Download cancer research

AACR and Cancer Centers:
Partners in Progress Against Cancer
Margaret Foti, Ph.D., M.D. (h.c.)
Chief Executive Officer
NACCDO/PAN Conference
Philadelphia, PA
April 28, 2009
Agenda for Today’s Presentation
• Present a general overview of the AACR and
how it carries out its mission
• Discuss the challenges we face today in public
education, public policy, and fundraising
• Offer my perspectives on how NACCDO and PAN
could forge a synergistic relationship with the
AACR to accelerate progress in cancer research
Agenda for Today’s Presentation
• Present a general overview of the AACR and
how it carries out its mission
• Discuss the challenges we face today in public
education, public policy, and fundraising
• Offer my perspectives on how NACCDO and PAN
could forge a synergistic relationship with the
AACR to accelerate progress in cancer research
AACR Mission
To prevent and cure cancer through:
• Research
• Education
• Communications
• Collaborations
AACR’s Long-Standing Leadership
in Cancer Research
• Collective brain trust in all aspects of basic, translational, and
clinical research
• Consistent focus on cutting-edge science in cancer etiology,
diagnosis, treatment, and prevention
• Strong emphasis on translational research and innovation
leading to improvements in patient care and prevention
• World-renowned scientific and educational programs
and publications
• Catalyst for international cross-disciplinary interactions,
innovation, and integrative cancer research
Profile of the AACR Membership
• The first and largest cancer research organization in the
world dedicated to the conquest of cancer
• >28,000 members working in 89 countries
• Senior and junior cancer researchers, physicianscientists, other healthcare professionals
• Undergraduate and high school students
• Cancer survivors and patient advocates
• Organizations and corporations that support mission
• Over 80,000 non-members who are part of the AACR’s
worldwide “Superfamily”
Exponential Growth in Membership
1993-2010
2009 and 2010 projected.
AACR Mission
To prevent and cure cancer through:
• Research
• Education
• Communications
• Collaborations
Leadership in Cancer Science
and Medicine
• Identify new promising research areas and interventions
• Foster innovation through various programs
• Fund cutting-edge research being conducted by both
junior and senior scientists
• Recommend national and international collaborations
• Forge partnerships with key organizations relevant to
cancer
AACR’s Unique Niche: Incorporation of
New Fields into Cancer Research
Creates a ripe environment for cross-disciplinary interactions
and translational cancer research
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Angiogenesis
Animal models
Behavioral science
Bioinformatics
Biomarkers
Carcinogenesis
Cell death and
senescence
Chemistry/chemical
biology
Clinical trials
Computational biology
Drug design
Early detection
Engineering
Epigenetics and
epigenomics
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Genetics
Genomics and other ‘omics
Imaging
Immunology
Infection
Inflammation
Mathematical modeling
Metabolism
Metastasis and the tumor
microenvironment
microRNAs
Molecular diagnostics
Molecular and genetic
epidemiology
Nanoscience
Nutritional science
Pathology
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Pharmacology
Pharmacogenetics
Pharmacogenomics
Pharmacoepidemiology
Physical science
Prevention research
Proteomics
RNAi therapies
Signal transduction
Stem cells
Systems biology
Vaccines
Virology
And many more. . .
Mechanisms for Achieving
Scientific Objectives
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Elected Board of Directors
Council of Scientific Advisors
Scientific Working Groups
Standing and Ad Hoc Scientific Committees
Task Forces and Think Tanks
Annual Meetings and Special Conferences
Educational Workshops
Scientific Journals and Electronic Communications
Science and Public Policy Initiatives
AACR Board of Directors
2009-2010
•
Tyler Jacks, Ph.D.
•
Daniel A. Haber, M.D., Ph.D.
President
•
V. Craig Jordan, OBE,
Ph.D., D.Sc.
•
Elizabeth H. Blackburn, Ph.D.
President-Elect
•
Kenneth W. Kinzler, M.D.
•
Bayard D. Clarkson, M.D.
•
Joan Massagué, Ph.D.
Treasurer
•
Jennifer A. Pietenpol, Ph.D.
Raymond N. DuBois, M.D., Ph.D.
•
Bruce A.J. Ponder, Ph.D.
•
Eddie Reed, M.D.
•
Margaret A. Shipp, M.D.
•
Margaret R. Spitz, M.D., M.P.H.
•
Craig B. Thompson, M.D.
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Eileen P. White, Ph.D.
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Past President
Margaret Foti, Ph.D., M.D. (h.c.)
Chief Executive Officer
•
José Baselga, M.D.
•
Lisa M. Coussens, Ph.D.
•
Judy E. Garber, M.D., M.P.H.
•
Joe W. Gray, Ph.D.
