CALL THE MEETING TO ORDER. I
WOULD LIKE TO WELCOME MEMBERS OF
THE ADVISORY BOARD. EX OFFICIO
MEMBER AND STAFF AND GUESTS.
MEMBERS OF THE PUBLIC, WHO MAY
WISH TO EXPRESS THEIR VIEWS
REGARDING ANY ITEMS DISCUSSED
DURING THIS MEETING MAY DO SO BY
WRITING TO THE DOCTOR WITHIN TEN
DAYS FOLLOWING THE MEETING. ANY
WRITTEN STATEMENTS OR QUESTIONS
SUBMITTED BY MEMBERS OF THE
PUBLIC WILL RECEIVE CAREFUL
CONSIDERATION. AS BOARD
MEMBERS, I WANT TO REMIND YOU
THAT YOU MUST ABSENT YOURSELVES
DURING SPECIFIC DISCUSSIONS
WHENEVER YOUR PARTICIPATION,
DELIBERATIONS ON A PARTICULAR
PRODUCT, PROGRAM OR OTHER
SPECIFIC MATTER WOULD CONSTITUTE
A CONFLICT OF INTEREST OR CREATE
THE APPEARANCE OF ONE. IT IS
INCUMBENT UPON OURSELVES TO
ADVISE THE EXECUTIVE SECRETARY
AND ABSTAIN FROM ANY DISCUSSIONS
REGARDING THESE MATTERS:
CONSIDERING THE CURRENT POLICIES
GOVERNING CONFLICT OF INTEREST
BASED ON FINANCIAL HOLDINGS OF
SPECIAL GOVERNMENT EMPLOYEES
WHICH WE ALL ARE AS BOARD
MEMBERS, WE MUST DEPEND UPON
OURSELVES TO VOLLEY ABSENT
OURSELVES DURING ANY AND ALL
DISCUSSIONS OF MATTERS THAT
COULD CONCEIVABLY IMPACT THE
STATUS OF THESE HOLDINGS WE
TRUST YOUR JUDGMENT IN THESE
INSTANCE DURING ANY CLOSED
SESSION, ANY MATERIALS OR
DISCUSSIONS OF CONFIDENTIAL
NATURE DELIBERATED ON TODAY ARE
PRIVILEGED INFORMATION AND ARE
MADE AVAILABLE TO YOU ON A NEED
TO KNOW BASIS SUCH DELIBERATIONS
ARE PRIVATE AND THEIR CONTENT
AND NOT BE DIVULGED. QUORUM,
REQUIRED FOR EACH INSTANCE IN
WHICH A VOTE MAY OCCUR WHETHER
IN OPEN OR CLOSED SESSION DURING
THIS MEETING A MINIMUM OF TEN
APPOINTED MEMBERS MUST BE
PRESENT TO VOICE THEIR VOTES
SINCE WE CAN'T PREDICT THE TIME
OR OCCURRENCE OF ANY MOTION YOUR
PRESENCE IN THE ROOM AND IN THE
HYBRID ROOM FOR ALL SEGMENTS OF
THE MEETING IS A MUST. DO WE
HAVE QUORUM? FUTURE MEETINGS
ARE LISTED ON THE AGENDA AND
LISTED ON CANCER.GOV WE NEED TO
APPROVE THE JUNE THROUGH
NOVEMBER HYBRID MEETING SUMMARY.
IS THERE A MOTION TO APPROVE?
SECOND? ANY FURTHER DISCUSSION?
SO LET'S VOTE. ARE THERE ANY
MAYS? ANY ABSTENTIONS? IT'S
UNANIMOUS. ALSO PHONES OR OTHER
DEVISES SHOULD BE TURNED OFF OR
SET TO VIBRATE. WHENEVER THESE
INSTRUMENTS GO OFF THEY CAN
DISRUPT THE MEETING. THIS APPLY
TO STAFF MEMBERS AND OTHERS IN
THE ROOM. AGAIN, TO ENSURE NO
INTERRUPTIONS DURING TODAY'S
MEETING MEMBERS PARTICULARLY
VIRTUALLY SHOULD PUT MUTE
YOURSE
YOURSELVES. SO WE'LL NOW START
TODAY'S AGENDA WITH THE NCI
DIRECTOR'S REPORT.
DR. RATHMELL.
>> DR. RATHMELL: GOOD MORNING,
WE HAVE THE SLIDES TOO? IT'S A
PLEASURE TO BE UP HERE WITH YOU
AND TELL YOU ABOUT WHAT'S BEEN A
REALLY BUSY SUMMER SINCE WE WERE
TOGETHER LAST IN JUNE. LET ME
JUST MOVE AHEAD. MAYBE, I'M
HAVING SOME CHALLENGES. SO MANY
THINGS TO PUSH SO TODAY WE'LL DO
SOME UPDATES SINCE THE LAST JUNE
MEETING. I AM GOING TO TALK A
LITTLE BIT ABOUT BUDGET BUT IN
THE FORMAT OF THE PROFESSIONAL
JUDGMENT BUDGET PROPOSAL THE
HEAVY LIFTING WILL BE RIGHT
AFTER ME BY DR. LOW WE AND
WESTON RICKS. WE WILL TALK
ABOUT OUR RESEARCH HIGHLIGHT AND
I WILL SET TIME AVAILABLE FOR
QUESTIONS. SO DIVING JUMP RIGHT
IN. IT HAS BEEN A REALLY BUSY
SUMMER.
TO GIVE YOU AN EXAMPLE OF SOME
OF THE THINGS THAT WE'VE BEEN
DOING, FIRST, ONE OF MY
INTENTIONAL ACTIVITIES HAS BEEN
SPENDING SOME TIME GETTING TO
KNOW OUR N CORP PROGRAMS.
YOU'LL HEAR MORE ABOUT THAT
LATER TODAY FROM PHIL CASTLE AND
JIM D. THE FIRST VISITS THAT I
WENT TO WERE TO KANSAS.
A FEDERATED SYSTEM GIVING ME
GREAT INSIGHTS INTO HOW YOU
DELIVER CARE ACROSS A REALLY
VAST REGION OF THE MIDWEST.
SOME REALLY INNOVATIVE WORK
THAT'S HAMMING THERE. I ALSO
VISITED THE BRONX.
TO NCORP SITES THERE. VERY
DIFFERENT OF COURSE. A SMALLER
GEOGRAPHY BUT 27 DIFFERENT
LANGUAGES COMMONLY SPOKEN BY
THEIR PATIENTS. 32% IMMIGRANT
POPULATION. 30% POVERTY AND IN
THAT SETTING, THEY HAVE HAD
RECORD CLINICAL TRIAL
ENROLLMENT. THEY WERE FIRST
OPENING THE CLINICAL TRIALS
OFFICE WHICH WE HIGHLIGHTED AT
ONE OF THE LAST SESSIONS AND
HAVE REALLY FOCUSED ON
STREAMLINING OPENING OF THEIR
CLINICAL TRIALS SO REALLY A LOT
WE CAN LEARN FROM THESE SITES
AND THIS IS WHERE OUR PATIENTS
RECEIVE THEIR CARE AND THIS IS A
PART OF OUR TALENT POOL IS OUR
COMMUNITY ONCOLOGY BASE. I ALSO
SPENT SOME TIME GOING OUT TO
PROGRAMS THAT SUPPORT TRAINING.
SO THE M.D.-PH.D. PROGRAM DOES A
NATIONAL MEETING AND WAS
PRIVILEGED TO BE ONE OF THEIR
KEYNOTES THAT WAS HELD IN
COLORADO.
THE PICTURE THERE SI THINK FROM
SOME STUDENTS FROM INDIANA
UNIVERSITY.
SO INCREDIBLE ENERGY AMONG OUR
FUTURE PHYSICIAN SCIENTISTS AND
IT WAS A REAL HONOR THERE TO
TALK ABOUT WHY CANCER RESEARCH
IS THE FIELD THEY SHOULD SPEND
THEIR TIME DEVELOPING. I ALSO
GOT TO VISIT THE UNIVERSITY OF
CHICAGO. THIS WAS THEIR 50TH
ANNIVERSARY OF THEIR CANCER
CENTER BUT THEY USED THAT 50TH
ANNIVERSARY AND SPENT THE
CELEBRATION ON A SYMPOSIUM FOR
THEIR STUDENTS, AN ANNUAL
SYMPOSIUM EVENT THAT THEY DO
WHICH HIGHLIGHTED EVERYTHING.
THEY ROW CENTLY REYOUED THEIR
PROGRAM.
YOU WILL HEAR MORE ABOUT THAT
FROM DR. SONYA SPRING FIELD.
THAT AND OTHER PROGRAMS BUT
THEY'RE ALSO PILOTING REALLY
EXCITING THINGS THAT I FOUND
USEFUL TO BE REALLY THINKING
ABOUT. LIKE, PILOTING PROGRAMS
THAT PARTNER WITH COMMUNITY
COLLEGES IN THE AREA, THE
MALCOLM X COMMUNITY COLLEGE IS
ONE EXAMPLE WHERE THEY'RE
LOOKING AT TAKING ASSOCIATE'S
DEGREE STUDENTS AND EQUIPPING
THEM WITH THE SKILLS TO BE PART
OF THE CLINICAL TRIALS OFFICE.
REALLY MEETING A NEED ON
MULTIPLE AREAS. AND THEN
BUILDING OUR RELATIONSHIPS
GLOBALLY. THE WHO HAD A VISIT
HERE. THEY HAVE A COLLABORATING
CENTER FOR GLOBAL HEALTH --
GLOBAL CANCER RESEARCH AND WE'RE
HERE SPENDING A DAY WORKSHOPPING
AROUND A LOT OF WORK IN THAT
AREA BUT I ALSO WANT TO
HIGHLIGHT A COUPLE OF SPECIFIC
FOCUS AREAS. AUSTRALIA IS ONE
EXAMPLE. WE HOSTED THE
AMBASSADOR TO AUSTRALIA,
CAROLINE KENNEDY AND TALKED
ABOUT WHAT THE EFFORTS ARE
AROUND HPV VACCINATION AND
CERVICAL CANCER. WE MET WITH A
GROUP OF SENATORS FROM
AUSTRALIA. I COULDN'T JOIN YOU
LAST NIGHT FOR THE SUBCOMMITTEES
BECAUSE I WAS WITH THE
AMBASSADOR TO AUSTRALIA TALKING
ABOUT WHERE LARGER SCALE
COLLABORATIONS CAN HAPPEN ACROSS
OUR SCIENTIFIC INTERESTS. WE
ALSO HAD TIME TO SPEND WITH OUR
COLLEAGUES FROM JAPAN. THIS IS
THE COALITION OF THE NATIONAL
CANCER CENTER IN JAPAN. LATER
NEXT WEEK THERE'LL BE A
SYMPOS
SYMPOSIUM ON THIS WHICH WE'LL BE
SPEAKING AT AGAIN TALKING ABOUT
SOME OF OUR COLLABORATIONS. I
DON'T HAVE A PICTURE HERE FROM
THE FIRST U.S. INDIA DIALOGUE
WHICH WAS ATTENDED IN-PERSON BY
THE DOCTOR. I ATTENDED
VIRTUALLY. LOOKING FOR OUR
COUNTRIES TO COLLABORATE WITH A
LOT OF EMPHASIS ON IMMUNOLOGY
BUT OTHER AREAS LIKE AI AND
TECHNOLOGY AS WELL. I PICKED
THESE ONES BECAUSE U.S.,
AUSTRALIA JAPAN AND INDIA FORM
WHAT'S CALLED THE QUAD AND THIS
IS BIGGER THAN CANCER.
THIS IS A GROUP OF COUNTRIES
THAT ARE WORKING TOGETHER WITH A
COMMITTED INITIATIVE TO TACKLE
THE WORLD'S MOST COMPLICATED
PROBLEMS. AND SO I WOULD ARGUE
THAT CANCER FITS THAT VERY WELL
AND SO BUILDING THOSE
RELATIONSHIPS IS A PART OF HOW
WE INVEST IN A LOT OF OUR
FUTURE. WE ALSO SPENT SOME TIME
WORKING WITH THE WHITE HOUSE
WHICH WAS STILL BUSY IN THE
CANCER ARENA THIS SUMMER. HERE,
I GOT THE OPPORTUNITY TO TALK TO
THE OFFICE OF MANAGEMENT AND
BUDGET. THE EXAMINERS CAME TO
THE NIH AND REALLY WANTED TO
HEAR ABOUT WHAT WE'RE DOING IN
CANCER. WHAT WERE THE OUTCOMES
OF THE MOON SHOT? HOW IS IT
THAT THE INVESTMENTS ARE SPENT
WISELY? THEY WERE SO INTERESTED
IN WHAT WE WERE DOING IN THE
FREDERICK NATIONAL LABS THAT WE
BROUGHT THEM BACK AND DID A TOUR
OF THE LABS. AND REALLY GOT TO
SHOW THEM WHAT THE CAPABILITIES
ARE OF THE CANCER INSTITUTE.
