Harold Varmus Becomes Fourteenth Director of the
National Cancer Institute
On July 12, Dr. Harold Varmus was sworn in by the U.S. Department of Health and Human Services Secretary Kathleen Sebelius to become the 14th director of NCI. Later that day, Dr. Varmus, who led NIH from 1993 to 1999, held a town hall meeting with NCI staff to lay out some of his objectives and "set the tone" for his time as NCI director. (View the videocast online.)
“Everything we do and everything that we say will be based on evidence,” Dr. Varmus said. He stressed that the meeting was not intended to detail his full agenda as NCI director, but to preview some of his priorities.
“We need to pay attention to the repair of some things that are obviously dysfunctional in the system. First on the list is reforming the clinical trials system,” he said, referring to the recent report by an Institute of Medicine (IOM) committee that recommended substantial restructuring and increased funding of NCI’s Clinical Trials Cooperative Group Program. “This is a very important moment for us to get the clinical trials system into much better shape.”
Another priority: better use of the resources available at the Mark O. Hatfield Clinical Research Center, a facility that was planned and developed during Dr. Varmus’s tenure as NIH director. “The Clinical Center should be full of the most adventurous clinical research on cancer in the world,” he said. “We need to figure out how to pay for that and how to get patients and researchers from everywhere around the country to begin using it.”
Dr. Varmus also highlighted the cancer drug approval and regulation process as a priority area. “The methods that are currently being used need to be readjusted to a modern era in which there are genetically based therapies and new ways to monitor the responses to therapies,” he said. Doing so will require more productive partnerships, including those with the FDA, other Federal agencies, academic researchers, and industry. “I know NCI already has relationships with these organizations and individuals, but I’ll be doing a lot to make those relationships stronger,” he said.
Dr. Varmus acknowledged that there are other issues and NCI programs that may need to be addressed, and he will seek advice and input from many sources. For instance, a working group of NCI’s National Cancer Advisory Board is developing a report, expected to be completed in the fall, that will examine NCI’s roles and authorities and how the Institute can best lead the National Cancer Program in the years to come.
A Nobel prize winner who served as president of Memorial Sloan-Kettering Cancer Center for the last 10 years, Dr. Varmus hopes to “change the ways we think about the scientific problems that we are trying to solve.” He told the town hall meeting audience, “We need to think a little more clearly about how we frame the questions that we’re trying to answer, so we know what we’re actually trying to achieve.” Rather than posing overly general, perhaps unanswerable questions, NCI needs to help researchers focus “with a new specificity, based on new developments in our science, and look at questions that are not pie in the sky, but have a substantial prospect of answerability in the foreseeable future.”
To achieve that vision, he continued, “Over the next year, I’m going to stage a series of meetings, inviting people who work in a variety of fields across the country, and try to establish a list of provocative, answerable questions that will help our scientists think about what the next steps ought to be.”
He also mentioned his keen interest in combating cancer on a global level in an organized way, especially in low-income regions of the world. That will entail “developing programs that are suitable for improving cancer control in poor countries, such as tobacco control and vaccination programs against oncogenic viruses,” he said.
“There is no better time, based on my view of working in cancer research for the last 40 years, to lead the nation’s cancer research efforts,” Dr. Varmus said.