Council of Scientific Advisors
• 30 outstanding scientists working in the U.S. and abroad
• George F. Vande Woude, Ph.D., Chairperson
• Charge:
- Review the status of cancer research and evaluate progress to date
- Identify scientific opportunities and challenges
- Consider ways to address national and international policy impediments
- Propose new strategies for implementation to expedite progress
- Make progress in reducing the burden of cancer worldwide
• Makes recommendations for programs to the Board of
Directors and to the AACR Foundation Board of Trustees
Scientific Working Groups
• Molecular Epidemiology Working Group
(MEG/AACR) Established 1998
• Chemistry in Cancer Research Working Group
(CICR/AACR) Established 1999
• Tumor Microenvironment Working Group
(TME/AACR) Established 2006
• Cancer Immunology Working Group
(CIMM/AACR) Established 2006
• Others are pending implementation
Standing and Ad Hoc
Scientific Committees
• Annual Meeting Program Committee
• Education Committee
• Special Conferences Committee
• Clinical and Translational Research Committee
• Ad Hoc Scientific Committees – as deemed
necessary
Selected Task Forces
and Think Tanks
• Human Epigenomics
• PI3 Kinase Inhibitors
• Pediatric Oncology
• Aging and Cancer
• Energy Balance and
Cancer
• Cancer Stem Cells
• Systems Biology and
Cancer (pending)
• Biostatistics in
Clinical Trials
• Cancer Biomarkers
Collaborative
• Cancer Prevention
• Behavioral Science
AACR 100th Annual Meeting 2009
Michael A. Caligiuri, M.D., Chairperson
• Held on April 18-22, 2009, Denver, CO
• Attendance: 16,000
• 6,225 proffered papers received for
presentation
• The theme “Science, Synergy, Success”
highlighted the best cancer science and
medicine from all over the world
• Underscored today’s potential for
effective translational research for
patient benefit
101st Annual Meeting Preview
April 17-21, 2010
Washington Convention Center
Washington, DC
Frank McCormick, Ph.D.
Program Chairperson
2009 Special Conferences
• Mouse Models of Cancer
San Francisco, January 12-15
• Advances in Prostate Cancer Research
San Diego, January 21-24
• Translation of the Cancer Genome
Boston, February 7-9
• Chemistry in Cancer Research
New Orleans, February 8-11
• Frontiers in Basic Cancer Research
Boston, October 7-11
• Advances in Breast Cancer Research
San Diego, October 13-16
• Genetics and Biology of Brain Cancer
San Diego, December 13-15
AACR Mission
To prevent and cure cancer through:
• Research
• Education
• Communications
• Collaborations
Increasing Needs of
Today’s Cancer Workforce
• A robust cancer workforce of experts to address the
complex scientific goals of the cancer field
• Specialized education and training in novel scientific
and highly technical areas
• Scientists from less traditional fields (engineering,
mathematics, physics, computer science)
• Changes in scientific structures and policies in order
to embrace team science and integrative cancer
research
• Guidance in professional development
AACR Educational Workshops and
Support of Young Scientists
• Methods in Clinical Cancer Research (Vail, Switzerland,
Australia)
• Molecular Biology in Clinical Oncology (Aspen, CO)
• Pathobiology of Cancer (Snowmass, CO)
• Cancer Biostatistics (Monterey, CA)
• Translational Cancer Research for Basic Scientists (Boston, MA)
• Molecular Epidemiology (in development)
• Scholar-in-training travel awards to attend meetings
• Research fellowships and career development awards in basic,
translational, clinical, and prevention research
• Mentorship and professional development
AACR Cancer Biostatistics Workshop:
Developing Targeted Agents
• Launched in July 2008; Sonoma, CA
• Steven Piantadosi, M.D., Ph.D.,
Chairperson
• Participants: 42 early- and mid-career
biostatisticians
• Faculty: 14 top biostatisticians and
7 clinical oncologists
• Intensive week-long introduction to
cancer biology, clinical trial design,
and productive collaborations
• 2009 Workshop is planned for
July 12-18, 2009, Sonoma, CA
New Educational Workshop:
Translational Cancer Research for
Basic Scientists
• To be held in Boston, MA, in the Fall of 2010
• Tom Curran, Ph.D. and George Demetri, M.D.,
Co-Chairpersons
• Goals: To provide basic scientists with an understanding
of the roadblocks facing the translation of laboratory
breakthroughs to clinical therapeutics, to give them the
unique opportunity to visit clinical settings, and to teach
them to consider how their own research protocols may
have the potential for later application
• Will stress the importance of team science and collaborations
in translational cancer research
• Participants: Late-stage Ph.D. students,
postdoctoral fellows, and junior faculty
AACR Mission
To prevent and cure cancer through:
• Research
• Education
• Communications
• Collaborations
AACR Scientific Journals
Electronic Usage of AACR Journals
2002 – 2009
Worldwide Manuscript Submissions
up 172% from 2002 to 2008
2008 Pages Published - 28,731
Online articles downloaded
worldwide –
2002: 4M
2003: 8M
2004: 14M
2005: 18M
2006: 19M
2007: 25M
2008: 36.8M
2009: 45M (projected)
AACR Electronic Products
and Services
• Scientific Journals Online
• Cancer Reviews Online
• Meeting Abstracts Online
• Cancer Prevention Journals Portal
• Publish Ahead of Print (2009)
• CR magazine in digital format
• Other scientific portals (in development)
AACR Strategic Communications
• Define the AACR brand and develop a communications