AND WHERE WE CAN MAKE A REAL
DIFFERENCE. WE ALSO HAVE BEEN
WORKING HHS WITH THE DEPUTY
SECRETARY WITH MEETINGS. THAT,
AGAIN, ALSO PIQUED THEIR
INTEREST IN WHAT IT IS THAT WE
HAVE CAPABILITIES OF AND BROUGHT
HER HERE TO CAMPUS TO DO A
VIRTUAL VISIT FOR THE FREDERICK
NATIONAL LABS AND ALSO TO TALK
ABOUT WORLDWIDE EFFORTS THAT WE
CAN MAKE A BIG DIFFERENCE,
AGAIN, FOCUSING ON HPV. IN
JUNE, I TOLD YOU THAT WE WERE
HAVING A RETREAT SO ONE OF THE
HIGHLIGHTS OF THE SUMMER WAS A
RETREAT THAT WE HELD THE FIRST
OF ITS KIND WHICH WAS OUR
LEADERSHIP PLUS THE BOARD
LEADERS SO DR. CARP TEN JOINED
US AND THE GOAL OF THIS RETREAT
WAS TO SURVEY THE LANDSCAPE OF
CANCER INITIATIVES TO DECIDE
WHERE WE CAN PUT BIG FOCUS AREAS
THAT CAN MAKE A REAL DIFFERENCE.
NOT A SMALL TOPIC TO TAKE ON.
BUT OVER THE COURSE OF THE DAY
WRESTLED WITH A LOT OF DIFFERENT
REAL ISSUES. PARTICULARLY
SPENDING A LOT OF TIME AROUND
WHATEVER WE DO, HAS TO BUILD
TRUST. HAS TO DEMONSTRATE OUR
TRUSTWORTHINESS AND DEMONSTRATE
OUR COMMUNITIES AND A
COMMUNICATION EFFORT ALONG WITH
GOOD SCIENCE SO WE TALKED ABOUT
A LOT OF DIFFERENT INITIATIVES,
THE TANGIBLE OUTPUTS. I WILL BE
ANNOUNCING A LITTLE BIT LATER
HOPEFULLY IN THE FALL SO LOOK
FORWARD FROM MORE TO COME ON
THIS BUT THIS WAS A GREAT
OPPORTUNITY TO BUILD IDEAS AND
BUILD MOMENTUM AROUND IMPORTANT
AREAS FOR CANCER RESEARCH.
OKAY. I ALSO LAST JUNE TOLD YOU
THAT WE HAD COME TO SOME
DECISIONS ABOUT SOME NEW
LEADERSHIP POSITIONS. BUT I
COULDN'T TELL YOU WHO THEY WERE.
SO -- BUT KNEW WE CAN. THEY
WERE SWORN IN LAST WEEK. SO
FIRST I WILL TELL YOU THAT PETER
GARRET, IF YOU WANT TO LET
EVERYONE KNOW WHO YOU ARE. SO
PETER GARRET, BEFORE I TELL YOU
ABOUT PETER. BOTH OF THESE
INDIVIDUALS WERE BROUGHT THROUGH
IN THE POSITIONS THROUGH
NATIONAL SEARCHES. BOTH WERE
INTERNAL HIRES. PETER HAS BEEN
LEADING THE OFFICE OF PUBLIC
LIAISON WHICH NOW WILL BE
WORKING VERY CLOSELY WITH, I
ALWAYS FORGET THE NAMES OF ALL
MY OFFICES THE OFFICE OF
GOVERNMENT AND CONGRESSIONAL
RELATIONS. MK WHO YOU WILL HEAR
FROM LATER. AND ALSO THE OFFICE
OF ADVOCACY RELATIONS. WHICH IS
AMY WILLIAMS. THAT GROUP WILL
BE WORKING CLOSELY TOGETHER.
THIS WILL BE TACKLING WHAT WE
TALKED ABOUT IN THE RETREAT.
HOW DO WE COMMUNICATE MOST
EFFECTIVELY ACROSS THIS BROAD
AREA AND BRING ALL OF THESE
RESOURCES MOVING VERY MUCH
FORWARD AND THEN AMBER LOWER RI.
AMBER HAS BEEN THE ACTING DEPUTY
DIRECTOR FOR MANAGEMENT. AND
REALLY THE KEYS TO HOW THE WHOLE
THING WORKS. WE'RE HAPPY TO
TAKE ACTING AWAY AND SHE WILL
TAKE US ON INTO THE FUTURE. I
ALSO MENTIONED IN JUNE A NEW
DEPUTY FOR DATA SCIENCE AND
STRATEGY. DR. K. WHERE ARE YOU?
NOT OFFICIAL YET. BUT NOW HE'S
OFFICIAL. AND HAS BEEN HIT --
HAS REALLY HIT THE GROUND
RUNNING, HAS BEEN LEARNING A LOT
ABOUT WHAT WE'RE DOING AND
HELPING US BE BETTER IN THE
AREAS OF DATA SCIENCE, AI,
YOU'RE GOING TO HEAR FROM HIM
AND A TEAM A LITTLE BIT LATER
TODAY. SO I'M REALLY EXCITED
ABOUT THAT SO THAT IS AT 1:10
TODAY. I ALSO WANT TO PUT OUT A
PLUG FOR A BIG PART OF THE WHAT
WE HAVE AROUND OUR DATA CENTERS
THAT PUTS TOGETHER A BLOG. IF
YOU'RE INTERESTED IN WHAT ARE WE
DOING IN CANCER DATA SCIENCE
THAT BLOG IS A REALLY GOOD ONE
TO FOLLOW AND KEEP TRACK OF
WHAT'S GOING ON IN THIS AREA.
OKAY, BUDGET. SO, AGAIN, MY
BUDGET WILL JUST BE TALKING
ABOUT WHAT WE PROPOSED FOR THE
PROFESSIONAL JUDGMENT BUDGET.
NITTY-GRITTY COMING AFTER. THE
ANNUAL PLAN IS WHAT WE CALL THE
PROFESSIONAL JUDGMENT BUDGET
PROPOSAL. IT'S A TOOL TO SHARE
WITH CONGRESS WHAT WE'RE, AND
WITH THE PRESIDENT, WHAT WE'RE
DOING TO HELP TO BUILD
UNDERSTANDING AND TO CONVEY HOW
IMPORTANT IT IS THAT INVESTMENTS
OCCUR IN CANCER RESEARCH.
YOU'LL BE SEEING A SERIES OF
E-MAILS YOU'VE ALREADY SEEN A
PREVIEW OF THE E-MAILS THAT WILL
GO OUT TO OUR CONSTITUENTS BUT
SOCIAL MEDIA WE REALLY WANTED TO
PLUG THIS DOCUMENT WHICH IS A
COMBINATION OF TEXT AS WELL AS
SOME SPREADSHEETS BECAUSE IT IS
A BUDGET. WE TELL PART OF IT IN
A STORY SO WE TELL THREE STORIES
AND THE STORIES ARE LIKE ALL
STORIES, REALLY MEANT TO COVER
MORE THAN ONE MORAL IN THOSE
STORIES. WE START WITH A
PATIENT BECAUSE PATIENTS COME
FIRST WHEN WE'RE TALKING ABOUT
CANCER AND CANCER RESEARCH. WE
TELL THE STORY ABOUT A PATIENT
NAMED JASON WHO HAS
NON-HODGKIN'S LIMB POE IF A WHO
CAME FOR AN INNOVATIVE CANCER
CENTER AND IS NOW THREE YEARS
OUT DISEASE-FREE.
THAT STORY TELLS US WHY WE'RE
HERE. WHAT IT IS THAT OUR
MISSION IS THERE TO ACCOMPLISH.
THE BIOLOGY OF TUMORS CAN MAKE A
DIFFERENCE AND WE CAN CURE
PATIENTS AND DO SO WITH LESS
TOXIC SIDE EFFECTS WE ALSO TELL
A STORY ABOUT EARLY STAGE
INVESTIGATOR. HER NAME IS LEAH
AND A MOON SHOT SCHOLAR AND A
VERY SUCCESSFUL PROGRAM TO BRING
DIVERSITY INTO OUR WORKFORCE, TO
ENABLE PEOPLE TO BE
INVESTIGATORS AND BRINGING
CERVICAL CANCER RESEARCH TO
LOWER AREAS. AGAIN TELLING
ABOUT INVESTMENT AND THE VALUE
THAT WE PLACE ON TALENT
DEVELOPMENT. THE IMPORTANCE OF
OUR COMMUNITY AND HOW
RESEARCHERS ENGAGE WITH THE
COMMUNITY AND HOW WE ADDRESS
SERIOUS ISSUES LIKE SOCIAL
DETERMINANTS OF HEALTH AND THEN
WE TELL A STORY ABOUT OUR SBIR.
OUR SMALL BUSINESS INNOVATION
RESEARCH PROGRAM AND A SMALL
COMPANY THAT'S STARTING TO LOOK
AT A MOLECULE THAT CAN DETECT
CANCER CELLS IN THE OPERATIVE
FIELD. THIS IS SHOWCASING WHERE
REALLY TECHNOLOGY BLENDS WITH
SCIENCE, INNOVATION AND
MEDICINE. IT'S PART OF OUR
ECONOMIC ENGINE. THIS IS A
SMALL COMPANY THAT WILL CREATE A
VALUE ADDED RESOURCE THAT WILL
BE A PART OF THE OVERALL
OPERATION AND ECONOMIC IMPACT IS
VERY, VERY REAL. OKAY. WE TELL
THE STORIES IN SPREADSHEETS TOO.
OUR TOTAL ASK IS ROUGHLY 11.5
BILLION DOLLARS. THAT'S THE
NUMBER I WANT YOU TO REMEMBER.
WHERE DO WE COME ONE A NUMBER
LIKE THIS? THIS IS AN
INVESTMENT IN CANCER RESEARCH
THAT CAN CAPITALIZE ON WHAT WE
HAVE AS OPPORTUNITIES TODAY.
WHICH YOU ALL AT THIS TABLE KNOW
ARE REALLY TREMENDOUS. IT ALSO
TELLS US ABOUT THE INCREDIBLE
RETURN THAT THERE IS ON
INVESTMENT. THIS KIND OF
INCREASE IN OUR CURRENT BASE
COULD REALLY CHANGE WHAT WE CAN
DO IN AREAS OF PREVENTION. IN
TRAINING. IN DISCOVERY. I WILL
TELL YOU THAT THIS NUMBER IS THE
SAME NUMBER THAT WE PUT UP LAST
YEAR. WE SPENT A LOT OF TIME
TRYING TO DECIDE WHERE WE WERE
GOING TO LAND AND I WILL SHOW
YOU WHERE OUR CURRENT
APPROPRIATION IS IN COMPARISON
TO THIS AND IT FELT LIKE GIVING
AN EVEN BIGGER NUMBER REALLY
WASN'T WISE IN THIS CURRENT ERA.
WE'RE TRYING TO SIGNAL THAT WE
GET IT. WE UNDERSTAND THAT
THERE'S A FINANCIAL REALITY. WE
UNDERSTAND THAT THERE ARE REAL
ECONOMIC CONSTRAINTS FACING OUR
COUNTRY AND THE WORLD. AND --
BUT OUR GAP JUST CAN'T KEEP
WIDENING. AND SO WE REALLY WANT
TO SHOW ALSO THAT WE NEED A REAL
INFUSION TO DO THE WORK THAT
PEOPLE ARE EXPECTING FROM US TO
DO. THE RISK IF WE DON'T IS
LOSING OUR COMPETITIVE EDGE.
