NCI Director Discusses State of Cancer Research After 50th Anniversary of National Cancer Act
The Society of Gynecologic Oncology (SGO) and other member organizations of One Voice Against Cancer (OVAC) were pleased to meet with Ned Sharpless, MD, Director of the National Cancer Institute (NCI), at the coalition’s annual meeting on Jan. 5. Dr. Sharpless thanked the advocacy community for their partnership and support as he reflected on the Dec. 23, 2021, commemoration of the 50thanniversary of the National Cancer Act and what lies ahead.
The theme of the 50th anniversary is “Nothing Will Stop Us,” which recognizes the progress made in cancer research and cancer care since the enactment of the National Cancer Act and the renewed commitment to overcome barriers and push ahead to change the tragic impact of cancer. Dr. Sharpless noted the declining mortality rates for many cancers over the last two decades and cited data indicating that NCI-supported clinical trials have led to 14 million life years saved through the development and approval of new therapeutics. Although there are areas in cancer research that are lagging, Dr. Sharpless believes continued progress and innovation can change the devastating consequences of the disease for the public. He discussed the following NCI priorities and opportunities that lie ahead.
Research Project Grants – The investigator-initiated research supported through research project grants (RPGs) is the source of some of the most innovative and transformative ideas in cancer research. This research has contributed to major advances, such as immunotherapies and targeted therapies for patients with cancer, as well as vaccines and drugs to prevent cancer. Due to the present-day excitement in cancer research, the NCI receives many more research applications than it can support. The NCI payline – the percentile of applications the NCI can fund – in 2021 is at the 11th percentile and the success rate for investigator-initiated research project grants is 12.8%. The NCI has set a goal of raising application paylines to the 12th percentile in 2022 as a step towards achieving the goal of funding the top 15th percentile of applications by 2025. (Most other NIH agencies currently have paylines at or near the top 15th percentile.) These goals may be in jeopardy, however, due to the uncertainty caused by the current stalemate in Congress that is preventing the finalization of the Fiscal Year (FY) 2022 appropriations process. If the current continuing resolution (CR) funding the government is extended through the entirety of FY 2022, it would present an enormous challenge for cancer research. The NCI payline in 2022 would not increase and non-competing RPGs would be funded at only 90%. This scenario is a clarion call to the advocacy community to push Congress to finish its work on all FY 2022 spending bills.
The Cancer Moonshot – The Cancer Moonshot initiative has enabled the creation of interdisciplinary teams that work together to lead and disseminate cutting-edge research, such as immunotherapy approaches for children and adults. With Cancer Moonshot funding set to end after FY 2023, the NCI is looking at ways to sustain this effort that has accelerated progress in cancer research.
International Cooperation in Cancer Research – A US-UK Bilateral Scientific Summit held Nov. 13-14, 2021, brought together a small group of world-leading cancer researchers, clinicians, patient advocates and industry representatives from both countries. The attendees began the process of identifying transformative research challenges and ways to resolve barriers to progress and fundamentally change the current understanding of cancer, approaches to it, and, ultimately, the experience of people with cancer and their families. Areas of initial discussion include cancer detection, prevention, cancer disparities and environmental relationships in cancer.
Expanding Access to Clinical Trials – The NCI will continue to work to make it easier for people with cancer to participate in clinical trials using the latest technology, including telemedicine, so they can enroll in their own communities.
Computer-Based Drug Design – Far too many people face cancers for which there are no effective treatments. Computer-based drug design could dramatically speed up drug discovery and, ultimately, help shorten the 10 to 15 years it typically takes for a new medicine to go from bench to bedside.
Precision Prevention – Precision prevention offers the promise of personalized prevention and screening approaches tailored to a person’s individual cancer risk based on their genetic makeup, family history, environmental exposures and behavioral factors.
Tumor Dynamics – The complexity of tumors makes it difficult to predict how a person’s cancer will progress or respond to treatment. The NCI plans to use the latest technologies, such as artificial intelligence, to enhance the study of tumor dynamics to help learn why some tumors evolve into malignant cancers, how they progress, and why they either respond to or resist therapy.
Dr. Sharpless also reiterated the NCI’s continued strong commitment and focus on health equity and eliminating health disparities in cancer, training the next generation of cancer researchers and enhancing diversity in the biomedical workforce. The NCI will also continue to prepare for future challenges, including future pandemics. During the early days of the COVID-19 pandemic, there was a drastic decline in cancer screening and, although it is starting to pick up, patients still require assistance to avoid any further delays in their cancer care.
Dr. Sharpless acknowledged that the Omicron variant has overtaken the public health agenda and is the immediate priority. However, he is hopeful about the future of cancer research with the keen interest in cancer research and discovery, and the strong support the NCI has in Congress and within the Biden Administration.