plan based on the findings
– Study was completed and presented on March 2,
2009 to the leadership during the Board’s Strategic
Planning Meeting
– AACR website will be redesigned and structured as a
key component in reaching target audiences
– Communications and public relations will be markedly
expanded to better support core AACR activities
including public education, policy, and
fundraising goals
AACR High-Priority
Communications Initiatives
• Craft an understandable definition of cancer research
for communication to the public
• Enhance public understanding about progress against
cancer by:
– Developing new outreach materials, both traditional and
new electronic media
– Enhance the AACR website
– Increase coverage of new data and breakthroughs in
cancer research in the lay press
– Solidify relationships with reporters from
important media outlets
AACR Clinical Trials
Awareness Campaign
• Recommended by colleagues at the AACR-Industry Roundtable
• Goal: To utilize the opportunity to kick-start public education
efforts about clinical trials in conjunction with the timing
of Stand Up To Cancer (SU2C)
• Our industry partners rallied to support a pilot project, entitled
“Clinical Trials PR Campaign”
– Outreach around patient stories in clinical trials in hometowns and
consumer media
– National Satellite/Radio Media Tour featuring scientists and
patient advocates delivering positive clinical trial messages
in local TV and radio stories
• 2009-2010 Goal: To launch a major new initiative to increase
public education about clinical trials and substantially
increase patient enrollment
Survivor and Patient Advocacy
• Educate and inform survivors and patient advocates
about the value of cancer research
• Engage survivors and family members in all aspects of
AACR’s mission and integrate this segment of the cancer
community into AACR’s work
• Bring the survivor and family perspective, experience,
and expertise to the AACR
• Facilitate access to accurate cancer information for
members of the public who are touched by cancer
Scientist↔Survivor Program
• Launched in 1999, the program is designed to build enduring
partnerships among the leaders of the scientific and cancer
survivor and patient advocacy communities worldwide
• The program exposes advocates to lectures by leading
scientists and clinicians, small group discussions, and other
interactions with scientists and advocates, and provides a
solid background in cancer research, treatment, and
prevention
• Scientists gain a more personal understanding of cancer’s
impact on patients and their loved ones, the key concerns of
survivors and patient advocates, and the vital role that
advocates play in supporting cancer research
• Thus far, >250 advocates have completed the
program
Other AACR Programs for Cancer
Survivors and Patient Advocates
• Websites and Podcasts
• Build relationships with key advocacy
and professional organizations
– The Wellness Community collaboration
– Collaborations with the Lance
Armstrong Foundation, NCI Office of
Advocacy Relations, and Association of
Oncology Social Workers
– Partnership with Susan G. Komen for the Cure
The AACR Magazine, CR
• Launched in Spring of
2006
• AACR’s first publication
geared to the needs of
cancer survivors and their
families, patient advocates,
and caregivers
• Dedicated to strengthening
understanding, collaborations,
and communications between
survivors and physicians
and scientists
AACR Mission
To prevent and cure cancer through:
• Research
• Education
• Communications
• Collaborations
AACR National and International
Scientific Collaborations
NCI of Canada
Italian Cancer Society, BACR, EACR, Fredrich Miescher
Institute, ECCO, EORTC, ESMO, IARC, ICA, ISREC, UICC
National Health Research
Institute of Taiwan, JCA,
JSMO, CACA, KCA, GIS of
Singapore
AACR
NCI, NCCR, OVAC,
NDC, FOCR, PCF,
NFCR, ASH, ASCO,
EMS, ONS, ACS, ICC,
LAF, PAF, SU2C, EIF,
PanCan, The Wellness
Community, Susan G. Komen
for the Cure
Brazilian Association of
Philanthropic Institutions
to Combat Cancer
Australian Cancer Society,
MOGA
AORTIC, CANFOG
AACR-NCI-EORTC Molecular
Targets and Cancer Therapeutics
• The premier annual
international drug
development meeting,
featuring novel targets and
cancer therapeutics
• November 15-19, 2009
Boston, MA
• Over 100 invited speakers
• >900 abstracts (projected)
• Projected Attendance: >3,600
New Partnership: CTRC–AACR
San Antonio Breast Cancer Symposium
• December 11-14, 2008
• Creates the largest and most
comprehensive meeting of its kind
by integrating basic, translational,
clinical, epidemiological, and
prevention research related to
breast cancer
• Over 9,200 attendees
• Over 1,400 abstracts submitted
• Two new award lectures sponsored
by the AACR and over 100 young
scientists received travel awards
• Next meeting: December 9-13, 2009
Love-Avon Army of Women
• AACR named the Scientific Partner
• National Breast Cancer Coalition is the
Advocacy Partner; affiliates are being added
• Goal: To link scientists with women across
the country to engage in studies that seek to
discover the causes of breast cancer and
aid in its prevention
• Provides researchers who have peer-reviewed
grants access to the Army of Women
• Over 278,000 women are already enrolled,
and four studies are underway
• Recruitment goal: 1 million participants
Trustees of the AACR Foundation
for the Prevention and Cure of Cancer
•
Bayard D. Clarkson, M.D.
