Bridge To A Cure advocates leveraging technological breakthroughs to end childhood cancers and brain tumors. We invest in various research opportunities, including Artificial Intelligence, data-driven therapies, and advanced imaging. These leading-edge research areas will eventually lead to a breakthrough in treating and inevitably curing these diseases. To that end, how we deliver healthcare is on the cusp of a major transformation. New, data-driven technologies are emerging that unlock the power of multimodal research.

Imagine a doctor diagnosing a patient by looking at X-rays or blood tests and analyzing a rich tapestry of information. This tapestry could include genetic data, electronic health records, wearable sensor readings, and medical imaging from different modalities In cancer research, modalities simply refer to the different tools or approaches scientists use to fight cancer. Imagine a toolbox filled with various instruments for different tasks. Similarly, cancer research has a toolbox filled with modalities for tackling this complex disease. This is the essence of multimodal research – combining data from various sources to create a more complete picture of a patient’s health.

Healthcare professionals rely on multiple data sources to diagnose and manage patients. However, analyzing each data type in-depth requires significant expertise, making it impossible for one person to master everything. This is where AI and machine learning come in. These technologies can seamlessly integrate and analyze data from diverse sources, breaking down data silos and creating robust predictive models. When used responsibly, the insights gained from these models can empower healthcare professionals to deliver even better care.

Unlocking Hidden Connections

Machine learning excels at weaving together data from various modalities, providing a holistic view of a patient’s health. This combined data becomes a powerful tool for extracting complementary information. Think of it like putting together puzzle pieces – each piece offers a glimpse. Still, the complete picture reveals a hidden connection you wouldn’t have seen otherwise. Studies have shown that multimodal data fusion models consistently outperform single-modality models, leading to increased accuracy (by as much as 27.7%) and improved performance.

Oncology: A Leader in Multimodal Research

Oncology, the cancer research and treatment field, is a prime example of how multimodal methods drive progress. Machine learning can be used to find patterns within a large volume of data and predict cell behavior with the aim of improving immunotherapies. Multimodal data can identify risk factors for non-invasive screening and preventive care. Patterns in readily available data can lead to the discovery of biomarkers, aiding in diagnosis, patient risk stratification, and clinical trial selection. Additionally, these models can identify signatures that predict patient response to treatment, allowing for more personalized treatment plans.

Beyond the Individual Patient

The power of multimodal research extends beyond individual patient care. With strict data privacy and security measures in place, this approach can accelerate medical research. Researchers can discover novel biomarkers and therapeutic targets for drug development by analyzing vast amounts of multimodal data. This data can also be used for population health management, providing a comprehensive view of health trends and outcomes across entire communities. The exponential growth of research publications on multimodal oncology data over the past decade underscores the recognition of its immense potential by the scientific and medical communities.

The Future of Healthcare is Multimodal

Leveraging machine learning to analyze the vast diversity of multimodal data is poised to revolutionize healthcare. We’re excited to support these revolutionary research areas through our partner organizations. We believe investing in these research opportunities will help us achieve our goal of reducing the childhood cancer death rate by 50% by 2030. As part of the commitment Bridge To A Cure Foundation is investing in Children’s Brain Tumor Network (CBTN).

This $200,000 grant will help CBTN make an immediate impact on pediatric brain tumor research. By leveraging AI-powered tools and fostering collaboration across leading institutions, and powerful data analysis tools, CBTN is poised to accelerate discoveries, and ultimately, save countless young lives. The future of pediatric brain tumor research is bright, and thanks to this innovative partnership, the fight against these devastating diseases is entering a new and exciting chapter.

What we can do to fight the trauma of childhood cancer + COVID-19

Every time 5-year-old Julia Malicki goes to the doctor for cancer treatments, she has to brave having a cotton swab stuck up her nose to the back of her throat to test for coronavirus. The fear and discomfort she endures seems almost unbearable for a child who has already lost her right eye, and 70% of the vision in her left, to a rare form of cancer called retinoblastoma.

It’s anguishing for her and for her mom, Jessica.

“It’s a lot of emotional turmoil as a child to have to go through that fear,” Jessica told USA Today in an article titled “‘Like a new diagnosis’: Cancer families struggle to continue treatment amid coronavirus pandemic.” “The COVID testing really impacted (her).”

Cancer + COVID-19: Traumatizing Kids & Families

Surgery, radiation, and chemotherapy already traumatize families emotionally, psychologically, and financially. Now they face the added fear and worry of contracting another potentially fatal disease.

Since October 2016, Julia’s family has traveled from Wisconsin to New York City every four weeks for her tests and treatments. After driving 17 hours, the family has arrived to find motels closed due to the pandemic. Due to COVID-19 rules, only her mother can be with her during hospital visits, depriving Jessica of the support of her husband or other family.

Disrupting Caregiving Comfort

Some patients have had their treatments postponed or delayed. Lakelynn Markham, a 6-year-old from Holly Springs, N.C., became a candidate for a clinical trial three years ago after doctors discovered a tumor pressing on critical nerves in her neck, disqualifying her from surgery.

For half of her life, Lakelynn and her family traveled to the Dana-Farber Cancer Institute in Boston for her treatment. The pandemic ended those trips. She now sees doctors at a Duke University Medical Center and receives treatments via overnight courier.

It means that she now has to fight for her life without her “superhero,”  a Boston nurse named Shawn, who used to help her through her treatments.

“He has magic,” Lakelynn told Raleigh, N.C. radio station WRAL, explaining that when Shawn prepared her IV, his magical hands made sure the needle didn’t hurt at all.

Children like Lakelynn get to know and trust their doctors and nurses, and depend on routines to help them through medical trauma. Changing routines can increase a child’s fear and anxiety.

They also face struggles that make the inconveniences healthy people face — like having to wear masks and maintain social distance — seem minor. Lakelynn has been doing these things since long before the pandemic began. And while she understands why she can’t play with her friends, it is still heartbreaking for her mom to watch her staring out the window at other kids having fun.

Raising the Stakes of Pediatric Cancer

For children battling cancer and their families, COVID-19 has disrupted surgeries, radiation and chemotherapy treatments, and added to their emotional, financial, and psychological trauma. The same is true for children and families fighting other major medical issues.

A new study in the journal JAMA Pediatrics looked at 48 children in the United States in intensive care with COVID-19. It found that 40 of them had significant medical issues and half of these were categorized as “medically complex,” meaning they were either dependent on technological support for survival or faced serious medical issues such as immunosuppression, usually connected to cancer treatment, the New York Times reports.

“Children with immunodeficiencies or children who have had chemotherapy are at higher risk for serious illness,” the article notes.

Yet children without previous medical problems have also ended up in intensive care, sometimes suffering from a condition related to COVID-19 known as pediatric multisystem inflammatory syndrome. It develops weeks after the initial coronavirus infection and assaults a child’s circulatory system with inflammation rather than directly attacking the lungs.

