Prostate Cancer Foundation-Department of Veterans Affairs Partnership: A Model of Public-Private Collaboration to Advance Treatment and Care of Invasive Cancers

In late 2016, the US Department of Veterans Affairs (VA) and the Prostate Cancer Foundation (PCF) announced a multiyear public-private partnership to deliver precision oncology and best-in-class care to all veterans battling prostate cancer.¹ The creation of this partnership was due to several favorable factors. At that time, VA Secretary Robert A. McDonald had created the Secretary’s Center for Strategic Partnerships. This Center provided a mechanism for nonprofit and industry partners to collaborate with the VA, thereby advancing partnerships that served the VA mission of “serving and honoring…America’s veterans.”^1,2 Concurrently, Vice President Joseph Biden’s Cancer Moonshot (later renamed the Beau Biden Cancer Moonshot) charged PCF and other cancer-focused organizations with the ambitious goal of making a decade’s worth of advancements in cancer prevention, diagnosis, and treatment in 5 years.³ As such, both organizations were positioned to recognize and address the unique prostate cancer challenges faced by male veterans, which ultimately led to the PCF-VA partnership.

A number of factors have allowed the PCF-VA partnership to scale the Centers of Excellence (COE) program. This article seeks to highlight the strategic organizing and mobilization techniques employed by the PCF-VA partnership, which can inform future public-private hybrid initiatives focused on precision medicine.

Executive Leadership as Patient Advocates

From its creation, the PCF-VA partnership placed as much importance on veteran patient care as it has on making oncologic advances. The fact that this focus came primarily from executive leadership was critical to the partnership’s success. PCF board members emphasized the significance of prioritizing veterans and military families in cancer research efforts.

A notable example is S. Ward “Trip” Casscells, MD, a veteran who was deployed to Iraq in 2006 and subsequently served as US Department of Defense Assistant Secretary of Defense for Health Affairs. He focused much of his leadership on ensuring that veterans and military families, having performed a critical service for the country, were served with this same degree of excellence when it came to health.⁴ Fellow PCF Board member Lawrence Stupski, spoke publicly about his drug-resistant form of prostate cancer, bringing awareness to the complexity of ending death and suffering from the disease.⁵ Like Casscells, Stupski has a military service background, and served in Vietnam in 1968 as an officer in the US Navy. Both participated in multiple prostate cancer clinical trials themselves, serving as models of veteran trial participants. This visibility and leadership created a culture where veterans were not just instrumental in advancing cancer research, but also representative of a responsibility to ensure high-quality care for an underserved and at-risk community (Figure 1).

Executive advocacy and visionary philanthropy on behalf of veterans were vital to catalyzing the PCF-VA partnership framework, allowing both organizations to act on shared goals through a joint venture. Stupski’s legacy also jump-started the partnership itself, as the Stupski Foundation provided the crucial initial funding to launch a pilot version of the partnership.

Ultimately, this suggests that entrepreneurial philanthropy, top-level patient-led advocacy, and executive leadership can bolster the success of future health partnerships by advocating for specific missions, thus allowing convergence of goals between public and private entities. Visibility of leaders also encourages participation in the initiative itself, specifically in regard to patients being willing to enroll in clinical trials.

During the Launch Pad: Pathways to Cancer InnoVAtion PCF-VA summit in November 2016, PCF and the VA signed a memorandum of understanding (MOU) that solidified joint goals and accountability practices to create a scalable model for veteran-centered, genomics-based precision oncology care. Special focus was placed upon developing clinical trials for vulnerable veteran populations (Figure 2). PCF dedicated $50 million of funding to this partnership, facilitated largely in part by several philanthropists who stepped up after the MOU was signed, and early, life-extending successes from the pilot were demonstrated. This “snowballing” of funding indicates that the establishment of a public-private health partnership—with clear and compelling goals and early proof-of-concept—galvanizes efforts to further advance the partnership by garnering critical philanthropic investment.