NCI Director Provides Update on New Programs and Initiatives
NCI Director Dr. Harold Varmus addresses staff at the NCI town hall meeting held January 10.
During a January 10 town hall meeting with NCI staff, NCI Director Dr. Harold Varmus outlined priority areas for NCI investment and provided a status report on some of the initiatives and changes he announced last July during his first town hall meeting as NCI director.
Progress against cancer has been and will continue to be made, he said, citing for example the results of the National Lung Screening Trial (NLST), which will help guide screening for lung cancer in those at increased risk of getting the disease, and the promising results from recent clinical trials of targeted therapies in advanced melanoma and lung cancer. (See the related Bulletin articles here and here.)
“There are a lot of reasons for hope,” Dr. Varmus said. In the United States, he pointed out, incidence and mortality rates for many cancers are declining. “We’ve shown that science helps to reduce the burden of cancer in this country and can do so in others.”
Moving forward, three areas will have priority for funding, he said. The first: awarding roughly the same number of new research project grants in 2011 as were awarded in 2010 (approximately 1,250), with priority given to young and first-time investigators.
“I view new [research] grants, especially grants to new investigators, as the single best means to pursue new ideas,” he said. “That’s something we simply must do.”
Maintaining robust funding for genomics-based research and instituting changes to the clinical trials system are also high priorities. Genomics, Dr. Varmus said, “is delivering discoveries for much of what we’re trying to do” in all areas of cancer research and patient care, so it’s important “to ensure that the cancer genomics machines are full of fuel for the foreseeable future.”
With regard to clinical trials, many changes are already taking place, including the initial stages of reducing the number of adult clinical trials cooperative groups from nine to no more than four groups. Other changes are in the works, he continued, such as increasing reimbursement to clinicians for participating in phase II and phase III clinical trials.
Fully funding these priorities will be particularly challenging in the current economic environment, he acknowledged. “We are facing very, very difficult times,” he said.
Soliciting Feedback on Provocative Questions in Cancer Research
Last week, NCI launched the Provocative Questions Web site to engage the cancer research community in this important initiative. The project is intended to assemble a list of novel questions that will help guide NCI and its scientific communities in efforts to control cancer through laboratory, clinical, and population sciences. The Web site allows individuals to submit questions, rank questions submitted by others, and participate in an online discussion of the initiative.
Provocative Questions are inquiries that address important problems and paradoxes in cancer research considered to have received insufficient attention, for a variety of reasons. Some may be built on older, neglected observations that have never been adequately explored; some on more recent findings that are perplexing; and some on problems that were traditionally thought to be intractable but that now might be vulnerable to attack with new methods. The questions are not intended to represent the full range of important questions that NCI and its constituencies should be studying, but they should draw attention to significant underappreciated opportunities for advancing the understanding of cancer and developing new prospects for controlling it.
Because the previous Congress failed to pass a budget for 2011, government agencies are operating under a continuing resolution that is keeping the government funded at 2010 budget levels until March 4. Although appropriations committees in the House and Senate in the previous Congress approved budgets with small increases for NIH in 2011, any hope of an increase actually being enacted this year is “vanishing,” Dr. Varmus said, and decreases could be on the horizon.
The situation is particularly troublesome, he continued, because much of NCI’s budget consists of money that is already committed to research grants, cancer center grants, contracts, staff salaries, and other costs. A flat or decreased budget will make it hard to meet both existing obligations and support new research grants and programs, meaning funding to cover such shortfalls may have to come from cuts to existing NCI programs, including potentially small reductions in cancer center core grants.
As for other changes that are under way, they include the process of searching for leaders of two new programs that were announced during his first town hall meeting: the NCI Center for Cancer Genomics and the Center for Global Health.
The Center for Cancer Genomics will “amalgamate the activities we’re undertaking in cancer genomics,” including The Cancer Genome Atlas, he said. And the response from the cancer community and other organizations to the formation of the Center for Global Health—which will coordinate and prioritize NCI’s research efforts that can have a direct impact on global cancer health, primarily in poorer countries—has been especially strong. “I think everyone recognizes that it’s time to put cancer on the marquee for global health,” Dr. Varmus said.
A new associate director for cancer prevention will also join the NCI Office of the Director, and some components of NCI’s tobacco control research portfolio will likely transition to a new NIH institute devoted to research related to substance use, abuse, and addiction. That new institute will be formed primarily by combining the National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism, a change that was recommended by the NIH Scientific Management Review Board. The component of NCI’s tobacco control portfolio that will shift to the new institute, he explained, will consist primarily of research into the neuroscience of addiction.
Increased collaboration with other government health agencies and cancer organizations will be critical moving forward, Dr. Varmus stressed. “In these conditions of strained budgets,” he said, “it will be important to keep our eye on the totality of the enterprise and not simply think about the NCI as the only place where cancer research occurs.”