Treatment Must Go On

Despite the risks posed by the pandemic, experts warn against discontinuing chemotherapy, surgery, radiation, and other therapies for children battling cancer.

“We have observed in our conversations with colleagues from around the world that it is giving us major disruptions, and that children will die or have died, not because of the infection but because of how COVID-19 has affected their (health care) services,” Dr. Carlos Rodriguez-Galindo, told U.S. News.

Rodriguez-Galindo is director of St. Jude’s Global COVID-19 Observatory and Resource Center for Childhood Cancer, a new database of resources for medical professionals specializing in treating pediatric cancer. Similar to the national pediatric cancer database advocated by Bridge to a Cure Foundation, it includes a resource library, a global registry of pediatric cancer patients infected with COVID-19, and a collaboration space for healthcare professionals.

“We have learned from them that even the children that have active therapy for cancer with COVID-19 don’t seem to do that poorly, and that is reassuring.”

As a result of the pandemic, children and families battling cancer and other chronic and terminal diseases and conditions face longer odds and more harrowing battles than they did before. They need our help.

How You Can Help

• Follow COVID-19 guidelines including wearing a mask and staying at least six feet away from people when in public and washing your hands frequently. Parents of kids battling cancer appreciate when we do our part to stop the spread and help keep their kids safe.
• Support families who have lost children to cancer and those still in the fight. Some families who have lost children are experiencing PTSD and anguish over what other childhood cancer families and patients now face in the pandemic. Some practical ways mentioned in this article include contacting families via social media and asking how you can help — financially, through donations of supplies, or by offering to help with shopping or other errands. Visit via phone and video and be there to listen and provide emotional support.
• Donate blood and blood products such as platelets to help combat shortages due to blood drives that have been canceled due to the pandemic. Cancer patients desperately need these, so contact your local blood bank to schedule an appointment.
• Join the National Bone Marrow Donor Registry. Donated bone marrow and stem cells are a critical part of cancer treatment that help save lives. Learn more and join the national database/registry at DKMS.org or BeTheMatch.org.
• Make your voice heard through Bridge To A Cure. The Bridge To A Cure Foundation is working to help kids with cancer and their families by advocating for greater efficiency, collaboration and data sharing to find effective treatments and cures. Stay updated on our efforts, comment on the fight, and learn about other ways to help when you visit BridgeToACure.org and sign up to receive updates.

Social media posts:

Children with immunodeficiencies and those who have had chemotherapy are at higher risk for serious illness due to COVID-19.

Families going through surgery, radiation, and chemotherapy now face added trauma of possibly contracting another potentially fatal disease.

Lakelynn has to fight for her life without her “superhero,”  a Boston nurse named Shawn who used to help her through her treatments.

Children fighting cancer get to know and trust their doctors and nurses. Changing caregivers and routines adds to their fear and anxiety.

Despite risks posed by the pandemic, experts warn against discontinuing chemotherapy, surgery, radiation and other therapies.

Support families who have lost children to cancer and those still in the fight. Visit www.BridgeToACure.org.

Bill Gates + Bridge to a Cure = Path Forward

In Bill Gates’ 2015 TED Talk titled “The next outbreak? We’re not ready,” Bill warned that we were woefully unprepared to deal with the threat of a pandemic. He was right.

In the Bridge to a Cure Foundation’s March 2017 release, we identified the five barriers contributing to the unacceptably slow development of pediatric cancer treatments and cures.  The same is true for infectious diseases.

Globally the coronavirus has infected millions, killed hundreds of thousands, and decimated national economies and the lives of many families. Bottom line: we weren’t prepared. The next time — and there will be a next time — we must be ready. The Path Forward is now and here’s how we should implement it:

• Develop the response plan proposed by Bill Gates and be ready to implement it to identify infectious disease outbreaks early: Gates proposed we look at how the military prepares for war and use that as a model to prepare for the net pandemic. This includes having trained “soldiers” ready to deploy, reserves we can scale up rapidly, and war games-like training simulations. “Those are the kinds of things we need to deal with an epidemic,” Gates said.
• Ensure that the required numbers of trained human resources are prepared to deploy: This includes epidemiologists ready to study the disease and identify how far it has spread, along with medical teams trained and ready to treat patients. Using the Ebola outbreak as an example, Gates noted we were unprepared in these areas and warned: “A large epidemic would require us to have hundreds of thousands of workers.”
• Advance preparedness for clinical research to combat pandemics: Speaking of our lack of preparedness for Ebola, Gates said, “There was no one there to look at treatment approaches. No one to look at the diagnostics. No one to figure out what tools should be used. As an example, we could have taken the blood of survivors, processed it, and put that plasma back in people to protect them. But that was never tried.” In an article titled “Advancing Preparedness for Clinical Research During Infectious Disease Epidemics,” the authors state: “Clinical research is vital for an effective response to infectious disease epidemics. To be viable, preparations must be made in anticipation of infectious disease epidemics and must address barriers to rapid deployment and implementation.”

To meet these challenges we should follow the same approach developed by the Bridge to a Cure Foundation to modernize pediatric cancer research by unleashing resources already available today. Measures we propose include:

• Develop a robust national database for each microbial threat: As the article notes, “In many instances the point at which an epidemic occurs is the only time to gather data and generate new knowledge regarding disease characterization, prevention, and treatment. Experience from previous epidemics highlights how time and again, the research response is delayed and the narrow window of opportunity for enrolling patients during peak epidemic waves is missed.” We must provide a process and framework to capture the hundreds of millions of pages of research, medical files, and the science behind every treatment, drug and alternative medicine so that this data is available in advance of the next pandemic. To learn more, read our Sept. 24, 2019 blog Dying in the Dark and the April 15, 2019 blog Stop Pediatric Cancer Like We do Terrorists.
• Include alternative medicine/treatments: Develop a methodology to evaluate/approve alternative medicines/treatments. To learn more, read our May 29, 2018 blog Breaking Down Barriers, Bridging to A Cure.
• Capitalize on the proven capability of artificial intelligence: Research institutions have been slow to embrace this technology, trusting more in the mind of the researcher alone. Once a robust national infectious disease database is developed, we need to provide the methodologies and tools for researchers to extract meaningful findings. There are computers that can read and review hundreds of millions of scientific pages in seconds. Algorithms can be written to discover, analyze and predict from the data a robust global database would provide. To learn more, read our Feb. 15, 2019 blog Putting the Pieces Together for the Fight Against Cancer.
• Simplify, sensitize, and modernize the clinical trial process by speeding up and reducing complexity. Some ways to do this include pursuing simulated research, balancing life expectancy and quality of life, and including exemptions to allow terminal patients to participate in trials of experimental drugs. To learn more, read our Jan. 31, 2020 blog Solving the Clinical Trial Debacle and the July 25, 2019 blog The National Cancer Institute Knows How to Cure Pediatric Cancer.
• Align and collaborate across institutions and practitioners: Develop a reward and recognition system unique to infectious disease research — one that reinforces a culture of collaboration and spans across and within nations, institutions, governments and sectors. The article referenced above states, “There are multiple challenges to building equitable and mutually supportive partnerships. These include unequal access to funding, academic reward systems that incentivize competition over cooperation, silo-thinking reinforced by (artificial) disciplinary boundaries and commonly held assumptions regarding mutual capacities or needs. Fragmentation and competition among stakeholder groups, research initiatives, and disciplines represent a lost opportunity for shared expertise and learning, and to strengthen global, national, and regional research preparedness.” To learn more, read our Nov. 25, 2019 blog Why Reward Systems are Barriers to Pediatric Research Breakthroughs & How to Fix it.

