|
 |
|
|
|
|
|
|
|
Discovery
The cell is no longer a complete mystery or "black box." Scientists have peered inside and shown it is a robust entity bombarded daily at its surface by hormones and chemicals, signals from neighboring cells, and nutrients.
|
|
 |
|
Cancer is both a genetic disease and a cell-signaling failure. Genes that normally control orderly growth, differentiation, and proliferation become unregulated, allowing cells to reproduce without restraint. Altered genes produce defective proteins that do not function properly in the cell. With knowledge of the intricate biology of a cancer cell, scientists are designing interventions to preempt cancer's progression to uncontrolled growth at many stages along the disease process.
Scientists are using the latest technologies to scan a cancer's genetic signatures, manipulating cells to devise powerhouse cancer-fighting immune cells, investigating novel biochemical pathways to disarm the most resilient cancer cells, and using imaging probes to visualize a cancer's impact on the body without the need for invasive biopsies.
NCI researchers are using the latest tools in genetic epidemiology to study the relationship between cancer susceptibility genes and environmental factors in large groups of people prone to certain cancers. They are pinpointing genes involved in the more aggressive forms of certain cancers, genes that scientists can use to distinguish between a smoker who can quit successfully and a smoker who will have more difficulty and is more likely to relapse. They are scouring large data sets from long-running studies to find links between some commonly used vitamin supplements and a lower risk for certain cancers, as well as links between therapies for menopause and cancer risk. Each of these studies moves us closer to a time when physicians can rely on genetic, molecular, and environmental details about each patient to choose the intervention most likely to succeed.
|
|
Development
The union of talent, scientific discovery, and advanced technology continues to expand our knowledge of the factors that increase cancer risk and of the processes within the cell that are disrupted in cancer's onset and progression. Our understanding of the molecular basis of cancer has led to more effective prevention strategies, improved tests for early detection, more precise diagnostic methods, and more powerful treatment approaches.
|
|
 |
|
NCI-supported scientists are testing the ability of a well known drug to prevent prostate cancer and studying a vaccine that could have a significant impact in helping to eliminate cervical cancer. They are opening new vistas into the body, using a simple blood test to detect cancer, marrying imaging techniques with tracers that can track down the smallest cancer cells, and exploiting nanotechnology to access and interact with the tiniest domains of the cell. Some of this development work sounds like science fiction, but researchers aim to make them part of the realities of improved cancer diagnosis and treatment in the 21st century.
|
|
Delivery
The culmination of the cancer research continuum is the delivery of science-based, rigorously tested interventions - in cancer prevention, detection, treatment, as well as communications and education - to all patients and populations that need them.
|
|
 |
|
Several of the achievements in this report are the results of clinical studies, or clinical trials - one of the last steps before delivery of new interventions to
those who need them. NCI annually enrolls approximately 25,000 patients into treatment clinical trials conducted by 10,000 investigators at more than 3,300 sites across the country. These trials address important questions about cancer treatments. To learn better how to find cancers sooner, approximately 100,000 individuals at risk for either breast cancer or lung cancer are enrolled in NCI-sponsored early detection studies. In addition to examining whether spiral
computed tomography reduces deaths from lung cancer compared with standard x-ray screening, the National Lung Cancer Screening Trial is studying biomarkers for early cancer detection. These studies are yielding the answers that will inform patient care for years to come, so it is critical that people continue to participate and that more join in the clinical trials process.
Our achievements in delivery are as diverse as completing the large-scale
studies that prove an intervention's readiness for FDA approval, to showing a new use for an old drug, to disseminating proven communications interventions so that health professionals can design effective cancer control programs for their own communities, to reaching a specific audience with cancer prevention messages aimed at reducing their exceptionally high rates of cancer.
|
|
Infrastructure
Laboratory scientists and clinical researchers, epidemiologists and geneticists, cancer centers and community hospitals are generating an immense volume of valuable information. The potential power of
these rich collections of information can be fully realized by enabling individual investigators and research teams to combine and leverage their findings and expertise across the cancer research community.
|
|
 |
|
NCI has launched several programs to align resources, enabling new technologies and knowledge of cancer to speed research across the discovery, development, delivery continuum, and to more rapidly bring new interventions to the people who need them.
The Institute has made a significant commitment of resources to build a bioinformatics infrastructure to share data across miles and get tissue samples to the researchers asking important questions about cancer biology and tumor response to therapy. As NCI celebrated the 20-year anniversary of the Community Clinical Oncology Program, which brings clinical trials into local communities, it launched a consortium of large cohort studies to pool data and confirm findings on the relationship of genes and environment to cancer. Effective collaborations across a diverse community will be central to many of these efforts. A partnership with the Food and Drug Administration, for example, will speed the process of developing and approving safe, more effective new cancer interventions.
The examples of infrastructure-building in this report are relatively new efforts designed to strengthen analysis, resource sharing, and dissemination of research findings. When fully realized, the scientific community will have the tools to integrate diverse data types, conduct analyses with accuracy and speed, and capture and share outcome data.
|
|
