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Cancer Policy Monitor: February 14, 2023

Leadership for Congressional Health Committees Takes Shape

-Matthew Gontarchick

A new Congress convened last month, and lawmakers recently took part in the biennial process of determining leaders for congressional committees. Following a change in control of the House from Democrats to Republicans and a spate of recent retirements, the leadership roster for committees in the 118th Congress is looking markedly different from the previous Congress.

Some of the most prominent leadership changes will occur on the House and Senate Appropriations committees, which play a pivotal role in determining funding for the National Institutes of Health (NIH). Sen. Patty Murray (D-WA) will now chair the Senate Appropriations Committee, replacing retired Sen. Patrick Leahy (D-VT), and Sen. Susan Collins (R-ME) will serve as the top Republican. In the House, Rep. Kay Granger (R-TX) is the new Appropriations Committee chair, while Rep. Rosa DeLauro (R-CT), the committee’s chair in the previous Congress, will serve as ranking member.

Another key committee to see a shift in leadership is the Senate Health, Education, Labor, and Pensions (HELP) Committee, which helps to develop authorizing legislation related to cancer and medical research. Following Sen. Murray’s decision to chair the Senate Appropriations Committee, Sen. Bernie Sanders (I-VT) is set to become the HELP Committee’s next chair. Meanwhile, Sen. Bill Cassidy (R-LA) will replace recently retired Sen. Richard Burr (R-NC) as the Committee’s ranking member. 

In contrast, leadership of the House Energy and Commerce Committee, which shares many responsibilities with the Senate HELP Committee, will see their leadership roles flip to reflect the Republican Party’s new majority in the House.  Rep. Cathy McMorris Rodgers (R-WA), the Committee’s ranking member in the previous Congress, will chair the Committee in the 118th Congress. Rep. Frank Pallone (D-NJ) will see a similar change, going from chair in the last Congress to ranking member in the new Congress.

The Senate Finance Committee, which shapes Medicare and Medicaid programs that millions of patients with cancer rely on, will remain with the same leadership in the 118th Congress. Sen. Ron Wyden (D-OR) will stay on to chair the committee, while Sen. Mike Crapo (R-ID) will continue to serve as ranking member.

However, following the retirement of former Ranking Member Kevin Brady (R-TX), the House Ways and Means Committee, which has similar jurisdiction to the Senate Finance Committee, will see new GOP leadership as Rep. Jason Smith (R-MO) will become the committee’s new chair. Rep. Richard Neal (D-MA), the former chair, will now serve as the Committee’s Democratic leader by serving as ranking member.

With a new session underway, these committee leaders face a challenging environment. A narrowly split Congress will make bipartisan cooperation difficult, and battles over contentious issues such as spending, and the debt ceiling will dominate the conversation in Washington over the next several months. The American Association for Cancer Research will continue to engage with Congress to advocate for the cancer research community. 

Diversity Action Plans Included in Fiscal Year 2023 Omnibus Appropriations Bill

-Tristen Tellman, PhD

On December 29, 2022, President Biden signed into law the 2023 Consolidated Appropriations Act which funded the federal government through Fiscal Year 2023. This large omnibus package also contained provisions for the FDA related to diversity in clinical trial enrollment and decentralization of clinical trials. Under this legislation, clinical trial sponsors are required to submit “diversity action plans” for late-stage drug trials and most device studies. These plans must include goals for enrollment, rationale for those goals, and how the sponsor intends to meet them. Diversity action plans must be submitted to the Secretary of the U.S. Department of Health and Human Services (HHS) who will coordinate further with the Commissioner of the U.S. Food and Drug Administration (FDA). The secretary has been charged with updating or issuing guidance on the format and content of diversity action plans no later than one year after the act’s effective date and to finalize such guidance no later than nine months after the close of the comment period. Additionally, the secretary will convene a minimum of one workshop within one year of the act’s effective date with various stakeholders to solicit input on diversity action plans and mechanisms to enhance enrollment in historically underrepresented populations and encourage clinical study participation that reflects the prevalence of the disease or condition among demographic subgroups. A summary report of these workshops will be made available on the FDA website including summary topics and responses to any recommendations raised. Annually, the secretary will present to Congress and publish on the FDA website a report summarizing the diversity action plans received containing aggregate information on whether the enrollment goals set in diversity action plans were met.

The AACR looks forward to continuing engagement on this topic with FDA and convening workshops to discuss the implementation of diversity action plans.

REGISTER TODAY! AACR Virtual Patient Advocate Forum: The Impact of Advanced Technologies on Cancer Research

Tuesday, February 28, 2023; 1 – 3:30 p.m. ET/10 a.m. – 12:30 p.m. PT

Powered by advanced technology, improved understanding of various cancers is proceeding at unprecedented speed, resolution, and scale. These new technologies are often referred to as the fourth industrial revolution as these advances are revealing new targets, mechanisms, and approaches for better diagnosing cancer earlier, developing novel cancer therapeutics, and ultimately preventing cancer. This forum will explore the impact of some of the most impactful and/or promising of these advanced technologies on cancer research and explore how it is (or will) accelerate progress against this complex array of diseases we call cancer. Registration is FREE.