FALLING BEHIND COMPARED TO PEERS
AND LOSING A GENERATION OF
WORKFORCE AND WE JUST CAN'T
AFFORD TO DO THAT. EVERYTHING'S
NOT EXACTLY THE SAME. WE DID
TINKER WITH WHERE WE WERE GOING
TO MAKE SOME OF OUR INVESTMENTS
AGAIN IN AREAS WE THINK ARE
REALLY POOR LIKE PREVENTION,
LIKE TRAINING. BUT EVERYTHING
NEEDS A BOOST. WE ALSO IN THE
ANNUAL PLAN GET THE OPPORTUNITY
TO HIGHLIGHT SOME AREAS TA WE
WOULD LIKE TO FOCUS ON. SO JUST
SOME EXAMPLES, TACKLING THE
EMERGENCE OF EARLY ONSET OF
CANCERS, AN IMPORTANT AREA WHERE
WE CAN LEARN ABOUT COMMON AND
RARE CANCERS AND SO WE HIGHLIGHT
THAT THIS IS AN AREA THAT WE
THINK IS DESERVING ADDITIONAL
FOCUS. APPROACHING CANCER IS A
DISEASE THAT AFFECTS THE WHOLE
BODY. A POINT TO LOOKING AT
SURVIVORSHIP ISSUES BUT ALSO
THINKING ABOUT THINGS LIKE HOW
THE H TAN PROGRAM, LOOKING AT
THE INTERSECTION BETWEEN CELLS
IN THE IMMUNE SYSTEM IS REALLY
VITAL FOR US TO MAKE THE
DIFFERENCES THAT WE WANT.
ALLEVIATING FINANCIAL TOXICITY.
LOOKING AT THE ROOT CAUSES AND
HOW TO COMBAT THEM FOR PEOPLE TO
GET THE THERAPY THAT THEY NEED
AND HAVE THE HEALTH CARE THAT
THEY DESERVE. AND EXPANDING ON
THE UTILITY OF VACCINES. WE'VE
SEEN THE PROMISE OF VACCINES
DELIVER FOR PREVENTION BUT THEY
CAN DELIVER AS WELL FOR
TREATMENT AND THOSE ARE
INCREDIBLE OPPORTUNITIES SO THIS
IS JUST THE REAL SPREADSHEET TO
SHOW WHERE THINGS COMPARE TO
PROFESSIONAL JUDGMENT BUDGETS
OVER THE LAST FEW YEARS AND
WHERE WE ARE TODAY. SO IN '23
OUR PROFESSIONAL JUDGMENT BUDGET
WAS FOR 7.4 BILLION. WE
RECEIVED 7.3. THERE WAS A GAP
BUT NOT ENORMOUS. IT REALLY
STARTED TO RISE LAST YEAR FY24
WHEN THE PROFESSIONAL JUDGMENT
WAS 9.9 BUT WE HAD A DECREASE
BECAUSE OF THE ENDING OF THE
CARES ACT BUT THE NET CHANGE WAS
A 96 MILLION DOLLARS DECREASE.
THE FY25 WAS THE 11.5 BILLION
AND THAT'S WHERE WE'RE HOLDING
FOR FY 26. SO WHERE WE
INVESTING WITH THE DOLLARS THAT
WE HAVE?
I WANT TO MAKE SURE THAT WHAT
YOU HEAR IS THAT WE ARE ALL IN
ON TRAINING AND ON EARLY STAGE
INVESTIGATOR TALENT AND
DEVELOPMENT. I SHOWED YOU THIS
SLIDE BEFORE I THINK. I HAVE
SHOWN THIS SLIDE A FEW TIMES NOW
SHOWING WHERE WE MAKE DECISIONS
ABOUT PLANNING EARLY STAGE
INVESTIGATORS ALTHOUGH OUR PAY
LINE IS TEN, WE KEPT THE EARLY
STAGE INVESTIGATOR PAY LINE AT
17%. WE'RE REALLY STILL
COMMITTED TO FUNDING AT LEAST AS
MANY EARLY STAGE INVESTIGATORS
THIS YEAR AS WE DID LAST YEAR.
THAT'S MEANT REALLOCATING SOME
RESOURCES TO MAKE SURE WE'RE
FUNDING AT LEAST AS MANY AS
BEFORE. REMEMBER, GRANTS GET
BIG SOGER SO THAT MEANS MORE
DOLLARS AND THE RATE IS STILL
PROJECTED BECAUSE THERE'S A FEW
MORE THAT IS 19%. SO FOR EARLY
STAGE INVESTIGATORS THAT ARE OUT
THERE, WE'RE INVESTING IN YOU
AND WE REALLY WANT YOU TO BE
PART OF OUR COMMUNITY AND SO
THIS IS HOW WE SHOW THAT. SO,
JUST A REMINDER, THE NATIONAL
CANCER PLAN THIS IS OUR ROADMAP
AND THIS HELPS US STAY ON TRACK.
WE'RE FOCUSING RIGHT NOW ON
OPTIMIZING THE WORKFORCE. WE'RE
FOCUSING ON EVERYTHING BUT TODAY
FOCUSING ON OOPT M OPTIMIZING T
WORKFORCE. WE'RE HEARING ABOUT
TRAINING BUT ALSO ABOUT NCORP
AND THAT'S A HUGE PART OF OUR
WORKFORCE AND THE FOCUS ON OUR
COMMUNITY ENGAGEMENT WILL BE ON
OPTIMIZING THE WORKFORCE SO LOOK
OUT FOR OUR SOCIAL MEDIA POSTS,
PLEASE JOIN US, I KNOW THAT THIS
IS AN IMPORTANT TOPIC FOR
EVERYONE IN THIS ROOM. JUST A
FEW EXAMPLES OF HOW WE'RE
PRIORITIZING OPTIMIZING THE
WORKFORCE. WE'RE THINKING ABOUT
INTERESTING WAYS THAT WE SUPPORT
TRAINING AND WORKFORCE R15 IS A
PROGRAM THAT I ENCOURAGE YOU TO
LOOK AT IN THE CANCER BLOG IT'S
A PROGRAM LIKE AN RO 1 BUT FOR
INSTITUTIONS THAT DON'T HAVE
HIGH LEVELS OF FUNDING WHICH
SUPPORTS INVESTIGATORS WITH A
PROGRAM BUILT INTO IT TO DEVELOP
TYPICALLY UNDERGRADUATE
STUDENTS. VERY SUCCESSFUL AND
VERY REWARDING TO LEARN ABOUT.
WE'RE ALSO PARTNERING WHERE WE
CAN. IT'S AN ENTIRE ECOSYSTEM
FOR CANCER. SO THE CATALYST
AWARD WAS JUST ANNOUNCED BY THE
AMERICAN CANCER SOCIETY. THEY
ARE WORKING WITH US TO HELP THEM
GET FUNDED. SO WE WERE ABLE TO
GET UP TO CLOSE TO 19. SO --
BUT THERE'S STILL GRANTS IN THAT
SPACE. STILL WELL DESERVING
AWARDS AND SO THEY'RE HELPING
HOWEVER THOSE INDIVIDUALS GET
FUNDED IS IMPORTANT.
AND JUST ENCOURAGE YOU TO FOLLOW
OLIVER BOWING HER WHO PUT OUT A
BLOG IN THE NCI BOTTOM LINE ON
THE COMMITMENT TO CANCER
TRAINING WE'RE NOT THE ONLY ONES
INTERESTED IN THIS. THE
PRESIDENT'S CANCER PANEL IS
FOCUSING IN JUST A FEW WEEKS ON
THEIR PROGRAM. ACTUALLY IT'S
NEXT WEEK ALREADY. IN
DEVELOPING A RETAINING A ROBUST
CANCER WORKFORCE. IT'S A TWO
PART OPEN DIALOGUE AND REALLY
ENCOURAGE YOU TO WATCH THAT AND
BE A PART OF IT. AND THEN JUST
TO GIVE YOU SOME HIGHLIGHTS.
THERE'S SO MUCH GOING ON IN THE
REALM OF CANCER RESEARCH. I
JUST WANT TO MAKE SURE YOU KNOW
THAT WE'RE NOT KEEPING -- LOSING
OUR SIGHT ON THE BALL OF HOW WE
MAKE REAL EXCITING ADVANCES. IN
IMMUNOTHERAPY. WE SAW THE FIRST
FDA APPROVAL FOR SARCOMA. WE
SAW NEW FDA APPROVED THERAPY FOR
ENDOMETRIAL CANCER ON TOP OF
THAT CANCER WITH THE WOMEN'S
HEALTH INITIATIVE WE TOOK A LOOK
AT WHAT OUR PORTFOLIO WAS AND IT
WAS POOR AND WE GOT AN
OVERWHELMING RESPONSE FOR
SUPPLEMENTS WE'RE TRYING TO
BOOST THAT PIELINE VERY
EFFECTIVELY.
THE RAS INITIATIVE HAS REALLY
BEGUN, WELL JUST BEGUN BUT IS
SHOWING TREMENDOUS OUTPUTS. NOW
WITH NEW INFORMATION ABOUT THE
STRUCTURE AND FUNCTION OF THE
KRAS 4 A VARIANT BUT ALSO THE
DISCOVERY OF CRAS G12C. WE HAVE
A NEW ANALYSIS THAT HAS GOTTEN A
CLAIM IN THE PUBLIC PRESS THAT
SHOWS THAT THE COST OF CANCER
SCREENING ALTHOUGH THAT'S A BIG
NUMBER 43 BILLION DOLLARS FOR
THE U.S. ECONOMY.
THE COST OF SCREENING IS LESS
THAN THE COST OF TREATMENT. AND
WE KNOW THAT NOT HAVING CANCER
OR HAVING A CANCER THAT WE
DETECT AND MANAGE MORE EARLIER
IS BETTER THAN TREATING A MORE
ADVANCED CANCER. SO WHAT DO I
NEED FROM YOU TODAY? WELL WE
HAVE A NEW CENTER TO FOCUS
COMMUNICATION. WHERE WOULD YOU
LIKE TO SEE MORE EFFORTS IN THAT
SPACE AS I WOULD LIKE TO HEAR
NOW OR IN THE FUTURE. YOUR
THOUGHTS OF MEETING THE NEEDS OF
AND THIS IS THE TOPICS THAT WE
WILL TALK ABOUT TODAY SO THIS
CAN BE HERE BUT ALSO IN OUR
SEGMENTS LATER, WORKFORCE, AI
ADVANCES, COMMUNITY BASED
ONCOLOGY RESEARCH AND PEDIATRIC
ONCOLOGY. AND THE THING WE TALK
ABOUT MORE IS BUDGET. WE WOULD
LIKE TO TRAIN MORE, CURE MORE
CANCERS AND SO HOW DO WE BEST
LEVERAGE THOSE RESOURCES, FORM
NEW PARTNERSHIPS AND REALLY HAVE
THE RESOURCES TO BE ABLE TO DO
WHAT WE WANT TO DO AND SO
ALWAYS, I WILL TAKE SUGGESTIONS
FOR HOW WE MOVE FORWARD FASTER.
WITH THAT I WILL TAKE SOME
QUESTIONS.
>> GREAT, THANKS, KIM. FLOOR'S
NOW OPEN FOR QUESTIONS FROM THE
BOARD. SO I HAVE ONE, YOU POKE
ABOUT COMPETITIVE ADVANTAGE I
THINK THAT IS REALLY IMPORTANT.
THAT DEFINITELY RESONATES WITH
ME HAS THERE BEEN ANY TYPE OF
ANALYSIS TO LOOK AT COMPARISONS
IN TERMS OF INVESTMENT IN CANCER
RESEARCH COMPARING AGAINST OTHER
COUNTRIES WITH HIGH GDPS?
EUROPE? UK? CHINA? HOW DO WE
COMPARE?
>> WE'RE STILL THE BIGGEST
FUNDER OF CANCER RESEARCH
WORLDWIDE BUT THAT'S ON A PER
CAPITA BASIS AND ON HOW IT
COMPARES TO PORTIONS OF THE
BUDGET I WOULD NEED TO DIVE
INTO.
>> WOULD BE INTERESTED TO SEE
THAT.
>> IT'S BECOME MORE COMPETITIVE
AND WHERE'S THE FUNDING COME
FROM, YEAH.
>> I HAVE A QUESTION. WHEN --
THANK YOU FOR THE EXCELLENT
REPORT. WHEN YOU WERE VISITING
WITH OTHER COMMUNITY PARTNERS AS
YOU MENTIONED IN THE FIRST
SLIDE. DID YOU SEE ANYMORE
OPPORTUNITIES FOR COMMUNICATION?