•
William H. Mears, Jr., J.D., CPA
•
Margaret Foti, Ph.D., M.D. (h.c.)
•
V. Craig Jordan, O.B.E, Ph.D., D.Sc.
•
Beverly W. Aisenbrey
•
Sherry Lansing
•
Irene D. Pritzker
•
Ellen V. Sigal, Ph.D.
•
Daniel D. Von Hoff, M.D.
•
Geoffrey M. Wahl, Ph.D.
•
•
Chairman and President
Secretary-Treasurer and CEO
Raymond N. DuBois, M.D., Ph.D.
Nance Guilmartin
•
William N. Hait, M.D., Ph.D.
•
Tyler Jacks, Ph.D.
Vice-Chairman
AACR Grants and Awards
• $6 million in research grants were administered
and distributed in 2008
• $4.608 million in research grants will be given
in 2009
– Grants for basic, clinical, translational or cancer
prevention research
– Targeted grants for pediatric cancer, lung cancer,
colorectal cancer, pancreatic cancer, angiogenesis,
HER family pathway, breast cancer, colon cancer,
bladder cancer, and international collaborations in
cancer research
AACR-PanCAN Partnership
FUNDING OPPORTUNITIES
PANCREATIC CANCER ACTION NETWORK –
AACR
2009 RESEARCH GRANTS
The Pancreatic Cancer Action Network and American Association for
Cancer Research (AACR) will begin accepting applications for their joint
2009 Research Grants Program on Monday, September 15, 2008.
Applications must be directly relevant and applicable to pancreatic cancer
and may be in any discipline of basic, translational, or clinical research.
Stand Up To Cancer (SU2C)
• AACR chosen as the Scientific Partner
• Raised $104 million net from the time of the
launch in LA on May 28, 2008, to the historic
commercial-free telecast by three major
networks on September 5, 2008
• Funds raised will go directly to support highly
meritorious translational cancer research
projects that will have the highest potential
for bringing effective new treatments to
patients in the shortest time possible
Stand Up to Cancer
Founding Principles
• Basic science and cutting-edge technologies
are ready to be translated to the clinic
• Goals:
– To accelerate advances in cancer research
by raising substantial philanthropic dollars
– To foster collaborations and team science in cancer research
rather than competition
– To achieve a paradigm shift by shortening the time from
discovery to patient benefit
– To require transparency, deliverables, and communication across
the teams funded
– To fund innovative research projects by young
investigators whose work has potential for
translation to the clinic
Stand Up To Cancer
Dream Teams
Dream Teams
- Multidisciplinary and collaborative
teams of scientists that will focus
on a specific cancer problem where
continued research will likely yield
near-patient benefit
– Teams of laboratory and clinical researchers across
disciplines and across institutions; talented young
researchers and experienced senior investigators; survivors
and patient advocates
– Research topics for Dream Team investigation chosen
based on perceived opportunities for success, as well as
high-priority areas with critical need for rapid
progress beyond current medical care
Stand Up to Cancer
Progress to Date
• 20-member Scientific Advisory Committee (SAC), led by Nobel
Laureate Dr. Phillip A. Sharp from MIT, received 237 concepts
for consideration
• Each submission was initially ranked, and the top 25
were then narrowed to 16
• Ultimately, in October 2008, 8 projects were selected
for further review
• Members of the SAC met with prospective team leaders,
and comprehensive proposals describing research plans
were reviewed
• The final five “Dream Teams” will be recommended for
funding, and the announcement will be made in May 2009
• 17 members of the five “Dream Teams” are
affiliated with NCI-designated Cancer Centers
Stand Up To Cancer
Innovative Research Grants
Innovative Research Grants
– Fund novel, high-risk research
proposals with the potential to
improve the lives of cancer patients
through the application of science to
the prevention or treatment of cancer
– Will encourage proposals not usually funded
by conventional peer review
– High priority will be given to funding
young investigators
• Progress to date: >400 applications received
for review; pediatric grant application
deadline was April 27, 2009
Agenda for Today’s Presentation
• Present a general overview of the AACR and
how it carries out its mission
• Discuss the challenges we face today in public
education, public policy, and fundraising
• Offer my perspectives on how NACCDO and PAN
could forge a synergistic relationship with the
AACR to accelerate progress in cancer research
The Status of Cancer
• Over the past three decades, there has been significant
progress in the understanding, diagnosis, treatment, and
prevention of the 200 diseases we call CANCER
• This new knowledge has resulted in lowering the
incidence of cancer in the U.S. and extending the lives
of cancer patients
• Sadly, it has not stemmed the tide of the major cancers
• Cancer incidence and mortality continue to markedly
increase around the world
Global Cancer Burden
• Global cancer incidence has more than doubled during
the past three decades
• This rapid increase represents a crisis in public health
and healthcare systems everywhere
• A major challenge for many countries, even highresource countries, will be to find sufficient resources to
diagnose and treat all cancer patients effectively and
provide the necessary palliative care
There is an increasing sense of urgency worldwide
for us to find new solutions to the cancer problem!!