We are at a moment in history where it is time to acknowledge the flaws in our approach to medical research and treatments, and how we respond to pandemics. Overcoming the barriers identified above is a good place to start. But that alone isn’t enough. We need a holistic strategic approach that engages participation from the medical community; pharmaceutical and technology companies; investment and investor communities; nonprofits/foundations and donors; and military, state, and local officials and government agencies.

It is time to recognize and value institutions and corporations for their contribution to the global good. The mantra of maximizing shareholder value alone is insufficient. Corporations should do more to better mankind — and they should be rewarded for it. In our May 2019 blog, we introduced the Millennial Organization. It revolutionizes the criteria for valuing organizations. The blog provides detailed evidence to support that the time has come for the Millennial Corporation — the organization whose stock value reflects not only sustainable profit growth but also its contributions to improving the human condition. Now is the time for the investment community and pharmaceutical industry to redefine the matrices for valuing this industry. Investing in childhood cancer would be a good place to start. To learn more, read our May 28, 2019 blog The Cure to Pediatric Cancer is at Our Fingertips.

The coronavirus outbreak is teaching us the importance of an “ounce of prevention.”

With the worldwide spread of coronavirus, we are all being asked to do our part to stop its spread. Washing hands, maintaining social distance, and staying home if you are sick are things we can all do to preempt COVID-19, the respiratory illness caused by coronavirus.

Much has been written about how COVID-19 largely spares children. However, families of children with cancer know that any infection, including this new one, can weaken their child’s defense system.

Amid the coronavirus pandemic and all we are being asked to do to stop it, we should not lose sight of the fact that cancer remains the leading cause of death by disease among children and adolescents, and the third leading cause of childhood death overall.

The exact cause of childhood cancer remains unknown; however, researchers believe it is most likely caused by a combination of genetic, environmental, and immune system factors. In today’s blog we examine some of these factors and what we should be doing to prevent more kids from developing cancer.

Risk factors for childhood cancer remain poorly understood for several reasons. For example, most children with leukemia don’t have any known risk factors, and many children who are affected by risk factors don’t develop cancer.

Nevertheless, we know that there are many factors that increase the risk a child will develop cancer. These include prenatal problems, exposure to infections and radiation, and genetic factors. Here is what we know about some of the risk factors, and recommendations for preventative measures we can take to preempt them:

Genetic Risk Factors

Cancer is a genetic disease, caused by certain changes to genes that control the way cells function, especially how they grow, divide and mutate. Genetic changes that promote cancer can be inherited from parents if the changes are present in reproductive cells. Inherited genetic mutations play a major role in about 5-10% of all cancers, according to the National Cancer Institutes.

“Genetic changes that cause cancer can also be acquired during one’s lifetime, as the result of errors that occur as cells divide or from exposure to carcinogenic substances that damage DNA, such as certain chemicals in tobacco smoke, and radiation, such as ultraviolet rays from the sun,” NCI states.

How We Can Preempt Genetic Risks

Genetic tests for hereditary cancer syndromes can determine if a person from a family that shows signs of such a syndrome has one of these mutations, NCI says. These tests can also show whether family members without obvious disease have inherited the same mutation as a family member who carries a cancer-associated mutation.

The World Health Organization classifies four different groups of external agents as carcinogens that cause cancer in children: physical, biological, chemical carcinogens, and dietary components such as cured meats. Limiting or preventing children’s exposure to highly processed foods, tobacco smoke, and environmental toxins such as pesticides, solvents, and household chemicals can help to preempt genetic risks.

Infectious Risk Factors

Certain infectious agents, including viruses, bacteria, and parasites, can cause cancer or increase the risk it will develop, NCI states. Some viruses can disrupt signaling that normally keeps cell growth and proliferation in check. Some infections weaken the immune system, making the body less able to fight off other cancer-causing infections. And some viruses, bacteria, and parasites cause chronic inflammation, which may lead to cancer.

Epstein-Barr virus and HIV, the virus that causes AIDS, have been linked to an increased risk of childhood cancers, including Hodgkin and non-Hodgkin lymphoma, according to Stanford Children’s Health. Hodgkin lymphoma accounts for 4-6% of all childhood cancers, with the highest incidence rates in ages 15-19, while non-Hodgkin lymphoma (NHL) account for 6-7% of all childhood malignancies, according to NCI.

Acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML) are the two most frequent types of leukemia in children. In a Kazakh study titled “Childhood cancers: what is a possible role of infectious agents?” researchers propose two possible models to explain how infectious agents could play a role in the development of childhood leukemia — either by directly transforming cells, or by secondary genetic or immunological alterations caused by abnormal immunological responses to congenital, neonatal, or post-neonatal infections. These can act as a “triggering mechanism” for leukemia and possibly other types of cancer, the study states.

How We Can Preempt Infectious Risks

Many infectious agents can be controlled by treatment and/or vaccination. For instance, using immune globulins during pregnancy and after birth has been shown to boost the protective effect against some herpes viruses linked with childhood cancer. Vaccines may also protect against mother-to-child transmission of infections, the Kazakh study notes. This includes sanitation measures to prevent infections during pregnancy and early childhood, as well as in healthcare institutions.

Not surprisingly, many standard measures now recommended to prevent the spread of coronavirus are important for preventing infections that are risk factors for childhood cancer, or can exacerbate illness in young people battling cancer.

Immune and Protective System Risk Factors

The immune system helps protect against cancer in three ways: It detects “nonself” antigens from pathogens or infected/malignant cells; specifically targets and destroys pathogen or infected/malignant cells while protecting the host; and develops “immunological memory” allowing it to adapt immune responses and defend against attacks.
“This multifaceted mechanism consists of the three primary phases: elimination, equilibrium, and escape, that contribute to cancer elimination, dormancy, and progression, respectively,” states one NCI study. “Interestingly, this ability of cancers to evade or escape the immune response is now recognized to be one of the most distinguished cancer hallmarks, which provides the platform for treatments within the context of immunotherapies.”

How We Can Preempt Immune System Risk Factors

Boosting research into immunotherapy is one of the most promising areas of Bridge to a Cure’s work to support building a National Pediatric Cancer Database. Building the database will also allow us speed up research into how cancer cells are able to evade apoptosis (programmed cell death), and to target angiogenesis, the formation of new blood vessels that feed tumor growth.