DID THEY FEEL LIKE THEY WERE
HEARING FROM THE NCI BECAUSE I
AM NOT SURE THAT PEOPLE FEEL
CONNECTED, YOU KNOW, AT THAT
LEVEL.
>> THAT CAME UP A FEW TIMES THAT
THAT THEY ARE LOOKING FOR MORE
AREAS OF HOW TO CONNECT. WE HAD
THAT CONVERSATION SEVERAL TIMES.
BOTH IN KANSAS AND IN NEW YORK.
YOU KNOW, THAT THIS IS ONE OF
THE HARDEST THINGS THAT I THINK
THAT WE DO IS HOW DO WE
PENETRATE INTO THE INCREDIBLE
AMOUNT OF INFORMATION THAT IS
OUT THERE AND THAT'S BY HAVING
GOOD TRUSTWORTHY INFORMATION SO
WE PRIORITIZE THAT BUT ALSO
FINDING WAYS TO REACH PEOPLE
WHERE THEY ARE. WHERE THEY'RE
LOOKING FOR INFORMATION SO WE'RE
SPENDING A LOT OF TIME TRYING TO
LEARN ABOUT HOW WE BEST REACH
PEOPLE ESPECIALLY A BUSY
COMMUNITY ONCOLOGIST WHO IS OUT
IN THE WESTERN PART OF KANSAS,
RIGHT, HOW DO WE COMMUNICATE?
IT NEEDS TO BE THROUGH THE
CANCER CENTER. I'M SO GLAD TO
HEAR ABOUT THE NETWORK THAT THEY
HAVE SO THAT IS ONE PART OF IT
BUT HOW TO MAKE SURE THE
MESSAGES DON'T GET LOST IN THAT
CHAIN SO THEY GET ALL THE WAY TO
THE PEOPLE THAT NEED THEM.
>> I THINK AS FAR AS YOUR ASK OF
US THAT MIGHT BE A PRIMARY
PRIORITY.
>> I WILL TAKE THAT ONE.
>> ANN HAS A QUESTION FROM THE
VIRTUAL ROOM.
>> HI, WONDERFUL, WONDERFUL
INSPIRATIONAL, A LOT OF GREAT
THINGS. I WANT TO CONGRATULATE
PETER. HE'S DONE SUCH A GREAT
JOB ALL THESE YEARS BUT I WANTED
TO JUST MAKE A SUGGESTION, KIM,
THE -- IT IS INTERESTING WE HAVE
A PROGRAM CALL THE SCIENTIST
SURVIVE PROGRAM. WE STARTED
SOME EDUCATION PROGRAMS FOR
ADVOCATES ABOUT THREE YEARS AGO
AND WE'RE NOTICING A PROGRAM, WE
HAD UP TO 30 COUNTRIES SIGN UP
TO THESE SO THE WHOLE ADVOCACY
MOVEMENT IS MOVING IN AN
INTERNATIONAL DIRECTION AND AS
YOU BUILD THESE ALLIANCE, IF,
YOU KNOW, I THINK PETER
ESPECIALLY AND A WHOLE GROUP
THERE AT NCI SHOULD FOCUS ON HOW
DO WE ACTUALLY SEND THAT INTO A
REAL INFLUENCE IN THESE VARIANCE
COUNTRIES? I THINK IT'S A REAL
UNTAPPED RESOURCE.
>> YEAH THAT'S A REALLY GOOD
POINT AND I WILL BUILD ON THAT
AND BRING IT BACK TO MORE LOCAL
IS ASK HOW VALUABLE IT IS TO
HAVE ADVOCATES AT THE TABLE. AT
THE RETREAT WE HAD THIS SUMMER
WE HAD OUR CHAIR OF ADVOCACY
COMMITTEE AND ALSO ANOTHER
ADVOCATE BROUGHT IN BY A WORKING
GROUP AND HAVING THEM IN THE
ROOM WAS REALLY, REALLY
POWERFUL, THEY WERE FANTASTIC IN
THE QUESTIONS THEY ASKED AND THE
WAYS THEY PUSHED THE GROUP TO
MAKE IT HARDER. I DON'T THINK
IT WOULD HAVE BEEN THE SAME
MEETING WITHOUT THEIR VOICES
THERE.
>> SO WE HAVE MISS ANDERSON AND
THEN KNOW LA. MAKE SURE YOU
BRING THAT MIC REAL CLOSE.
>> THANK YOU FOR THE
PRESENTATION, SO MY QUESTION
RELATE TO THE STUDY ON THE COST
OF CANCER SCREENING BEING
CHEEPER THAN THE TOTAL COST OF
TREATMENT. DO YOU -- CAN YOU
ELABORATE MORE ON HOW THEY
RELATE BACK TO PROGRAMS AND
DIFFERENT ADVOCACY EFFORTS.
THAT'S A POWERFUL ONE AND I'VE
HAD CONVERSATIONS WITH YOU, MY
HUSBAND WAS DIAGNOSED EARLY WITH
A LUNGS CANCER CT SCREENING THAT
HE HAD EARLIER WHICH HE WOULD
HAVE NOTICED EARLIER IF HE WOULD
HAVE LISTENED TO ME. THAT WAS
ONE OF THOSE KEY EARLY SCREENING
TOOLS THAT PHYSICIANS ARE NOT
TALKING ABOUT ENOUGH AND I AM
SURE HIS TOTAL COST OF CANCER
TREATMENT WILL BE MUCH HIGHER
THAN IF HE HAD GOTTEN THE TEST
TWO YEARS AGO. SO WHAT ARE
YOUR -- THOUGHTS ON THAT.
>> THIS IS WHY I'M SO GLAD IT
WAS PICKED UP IN USA TODAY AND
NEW YORK TIMES TO GET THE
MESSAGE OUT NUMBER ONE. I
THINK, THIS IS WHERE WE LEAN ON
DIVISIONS LIKE DCCPS AND I'M NOT
SURE WHERE DR. CASTLE IS TO HELP
US KNOW WHAT IS THE NEXT STUDY
THAT WE NEED TO DO TO REALLY
BRING SOME OF THESE THINGS INTO
PRACTICE TO PUT THIS IN THE
PUBLIC CONSCIOUSNESS TO HELP,
YOU KNOW, KNOW WHAT QUESTIONS
PEOPLE ARE EVEN ASKING ABOUT
THIS BEYOND -- IT'S ONE THING
FOR US AS SCIENTIST TO KNOW
THERE'S THIS REALLY BIG
DIFFERENCE AND ECONOMICALLY
THAT'S A BIG DEAL BUT WHEN IT
COMES TO AN INDIVIDUAL AND THEIR
POCKETBOOK AND THEY'RE TRYING TO
DECIDE WHAT SEEMS LIKE A VERY
EXPENSIVE SCREENING TEST AND IF
THAT'S A THING THEY SHOULD DO
TO -- IT'S HARD FOR THEM TO KNOW
THAT THIS IS BENEFITTING AND SO
HOW DO WE COMMUNICATE THAT. SO
THAT'S WORK THAT WE'RE DOING.
AND IF EITHER OF YOU HAVE
COMMENTS, PLEASE.
>> THAT'S GREAT AND THEY'RE
CONSIDERATIONS AND WH YOU TALK
ABOUT EARLY CANCERS AND
SCREENING GUIDELINES THAT'LL BE
ANOTHER IMPORTANT ASPECT SO WE
HAVE KNOW LOW AND I BELIEVE
SUSAN.
>> YEAH, IT'S WONDERFUL TO SEE
EVERYTHING THAT'S BEEN HAPPENING
THIS SUMMER AND WHAT'S HAPPENING
GOING FORWARD. YESTERDAY IN THE
THERAPEUTIC COMMITTEE MEETING WE
HAD A CONVERSATION ABOUT PRIVATE
PARTNERSHIPS AND I THINK TO YOUR
QUESTION OF NUMBER ONE BUDGET
AND THEN THE PARTNERSHIPS AS
WELL. I REALLY THINK
CONSIDERING THE AMOUNT OF
RESEARCH LED BY PRIVATE INDUSTRY
RIGHT NOW THAT THIS IS AN
OPPORTUNITY WE'RE NOT GOING TO
GET EVERYTHING FROM WHAT WE SAID
IN THE NEXT YEARS OUR BUDGET
WILL MATCH WHAT WE NEED AND IF
WE CAN INFLUENCE SOME OF THOSE
DOLLARS AND I THINK EVEN TO THE
SCREENING QUESTION YOU MENTIONED
WE HAVE MULTIPLE HUGE COMPANIES
THAT HAVE SPUN OUT AROUND NEW
TECHNOLOGIES HOW CAN WE PARTNER
WITH THEM AND THEN THAT WILL
HELP FREE UP MORE MONEY THAT WE
COULD THEN INVEST IN JUNIOR
INVESTIGATORS BECAUSE WE
WOULDN'T NECESSARILY HAVE TO
FUND EVERY PIECE OF THE OTHER
RESEARCH THAT THE NCI FUNDS AND
SO IT'S NOT A SMALL LIFT BECAUSE
THERE ARE SO MANY CONFLICTS I
THINK JULIE GRANT BROUGHT UP THE
ISSUES OF FOR-PROFIT VERSUS
NONPROFIT. THESE ARE NOT SMALL
ISSUES AND WILL REQUIRE SMALL
CHANGES IN THE WAY NCI DOES
THINGS TO MOVE MORE QUICKLY
WHICH IS WHAT THE INDUSTRY
SIGNIFICANTLY CARES MORE ABOUT
AND IF WE CAN DISRUPT THE WAY
THINGS ARE GOING AND DO IT IN A
NEW AND FASTER WAY I THINK THERE
ARE BILLIONS OF DOLLARS THERE
THAT WE COULD LEVERAGE.
>> I DON'T KNOW THAT I CAN SAY
IT BETTER THAN THAT. I
COMPLETELY AGREE. BUT THIS IS
NOT AN US AND THEM GAME. WE ARE
ALL HERE FOR CANCER. AND THAT'S
WORKING TOGETHER ACROSS WHATEVER
LINES ARE NECESSARY. SO WE'RE
ALL IN SAY SUSAN .
>> SUSAN.
>> I WANTED TO GO BACK TO THE
QUESTION YOU ASKED ABOUT THE
UTILITY OF FINDINGS. AS SOON AS
I SAW THOSE FINDINGS I THOUGHT
ABOUT HOW THEY REVERBERATES IN
OUR COMMUNITY. MANY TIMES
STUDIES LIKE THIS GET PICKED UP
EVEN IN LOCAL NEWS OR OUR LOCAL
POLICYMA
POLICYMAKERS. ET CETERA, IT'S
REALLY A WAY THAT NCI HAS
SUPPORTED GENERATING EVIDENCE
THAT THEN INFORMS WHAT WE BRING
AS COMPELLING EVIDENCE TO INVEST
IN SCREENING OR TO CHANGE SORT
OF THE SPEND OR TO ENCOURAGE
INDIVIDUALS TO REALLY PRIORITIZE
IN A WAY THAT SAYS SHOW ME THE
DATA, SHOW ME THE NUMBERS AND
THIS IS SUCH A GREAT TOOL FOR US
AT CANCER CENTERS TO BE ABLE TO
DO THAT TYPE OF WORK. I WANTED
TO GIVE A SHOUT-OUT FOR THAT.
>> AND IT WAS INTERESTING IN
LOOKING AT THE BREAKDOWN OF THE
PROGRAMMATIC FUNDING. CANCER
CONTROL WAS ABOUT HALF FOR
TREATMENT. AND THERAPEUTICS. I
THINK THERE COULD BE SOME
DISCUSSIONS ABOUT SORT OF
SHIFTING THE BALANCE OF IT. I
THINK WE HAVE ED HERE.
>> YEAH, NEW MEMBER AND I WILL
SAY THIS IS ME SITTING ON MY
HANDS. IT TOOK ME A LONG TIME
TO ASK THIS FIRST QUESTION.