Global Cancer Burden in 2008
12.4 million new cases
7.6 million deaths
28 million survivors
WHO-International Agency for Research on Cancer
World Cancer Report 2008
Global Cancer Burden:
2030 Projections
26.4 million new cases
17 million deaths
75 million survivors
WHO IARC World Cancer Report 2008
Causes of Significant Increases in the
Global Cancer Burden by 2030
• Growth and aging of the world’s population
• Lifestyle factors (tobacco, diet, obesity, lack of
exercise, alcohol, excessive exposure to sunlight, other)
• Environmental and occupational exposures to
carcinogens and mutagens
• Impact of chronic infection and inflammation
• Introduction of risk factors from developed countries into
developing countries
Cancer: On Track To Be the
No. 1 Cause of Death in 2010
• Cancer is expected to supplant cardiovascular disease as
the Number 1 cause of death worldwide in 2010
• Global increases in cancer incidence are projected at a
rate of 1% per year, with even greater percentage
increases in China, India, and Russia
• It is projected that 84 million people will die from cancer
between 2005 and 2015 unless this pandemic is averted
by a combination of early diagnosis, novel therapeutics,
and prevention
Reality of Cancer in the U.S.
• 1,444,920 Americans were diagnosed in 2007
• 559,650 deaths in 2007, one-third of which are tobacco-related
Deaths Per
100,000 Americans
Unlike Other Major Disease Killers, Cancer Continues to
Take the Nearly Same Toll As In 1950
600
586.8
1950
2005
500
400
300
222
180.7
193.9 188.7
200
48.4
100
0
Heart
Diseases
Cerebrovascular
Diseases
Source: NCI Key Facts About the Burden of Cancer
Source for 2005 Death Rates: National Center for Health Statistics,
U.S. Department of Health and Human Services, NCHS FastStats.
Cancer Facts & Figures 2008, American Cancer Society
Cancer
Economic Burden of Cancer
in the U.S. (2007)
• The economic cost of cancer in 2007 was
$219.2 billion:
– $89.0 billion for direct medical costs
– $130.2 billion for indirect morbidity and mortality costs*
• University of Chicago economists estimate that a permanent
1% reduction in cancer mortality would translate to an overall
savings of $500 billion in national wealth for current and
future generations of Americans**
*Cancer Facts and Figures 2008, American Cancer Society
** Kevin M. Murphy and Robert H. Topel, “The Value of Health and Longevity”
Journal of Political Economy, 2006, vol. 144, no. 5.
Extraordinary Impact of Cancer
Survivors and Patient Advocates
Hamilton Jordan
Chief of Staff to
President Jimmy Carter
(1944-2008)
Lance Armstrong
AACR–Lance Armstrong Foundation
National Poll (December 2003)
What do you fear the most?
Getting into a serious car accident
Being the victim of a serious crime
Getting cancer
Being the victim of a terrorist attack
All of the above
None
19%
12%
30%
13%
9%
12%
AACR–Lance Armstrong Foundation
National Poll (December 2003)
Which of the following diseases or medical
conditions concerns you most?
Cancer
Alzheimer’s Disease
Heart Disease
HIV/AIDS
Diabetes
All of the above
None
34%
14%
16%
9%
9%
9%
5%
Expectations of the
Public and Cancer Patients
• Latest information on:
– Research
– Progress in medical care
– Access to clinical trials
– Policies that affect patient care and survival
• Quality healthcare
• Quality of life
• Return on investment in medical research
The public wants cures and faster progress now!!
AACR Science Policy and
Government Affairs Office Activities
• Advocate for increased appropriations
• Strengthen public awareness about the economic cost of
cancer vis-à-vis the cost of research
• Emphasize concerns about U.S. scientific competitiveness
in science and technology
• Focus on expediting drug approvals at FDA
• Collaborate with other organizations to maximize consistent
messages to legislators and the Administration
• Educate legislators about the importance of funding to
research advances
• Advocacy is a responsibility for all, for there
is an inextricable link between advances
in science and good science policy!!
