Mapping a Strategic Scientific Vision for the National Cancer Program
When we at NCI cite the National Cancer Act of 1971, it is not simply as a recitation of history, but rather a recognition of the tremendous responsibility assigned to the Institute. That legislation, which launched what is often referred to as the “War on Cancer,” imparted a series of distinctions and special authorities to NCI as the leader of the National Cancer Program. Because of the 1971 law, the position of NCI director became a presidential appointment; the outstanding and much envied NCI-designated Cancer Centers Program came into existence; and the Institute gained the authority to prepare and submit directly to the President an annual budget for review and transmittal to Congress.
The act also established a new, powerful advisory board to both the President and the NCI director: the National Cancer Advisory Board. The NCAB, the act stated, would be a presidentially appointed panel of “leading scientific or medical authorities outstanding in the study, diagnosis, or treatment of cancer or in fields related thereto.”
It was clearly the intent of Congress in drafting and passing this legislation, that the NCI director and the NCAB would work together to provide leadership for the nation’s efforts against cancer. “With the advice of the National Cancer Advisory Board,” the cancer act said, the NCI director would “plan and develop an expanded, intensified, and coordinated cancer research program encompassing the programs of the National Cancer Institute, related programs of the other research institutes, and other Federal and non-Federal programs.”
The NCAB meets four times a year to hear updates on key NCI initiatives and fulfill a most-important role of reviewing all internally vetted and scored grants before they can be selected by NCI program staff members for awards. NCAB members have also been of tremendous service in forming and managing a number of special working groups, which have greatly helped NCI establish large-scale programs, review existing programs, and create research priorities. Among them are:
- P30-P50 Working Group (2003), which looked at how NCI-designated cancer centers and SPOREs could facilitate the discovery and translation of future research
- Working Group on Biomedical Technology (2005), which recommended a human cancer genome project
- Clinical Trials Working Group (2005) and the Translational Research Working Group (2006), which made recommendations on coordination, prioritization, scientific quality, and operational efficiency of NCI-supported clinical studies and on advancing discoveries more rapidly toward human testing
Continuing its role in helping NCI develop and support programs vital to the national cancer agenda, the NCAB recently voted to convene a new working group to develop a strategic scientific vision for the National Cancer Program. This working group, which is tasked with producing a report by September, will have four co-chairs: current NCAB members William Goodwin, Robert Ingram, and Dr. Bruce Chabner, along with a former NCAB chair and Nobel laureate, Dr. Phillip Sharp. Other members of the panel will be named in the weeks ahead.
We are clearly at a crossroads in cancer research. We can no longer afford to proceed with a sure but steady pace. We have invested far too many resources and far too much time on solving the riddles of cancer to not move ahead more aggressively now to fulfill the promise of the 1971 act.
To that end, the working group will look back at how NCI has evolved in its use of special authorities and its structure over the almost 40 years since the passage of the act. Even more important, the group will project what NCI needs to do, in terms of authorities and leadership, to aggressively move forward in this new era of science during the next decade. The working group is charged with assessing the scientific strategic vision and the required structure to enhance the organizational effectiveness of NCI to further advance our progress in understanding, diagnosing, treating, and preventing cancer.
It is abundantly clear that cancer research is moving toward an era when we will characterize tumors at the molecular level and employ electronic cancer health records and massive databases to follow patients through the evolution of their disease. These patients, millions strong, will be the research cohort for a virtually on-demand system of clinical trials, which will change the very nature of drug development. NCI’s capacity to lead this biologic, data-driven revolution of cancer research—and our cancer health care system, for that matter—will be greatly improved by the guidance of this NCAB working group.
Members of the NCAB devote considerable hours and great helpings of their expertise to help make sure NCI conducts only the best, most rigorous science. Their wisdom is without parallel. I thank them all for their service.
Dr. John E. Niederhuber
Director, National Cancer Institute