Varmus: “Let's Do the Best We Can”

Although its budget will drop about 5% this year, the National Cancer Institute (NCI) aims to maintain its current 13% to 14% grant approval rate and to push forward with major initiatives, director Harold Varmus, MD, told attendees at the American Association for Cancer Research Annual Meeting 2013 in Washington, DC, on April 8.

Except for maintaining grant awards and trainee support, “we're trimming everything we can trim,” Varmus commented. “However, the NCI still has a budget of $4.8 billion and a lot can be done with that.”

Among initiatives this year, the NCI will accelerate its push into precision medicine by taking steps toward a “cancer knowledge commons” that aggregates information from many sources. “The NCI and many other agencies are in the process of figuring out how to do that,” Varmus said. While The Cancer Genome Atlas (TCGA) is scheduled to wind down by late 2014, part of the TGCA network will be sustained to aid this work, he said.

In a related effort, NCI is planning clinical trials designed to further explore the use of whole-genome sequencing, including one trial that examines patients' exceptional responses to investigational therapies. (Varmus gave examples from research by the lab of David Solit, MD, of Memorial Sloan-Kettering in New York, NY, including one recent Science article; Science 2012;338:221.) A second planned trial will match more than 1,000 patients with existing therapies, while a third trial will test the use of adjuvant therapies in patients with early-stage lung cancer.

Varmus noted that in recent months the Frederick National Laboratory for Cancer Research (formerly known as the Frederick Cancer Research and Development Center) in Frederick, MD, has gained not just a new name but new leaders, a new advisory group, new facilities, and new projects. Among those projects, one will target the RAS pathway, while another will seek advances in preclinical testing—including better models for patient-derived xenografts and improved analyses of combination therapies.

Additionally, Varmus called for “cultural change” in 3 areas of cancer research. One concerns broader sharing of information and resources, and he said that in the coming year NCI will take steps to “ensure that clinical trials, negative and positive, are adequately reported.” A second is in the ability to replicate research results; “we're going to move with delicacy here, but this is an important issue,” he declared. The third is in attempts to improve the evaluation process, including a pilot experiment in which grant applicants include a different form of biographic sketch that emphasizes their 5 leading contributions to science.

Overall, in cancer science today, “we do have better tools, we have more information, and we have better talent,” Varmus summarized. “Unfortunately, we have less money, but we can do a lot, so let's do the best we can.”

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