Agenda of the Obama Administration
• Science and cancer research, although important
to the President, are competing with his top line
agenda items:
– The economy
– Energy
– Health care reform
Obama Administration’s
Priorities in Science
• Scientific research is a clear priority
– Presidential Memorandum on Scientific Integrity
• Restore scientific integrity to government
decision-making
– Stem Cell Executive Order
• Allows federal funding for stem cell research
– Budget Outline
• Plans to double Nation’s investment in science
over the next decade
Obama Administration’s
Priorities in Cancer Research
President’s Address to Congress:
“Our recovery plan will… launch a new
effort to conquer a disease that has
touched the life of nearly every
American by seeking a cure for cancer
in our time.”
President’s Budget Outline:
“Invests over $6 billion for cancer
research at the National Institutes of
Health as part of the Administration’s
multi-year commitment to double
cancer research funding.”
Key Players in the Administration
Department of Health and Human Services
• Secretary of HHS-designate,
Kathleen Sibelius
– Experience
• Eight years as Kansas Insurance
Commissioner
• Governor of Kansas from 2002 to present
• Seen as a talented, bipartisan administrator
– Focus
• Health care reform
– Nomination delay
• Senate vote to confirm has been delayed because
of objections to her pro-choice record.
• Confirmation is expected before the end of April
Key Players in the Administration
U.S. Food and Drug Administration
• FDA Commissioner-designate,
Margaret Hamburg, M.D.
– Vice President of the Nuclear Threat Initiative’s
Biological Program
– Former New York City Commissioner of Health
– Former Assistant Director of NIAID
– Long-standing focus on public health
• FDA Deputy Commissioner,
Joshua Sharfstein, M.D.
– Former Commissioner of Health for the City of Baltimore
– Is currently functioning as Acting Commissioner
– Known for work on consumer protection issues
Key Players in the Administration
President’s Council of Advisors on
Science and Technology
PCAST Co-chairs
• Harold E. Varmus, M.D.
– President, Memorial Sloan-Kettering
Cancer Center
– 1989 Nobel Prize in Physiology or
Medicine for discovery of the cellular
origin of retroviral oncogenes
• Eric S. Lander, Ph.D.
– Member, Whitehead Institute
– Professor of Biology, MIT
Key Players in the Administration
NIH and NCI
Acting NIH Director
Raynard S. Kington, M.D.,Ph.D.
NCI Director
John E. Niederhuber, M.D.
Trends in Research Funding
• FY2003 – 2008
– NIH funding was essentially flat
– NIH researchers’ purchasing power declined 14%
– NIH received $150 million increase from an emergency
supplement in FY2008
• FY2009
– 3.2% increase for the NIH
• FY2009 – 2010
– American Recovery and Reinvestment Act (ARRA)
contained $10.4 billion for NIH, including $1.25 billion for
the NCI
• FY2010
– In progress
NIH/NCI Funding
Annual Inflation-Adjusted Percentage Change
in Research Budgets
14%
12%
10%
8%
NCI
6%
NIH
4%
2%
0%
-2%
-4%
-6%
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
FY2009
• $938 million increase for NIH
• $133 million increase for NCI
• Close to breaking even with medical inflation
2008
2009
Economic Stimulus Funding
•
American Recovery and Reinvestment Act of 2009 (ARRA) was signed into
law on February 17th, 2009
•
NIH funding was championed by Senator Specter (R-PA)
– $10.4 billion for NIH
• $8.2 billion for NIH research
• $1.25 billion for NCI research
• $400 million, specifically for NIH Comparative Effectiveness Research
•
Reporting requirements will be increased to ensure accountability,
transparency, and a positive economic impact of the funds (focus on progress
and jobs creation)
•
NIH will post information about its role in the recovery and impact on
http://www.recovery.com
ARRA funds at the NCI
• NCI is attempting to stimulate research while
avoiding a “crash landing” when grants expire in
2011 and 2014, using three main approaches:
– Adjust the payline (potentially from 16th to 25th
percentile)
– Build training capacity by assisting with faculty
recruitment, increasing funding for training grants,
and supporting two-year and four-year challenge
grants
– Support large-scale projects such as TCGA,
caHUB, and other translational
research efforts
FY 2010 NIH/NCI Funding
• President’s Budget
– Outline released in February
• “$6 billion for cancer research”
– Full budget expected in early to mid-May
• Congressional Budget Resolution
– Includes a 7% increase for discretionary, non-military
spending
– House/Senate compromise expected to pass at the end of
April
• Appropriations legislation
– Introduction may be delayed until after Memorial Day
– Current rumors are that NIH will receive an overall
increase of $1 billion (3% increase)
Cancer Research Legislative Agenda
•
•
•
•
•
•
Health Care Reform
Comparative Effectiveness Research
Personalized Medicine
21st Century Cancer ALERT Act
Stem Cells
Tobacco
Health Care Reform – Primary Focus of
the President and Congress
• The economic problem
– U.S. spent
$2.2 trillion in 2007; 16.2% of GDP and
1
growing
• The coverage/access problem
– One out of three people (86.7 million people) under the2
age of 65 were uninsured for some or all of 2007-2008
• The quality problem
– The U.S. lags behind other developed nations in
error-reducing techniques
– There is a lack of evidence on what works
Biomedical research does not appear to be a part of
the Administration’s health cancer reform equation
1 – Office of the Actuary, Centers for Medicare and Medicaid Services, National Health Expenditure Data for 2007. U.S. Department of HHS
2 – Families USA and The Lewin Group. Americans at Risk: One in Three Uninsured.