THANK YOU FOR THAT WONDERFUL
PRESENTATION. IT'S INTERESTING
I THINK A LOT OF PEOPLE
INCLUDING MYSELF REALLY LIT UP
AT THAT SCREENING VERSUS
TREATMENT SLIDE IN PART BECAUSE
THERE WERE DOLLARS ATTACHED TO
IT AS FAR AS A RETURN ON
INVESTMENT IN THE SCREENING
ACTUALLY SAVED THE COUNTRY MONEY
AND THERE'S BEEN MANY QUESTIONS
I THINK THAT HAVE BEEN STICKING
WITH THAT BECAUSE I FEEL THAT
ARGUMENT REVERBERATES A LOT AND
I KNOW U E-MAILED YOU ABOUT THIS
BUT I REMEMBER HAVING A
CONVERSATION WITH A BUSINESS
COLLEAGUE WITH MINE AND
CONVINCING THEM THAT IT WAS
IMPORTANT THAT THE GOVERNMENT
INVEST IN SCIENCE BECAUSE
INDUSTRY WON'T DO IT,
PARTICULARLY FOR RARE CANCERS
BUT ONCE THE INVESTMENT IS MADE
IT MAKES WAY FOR INDUSTRY. I
WANTED TO HEAR MORE AFTER YOUR
THOUGHTS ON HOW WE CAN CONTINUE
TO GENERATE MORE DATA THAT COMES
INTO THESE PRESENTATIONS, THAT
TALKS TO THAT PARTICULAR ROI AND
IF YOU LOOK AT EARLY STAGE OF
INVESTIGATORS IS THERE A
DIFFERENT ROI THAT WE HAVEN'T
SEEN BEFORE THAN THOSE
ESTABLISHED INVESTIGATORS THAT
WE CONTINUE ON THAT ARGUMENT AND
DOUBLE DOWN ON THAT STRATEGY.
>> THAT'S A GREAT COMMENT AND I
WILL TAKE THAT IN A COUPLE
DIFFERENT WAYS. WHEN WE TALK
ABOUT WHAT THE RETURN ON
INVESTMENT IS I THINK THE PUBLIC
TENDS TO THINK ABOUT HEALTHY
AMERICANS BUT IT'S REALLY SO
MUCH MORE THE EFFECT ON THE
ECONOMY REALLY CAN BE BROKEN
DOWN IN LOTS OF DIFFERENT WAYS
THE WORKFORCE IS A HUGE ONE AND
HAVING A TALENTED SKILLED
WORKFORCE THAT'S DOING
DISCOVERIES AND MAKING
DISCOVERIES THAT WILL IMPACT
CANCER TODAY AND HEALTH
TOMORROW. THAT'S REALLY
IMPORTANT AND HOW WE STIMULATE
THE ECONOMY WITH NEW COMPANIES
AND A LOT OF WHAT WE TALK ABOUT
IS DE-RISKING. AND WORK THAT WE
CAN DO TO TAKE A GREAT IDEA AND
TAKE THE RISK AWAY TO BE TAKEN
ON INTO THE PRIVATE SECTOR.
THAT'S A HUGE ASSET OF THE
FREDERICK WITH A LOT OF PROGRAMS
THAT WE HAVE. WE CAN LOOK AT
WAY TO DEMONSTRATE THAT A LITTLE
MORE EFFECTIVELY.
>> SO WE HAVE DOUG AND THEN
JULIE.
>> I SIMPLY WANTED TO POINT OUT
THAT THE SIS NET GROUP PUBLISHED
WHAT I THOUGHT WAS A VERY
INTERESTING PAPER AND KATRINA
GOD GODDARD IS THE HEAD OF THAT
DIVISION.
LOOKING AT HOW MANY LIVES COULD
BE SAVED BY 10% FOR SEVERAL
DIFFERENT CANCER TYPES IT'S
REALLY IMPRESSIVE. IT'S
SOMETHING I CAN SEND AROUND THE
REFERENCE IF YOU'RE INTERESTED.
>> JULIE.
>> THANK YOU FOR AN INSPIRING
CLEAR COMMUNICATION ABOUT YOUR
PRIORITIES. I WAS STRUCK AS YOU
SPEAK ABOUT WORKFORCE
DEVELOPMENT. IN PARTICULAR, A
LOT OF THE EMPHASIS IS ON EARLY
STAGE INVESTIGATORS. I'M
CURIOUS IF THAT IS THE PRIORITY.
AND AS YOU THINK ABOUT OTHER
GAPS THAT WE HAVE IN OUR
NATIONAL CANCER WORKFORCE,
SHOULD WE BE PRIORITIZING THAT
BECAUSE OF OBSERVATIONS YOU'VE
MADE IN THE DATA THAT REALLY ARE
IMPORTANT FOR US TO UNDERSTAND
THAT THAT IS THE PRIORITY? I
WOULD LIKE TO UNDERSTAND MORE SO
WE CAN HELP YOU WITH THOSE
GOALS.
>> THANK YOU FOR THAT QUESTION
BECAUSE THAT IS A PRIORITY AND
IMPORTANT TO ME BUT NOT THE ONLY
PRIORITY. WHEN I TALK ABOUT
WORKFORCE I REALLY MEAN
DEVELOPING EVERYBODY. THAT'S
WHY I'VE BEEN SO HAPPY TO BE
WORKING WITH PROGRAMS THAT ARE
DEVELOPING HIGH SCHOOL AND
UNDERGRADUATE STUDENT TO GET
THEM INTERESTED IN STEM CAREERS.
THAT'S WHY WE'VE BEEN TALKING --
I AM REALLY INSPIRED BY THIS
COMMUNITY COLLEGE PROGRAM AND,
YOU KNOW, WAYS WE BOTH START
WORKFORCE AROUND CLINICAL TRIAL
OPERAT
OPERATIONS, THAT'S A REAL JOB
FOR PEOPLE. BUT I ALSO SEE
WORKFORCE DEVELOPMENT IN WHO IS
REALLY DELIVERING CARE. I
MENTIONED ONCOLOGISTS AND
DEVELOPING THEIR CAPABILITIES TO
BE PART OF OUR RESEARCH ENGINE
BECAUSE THEY'RE A HUGE PART OF
OUR RESEARCH ENGINE BUT IT'S NOT
JUST ONCOLOGISTS, IT'S
NURSE-PRACTITIONERS IN THE REALM
OF PREVENTION THIS IS PRIMARY
CARE. I MEAN, DEVELOPING THAT
ASPECT OF OUR WORKFORCE ALSO
SUPER IMPORTANT. YOU KNOW, I
HIGHLIGHT THE EARLY STAGE
INVESTIGATORS AND WE'LL TALK
LATER ABOUT POSTDOCS AND THOSE
BECAUSE THAT IS ALSO SORT OF A
CORE PART OF WHAT WE ARE AND
WHAT WE NEED AND WHEN I LOOK AT
NEEDLES THAT WE NEED TO MOVE,
ONE IS THE AGE TO FIRST RO 1.
AT, YOU KNOW SH, WE GET THEM IN
THE FUNDING POOL EARLIER.
THAT'S ONE REASON TO FUND EARLY
STAGE INVESTIGATORS. SO TO ME
IT'S ABOUT KEEPING OUR PIPELINE
ROBUST. MAY I.
>> IF YOU WANT TO EXTEND WE HAVE
A FEW MINUTES.
>> I THINK WHAT YOU SAID IS
REALLY IMPORTANT. I WAS STRUCK
SUICIDE BY THE CANCER FUNDING
GAP.
I THINK AS WE THINK ABOUT OUR
COMMUNICATION PLAN FOR THE NCI
AND HOW WE CAN BRING OTHER TO
THE TABLE FOR THOSE SPECIFIC
OCCUPATIONAL ROLES THAT ARE
COMPLEMENTARY TO THEIR MISSION
WHAT, YOU JUST DESCRIBED SEEMS
REALLY COMPELLING TO ME. WHEN I
THINK ABOUT THE JOBS THAT ARE
TIED TO THE IMPLEMENTATION OF
CANCER AND NURSES OR IN MY CASE,
AS I'M TIED TO THE BIOTECH
INDUSTRY, THE PHARMACEUTICAL
INDUSTRY IT'S CLINICAL TRIAL
COORDINATORS, MANAGERS,
INDIVIDUAL WHO IS -- INDIVIDUALS
WHO ARE TRAINED.
I WOULD REALLY LOVE TO CONTINUE
TO ENGAGE IN THE CONVERSATION.
HOW DO WE BRING OTHER TO HELP
SUPPLEMENT FUNDING WHERE WE SEE
GAPS IN OUR WORKFORCE AND HOW DO
WE BRING THEM TOGETHER AND THANK
YOU FOR OUTLINING THE ADDITIONAL
JOBS THAT YOU THINK WE NEED TO
INVEST IN. IT'S VERY HELPFUL
FOR ME.
>> DR. CLARK, PLEASE.
>> HI, I'M DR. CLARK, ALSO NEW
TO THE BOARD SO THANK YOU SO
MUCH. I'M VERY PLEASED TO SEE
THE EFFORTS ON DEVELOPING AND
MAINTAINING A WORKFORCE THAT'S
ROBUST AND DIVERSE. I THINK
THIS HAS BEEN UNDERRECOGNIZED
AND UNDERFOCUSED ON FOR A LONG
TIME. AS WE TALK ABOUT
PRODUCING INNOVATIVE TREATMENTS
FOR CANCER WE HAVE TO UNDERSTAND
THAT THESE TREATMENTS OFTEN
WIDEN THE DISPARITIES FOR PEOPLE
WHO DON'T GET ACCESS TO THESE
TREATMENTS. AND WE'VE SEEN THAT
CONCORDANCE AND CARE RACIALLY
FROM GENDER STANDPOINT AND
ESPECIALLY FROM FIRST LANGUAGE
ACTUALLY IMPACTS A PATIENT'S
ABILITY TO EITHER GET THEIR
CANCER TREATMENT OR TO ACTUALLY
UNDERGO CANCER SCREENING SO
UNTIL WE FOCUS ON MAKING SURE WE
HAVE A WORKFORCE THAT REPRESENTS
OUR PATIENTS WE'LL CONSISTENTLY
BE CHASING OUR TAILS. SO I'M
REALLY EXCITED TO ACTUALLY SEE
THAT THE PRESIDENTIAL CANCER
PANEL WILL BE TALKING ABOUT
THIS, I'LL BE PARTICIPATING BUT
IT'LL BE REALLY IMPORTANT FOR
EVERYBODY IN THE ROOM TO
UNDERSTAND EXACTLY WHY THIS IS
SO CRITICAL AND FOR THE NCI TO
RECOGNIZE THAT THIS IS AS
IMPORTANT AS A PILLAR AS A
DEVELOPMENT OF INNOVATIVE
TREATMENT.
>> AGREED. IT'S LONG-STANDING
ISSUE. I REMEMBER THE EARLY
PAPER ON LYMPHOMA SHOWING THE
HUGE DISPARITY BY RACE AND BY
INSURANCE STATUS AND THE LAST
QUESTION WILL GO TO FRED.
>> THANKS.
>> HI, IT'S VERY COMPELLING THE
NUMBER OF SCREENING VERSUS
TREATMENT. IN JUNE WE HAD AN
EXCELLENT PRESENTATION FROM
DR. CASTLE ON LIQUID BIOPSIES
AND WHAT INDUSTRIES ARE LOBBYING
AND MOVING MUCH FASTER THAN THE
SCIENCE AND I'M WONDERING, YOU
KNOW, HOW DO WE SQUARE THAT?
ESPECIALLY ON CLINICAL UTILITY
OF THOSE SCREENINGS. YOU KNOW,
HOW WE BALANCE THE OPTIMISM WITH
THE SCIENCE. HOW DOES NIH --
NCI CATCH UP. ESPECIALLY WITH
THE SCIENCE.
>> YEAH, I THINK THAT'S -- IT'S
A REALLY IMPORTANT AND THERE ARE
TIME WHEN IS THE CLINICAL
TESTING THE AHEAD OF THE
SCIENCE. THAT'S OUR JOB IS TO
BE ON TOP OF THOSE THINGS AND TO
BE DESIGNING STUDIES LIKE WE ARE
TO GET THE INFORMATION THAT WE
NEED TO MAKE SOUND DECISIONS.
>> WELL THANK YOU SO MUCH, KIM,
FOR REALLY AMAZING DIRECTOR'S
REPORT. I THANK YOU ALSO SENT
US AWAY WITH SOME HOMEWORK. A
FEW QUESTIONS THAT YOU'D LIKE TO
GET SOME FEEDBACK FROM THE BOARD
ON IT WOULD BE GREAT IF WE COULD
SHARE THOSE. SOME KIND OF WAY
TO THE BOARD SO WE CAN ALL THINK
ABOUT THEM PERHAPS AND PROVIDE
SOME COMMENTS AND FEEDBACK TO
YOU. THANK YOU. OKAY, GREAT,
SO NEXT IS THE BUDGET UPDATE
FROM DR. DOUGLAS LOW WE AND
MR. WESTON RICKS WHO IS THE NCI
BUDGET OFFICER. DOUG AND
WESTON.
