Abstract

The objective of this study was to develop winning formulas to fulfill cancer moonshot declared by President Biden on Sept. 12, 2022, the 60th anniversary of the moonshot speech of President Kennedy. The intention of President Biden was to use the spirit of successful moonshot project to salvage the failure of war on cancer project declared by President Nixon in 1971 [1]. Cancer therapies based on killing of cancer cells were the choice of cancer establishments in the past. The choice of killing cancer cells is understandable because the perpetual replication of cancer cells constitutes the most outstanding feature of cancer. Cancer is contributed by multiple factors. Factors other than replication of cancer cells also play essential roles on the development of cancer. Cancer arises as a consequence of wound not healing properly due to the collapse of chemo-surveillance, thus allowing Progenitor Stem Cells (PSCs) to evolve into Cancer Stem Cells (CSCs), and then to progress to faster growing Cancer Cells (CCs) through activation of oncogenes and/or inactivation suppressor genes. Cell killing creates more wounds to aggravate the already bad situation on the functionality of chemo-surveillance, which is an important mechanism to suppress the build-up of cells with abnormal Methylation Enzymes (MEs) that include PSCs, CSCs, and CCs. PSCs and their immediate derivatives CSCs are protected by drug resistant and anti-apoptosis mechanisms. Cytotoxic agents can wipe out CCs but cannot affect CSCs. The damage to chemo-surveillance contributed by cell killing agents allows CSCs to become dominant cells to cause he failure of cancer therapy, thus losing the war on cancer. Cell Differentiation Agent (CDA) formulations are the preparations consisting of Differentiation Inducers (DIs) and Differentiation Helper Inducers (DHIs), plus phenylacetylglutamine as an anti-cachexia agent. Such preparations are perfect cancer drugs to take out both CCs and CSCs by the induction of terminal differentiation through destabilization of abnormal MEs, and to restore the functionality of chemo-surveillance. Cancer therapies mediated by CDA formulations are the nature’s choice to combat cancer that can fulfill the goal of President Biden’s cancer moonshot. CDA formulations, however, cannot make the tumor to disappear, which can be easily accomplished by therapies based on cell killing. President Biden’s goal is very modest, requiring reduction of cancer mortality 50% in 25 years. That goal can be easily accomplished by winning formulas that include CDA formulations and therapies to eliminate or to kill CCs. We offer the following winning formulas: 1. Therapy with CDA-CSC, a preparation made up by an approved DI and an approved DHI, to eradicate CSCs and CCs by the induction of terminal differentiation and to restore the functionality of chemo-surveillance, followed by the surgical removal of the residual tumor. 2. Surgical removal of the primary tumor, followed by the administration of CDA-CSC to prevent recurrence and metastasis, and to restore the functionality of chemo-surveillance. 3. Radiotherapy, immunotherapy, or chemotherapy to kill CCs, followed by the administration of CDA-CSC to eradicate CSCs and to restore the functionality of chemo-surveillance.

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