Just like with coronavirus, there are things we can all do to help boost our children’s immunity and our own, including maintaining healthy diets, immunizations, regular exercise and medical exams, and of course, frequent hand-washing. As our nation copes with the unprecedented coronavirus epidemic, Bridge to a Cure will continue the fight to tear down the five deadly barriers against finding a cure, and to make a national database a priority.

Childhood Cancer Facts

• The incidence of childhood cancer is on the increase, averaging 0.6% increase per year since the mid-1970s, resulting in an overall increase of 24% over the last 40 years.(1)
• 1 in 285 children was diagnosed with cancer in 2014.(1)
• 43 children per day or 15,780 children per year are expected to be diagnosed in with cancer (10,450 ages 0 to 14, and 5,330 ages 15 to 19). (1)
• The average age at diagnosis is 8 overall (ages 0 to 19), 5 years old for children (aged 0 to 14), and 17 years old for adolescents (aged 15 to 19) (9), while adults’ average age for cancer diagnosis is 65.(7a)
• Childhood cancer is not one disease — there are more than 12 major types of pediatric cancers and over 100 subtypes.(1)

Source: https://cac2.org

This month, we acknowledge those committed to identifying and destroying the most horrific terrorist cells in America – cancer cells!

These terrorist cells kill more children than any other disease. If we are to destroy them, we will need to provide our healthcare professionals with the medical arsenal to fight the fiercest terrorists targeting our children.

Thanks to the insight and input collected by the Bridge to a Cure Foundation from over 120 childhood cancer researchers and practitioners, we now know what our medical professionals need to finally wipe out these terrorist cells that target our children:

• A robust and dynamic national childhood cancer database.
• Algorithms that optimize the full capability of artificial intelligence.
• A simplified, sensitized, and modernized clinical trial process.
• A methodology to evaluate/approve alternative medicines/treatments.
• Collaboration and alignment within and across institutions.
• Pharmaceutical companies motivated to invest in ending childhood cancer.

CHILDHOOD CANCER HEROES

There were many institutions and medical professionals involved in the identification and development of these remedies for which we are appreciative. Today, we would like to give special recognition to those whose counsel and support have made a significant contribution to Bridge to a Cure’s work to identify the armaments we need to win the war on childhood cancer:

• Dr. Darell Bigner – Duke Cancer Institute
• Dr. Saskia Biskup – Center for Genomics and Transcriptomics, Germany
• Dr. Melissa Bondy – MD Anderson Cancer Center
• Dr. Alberto Broniscer – University of Pittsburgh School of Medicine
• Dr. Robert Darnell – The Rockefeller University
• Dr. Ira Dunkel – Memorial Sloan Kettering
• Dr. Henry Friedman – Neuro-oncologist, Duke Cancer Center
• Dr. James Garvin – NY Presbyterian/Columbia University Medical Center
• Dr. Todd Golub – The Broad Institute
• Dr. Dirk Hadaschik – CeGat Germany
• John Kelly III – Senior Vice President, IBM
• Dr. Robert Kerbel – Sunnybrook Research Institute, Toronto
• Dr. Mark Kieran – Dana-Farber Cancer Institute
• Rebecca Lambert – NED Biosystems
• Dr. John Letterio – University Hospital Cleveland
• Dr. Duane Mitchell – University of Florida
• Dr. Filiberto Munoz – San Diego Clinic, Mexico
• Dr. Jeremy Rich – Cleveland Clinic
• Dr. Ned Sharpless – Director, National Cancer Institute
• Dr. Linda Van Aelst – Cold Spring Harbor Labs
• Dr. William Weiss – University of California, San Francisco
• Dr. Ben Williams – Anti-Cancer Alliance

We especially want to give recognition to the institutions and individuals that have advanced the effort to develop the arsenal needed to destroy childhood cancer cells. These are the ones who want to change the status quo — the ones who realize that we cannot continue to repeat what has not worked and who feel the urgency to implement a better approach to childhood cancer research.

IBM’s Watson computer system uses artificial intelligence (AI) to aid cancer research.

KEY INITIATIVES

• A robust and dynamic national childhood cancer database — The National Cancer Institute’s (NCI) Childhood Cancer Data Initiative (CCDI) aims to make it easier for researchers to learn from each of the approximately 16,000 children and adolescents diagnosed with cancer in the US each year. CCDI is the beginning of realizing Bridge to A Cure’s top objective: creating a robust national database that contains everything we know about childhood cancers. CCDI aims to maximize every opportunity to improve treatments and outcomes for children with cancer; build a connected data infrastructure to enable sharing of childhood cancer data from multiple sources; identify opportunities to make data work better for patients, clinicians, and researchers; and develop and enhance tools and methods to extract knowledge from data.

• Algorithms that optimize the full capability of artificial intelligence — We are beginning to see AI used to guide cancer management, with the most prominent example being IBM’s Watson for Oncology (WFO). Each month Watson ingests about 10,000 new scientific articles and data on 100 new clinical trials to keep up-to-date on new findings. While some point to the system’s limitations, it is important to keep in mind how new the technology is, and to recognize those who are adapting it to the real world fight against cancer. Other childhood cancer institutions experimenting with the potential of AI include: Lucile Packard Children’s Hospital Pediatric Molecular Imaging Program and the Department of Pediatrics, Hematology/Oncology Section, both at Stanford University School of Medicine; Memorial Sloan Kettering Cancer Center; The University of Texas MD Anderson Cancer Center; the Department of Pediatrics, UNC School of Medicine; and the Sherry and John Woo Center for Big Data and Precision Health at Duke University.

• A simplified, sensitized, and modernized clinical trial process — Organizations such as The New York Genome Center are using state-of-the-art genomic technologies and collaborating with leading research institutions to investigate the origins, diagnosis, and evolution of cancer. This includes working with The Broad Institute to simulate pediatric tumors in the laboratory to the map the capacity of tumors to develop resistance to drugs and drug combinations.

• A methodology to evaluate/approve alternative medicines/treatments — Opposition to alternative treatments is one of the barriers we’re working to remove in the fight against pediatric cancer. Some efforts worthy of recognition include research studies in Complementary and Alternative Medicine (CAM) to reduce symptoms and improve well-being for children with cancer. While most of these have been limited to single institutions, publications such as The Journal of Alternative and Complementary Medicine are providing peer-reviewed studies to evaluate and integrate of CAM into mainstream medical practice. Medical marijuana is another promising area. Research by Yale Cancer Center showed a majority of pediatric cancer providers endorse its potential use for children with advanced cancer, although clinicians want to see much stronger clinical evidence that marijuana treatments can help relieve symptoms such as nausea and pain.

• Collaboration and alignment within and across institutions — We see increasing recognition of our goal of increasing collaboration among groups such as Stand Up To Cancer. SU2C funds “multidisciplinary and multi-institutional collaborative research projects that address critical problems in cancer prevention, diagnosis, and treatment to deliver near-term patient benefit.”