>> THANK YOU FOR INVITING US TO
COME AND VISIT. I'M GLAD TO BE
ABLE TO PRESENT WITH DOUG. A
LOT OF PEOPLE WORK TO HELP US
MOVE THE BUDGET FORWARD.
AND MAKE A LOT OF STRATEGIC
DECISIONS ACROSS THE INSTITUTE.
PARTICULARLY FOR THIS
PRESENTATION WE'D LIKE TO THANK
TENNILLE AND CHRISTINE WHO HAVE
HELPED UPDATE SOME OF THESE
SLIDES. NOW ONE OF THE THINGS I
HOPE YOU WILL TAKE A WAY IS TO
HAVE A PERSPECTIVE OF THE BUDGET
OVER TIME. MY CHILDREN ARE
REALLY INTO BAKING. OVER THE
LAST YEAR ONE OF MY SONS DECIDED
HE WANTED TO MAKE COOKIES AND
SELL THEM AT THE HIGH SCHOOL.
TWICE A WEEK HE WOULD STAY UP
LATE INTO THE NIGHT BEYOND MY
OWN BEDTIME AND I'D WAKE UP AND
HE'D HAVE A BACKPACK FULL OF
COOKIES AND WOULD GO AND SELL
THEM AND WHILE I REALLY
RESPECTED HIS ENTREPRENEURIAL
ENDEAVOR HE AND I HAD A
CONVERSATION ABOUT WHAT IT COSTS
TO CREATE THOSE COOKIES AND WHAT
MY CONTRIBUTION WAS AND SO HE
EVENTUALLY GOT ENOUGH OF HIS OWN
MONEY THAT HE WAS TABLE REINVEST
INTO HIS ENDEAVOR AND BUY HIS
OWN INGREDIENTS AND HE HAD HIS
OWN GARBAGE LOOKING BOX OF
INGREDIENTS THAT SAT ON THE
COUNTER FOR QUITE SOME TIME AND
I REALLY APPRECIATED IT BECAUSE
I WOULD WATCH HIM, HE WOULD BUY
SOME OF HIS INGREDIENTS. EVERY
NOW AND THEN WOULD NEED SOME
CHOCOLATE CHIPS AND I WOULD GET
A CASH OUT PURCHASE FROM MYSELF
AND ONE OF THE THINGS THAT WE
DIDN'T ALWAYS... I DID NOT
ADDRESS WITH HIM IS IT'S NOT
JUST ABOUT THE DOUGH THERE ARE A
LOT OF OTHER THINGS I WAS
PROVIDING TO HIM THAT HE MAYBE
DIDN'T APPRECIATE. IF YOU'RE
LOOKING AT THIS PIE RIGHT HERE
BECAUSE WE IN BUDGET LIKE TO
TALK ABOUT PIES A LOT WE'LL SHOW
YOU A PIE OR TWO ONE OF THE
THINGS IS YOU CAN SEE THIS PIE
IS IN A PIE BOWL OR A PIE PAN
AND IT'S ALSO SITTING ON THE
STOVE THAT HAPPENS TO BE FUELLED
BY GAS THAT I PAY FOR. I ALSO
BOUGHT THAT STOVE. AND IT
HAPPENS TO BE IN A HOUSE I MAKE
PAYMENTS ON ROUTINELY JUST TO
KEEP US IN THAT SORT OF
SITUATION. SO I WANT YOU TO
KEEP THAT IN MIND AS WE GO
FORWARD. IT'S NOT JUST ABOUT
THE DOUGH HERE BUT WHAT GOES
INTO THE NCI PIE? OVER THE LAST
SEVERAL YEARS AND I WILL BE
PUTTING THIS IN PERSPECTIVE OVER
THE LAST TWO DECADES
ESSENTIALLY. THERE ARE A LOT OF
THINGS THAT THE NATIONAL CANCER
INSTITUTE LEADERSHIP, OUR
COMMUNITY STAKEHOLDERS, OUR
RESEARCH STAKEHOLDERS THINK
ABOUT WHAT THEY WANT TO PUT INTO
THE PIE AND THIS IS A SHORT LIST
OF THEM. THERE ARE PLENTY OF
OTHERS I JUST DIDN'T WANT TO
BORE YOU WITH THE SLIDES SHOWING
YOU EVERY SINGLE THING THAT WE
HAVE TO PARTICIPATE IN OR WE
SUPPORT OR THAT HELPS SUPPORT
THIS GOING FORWARD BUT YOU CAN
SEE HERE THERE'S A SCORE --
SPORE PROGRAM. THERE'S THE
CLINICAL RESEARCH HOSPITAL IN MY
OPINION. WE SPEND A LOT OF
MONEY, AND ALSO THE SMALL
BUSINESS LINE RIGHT HERE.
BECAUSE OF THE NATURE OF US AS A
FEDERAL AGENCY. WE'RE REQUIRED
TO FUND SOME ASPECTS OF OUR
BUDGET TOWARD SMALL BUSINESS,
THESE ARE THINGS THAT SOME OF
OUR INSIDER CONTROL, SOME OF
THEM ARE OUTSIDE OF OUR CONTROL
BUT THEY ALL CONTRIBUTE TO THE
RECIPE.
AND ONE OF THE OTHER THINGS
SOMETIMES PEOPLE DON'T
APPRECIATE ABOUT WHEN YOU ARE
CREATING A RECIPE IS THAT
DIFFERENT THINGS TAKE MORE TIME
THAN OTHERS AND SO DEPENDING ON
WHAT YOU'RE TRYING TO BAKE OUT
THAT TIME IS GOING TO TAKE
AWHILE. MY WIFE HAS LATELY BEEN
WORKING WITH SOUR DOUGH STARTS.
YOU HAVE TO GROW IT, PROOF IT,
COOK IT AND THEN YOU HAVE TO
ACTUALLY EAT IT WHICH DEPENDING
ON YOUR PERSPECTIVE ON SOUR
DOUGH MIGHT TAKE LONGER THAN SHE
EXPECTS. AS YOU'RE DOING THESE
THINGS THERE ARE ASPECTS OF LIFE
THAT NIBBLE AWAY AT YOUR DOUGH
AND I WILL GIVE YOU AN EXAMPLE
HERE. THE BIOMEDICAL RESEARCH
AND DEVELOPMENT PRICE INDEX,
THIS -- WE'VE TALKED ABOUT
BEFORE BUT THIS IS ESSENTIALLY
AN INFLATIONARY PRICE INDEX
ASSOCIATED WITH MEDICAL
RESEARCH. IT IS ESTABLISHED BY
AND RUN BY THE NATIONAL
INSTITUTES OF HEALTH. THEY
RELEASE IT EVERY YEAR AND THEY
LET YOU KNOW WHAT THEY THINK THE
INFLATIONARY IMPACT OF THE COST
ASSOCIATED WITH BIOMEDICAL
RESEARCH EACH YEAR.
OVER TIME THAT CAN HAVE A
SIGNIFICANT IMPACT. YOU CAN SEE
IN 2003, THE BUYING POWER AND
THE BUDGET AND NOMINAL TERMS ARE
EXACTLY THE SAME.
BUT AS YOU GO FORWARD, DEPENDING
ON HOW MUCH MONEY IS ADDED TO
THE BUDGET AND THAT INFLATIONARY
PRICE INDEX, IT GETS OUT OF SYNC
AND IN 2013 YOU CAN SEE THERE'S
A MAJOR, MAJOR DIFFERENCE. AND
THEN YOU MOVE FORWARD AND YOU
SEE WE HAVE NOT REACHED PARITY
WITH WHERE WE WERE IN 2003. IN
FACT IN 2024 WE'RE 15% LESS
BUYER POWER. THOSE NUMBERS
BECOME VERY, VERY REAL YEAR OVER
YEAR. OKAY? ANOTHER ASPECT
THAT CHEWS AWAY AT OUR BUDGET
AND STICKS THE FINGER IN THE
DOUGH A LITTLE BIT IS THE
COMPETING NEEDS ACROSS THE
FEDERAL GOVERNMENT. OVER THE
LAST TWO YEARS YOU PROBABLY HAD
A LOT OF INFORMATION CERTAINLY
READ IN THE NEWS AND I THINK MK
WILL TOUCH ON THIS A LOT MORE.
IS THERE ARE A LOT OF COMPETING
NEEDS ACROSS THE FEDERAL
GOVERNMENT. WE ARE NOT THE
UNITED STATES OF CANCER
RESEARCH. WE ARE THE UNITED
STATES OF AMERICA WITH A LOT OF
SECURITY NEEDS, INFRASTRUCTURE
NEEDS ACROSS THE ENTIRE EXPANSE
OF GLOBAL REQUIREMENTS BECAUSE
OF THAT A LOT OF DECISIONS THAT
GOES INTO WHAT MAKES OR IMPACTS
THE LEDGER OF THE NATIONAL
CANCER INSTITUTE ARE IMPACTED BY
THOSE DECISIONS THAT COMPLEMENTS
THOSE PRIORITIES.
HOW IS THAT IMPACTED US MOST
RECENTLY? YOU MAY HAVE SEEN
THIS BEFORE BUT YOU CAN SEE HERE
IN PURPLE IS OUR TOTAL. THERE'S
THE MOON SHOT AND THEN THERE'S
THE BASE BUDGET. AND FROM
2023-24, THE CANCER MOON SHOT
ENDED, THE ORIGINAL CANCER MOON
SHOT STOPPED GETTING NEW MONEY
AND OUR REGULAR BUDGET WAS
INCREASED A LITTLE BIT AND THIS
IS ESSENTIALLY WHAT HAPPENED.
IS WE GOT 120 MILLION DOLLARS
ADDED TO OUR BASE BUDGET BUT WE
ENDED UP WITH A 96 MILLION
DOLLAR TOTAL DECREASE AND IF YOU
TAKE INTO ACCOUNT BIRD PIE THE
IS ABOUT 3.3%.
THAT'S OVER 2 MILLION DOLLARS.
WE'RE LOSING WHILE WE'RE TRYING
TO SAVE MONEY AND THE DOUGH IS
BEING IMPACTED. THE RECIPE,
THESE THINGS, THE UNDERLYING
ASPECTS OF THE NATIONAL CANCER
INSTITUTE WILL BE IMPACTED BY
THE DECISIONS THAT WE HAVE TO
MAKE IN ORDER TO KEEP PROGRAMS
MOVING FORWARD. A LITTLE MORE,
WE NEED TO KEEP IN MIND IS THE
NATIONAL CANCER INSTITUTE STILL
PRIORITIZES EMERGING
OPPORTUNITIES EVEN WHEN THINGS
ARE TIGHTENING WE STILL SEE
IMPORTANT PRIORITIES THAT EMERGE
THAT NEED TO BE FUNDED,
OPPORTUNITIES THAT NEED TO BE
ACTED UPON. SOME EXAMPLES FROM
THE LAST 20 YEARS THAT HAVE GONE
INTO THE PIE ARE THESE. THERE'S
A LOT OF THEM, SOME OF THEM
CONTINUING, SOME OF THEM MAYBE
HAVE COME TO FRUITION. BUT WHEN
WE'RE TALKING ABOUT THINGS THAT
HAVE TO BAKE OUT OVER TIME THIS
IS JUST A HANDFUL THAT WERE
PULLED THERE OUR OWN INTERNET SO
KUDOS TO PETER'S TEAM FOR THAT
BUT A LOT OF THESE THINGS, I
TOOK THE SAME TOUR WITH
DR. RATHMELL WITH THE OMB AND
THEY WERE REALLY IMPRESSED, THE
OMB PERSON WAS IMPREZZED WITH
SOME OF THE THINGS THAT WE WERE
ABLE TO CREATE.
THE NCI, THE FREDERICK, THAT THE
RESEARCH CAN TAKE ADVANTAGE OF
AND THOSE THINGS WE CONTINUE TO
BUILD UP WHILE AT THE SAME TIME
WE HAVE TO SUPPORT SOME OF THE
KEY COMPONENTS OF THE NATIONAL
CANCER INSTITUTE. WHAT DOES
THAT MEAN FOR US? THIS IS MY
FINAL IMAGE. OKAY? THIS IS
WHAT THE PIE LOOKS LIKE.
