Speaking to an audience of cancer researchers and clinicians at the American Association for Cancer Research, the director of the National Cancer Institute colored in some of the details of how his agency intends to spend its share of the federal stimulus windfall.
After four years of flat-funding, the NCI will pour much of the $1.3 billion into seeding a next generation of cancer research and into expanding the three-year-old Cancer Genome Atlas, according to director John Niederhuber.
The money, part of President Obama’s $787 billion American Recovery and Reinvestment Act, is targeting genetic and cancer research in part because of the efforts of US Senator Arlen Specter, a cancer survivor who is interested in translational biomedical research. In other words, Specter is pushing for the kind of science that can leap from lab bench to bedside.
When it became clear that NCI was due for a significant share of stimulus money over a two-year period (2009 and 2010), Niederhuber and his colleagues took a moment to weigh all the demands — to assess what Americans want in terms of next steps in the so-called war on cancer.
“We came back repeatedly, in these discussions, to the conclusion that they want better ways to prevent cancer; they want the earliest diagnosis; and they want new therapies with fewer side-effects that turn cancer into a condition you can live with and not die from,” he told the conference in his talk on April 20.
Then, he sketched out a broad vision. “Economic stimulus funds give us the chance to be visionary; to make strides today toward realizing the promise of personalized medicine; to enhance the process of drug development from target identification to translation into viable therapies; to move cancer research from the accumulation of scientifically exciting genomic data to a new way of approaching prevention, diagnosis, and therapy and to ensure access to our latest science for all.”
Mindful of Obama’s command to “ignite our imagination,” Niederhuber says the NCI has an eye on the future: fostering a next generation of cancer science and cancer scientists. To that end, the agency plans to award grant money to young investigators who are MD-PhDs, “who are committed to careers in translational cancer research.”
The money will supply some rocket fuel to The Cancer Genome Atlas (TCGA), launched in 2006 by the NCI and the National Human Genome Research Institute. Since then, Niederhuber says, TCGA has sequenced more than 200 tumors in the brain (glioblastoma), and in lung cancers and ovarian cancer.
“With that foundation of success,” he said, “we plan to move TCGA forward, with a goal of identifying all of the relevant genomic alterations in 20 to 25 major tumor types.” Another NCI program, called TARGET, will get money to expand sequencing to 100 tumor types in childhood cancer. (In the realm of NCI acronyms, TARGET stands for Therapeutically Applicable Research to Generate Effective Treatments.)
Translated into bottom lines and budgets, the stimulus package means money for science: new equipment, and salaries for lab technicians and post-doctoral students who work, like chefs in an exquisite kitchen, with the raw ingredients of life. Mindful that research begun with stimulus funds must be continued beyond the two-year window, the Niederhuber remains an optimist.
Although the TCGA has been criticized by those who believe it is too expensive, inefficient, and likely to lead to descriptive studies rather than real breakthroughs, Niederhuber and his colleagues believe this kind of research is a blueprint for the 21st century. It is, in effect, all about drawing a clear, bright line from discovery to the patient, from the molecular view to the whole of a person.
“This wide-ranging plan will require the contributions of biologists, chemists, informaticians, and clinical scientists who are devoted to a clear path from discovery to patient. that is not only the nature of translation; I believe it will be a model for the study of many diseases and, ultimately, a model of 21st century healthcare, when we are able to match pharmacogenomically characterized patients and molecularly profiled tumor types to highly specific molecularly targeted therapies.”