• Motivating pharmaceutical companies to invest in ending childhood cancer — As millennials become the dominant force in corporate culture, they demand companies work to improve the common good and not just the bottom line. Impact investing is one way to achieve both financial and social returns. Although impact investing is a relatively new strategy, its global market size is estimated to be $228 billion and growing, with 75% of investments generated from private investing strategies. Last year the CEO of BlackRock, the world’s largest asset manager with over $6 trillion in investments, called on CEOs of the world’s largest public companies to not just deliver profits but to fulfill their responsibility to make “a positive contribution to society.” The time is right to capitalize on the movement to value companies for their contributions to improving the human condition in addition to sustainable profit growth.

These are just a few of the innovations we want to highlight for International Children’s Cancer Day, which took place on February 15th. There are many others. As we raise awareness of the children battling cancer, we must focus and accelerate the momentum toward achieving the breakthroughs kids and their families so desperately need.

In closing, we want to dedicate International Childhood Cancer Day to all the childhood cancer researchers and child oncologist professionals for their dedication, caring, and drive to make a difference. Their commitment to saving children is a challenge both intellectually and emotionally. These dedicated professionals are motivated by the desire to save lives and to stop the diseases that remain the most common cause of death among children in America.

The mission of the Bridge to a Cure Foundation is to increase the pace and success of childhood cancer research. In order to do that, we need to remove barriers to finding cures and effective treatments.

In our last blog, we explored why the clinical trial process is one such barrier, including the fact that few new drugs have been developed for treating children with cancer, and that the few drugs that have been developed have not resulted in cures, but have been appallingly harmful. In this blog we examine some possible solutions.

Acknowledgement of the problem and its cause

Rectifying persistent unsolved problems begins with the acknowledgement that there is a problem, and agreement as to the root cause of the problem. Our prior blog provided evidence that:

• Our childhood clinical trial approach is a serious problem.
• We know the root causes contributing to the problem.
• Those participating in the clinical trial process are aware of the magnitude of the problem and its causes.

Why it has not been resolved

If the medical community knows this, why hasn’t the problem been resolved? There are three overarching reasons:

1. Methodology – It relies on a problem/solution approach whereas what is needed is a process improvement approach.
2. Money – The population of children with cancer is too small for pharmaceutical companies to invest in. Funding for clinical trials is not typically covered by federal grants, and federal laws meant to encourage drug companies to invest in pediatric clinical trials have not been very effective, according to an article titled “Drug Discovery: A Challenge for Pediatric Cancers,” published by Johns Hopkins Medicine. Bottom line, the money isn’t there. “We are completely at the mercy of the drug company as to whether or not it will provide the drug for this study,” pediatric cancer expert Dr. Patrick Brown says in the article. “If it says no, which is the most likely answer, the study doesn’t happen.” This has hindered the efforts of the Children’s Oncology Group, a collaborative of oncologists from 220 institutes that does most large clinical trials.
3. Matriculation – The investment, government and nonprofit communities are not fully immersed as critical components in an effort to fix our approach to childhood clinical trials.

The solution

The following proposed solutions would hopefully encourage the medical, investment, government and nonprofit communities to make fixing the childhood clinical trial process a shared priority, with a clearly stated mission, strategy, and plan.

Methodology
1. Set vigorous performance standards. There are two problems with the current performance metric of extending a child’s life five years:

• It assumes that extending a child’s life by five years justifies the pain and hardships faced by the child and family. This measurement needs to be revisited. A robust analysis that measures the benefit vs. the risks (pain, financial burden, psychological impact, quality of life) is long overdue.
• It encourages the same past practices that have produced too few breakthrough cures and treatments. We need to set standards that will require greater collaboration and the expanded use of machine technology.

2. Capitalize on the enormous potential of existing and emerging technology:

• Today, laboratory analysis of a child’s cancer is limited to the few samples available from the tumor. Simulating the child’s tumor in the laboratory will provide an unlimited ability to analyze and test treatments. The Broad Institute has had some success and we need to invest more in this.
• The population of children with cancer, as is true for many other childhood diseases and disorders, is too small to benefit from the analytical power of artificial intelligence (AI). Without AI, the treatment and cure possibilities are limited. To address this problem, we need to invest money and minds to establish a dynamic methodology to translate the results from adult clinical trials to inform childhood treatments and cures. This would be a singular funded initiative focused only on this goal.

3. Implement reward and recognition programs that:

• Foster collaboration within and across institutions and industries.
• Include objectives designed specifically to improve the clinical trial process.
• Are linked to a more vigorous performance standard.

Both behavior and performance are most influenced by goal expectations. If we want greater collaboration and more effective/compassionate treatment solutions, the performance goals need to clearly articulate what’s expected.

Money
We will need more than just a fresh approach to generate the funds required to finance the testing of potential cancer cures for our children. In our May 2019 blog we introduced the Millennial Organization to do just that. It revolutionizes the criteria for valuing organizations. The blog provides detailed evidence to support that the time has come for the Millennial Corporation – the organization whose stock value reflects not only sustainable profit growth but also its contributions to improving the human condition. Some reasons we cited to justify this approach include:

• Investors want it: Individuals everywhere are concerned about our country, the world, its people and the environment. The horrors of pediatric cancer are at the top of the list of concerns for many Americans. “For these and other reasons, more people are investing their money to get back more than just a monetary return on their investment. Many are investing to make a positive impact in our country and around the world as well as to feel that societal concerns should be made an important part of their investment focus.” (1)
• Investment companies want it: “Our global goal is to develop a comprehensive, industry-leading platform of research, advice, and products that is dedicated to sustainable investing and philanthropy.” (2)
• It’s already happening: “Over the last two years, SRI (Socially Responsible Investing) has grown by more than 22% to $3.74 trillion in total managed assets, suggesting that investors are investing with their heart, as well as their head. In fact, about $1 of every $9 under professional management in the U.S. can be classified as an SRI investment.” (1) Signatories of the UN-PRI (The United Nations-supported Principles for Responsible Investment) manage $59 trillion.

Children continue to suffer the effects of toxic chemotherapies because drug companies refuse to provide promising immunotherapy drugs. This is an example where investors can make a difference, by demanding that pharmaceutical companies invest in clinical trials as part of a move toward socially responsible investing. Now is the time for the investment community and pharmaceutical industry to redefine the metrics for valuing this industry. Pediatric cancer would be a good place to start.