Comparative Effectiveness Research (CER)
• CER is the head-to-head comparison of two
interventions to examine benefits and risks to help
medical decision making
• Concerns about research quality and health care
rationing
• Unprecedented increase in funding from ARRA for
CER
– $1.1 Billion for NIH, AHRQ, and HHS
• Administration is seeking input from the community
for ARRA CER funds
• Possible legislation: Establish a National
Comparative Effectiveness Research Center
Personalized Medicine Outlook
• Stage is set for progress
– Advances in science and technology
• Cost of sequencing, other HTP “omics” methods
– Advances in law
• GINA—The Genetic Information Nondiscrimination
Act, signed into law in May 2008
– President Obama’s interest
• Genomics and Personalized Medicine Act
(introduced in 2007 by Senator Obama)
• Related initiatives are priorities (e.g., Health
information technology)
• FDA created a new position: Chief Scientist of
Genomics Advisor
21st Century Cancer ALERT Act
Senators Kennedy (D-MA) and Hutchison (R-TX)
• Aimed at reinvigorating the “War on Cancer”
• AACR was integral in developing the research
sections of the bill
– Supported a 30-member Research Working Group
chaired by AACR Members, Dr. Ray DuBois from
M.D. Anderson Cancer Center and Dr. Ed Benz
from Dana Farber Cancer Center
21st Century Cancer ALERT Act:
Provisions
• Modernization of the National Cancer Program
– Emphasis on coordination and collaboration
• Allows public-private partnerships in translational
research
• Supports a national biorepository network
• Promotes biomarker development
• Improves privacy standards in clinical research
• Provides coverage of standard of care for
clinical trials, although this section is in jeopardy
21st Century Cancer ALERT Act:
Outlook
• HELP Committee markup will be completed soon
• The Kennedy and Hutchison staffs are working
to garner bipartisan support in the Senate
• House effort is to be led by Rep. Lois Capps
(D-CA)
• Cancer community must weigh in to support
relevant provisions – especially the clinical trials
coverage
21st Century Cancer ALERT Act:
Clinical Trials Coverage
• Clinical trials are central to advancing new cancer
treatments
– Only about 5% of cancer patients participate in
clinical trials
– Lack of coverage is one of the major barriers to
participation
• The bill requires ERISA-governed health plans to
continue to provide coverage of routine care if the
patient enrolls in a clinical trial
• Significant pushback by Republicans on this
provision threatens progress
Embryonic Stem Cells
• Stem Cell Executive Order
– Allows federal funds to be used for stem cell research
on existing embryonic stem cell lines
– Does not allow federal funds to be used to derive
embryonic stem cell lines
• Pending Legislation
– To codify the Executive Order
• Possible Legislation
– To overturn “Dickey-Wicker” – which prohibits federal
funds to be used for research on human embryos
Tobacco Regulation
• House passed The Family Smoking Prevention
and Tobacco Control Act (H.R. 1256)
– Grants the FDA authority over tobacco products
– Prohibits tobacco marketing and sales to kids
– Requires larger, more effective health warnings on
tobacco products
• Senate version is to be introduced soon
• President Obama strongly supports the bill
Strengthening the FDA:
A Vision for the Future
• There is a great need to increase the effectiveness and
efficiency of the Agency
• Significant challenges persist in the approval of new
compounds as well as combinations of agents
• There are insufficient resources, infrastructure, and personnel
to fully integrate the latest science and technology
• Extensive partnerships across FDA’s Centers and with
equivalent international agencies are called for in order to
increase efficiency, productivity, and speed of approval
• The training of regulatory oncologists in the new sciences
must be a high priority as they face hurdles in product safety
review at both the pre-approval and
post-marketing stages
Link Between Progress
in Science and Policy
• The economic recession brings new challenges for
advances in cancer and medical research
• Physicians and scientists must become more active
in public policy and government affairs
• The education of your cancer center directors is
extremely important to making inroads with
policymakers
• Your personal efforts in this area will increase the
likelihood of decisions that serve the needs of patients
Key Sources of Funding
for Cancer Research
Federal government
Pharmaceutical and biotechnology industries
Other corporations (cause-related marketing)
Philanthropic organizations and foundations
The lay public
Interested philanthropists – national and
international – who want to make a difference
• Novel fundraising approaches such as venture
philanthropy
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•
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Agenda for Today’s Presentation
• Present a general overview of the AACR and
how it carries out its mission
• Discuss the challenges we face today in public
