NCI Director Says Basic Research among Top Priorities

Expanding investment in basic research is a top priority for the NCI as it works to achieve the goals of the recently released National Cancer Plan, said its new director, Monica Bertagnolli, MD, during her address at the American Association for Cancer Research (AACR) Annual Meeting 2023, held April 14–19 in Orlando, FL. She also singled out data science and clinical trials as priorities that will require substantial, ongoing investment to make meaningful progress against cancer in the coming decades.

“Basic science is the fundamental backbone of everything we do, and we can never take it for granted,” said Bertagnolli, who fielded questions during a session moderated by Lisa Coussens, PhD, of the Knight Cancer Institute at Oregon Health & Science University in Portland, who concluded her 1-year term as AACR's president during the meeting. “At the same time, we need major new emphasis and investment on data science and structures, and strategies to increase involvement in clinical trials.”

All such efforts should aim to eliminate health care disparities, said Bertagnolli, who stressed the importance of tailoring solutions to the ­specific needs of different underserved communities. To that end, she said the NCI will seek to partner with and fund people and organizations already integrated into these communities and familiar with the barriers patients face.

Bertagnolli noted that although the NCI received a much-needed 5.9% funding boost for fiscal year 2023, paylines increased by just 1% and many planned initiatives remain unfunded. Annual, consistent budget increases are needed to fund new grants while covering the ongoing costs of previous multiyear commitments.

The director said she is working closely with Renee Wegrzyn, PhD, head of the Advanced Research Projects Agency for Health (ARPA-H), a new independent agency within the NIH that funds high-risk, high-reward projects aimed at speeding development of treatments for cancer and other serious medical conditions. The two agencies have complementary approaches, she remarked, as ARPA-H focuses on rapidly attacking specific problems from multiple angles, while the NCI launches many parallel efforts that may continue for decades.

“We are working closely with their team to make sure good ideas from NCI researchers are integrated into ARPA-H plans,” she said. Similarly, “we want to make sure that what gets developed at ARPA-H gets deployed at NCI.”

Tackling issues around data processing, storage, and sharing is a major area of focus and collaboration for the two agencies, said Bertagnolli. Although it's premature to disclose details of specific projects, she said, improving access to real-time clinical information is critical.

“We don't yet know the real impact that the pandemic has had on cancer survival because we lack the ability to obtain, process, and properly analyze data quickly from the clinical care environment,” she said. “We don't get real-time cancer data, and without that data and knowledge it's hard to respond to problems strategically and properly.”

Bertagnolli, who discussed her own recent experience being diagnosed with and treated for breast cancer, noted that the overarching vision for the National Cancer Plan is identical to that set by the Cancer Moonshot—to cut the cancer death rate by 50% within 25 years and improve the lives of those diagnosed and living with cancer (see http://nationalcancerplan.cancer.gov and http://www.cancer.gov/research/key-initiatives/moonshot-cancer-initiative).

“For me, ending cancer as we know it means that one day every person who has cancer will live a full and active life free from any of the effects of their cancer,” she said. “That includes freedom from every kind of toxicity, including financial toxicity, as well as other lingering effects of treatment.” –Janet Colwell

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