Matriculation
To reinvent the clinical trial process, and to significantly increase the availability of new drugs and treatments for childhood cancer, will require participation and commitment from all cancer related sectors, including:

1. Pharmaceutical and investment communities: Develop criteria for valuing a pharmaceutical company’s contribution to improving childhood cancer. This will require shared leadership from both sectors such as the Security and Exchange Commission and the Pharmaceutical Research and Manufactures of America Foundation  (www.phrma.org )
2. Childhood Cancer Nonprofits and Donors: This community funds both “care” to children/families fighting cancer and childhood cancer research. The “care” support they provide is important and effective. It should be continued. However, the funding of childhood cancer research is not. Instead they should redirect these funds to efforts that will greatly advance discovery by removing barriers to meaningful breakthrough. Fixing the childhood clinical trial process is a good place for them to start.
3. Government: Government laws and policies are among barriers to an effective and sensitized clinical trial process. Legislators should assess all such rules to assure they are not “suffocating, discouraging or preventing the research they seek to regulate.”
4. Tech companies: As noted above, fixing the clinical trial process will need to include artificial intelligence.

While each sector needs to take responsibility for their contribution to improving the clinical trial process, a holistic approach is still required. Fixing the childhood clinical trial process demands a coordinated effort framed by a shared mission, strategy and plan. We recommend that Dr. Ned Sharpless, NCI Director, lead this initiative.

In conclusion, our clinical trial process is broken. We need a new approach. One that is:

• Sensitized by the horrific journey, modernized by machine technology, and optimized to reward higher performance standards and collaboration.
• Built to reward pharmaceutical companies for investing in childhood cancer research.
• Holistic, with active participation and commitment from each sector.

To read our prior posts providing solutions to improving our approach pediatric cancer research, visit BridgeToACure.org.

The mission of Bridge to a Cure Foundation, a nonprofit fund, is to accelerate the pace and success of childhood cancer research by unlocking the full potential of resources already available today. Our vision is happier, healthier lives for children who face the challenges of this debilitating disease.To learn more about the foundation and add your support, visit BridgeToACure.org.

(1)  Forbes, April 24,2013 – Socially Responsible Investing: What You Need To Know
(2) UBS editorial in their March 2015 newsletter.

The mission of the Bridge to a Cure Foundation is to increase the pace and success of childhood cancer research. In order to do that, we need to remove barriers to finding cures and effective treatments. The clinical trial process is one such barrier. Without clinical trials, there are no new drugs. In this blog we examine:

• Why we need childhood cancer clinical trials.
• Proof that today’s clinical trials are a debacle.
• The reasons why the current process is failing.

Why we need childhood cancer clinical trials

• To ensure that the drug(s) are effective. “Children and adolescents are not small adults, and their bodies’ physiology and chemistry react very differently to illness and disease. Thus, pediatric clinical trials are critical to developing treatments and cures for childhood disease and illnesses.”
• To identify harmful side effects and “provide reliable evidence of treatment effects by rigorous controlled testing of interventions on human subjects.“

Proof that today’s clinical trials are a debacle

• In the last 25 years, the FDA has received only 30 applications for new drugs for use in pediatric-specific oncology.
• Few drugs have been developed — Since 1980, fewer than 10 drugs have been developed for use in children with cancer.
• The few drugs that have been developed have not delivered a cure and have been appallingly harmful and ineffective. As a result:
  • Cancer remains the number one cause of death by disease among children.
  • There has been no change to the survival rate for children with brain and other nervous system cancers for the past 20 years.
  • Even with survival defined as a child living for a mere five years, only 75% of childhood cancer patients meet that yardstick.
  • More than 95% of childhood cancer survivors will have a significant health-related issue by the time they are 45 years of age.
• Many clinical trials for children are abandoned and their results never published.
• Few clinical trials are conducted in childhood patients compared to the number of industry-supported clinical drug trials conducted in adults, a 2012 study found.

Why the current childhood clinical trial process is failing

• The criteria for approval is insufficiently vigorous — Children are considered survivors if they live a meager five years. If a child surviving five years is a goal researchers can celebrate and be rewarded for, then we should not be surprised that that’s what our solutions deliver. The five-year measurement fails to acknowledge the child’s horrific suffering, the emotional strain on parents and siblings, or the financial impact on the family.
• Lack of participation — One study identified 30 potential barriers to participation in childhood clinical trials including a relatively small population of available participants; high cost and lack of incentives for pharmaceutical companies to perform drug trials; potential legal risk to the pharmaceutical sponsor; ethical concerns regarding participation of children in trials; and a lack of adequately trained pediatric investigators.
• Lack of Funding — Pharmaceutical companies won’t invest. “One significant challenge in developing drugs for children is the perspective that pediatric medicines do not provide industry with similar financial rewards as adult medicines,” said Benjamin Ortiz, MD, who formerly served as Medical Officer in the Office of Pediatric Therapeutics at the FDA.
• The pharmaceutical industry “may have been reluctant to study medicines in children” for several reasons, another NCBI study says in an obvious understatement. “The market for the sale of many drugs for children is smaller than that for adults, and therefore investment in childhood drug testing might be less attractive financially. Other reasons cited in this report include ethical difficulties, problems with blood sampling, and difficulties in recruiting sufficient numbers of children.”
• Pharmaceutical companies won’t provide drugs — “Access to drugs and the ability to explore them are the biggest barriers to changing standard of care for pediatric patients,” says childhood cancer expert Patrick Brown, Associate Professor of Oncology and director of the Pediatric Leukemia Program at John’s Hopkins. “We can’t mass-produce drugs, so we usually rely on drug companies to provide drugs for clinical trials,” says Brown. “The much smaller number of patients with childhood cancers compared to adult cancers and the risk of something going wrong with a drug being tested in children can make pharmaceutical companies reluctant to provide drugs.”
• The current clinical trials process favors research into diseases that affect adults over those that afflict children — There are over 300,000 clinical trials available today worldwide, of which there are only 26 childhood clinical trials in the U.S. (https://pediatrictrials.org).
• Ethical concerns — “Pediatric trials are more challenging to conduct than trials in adults because of the paucity of funding, uniqueness of children, and particular ethical concerns,” says a study from the National Center for Biotechnology Information (NCBI), which is under the National Institutes of Health.

We need a new national strategy and commitment to improve the clinical trials process for childhood cancer drugs and therapies. In part 2 of this blog, we will explore what needs to be done.

To read our prior posts providing solutions to improving our approach childhood cancer research, visit Bridge to a Cure.

The Bridge to a Cure Foundation is the lead advocate for modernizing our approach to childhood cancer, with a priority on building a childhood cancer database to speed up the search for cures. We have met and gained the support of over 120 institutions and practitioners, including the former NCI Director Ned Sharpless, who has become a forceful proponent and driver of this initiative in Washington. To learn more about the foundation and add your support, visit Bridge to a Cure.

Government regulations and controls hinder discovery, treatment, and affordability

The mission of the Bridge to a Cure Foundation is to increase the pace and success of pediatric cancer research. In order to do that, we need to remove barriers to finding cures and effective treatments. In this blog we will look at:

• How government red tape hinders cancer research.
• Costs of childhood cancer to families and society.
• Why we need a national strategy to align priorities and streamline the search for cures.