New “Non-menthol” Cigarettes Flaunt California’s Flavor Ban with Synthetic Cooling Agents

-Nicholas Warren, PhD

Flavored tobacco products are a key driver of youth tobacco use and have been shown to be an intentional strategy to attract youth and young adults. To help reduce youth tobacco use, Californian voters approved Proposition 31 during the November 2022 general election, which bans nearly all flavored tobacco products. The ban went into effect at the beginning of 2023; however, new products are attempting to circumvent the ban with synthetic chemicals that provide a cooling sensation and similar marketing and packaging as menthol cigarettes. Because the new products are odorless and flavorless, manufacturers argue this is a loophole in the new law and that their products are permissible, causing concern in the public health community due to the increased appeal these products have to youth and young adults who have not previously smoked.

Menthol and other chemicals that cause a cooling sensation function by activating the TRPM8 receptor on sensory nerve endings. TRPM8 is a protein that changes shape in cold temperatures or when certain chemicals bind to it, which allows nerve cells to sense and transmit an electrical charge to the brain. Cooling sensations such as these increase the addictiveness of tobacco products in part by masking the harsh sensation of inhaling smoke.

The new Newport-brand cigarette products for sale in California contain the synthetic cooling agent n-Ethyl-p-Menthane-3-Carboxamide (commonly known as WS-3). Advertisements and packaging for these new cigarettes also imply they provide a cooling sensation, and in some instances, closely mimic packaging for popular menthol cigarettes. It is unclear whether California will take any enforcement actions against the products. Additionally, these products may also be in violation of the federal Family Smoking Prevention and Tobacco Control Act of 2009, which requires any new tobacco product to be reviewed by FDA. However, there are very limited examples where FDA has utilized its authority to pursue the removal of illegally marketed tobacco products, resulting in widespread availability.

The actions of tobacco companies in California foreshadow a national strategy, should FDA finalize its draft regulations, that would prohibit menthol cigarettes and flavored cigars nationally. In public comments, the AACR warned the FDA about the likely use of synthetic cooling agents to violate the spirit of these draft regulations. To improve the ability to enforce a ban, AACR’s public comments called for a strict limit on the concentration of any chemicals that can activate TRPM8, particularly the WS chemicals, instead of the proposed prohibition on a “characterizing flavor.” The AACR will continue advocating for strong tobacco control policies to reduce youth tobacco initiation and tobacco-related illness.

AACR Continues Partnership with St. Jude Children’s Research Hospital to Increase HPV Vaccination Rates in Rural Communities

-Calais Prince, PhD

Human papillomavirus (HPV) infections are incredibly common as more than 42 million people in the United States are currently infected and have an increased risk of developing cervical, vaginal, vulvar, anal, penile, or oral/throat cancers. Alarmingly, more than 200,000 people will be diagnosed with cervical pre-cancer and nearly 36,000 men and women will be diagnosed with HPV-associated cancers this year. A powerful tool against HPV-associated cancers is vaccination prior to exposure. The HPV vaccine is safe and highly effective as it prevents cancer-causing infections and precancers. HPV vaccination completion rates increased in adolescents from 40.3 percent to 59.3 percent, but this trend is not consistent across the United States.

In rural communities, HPV vaccination completion rates are at 47 percent and HPV-associated cancers are elevated when compared to urban and suburban communities. Many of the barriers preventing HPV vaccination in rural communities include accessing health services, insufficient health insurance coverage, lack of knowledge about the HPV vaccine, transportation, and cultural views. The pressing need to increase awareness of HPV vaccinations led to the AACR’s continued partnership with the St. Jude Children’s Research Hospital initiative to improve HPV vaccination coverage in rural communities. More than 80 organizations participated in the introductory initiative meeting to discuss the state of HPV prevention in rural communities and how to identify actionable solutions that will increase HPV vaccinations and cancer prevention.

The AACR will continue to support evidence-based cancer prevention and control policies that provide equitable and timely access to HPV vaccinations.

Advocate Registration Rates for AACR Annual Meeting 2023

We are pleased to invite patient advocates to attend the AACR Annual Meeting 2023 from April 14-19 in Orlando, Florida. The theme of this year’s meeting is “Advancing the Frontiers of Cancer Science and Medicine.” Please check for program announcements.

Learn more about reduced registration rates available for all patient advocates.

Save the Date for the 2023 AACR-AACI Hill Day

The AACR and the Association of American Cancer Institutes (AACI) invite you to participate in a Hill Day in support of cancer research on Capitol Hill on Thursday, May 18, 2023. This Hill Day will bring cancer center directors, researchers, physician-scientists, cancer survivors, and other advocates together to build support for a strong federal investment in biomedical research, and cancer research in particular, through the National Institutes of Health (NIH) and the National Cancer Institute (NCI).

Participation is open to AACR and AACI members. Registration will open this spring; stay tuned for more information.