THERE'S A LITTLE PIECE TAKEN
OUT. ABOUT 15%. WHATEVER, FOR
A PERFECTLY INNOCENT REASON IS
MOVING AWAY AT THE BUDGET. WE
WILL CONTINUE TO MOVE THINGS
FORWARD BUT THAT GIVES YOU THE
PERSPECTIVE AND GIVES YOU THE
NEXT CONVERSATION INTO THE
CONTEXT OF HOW WE MOVE FORWARD
AS AN INSTITUTE. THANK YOU.
>> SO I'M GOING TO TALK FOR
ABOUT SEVEN OR EIGHT MINUTES AND
THERE SHOULD BE TIME FOR
QUESTIONS AND COMMENTS
AFTERWARDS FOR BOTH OF US. I
WILL TAKE ALL THE EASY QUESTIONS
AND WESTIN WILL TAKE THE
DIFFICULT ONES. BUT FIRST, I
WANT TO -- I'M GOING TO TALK FOR
A FEW MINUTES MAINLY ABOUT THE
RPG POOL AND WHAT IS SUPPORTED
THERE. BUT BEFORE WE GET TO
THAT, I HAVE ONE SLIDE WHICH
TELLS YOU ABOUT THE OTHER AREAS
WHICH ARE VERY IMPORTANT. NCI
SUPPORTS A LOT OF RESEARCH
OUTSIDE THE RPG POOL, SPORE
GRANTS, CANCER CENTER SUPPORT
GRANTS AND WE NEED TO SUPPORT
THESE IN ADDITION TO THE RPGS.
AND I HAVE FOUR SLIDES TO TELL
YOU A LITTLE BIT ABOUT WHAT HAS
HAPPENED OVER TIME WITH GRANT
APPLICATIONS AS WELL AS AWARDS.
THIS SLIDE SHOWS YOU THAT SINCE
2013, THERE HAS BEEN -- AN
INCREASE OF MORE THAN TWICE AS
MANY APPLICATIONS TO NCI
COMPARED TO THE REST OF THE NIH.
AND THIS IS REALLY BECAUSE THERE
ARE SO MANY OPPORTUNITIES AT NCI
IN TERMS OF RESEARCH IN CANCER.
REALLY WHAT WESTIN WAS TALKING
ABOUT OPPORTUNITIES AND SO A LOT
OF PEOPLE HAVE WANTED TO APPLY
FOR GRANTS AND IT'S MORE THAN WE
CAN ACTUALLY KEEP UP WITH. IN
ADDITION PEOPLE VOTE WITH THEIR
FEET. THERE ARE WHAT WE CALL
MODULAR AWARDS AND NON MODULAR
AWARDS. THE NON MODULAR AWARDS
HAVE A MAXIMUM OF 250,000
DOLLARS PER YEAR IN DIRECT
COSTS.
WHEREAS THE NON MODULAR ALMOST
ALWAYS ARE GOING ABOVE THAT.
AND THERE IS A TENTATIVE CEILING
OF 499,000 DOLLARS BUT IF YOU
APPLY TO THE DIVISION IN ADVANCE
YOU CAN GET AN APPROVAL TO APPLY
FOR A GRANT THAT IS HIGHER THAN
499,000. BUT WHAT I WANT YOU TO
SEE FROM THIS SLIDE IS THAT IN
2012, THE MAJORITY OF THE AWARDS
WERE MODULAR. SO THEY WERE
250,000 DOLLARS OR LESS. FAST
FORWARD TO 2023. AND BASICALLY
ONLY ONE IN SEVEN OF THE AWARDS
WERE MODULAR AND SO IT MEANS
THAT THE OTHERS WERE NON MODULAR
AND THIS -- NOT JUST WITH
INFLATION BUT THIS ACCOUNTS FOR
THE INCREASED COST ALMOST EVERY
YEAR TOWARD THE AVERAGE GRANT
THAT WE MAKE. NEVERTHELESS,
THIS LOOKS AT THE PAY LINE
EXPERIENCED INVESTIGATORS THAT
IS IN BLUE. THAT'S THE BLUE
LINE AND THEN THE GREEN
REPRESENTS THE NUMBER OF AWARDS
THAT WE'VE BEEN ABLE TO GIVE OUT
EACH YEAR AND WHAT I HOPE YOU
CAN APPRECIATE IS THAT WE
REACHED NADIR IN 2019 OF 8%.
AND IT WAS -- YOU KNOW, BEYOND
NONSUSTAINABLE. AND WE HAVE
ESSENTIALLY PRIORITIZED THE RPG
POOL GIVING PROPORTIONALLY MORE
FUNDS TO THE RPG POOL EACH YEAR
WHICH IS RELATIVELY EASY TO DO
WHEN THERE ARE INCREASES TO THE
BUDGET. AND WHAT I HOPE YOU CAN
APPRECIATE IS THAT BY 2023, WE
HAD GONE FROM LITTLE UNDER 700
AWARDS IN 2019 TO JUST UNDER
900. THIS YEAR, BECAUSE WE HAD
TO GO DOWN TO THE 10TH
PERCENTILE THE NUMBER OF AWARDS
IS GOING TO DECREASE, WE WILL
STILL BE OVER 800 BUT WE WON'T
BE AT THE NUMBER OF 893 THAT WE
HAD LAST YEAR. THIS IS FOR ALL
INVESTIGATORS. WHAT IF WE DRILL
DOWN ON EARLY STAGE
INVESTIGATORS? THE TREND IN
TERMS OF THE PAYLINE HAS BEEN
CONSISTENTLY UPWARD FROM 2016 A
12 PERCENTILE PAY LINE GOING UP
PRETTY MUCH EACH YEAR SO THAT IN
2023, IT WAS IN THE 17TH
PERCENTILE AND WE KEPT IT FOR
2024 AT THE 7TH PERCENTILE FOR
EARLY STAGE INVESTIGATORS.
ALTHOUGH, THE THE PAY LINE FOR
THE EXPERIENCED INVESTIGATORS
WENT DOWN TO 10. WHAT I HOPE
YOU CAN APPRECIATE IS BACK IN
2016-17 WE WERE FUNDING FEWER
THAN 100 EARLY STAGE
INVESTIGATORS: AND STARTING WITH
2018, IT HAS BEEN SUBSTANTIALLY
OVER 100. 2021-22 A LITTLE OVER
130 THIS PAST YEAR IT WAS 120.
MY UNDERSTANDING IS WE ARE ON
TRACK TO BE OVER 120 FOR FY24
BUT PROBABLY NOT QUITE AS HIGH
AS IN THE HIGH YEARS OF '21 AND
'22. MY LAST TWO SLIDES ARE
REALLY TALKING ABOUT WHO WHAT
HAPPENS WHEN YOU HAVE A
CONSTRAINED BUDGET. WESTIN
DIDN'T POINT OUT THAT OUR BUDGET
FOR FY24 WAS ACTUALLY 96 MILLION
DOLLARS LESS THAT IS IN ACTUAL
DOLLARS NOT INFLATED DOLLARS
THAN WE HAD IN FY 23 AND THIS IS
JUST A SMALL EXAMPLE WITH THESE
DIFFERENT BULLET POINTS OF AREAS
WE NEED TO THINK ABOUT
PRIORITIZATION. I WAS GOING TO
ADD MORE BUT DR. RATHMELL TOLD
ME WE WOULD NEED TO GIVE OUT
BINOCULARS IF I DID THAT SO JUST
TO GO THROUGH THESE QUICKLY.
NEW STANDARD OF CARE VERSUS
RESEARCH TO INCREASE UPTAKE OF
CURRENT STANDARD OF CARE AND WE
ALREADY HEARD DURING ESPECIALLY
DURING THE QUESTION PERIOD ABOUT
THE IMPORTANCE OF INCREASING
UPTAKE OF CURRENT STANDARD OF
CARE. RPG POOL, I'LL COME BACK
TO THAT IN THE LAST SLIDE.
CANCER TRAINING, CANCER CENTER
TO THE SPORE GRANTS. SHOULD WE
CONTINUE TO GIVE INCREASES IN
THE FACE OF FLAT BUDGETS?
SHOULD WE CONTINUE TO INCREASE
THE NUMBER OF DESIGNATED CANCER
CENTERS WHICH ALSO INCREASE THE
COST OF -- FOR THE CANCER CENTER
LINE. SPORE GRANTS. VERY
IMPORTANT. CANCER DISPARITIES,
COMMUNITY ENGAGEMENT. JUST A
SUBSET AND THEN THE LAST SLIDE
JUST TALKING ABOUT WHAT WE HAVE
THOUGHT ABOUT IN TERMS OF
PRIORITIZATION. JUST FOR SOME
OF THESE AREAS AND NOT EVERYONE
IS GOING TO AGREE. FOR EXAMPLE,
TO PRIORITIZE THE DEVELOPMENT OF
NEW STANDARDS OF CARE AND THE
DEVELOPMENT OF NEW STANDARDS OF
CARE AS WAS POINTED OUT DURING
THE QUESTION PERIOD OFTEN MAY
EXACERBATE GAPS AND INCREASE
CANCER DISPARITIES BUT
DR. RATHMELL ANNOUNCED AT THE
BEGINNING OF THIS YEAR DOWN AT
THE WHITE HOUSE THAT THERE IS A
CERVICAL CANCER SCREENING TRIAL
CALLED EITHER THE SHIP TRIAL OR
THE LAST MILE UNDER THE AEGIS OF
DR. PHIL CASTLE AND HIS
COLLEAGUES IN THE DIVISION OF
CANCER PREVENTION THAT IS TRYING
TO MAKE IT FDA APPROVABLE FOR
SELF-SAMPLING OF WOMEN THAT
ACTUALLY WE HOPE WILL DECREASE
THE GAP IN TERMS OF WHO IS BEING
UNDERSCREENED. I THINK FOR THE
RPG POOL TO PROTECT NEW
INITIATED AWARDS ESPECIALLY
EARLY STAGE INVESTIGATORS AND
REDUCING INVESTMENT IN THE RFAS.
THEY'RE VERY IMPORTANT. AND AS
YOU HAVE HEARD EARLY CANCERS IS
GOING TO BE SORT OF A VERY
IMPORTANT AREA BUT WE ARE GOING
TO BE DOING FEWER RFAS SO THAT
WE CAN PROTECT INVESTIGATOR
INITIATED RESEARCH. AND ONE OF
THE PROBLEMS OF COURSE IS THAT
WE LOVE ALL THE TIME TO BE ABLE
TO GIVE IN THE OUT YEARS 100% OF
GRANTS BUT IN ORDER TO TRY TO
MAINTAIN THE NUMBER OF AWARDS IT
HAS BEEN NECESSARY TO GIVE LESS
THAN 100%. AND THEN CANCER
TRAINING. TRYING TO MAINTAIN
THE NUMBER OF PEOPLE THAT WE ARE
TRAINING THROUGH OLIVER'S
TRAINING BRANCH AND ALSO WITH
WHAT USED TO BE THE CENTER
FOR -- TO REDUCE CANCER HEALTH
DISPARITIES AND NOW THE CANCER
CENTER FOR HEALTH EQUITY THAT
SONYA SPRINGFIELD RUNS. THIS
HAS KIND OF BEEN A QUICK
OVERVIEW OF DIFFERENT ASPECTS OF
THE BUDGET AND WESTIN AND I ARE
HAPPY TO TRY TO ANSWER YOUR
QUESTIONS AND ALSO VERY
INTERESTED IN YOUR COMMENTS.
THANK YOU VERY MUCH.
>> THANKS. THANK YOU SO MUCH.
GREAT PRESENTATION. THE FLOOR
IS NOW OPEN FOR QUESTIONS. Z
SO I HAVE ONE, I WAS INTERESTED
IN THE HISTOGRAM THAT SHOWED THE
SINGLE POSITIONS. IS THAT
INCREASE ASSOCIATED WITH AN
INCREASE IN TEAM SCIENCE OR MPI
GRANTS?
>> I WOULD SAY IN GENERAL THE
MULTI-PI APPLICATIONS ARE GOING
TO BE NON MODULAR IN ORDER TO BE
ABLE TO PAY FOR ENOUGH OF THEM.
DIANE CENTER FOR RESEARCH
STRATEGY IS HERE. DO YOU WANT
TO SAY MORE ABOUT THAT? .
>> SO THAT COULD POSSIBLY
EXPLAIN THE DECREASE.
>> I WAS CURIOUS THE FUNDING
LINE AND OTHER TRAINING GRANTS.
HOW HAS THAT BEEN OVER THE
LAST....