1. Government red tape and cancer research.

The cost of government regulations is well known to the industries that pay the burden. One study put the cost of new regulations implemented in the Obama era at $100 billion. These costs are not just born by manufacturers and utilities, but also in the research arena where agencies such as the Food and Drug Administration have stymied development of drugs to treat cancer. Thousands of families have suffered as a result of government red tape.

Dr. Vincent DeVita, who developed the first curative chemotherapy protocol for adult cancer, argues that the FDA has held up vital cancer treatments through its cumbersome and outdated approval process. In his book The Death of Cancer, he says that bureaucracy is the only thing standing in the way of transforming cancer from a killer to a “chronic but survivable illness.”

DeVita argues that the FDA should not be approving drugs for treating cancer because it treats them like traditional drugs, not taking into account the fact that cancer patients may die without trial medicines. FDA approvals, he argues, are one of the biggest obstacles to patients receiving life-saving treatments.

“The FDA is approving drugs based on outdated methods,” he said in an interview. “It should approve new cancer drugs based on their safety profile and their ability to hit important molecular targets. And I think cancer centers have matured enough to handle all the early trials by themselves.”

The National Cancer Institute (NCI) and FDA should delegate responsibility for all phase I and II trials to NCI-approved cancer centers, he says. This would increase the speed of developing new drugs tenfold, and cost a lot less than the current system.

“Guidelines are backward-looking in a rapidly changing field like cancer,” DeVita says. “But what worries me more are the constraints on innovation. New approaches to treatment in this era of targeted therapy need maximum flexibility to mix and match treatments in order to control the wily cancer cell.” He also calls for greater collaboration between cancer treatment centers.

2. Government and the high costs of childhood cancer.

Since the early 1900s, medical special interests have been lobbying politicians to reduce competition. By the 1980s, the U.S. was restricting the supply of physicians, hospitals, insurance and pharmaceuticals, while subsidizing demand. “In too many areas of the economy — especially health care — free enterprise has given way to government control in ‘partnership’ with a few large or politically well-connected companies.” (Ryan 2012).

Meanwhile, a National Children’s Cancer Society survey of 449 families coping with childhood cancer found that 95 percent reported their child’s cancer caused a financial burden on the family. Among families who were not poor when their child was diagnosed, 10 to 15 percent became impoverished as a result of medical bills. A quarter of families reported losing more than 40 percent of their income to help pay the bills, and this did not even count out-of-pocket expenses like travel to hospitals and childcare.

These findings are not surprising when you consider that the average cost associated with each case of childhood cancer is $833,000. The average cost of hospitalizations for pediatric cancer is $40,000 — nearly five times as much as hospitalizations for other pediatric conditions. And let’s not forget that cancer is just one of the pediatric diseases that rob family finances. An estimated 30 million children in America struggle with a chronic disease or psychological disorder.

The economic cost to families and our nation is staggering. The emotional stress on families is not quantifiable — nor is what our nation forfeits from not having many of these children achieve their potential.

Disturbingly, the culprit contributing to this emotional and economic devastation is the medical industry’s antiquated approach to childhood cancer research and their influence on government.

3. Why we need a national strategy to align priorities and streamline the search for cures.

Government regulations should be linked to an overarching strategy that improves our individual and national health, safety, and economic conditions. Economic return must be part of the strategy.

Regulations on automobile safety and emissions are as example. A study by the Institute of Transportation Studies at the University of California, Davis found that added costs from such regulations are significant, but “represent only a modest part of overall vehicle cost increases.” Regulations “had little discernible effect on industry performance and activities,” with cost increases “largely accommodated within normal business and market planning processes of companies.”

The same cannot be said of government regulations restricting new cancer drugs, since they actually prevent patients who have been diagnosed with terminal diseases from accessing medications that are experimental in nature.

I am not arguing for eliminating all regulations, but rather for eliminating those that create barriers for research into cancer and other pediatric diseases — the kind outlined in a study by the Regulatory Transparency Project:

“Poorly designed regulations may cause more harm than good; stifle innovation, growth, and job creation; waste limited resources; undermine sustainable development; inadvertently harm the people they are supposed to protect; and erode the public’s confidence in our government,” the study found.

We should also work to eliminate regulations that drive up the cost of research and treatment in response to legal risk. On the other hand, we need new regulations to address the imbalance in funding for childhood vs. adult diseases. Here’s the dilemma:

• The 60+ age group is huge and they face many medical issues. It’s an attractive market for the pharmaceutical industry and other research institutions. But our youth are the future of our nation, the “seed corn” that hold the key to productivity and a better life.
• Despite their tremendous potential, children under 18 make up less than a quarter of the total population. Those suffering from serious diseases are an even smaller percentage. About 11,060 children in the United States under the age of 15 will be diagnosed with cancer this year. This accounts for less than 1 percent of all cancers. Yet while their numbers are small, the costs to families and society are enormous.

When it comes to new regulations, we should adopt ones that encourage collaboration, investment and promising new approaches. At the top of the list is building a national pediatric cancer database — one that will allow us to tap into the power of artificial intelligence to end the scourge of childhood cancer.

What regulations can be put in place to encourage government, research institutions, and private industry to do the right thing: collaborate and invest in our future? If the government can demand that carmakers invest in seatbelts, why can it not demand that pharmaceutical companies invest more in pediatric research?

It’s time to review our country’s regulatory strategy to eliminate regulations that are a barrier to research, and to add regulations and incentives to accelerate meaningful breakthroughs.

Redefining the role of government in pediatric cancer research is essential to achieving the breakthroughs so many children are counting on. To read our prior posts providing solutions to improving our approach pediatric cancer research, visit www.bridgetoacure.org.

The Bridge to a Cure Foundation is the lead advocate for modernizing our approach to pediatric cancer, with a priority on building a pediatric cancer database to speed up the search for cures. We have met and gained the support of over 120 institutions and practitioners, including the former NCI Director Ned Sharpless who has become a forceful proponent and driver of this initiative in Washington. To learn more about the foundation and add your support, visit www.bridgetoacure.org.

The Mission of the Bridge to a Cure Foundation is to increase the pace and success of pediatric cancer research. Building a robust national database is essential to making that happen. But it won’t happen without creating an environment of collaboration within and across research institutions.

This blog discusses:

• Why collaboration is important.
• The primary barrier to collaboration within the pediatric cancer research community.
• What needs to be done to fix it.

Why collaboration is important.

• Pediatric cancer is so complex and multifaceted that to expect individual researchers or institutions to have the breadth of knowledge necessary to deliver breakthroughs is unrealistic. To solve the many urgent challenges that individuals have failed to solve on their own, science must be able to harness ideas, people, and resources from across disciplinary and organizational boundaries.
• The building of a robust national pediatric cancer database will require a level of transparency and data sharing our nation has never seen before. It won’t happen unless collaboration is institutionalized throughout the pediatric cancer research community.
• It works. We know one attribute that the most successful companies in the private sector share is a culture of collaboration.
• An extensive study by the National Bureau of Economic Research illustrates the changing nature of scientific work with the need for large numbers of individuals with distinctive expertise to work collaboratively in the solution of a complex scientific problem.
• Collaboration is more than just getting a group of people in a room to work together to solve a problem. Collaboration is a mindset and a way of life, a core value that helps define an organization’s culture. Collaboration is how an organization works to achieve goals and objectives.

