Abstract
After 12 years at the helm of the NIH, geneticist Francis Collins, MD, PhD, announced plans on October 5 to step down as the agency's director by the end of 2021.
After 12 years at the helm of the NIH, geneticist Francis Collins, MD, PhD, announced on October 5 that he will step down as the agency's director by the end of the year. When he does, Collins will leave a lasting mark on the cancer research enterprise.
Collins helped launch the Cancer Moonshot Initiative, which provided $1.8 billion in additional funding to the NCI over 7 years. He also spearheaded the creation of a 5-year, $220 million collaboration with pharmaceutical companies, the Partnership for Accelerating Cancer Therapies, centered around validating biomarkers for immunotherapy treatments (Cancer Discov 2017;8:OF7).
Even though most Collins-led undertakings did not explicitly focus on cancer, they often contained substantial funds earmarked for the NCI, or they affected cancer research indirectly.
Take, for example, the Precision Medicine Initiative, later renamed the All of Us Research Program. The effort's cornerstone is a massive longitudinal cohort study that combines health data with biospecimen collection and analysis; many of the million or so participants invariably have or will develop cancer, providing a window into the etiology of the disease (Cancer Discov 2015;5:1230).
But with $70 million set aside for the NCI, the initiative also helped fund studies such as the Molecular Analysis for Therapy Choice (NCI-MATCH) trial. Plus, it supported efforts to create precision oncology resources, such as cancer genomic data repositories and a collection of tumor-derived tissue models.
“Taking big difficult problems and bringing lots of people, money, and resources to bear on them is a signature thing that Francis does,” says Lawrence Brody, PhD, of the National Human Genome Research Institute (NHGRI), who has shared lab space with Collins for nearly 30 years.
To make such large-scale programs happen, Collins needed to ensure buy-in from multiple stakeholders across government, academia, industry, and elsewhere—a skill that comes naturally to the politically savvy physician-scientist, according to Greg Simon, JD, a former policy adviser to Vice President Al Gore who later led the White House Cancer Moonshot Task Force and the Biden Cancer Initiative.
“Francis is the master diplomat,” Simon says. “He has always been really good about organizing complicated large science projects.”
Collins has also proven adept at securing money. During his tenure, the NIH budget increased from $29.5 billion to $43 billion; around one sixth of those funds consistently went to the NCI. Such a steadily rising budget commitment owes a lot to Collins and his “consummate skill in explaining the science to the Congress and making a compelling case” for biomedical research, according to David Wholley, MPhil, interim president and executive director of the Foundation for the National Institutes of Health.
Collins started his career as a gene sleuth. Although most famous for co-discovering the gene responsible for cystic fibrosis, he made important contributions to cancer genetics through studies detailing how particular heritable mutations could confer susceptibility to breast and prostate cancers.
Throughout the 1990s, Collins, as director of what became the NHGRI, oversaw the mapping of the human genome—a scientific project that opened the doors to other massive sequencing efforts, such as The Cancer Genome Atlas, notes Lisa Butterfield, PhD, head of R&D at the Parker Institute for Cancer Immunotherapy in San Francisco, CA. “To have the genetic tools and big data tools that he supported is now huge for cancer immunotherapy,” she says.
In addition to steering the NIH's pandemic response, Collins has spent the past 6 months advocating for a new multibillion-dollar entity, the Advanced Research Projects Agency for Health (ARPA-H), to support more high-risk, high-reward biomedical ventures. A new NIH director may see the idea through to fruition. But as with his other major initiatives, Collins will deserve credit for yet again reshaping the biomedical research enterprise. –Elie Dolgin