education, public policy, and fundraising
• Offer my perspectives on how NACCDO and PAN
could forge a synergistic relationship with the
AACR to accelerate progress in cancer research
Extraordinary Time in the Historical
Development of Cancer Research
• Basic research—systematic approach to link specific
signaling pathways to biologic endpoint
• New technologies—high throughput screens, array
analysis, proteomics, and deep sequencing advances
• Translational cancer research—attempts to personalize
treatment to each individual tumor
• Cancer prevention research—looking for safer ways
to prevent cancer and to devise more effective early
detection methods
Overarching Challenges for the Future
in This Time of “Change”
• Encourage unconventional scientific ideas
• Put more emphasis on meeting research milestones
• Integrate new knowledge in related scientific disciplines
• Build a modern research infrastructure that facilitates
translational research
• Maintain our funding base for cancer research while
stimulating new sources of funding
• Encourage essential collaborations
• Educate the public and members of the
media about cancer and cancer research
2009 Poll: Americans’ Views
on Cancer Research
• CBS News/New York Times conducted a poll of a random
sample of 998 adults nationwide via telephone
interviews during April 1-5, 2009 (data published April
24, 2009)
• The poll found that a majority of Americans believe
progress against cancer has been made over the last 30
years
• One-third think the federal government spends too little
on cancer research compared with other medical
research
2009 Poll: Americans’ Views
on Cancer Research
• As far as you know, how much progress has been made
in finding a cure for cancer in the United States over the
last 30 years – a lot, some, not much, none at all, or
don’t know enough to say?
–
–
–
–
–
–
A lot
Some
Not much
None at all
Don’t know enough
DK/NA
30%
30%
16%
5%
17%
2%
2009 Poll: Americans’ Views
on Cancer Research
• What do you think about federal government spending
for cancer research compared with federal government
spending for other medical research? Do you think the
government is spending too much, too little, or about
the right amount on cancer research?
–
–
–
–
Too much
Too little
Right amount
DK/NA
7%
34%
34%
25%
Collaborations Between AACR
and Cancer Centers
• Encourage the participation of scientists at cancer centers
in AACR scientific programs and publications
• Address the educational needs of young basic, clinical,
and population scientists
• Fund senior and junior investigators at cancer centers by
AACR research grants and other funding mechanisms
• Collaborate on science and public policy issues
• Help to publicize in the media the advances made by
cancer researchers at cancer centers
AACR and NACCDO
• Share knowledge about the latest developments in the
cancer field
• Develop creative ways together to raise funds for cancer
research, especially in this economic downturn
• Work together strategically to strengthen relationships
with philanthropists – in particular, those who wish to
dedicate their monies to cutting-edge projects, both local
and national
• Keep each other informed about trends that may impact
current and future funding of cancer researchers working
at cancer centers
AACR and PAN
• Work together on the challenges in the field, sharing knowledge,
expertise, and advice
• Enhance our interactions with other sectors: academia,
government, industry, philanthropic community, the general
public, and survivors and patient advocates
• Consider new mechanisms for collaborating:
-
Hold our respective Annual Meetings at the same time
and place, and convene jointly sponsored sessions
Conduct special forums for science/medical writers
(e.g., Webinars, other)
Produce an AACR/PAN Directory of Cancer Experts
Link PAN Press Releases to the AACR Website
for maximum exposure
May is National Cancer
Research Month
• On May 7, 2008, AACR secured the official Congressional
designation of National Cancer Research Month
• According to Rep. Baldwin, this “will remind us that basic,
clinical, epidemiological and behavioral research is integral to
identifying causes and developing strategies for prevention,
diagnosis, treatment, and cures for cancer.”
• AACR has built a multi-year plan to build public awareness of
the importance of support for cancer research
• The plan includes working with the Public Affairs Network
(PAN) of cancer centers to increase local and national media
coverage
In Conclusion
• The great cancer centers of this country are collectively
the jewel of the National Cancer Act from the point of
view of cutting-edge research, patient care, education,
communications, and fundraising
• You are the “army” on the ground in the fight against
cancer. By working together, we can amplify our voice
on the Hill, in the media, and among the lay public
• The AACR looks forward to opportunities for increasing
collaborations with NACCDO/PAN to further our
respective goals and advance progress against cancer
THANK YOU FOR YOUR ATTENTION!!