Primary barrier to collaboration – reward systems

• The study noted above highlights that while the demands for new, more expansive modes of organization push scientists towards larger collaborative groups, the reward system for science has not necessarily changed as dramatically.
• Reward systems are foundational to the culture within many organizations. Yet reward programs in pediatric cancer research often reinforces a culture of insularity that discourages collaboration. We need to change these systems to inspire collaboration if we are going to start generating breakthroughs in pediatric cancer.
• The reward system in medical research, including pediatric cancer research, generally recognizes behavior that is in conflict with collaboration; rewards and awards tend to go to individuals for breakthroughs. This is true for research institutions, grants issued by foundations, and national recognition programs.

How to fix it

• Pediatric cancer research institutions need to establish reward and recognition programs that inspire and motivate individuals to work collaboratively. Some ways to do this include:

Have team goals and team milestones. Make the team achievements the focus of the reward system.

Don’t ignore the individual. Each team member is still thinking about how their individual performance review will go. Include their individual performance towards collaboration and team goals, not just individual goals, in their reviews.

Keep the team focused on achieving outcomes, but reward acts of collaboration as well, especially if your team is in the early stages of creating a collaborative culture.

• Foundations need to add collaboration as criteria for awarding grants.

Foundations can influence and change culturesollaborative, if they make teamwork and information sharing a requirement for awards.

They need to find ways that allow the evaluation of grant proposals to factor in collaboration – between teams, disciplines, and even companies and institutions that may be considered competitors.

Within the context of collaboration, grant awards must include data sharing and transparency.

• Most annual recognition programs reward individual achievements. This holds true across all organizations, from the Nobel Prize to research foundation awards to the numerous industry association citations presented each year. Collaboration should be made an important criterion for all annual recognition programs.

Making collaboration a priority for the pediatric cancer research community is essential to achieving the breakthroughs so many children are counting on. To read our prior posts providing solutions to improving our approach pediatric cancer research, visit www.bridgetoacure.org.

The Bridge to a Cure Foundation is the lead advocate for modernizing our approach to pediatric cancer, with a priority on building a pediatric cancer database to speed up the search for cures. We have met and gained the support of over 120 institutions and practitioners, including the former NCI Director Ned Sharpless who has become a forceful proponent and driver of this initiative in Washington. To learn more about the foundation and add your support, visit www.bridgetoacure.org.

Much has been written about why the U.S. healthcare system costs so much and rates so poorly compared with healthcare in other industrialized nations.

Last year healthcare spending skyrocketed to $3.65 trillion, an increase of $250 billion in just two years. That’s more than the GDPs of many countries – including Brazil, the U.K., Mexico, Spain, and Canada – and by far the highest in the developed world.

“The national doctor bill dwarfs anything else we spend money on, including food, clothing, housing, or even our mighty military,” states a 2017 analysis in The Atlantic. It found that five percent of patients, including people with chronic diseases and victims of accidents and violence, account for 50 percent of all medical costs.

“For most people, the vast majority of all the health care they’ll ever get comes near the hour of death. Hundreds of billions of dollars each year are spent treating Americans who are in the last weeks, or days, of life.”

Medical research and development accounted for $171.8 billion in 2016, according to Research!America, less than 4.9 percent of the total $3.5 trillion healthcare bill that year. Hospital and surgery costs accounted for 32 percent, $1.1 trillion. Physician care accounts for about 20 percent and prescription drugs about 10 percent among medical spending categories.

People age 55 and over were responsible for 56 percent of health spending, according to a Kaiser Family Foundation analysis. It found that 36 percent of spending went toward people age 65 and older, while young people 18 and under comprised only 10 percent. Adults age 19 to 64, the largest group, made up 54 percent of spending.

The bottom line: we’re spending only about five percent of our total medical costs on research and 95 percent on everything else. This formula has not served us well when it comes to discovering cures for cancer and other chronic and terminal conditions, including those that affect children.

This fact weighs on my mind and informs our work at Bridge to a Cure. It’s especially acute for me when October rolls around. Oct. 8 is the second anniversary of the day we lost my granddaughter Clara to brain cancer. Her positive attitude and courage never wavered. Her memory inspires me every day to challenge the status quo and to address the barriers that prevent researchers from delivering the breakthroughs our children expect and deserve.

Are we spending that ever-growing $3.65 trillion annually for healthcare as wisely as we should? The answer is an obvious and emphatic “No!” It’s clear to me we would be better off if we reallocated a large chunk of the money we are paying out for hospitalizations, surgery, and end-of-life care and put it into research – beginning with the building of a robust national pediatric cancer database.

Many of the treatments we use today to fight cancer and other diseases, such as radiation and chemotherapy, have horrific side effects. Then there are those hundreds of billions of dollars we spend each year treating folks in their final months, weeks, or days of life. It’s no wonder our healthcare system is so costly, so inefficient, and so ineffective. It’s like we are pouring money into a deep hole, and just keep doing it because it’s the way we have always done it.

We have to find a better way to reallocate more spending to research, and to ensure we spend those dollars as wisely as possible. We advocate a process that focuses research dollars into the five areas we believe hold the most promise when it comes to finding cures and effective treatments for pediatric cancer and other conditions affecting children:

1. Develop a robust national database for each pediatric disease and disorder. Provide a process and framework to capture the hundreds of millions of pages of research, medical files, and other information.
2. Align and collaborate across institutions and practitioners. Develop a reward and recognition system unique to pediatric research – one that reinforces a culture of collaboration and spans from researcher to investor.
3. Include alternative medicine/treatments. Provide an assessment process to qualify as a treatment option in database.
4. Capitalize on the proven capability of artificial intelligence. Provide methodology and tools for researchers to extract meaningful findings from the robust database.
5. Simplify, sensitize, and modernize the clinical trial process. Streamline processes, pursue simulated research, and balance life expectancy and quality of life, including exemptions to allow terminal patients to participate.

Healthcare spending continues to grow at an alarming rate and is expected to approach 20 percent of GDP in the coming decade. The time is now to for us to demand that we redirect more of that spending to research. It’s the key to curing disease and preventing it in the first place – and to begin reining in costs of our out-of-control system.
To read our prior posts providing solutions to improving our approach healthcare visit www.bridgetoacure.org.

The Bridge to a Cure Foundation is the lead advocate for modernizing our approach to pediatric cancer, with a priority on building a pediatric cancer database to speed up the search for cures. We have met and gained the support of over 120 institutions and practitioners, including the NCI Director Ned Sharpless who has become a forceful proponent and driver of this initiative in Washington. To learn more about the foundation and add your support, visit www.bridgetoacure.org.