [be by] aggregating large data sets,” he said.

Several organizations have launched smaller databases. Cancer experts who met with Biden’s staff last week to suggest initiatives want the government to create or fund a bigger one.

And this week, major pharmaceutical, biotech and insurance companies announced a collaboration to accelerate the next generation of immunotherapy — which unleashes the body’s immune system to fight cancer. Officials said that work must be underpinned by research at the National Cancer Institute. After years of flat or declining funding, its budget was increased by $260.5 million, to $5.21 billion, for fiscal 2016. About 70 percent goes for research.