>> WE ACTUALLY OVER THE LAST FEW
YEARS HAVE PRIORITIZED
INDIVIDUAL AWARDS OVER THE T32
GRANTS ON THE OTHER HAND WE
STILL HAVE GRANTS OLIVER BOG
HER, HEAD OF THE CENTER FOR
CANCER STRAINING IS -- TRAINING
IS HERE. WE WILL AANSWER ALL OF
YOUR QUESTIONS AND MORE.
>> YEAH, SO I DON'T KNOW IF YOU
CAN HEAR. ONE OF THE THINGS WE
HEAR IS ABOUT THE SCOPE PROGRAM.
CAN YOU HEAR ME NOW? OKAY. SO
ONE OF THE THINGS WE HEAR ABOUT
OVER AND OVER AGAIN IS THE SPORE
PROGRAM AND IS IT GOING TO
CONTINUE? IT ALWAYS FEELS LIKE
IT'S A LITTLE BIT AT RISK
SOMEHOW. BECAUSE PREVIOUS NCI
DIRECTORS OR NIH DIRECTORS HAVE
MENTIONED THAT THIS -- IT MIGHT
NOT BE A SUSTAINABLE PROGRAM.
WHEN YOU LOOK AT IT IN YOUR
BUDGET IS THIS SOMETHING THAT
YOU THIS WILL CONTINUE TO BE A
SUSTAINABLE PROGRAM?
>> YES. SO I... WE'RE VERY
FORTUNATE DR. TOBY IS HERE WHO
IS THE HEAD OF THE SPORE PROGRAM
MAY WANT TO SAY MORE BUT I THINK
OF THE SPORE PROGRAM A LITTLE
BIT LIKE WHAT MARK TWAIN SAID
ABOUT HIS DEATH. GREATLY
EXAGGERATED. THE SPORE PROGRAM
HAS BEEN CONTINUALLY DOING MORE
WITH LESS JUST LIKE MANY OTHER
AREAS. AND AS DR. RATHMELL
MENTIONED, WE NOW HAVE IN THE
SPORE PROGRAM HEALTH DIVERSITY
AS WELL AS THE INDIVIDUAL
CANCER -- THE INDIVIDUAL CANCER
TYPES. THIS HAS BEEN ASSOCIATED
WITH A SMALL INCREASE TO THE
BUDGET FOR THE SPORE PROGRAM BUT
LIKE EVERYTHING ELSE THAT WE DO,
GREATLY UNDERSTOOD FUNDED.
DR. HECK, DO YOU WANT TO SAY
SOMETHING?
>> NO. RIGHT THERE. SHE HAS TO
UNMUTE IT. YEAH, SHE HAS TO
UNMUTE IT.
>> OH, GOOD. I DON'T HAVE THAT
MUCH TO SAY EXCEPT THAT BACK IN
2015 THERE WAS AN EVALUATION OF
THE SPORE PROGRAM AND IT WAS
REALLY A DMRGLOWING EVALUATION.
THEY DID MAKE SOME SUGGESTIONS
WHICH WE INCORPORATED BUT LIKE
EVERY PROGRAM IN THE LAST COUPLE
OF YEARS, WE HAVE HAD TO TAKE
CUTS AND SO WE HAVE ACTUALLY
LOST SEVEN SPORES THIS PAST YEAR
BECAUSE OF BUDGET CUTS. WE'RE
HOPING THAT THAT IS NOT GOING TO
BE FOREBODING FOR THE FUTURE BUT
WE'RE DOING VERY, VERY WELL AND
I SHOULD ADD THAT WE HAVE AN RFA
OUT NOW WHICH IS A COMPANION TO
THE SPORE PROGRAM WHICH IS IN
CANCER HEALTH DISPARITIES AND
THERE HAS BEEN TREMENDOUS
INTEREST IN APPLYING FOR THIS,
THE APPLICATIONS ARE DUE AT THE
END OF THIS MONTH. AND WE'RE
REALLY EXCITED. WE'VE ALREADY
DONE SOMETHING LIKE 25
PRE-APPLICATION CONSULTATIONS
WITH GROUPS THAT ARE INTERESTED
IN THIS. AND WE'RE HOPING THAT
WE'RE GOING TO HAVE A VERY
ROBUST, YOU KNOW, APPLICATION
GROUP COMING IN. I WOULD SAY
THE SPORES ARE VERY HEALTHY. WE
COULD USE MORE MONEY OF COURSE.
BUT THE RESEARCH THAT IS COMING
OUT IS REALLY QUITE AMAZING.
WE'VE GOTTEN MANY COLLABORATIONS
BETWEEN SPORES IN INDUSTRY AND
HAVE ALLOWED FOR DEVELOPMENT OF
NEW AGENTS THAT ARE IN THE
CLINIC NOW. SO THANK YOU VERY
MUCH FOR THE QUESTION.
>> THAT'S GREAT TO HEAR.
>> ONE -- IT'S A LITTLE
CONTROVERSIAL AND PROVOCATIVE.
WESTIN, YOU TALKED ABOUT THE
OVEN AND THE MORTGAGE COSTS THAT
GO INTO BAKING COOKIES AND PIES.
FOR US AN EXTRA MILE MEAL THAT
EQUATE TO INDIRECTS.
HOW DOES THAT PIE BREAK DOWN IN
TERMS OF THE OVERALL BUDGET AND
IS THAT SOMETHING WE THINK ABOUT
IN DIRECT WAYS?
>> YOU'RE TALKING ABOUT INDIRECT
RATES INSIDE OF THE COMMITTEE.
>> YES, IN TERMS OF THE GRANTS.
>> SO THE INDIRECT RATE IS
OFTEN -- IS MANAGED BY AN
ENTIRELY DIFFERENT ORGANIZATION
OUTSIDE OF NIH'S CONTROL.
>> SO WE'RE ONLY FUNDING THE
DIRECTS.
>> NO, WE FUND IT.
>> THAT'S WHAT I MEAN.
>> WHAT HAPPENS -- IT'S A
SIGNIFICANT AMOUNT. I CAN'T
TELL YOU THE EXACT PERCENTAGE.
>> IT WOULD BE GREAT TO KNOW.
>> WITH RO 1 AWARDS, THE AWARDS
IS ABOUT 60% OF THE DIRECT IS
THEN PUT ON TOP OF THAT WITH
INDIRECT. OKAY? SO YOU CAN
THINK OF TWO-THIRDS ONE-THIRD.
SOMETHING ALONG THOSE LINES.
>> OKAY. I THINK WE'RE JUST
ABOUT RIGHT ON TIME UNLESS
THERE'S ANY. ONE MORE QUESTION.
>> SO ON THE SLIDE AROUND THINGS
THAT NIBBLE AWAY AND YOU TALKED
ABOUT A LOT OF DIFFERENT
PROGRAMS. I KNOW THE TERM
UNFUNDING MANDATE CAN HAVE A
PEJORATIVE CONTEXT BECAUSE
THOSE -- THOSE PROGRAMS ARE
INCREDIBLY IMPORTANT HOWEVER I
KNOW THAT YOU ARE LEGISLATIVELY
MANDATED TO DO THINGS AT TIMES
WITHOUT EXTRA FUNDS. I OFFER
THIS AS AN IDEA, WE IN A
COALITION FOR FDA CALLED THE
ALLIANCE FOR A STRONGER FDA, I
CHAIRED IT I WAS CHAIR FOR
YEARS. WE SAW THE MANDATES.
AND THAT IMPACTED STAFF WHEN
THEY UNDERSTOOD, HEY, YOU'RE
TELLING THEM TO DO ALL THESE
THINGS BUT YOU'RE ONLY GIVING
THEM THIS SO JUST AS YOU'RE
THINKING ABOUT, I KNOW YOU GUYS
DON'T ADVOCATE BUT AS YOU'RE
TELLING YOUR STORY AND THE
ADVOCATES ARE TELLING THEIR
STORY THAT MIGHT BE HELPFUL.
THAT NEW PROGRAMS ARE GREAT.
THE NEED IS GREAT. ESPECIALLY
FOR RARE CANCERS BUT IF YOU'RE
NOT GETTING EXTRA MONEY THAT
COMES AT A COST. SO --
>> ABSOLUTELY.
>> THANKS FOR THAT COMMENT.
>> THANK YOU, DOUG AND WESTIN.
NEXT IS A PRESENTATION ON NCI
SUPPORT OF EARLY CAREER CANCER
INVESTIGATORS. WE HAVE DOCTORS
OLIVER BOWING HER. OH, OKAY.
WE -- OH, I'M SORRY, NEXT WE
HAVE THE LEGISLATIVE REPORT FROM
MK. SORRY ABOUT THAT MK.
>> THANK YOU FOR THE OPPORTUNITY
TO SPEAK WITH YOU TODAY. IN
THE -- SO AFTER THAT
PRESENTATION, I THINK WHAT YOU
PROBABLY WANT TO KNOW FROM ME IS
WHAT ARE WE GOING TO GET FROM
OUR APPROPRIATION FY25 AND WHEN?
I CAN'T GIVE YOU AERT OF --
EITHER OF THOSE ANSWERS BUT I
CAN PROVIDE CONTEXT ABOUT THE
POLITICAL REPORTING YOU'RE GOING
TO HEAR INCESSANTLY FOR THE NEXT
COUPLE OF MONTHS. THERE'S AN
UPDATE IN YOUR MATERIALS AS I
ALWAYS SAY. I WILL BE BRIEF
TODAY BUT IF YOU HAVE QUESTIONS
OR WANT TO GET IN TOUCH WITH ME
OR YOUR STAFF WE'RE ALWAYS HAPPY
TO HEAR FROM YOU AND ENGAGE WITH
OUR BOARDS AND RESEARCH
INSTITUTIONS. NEXT SLIDE,
PLEASE. SO THESE ARE THINGS I'M
GOING TO TALK ABOUT TODAY. I'M
GOING TO TOUCH ON FY25, THE
CONGRESSIONAL CALENDAR.
LEGISLATIVE ISSUES THAT CONGRESS
ALSO HAS TO DEAL WITH AND TOUCH
ON THE IMPORTANCE OF ENGAGEMENT,
ADVOCACY AND HIGHLIGHT SOME OF
THE DETAILS THAT DR. RATHMELL
HAVE PARTICIPATED IN. THE
SPOILER ALERT IS THAT ANYONE OF
THESE ARE GOING TO BE EASY NO
MATTER WHAT THE ELECTION
OUTCOMES THE BUDGET IS GOING TO
BE QUITE DIFFICULT. NEXT SLIDE,
PLEASE. THERE'S A LOT OF
REASONS FOR THAT AND I'LL DO IT.
NEVER MIND. I'M SO USED TO
DOING NEXT SLIDE. PLEASE,
EXCUSE ME. I GOT VERY MUCH IN
THE REMOTE PRESENTATION MODE.
SO FY25 APPROPRIATIONS. THE
GOVERNMENT RUNS OUT OF FUNDING
IN 26 DAYS. FOR FY25, WHAT WE
EXPECT IS THERE'S GOING TO BE A
CR, A CONTINUING RESOLUTION
UNTIL THE NEXT ELECTION. WE
DON'T KNOW HOW LONG IT'LL BE.
JUST BECAUSE IT'S INEVITABLE
DOESN'T MEAN IT'LL BE WITHOUT
DRAMA. JUST ON MONDAY, SPEAKER
MIKE JOHNSON ANNOUNCED THAT HE
WAS GOING TO ADVANCE SIX MONTHS
CR GOING INTO MARCH THAT WOULD
ALSO HAVE ATTACHED TO IT
SOMETHING CALLED THE SAVE ACT
WHICH IS SOMETHING ABOUT
SAFEGUARDING VOTING RIGHTS. IT
WOULD PROHIBIT NONCITIZENS FROM
VOTING IN FEDERAL ELECTIONS
WHICH YOU MAY GUESS IS ALREADY
ILLEGAL BUT THIS IS A MESSAGING
BILL, IT PASSED THE HOUSE IN THE
SUMMER. THERE IS A LOT OF
OPPOSITION TO THIS APPROACH FOR
MANY, MANY REASONS. PUNTING
APPROPRIATIONS INTO MARCH WOULD
HAVE THE 119TH CONGRESS DECIDE
APPROPRIATION. OBVIOUSLY THE
ELECTIONS, WE KNOW WE'RE GOING
TO HAVE A NEW PRESIDENT AND NEW
LEADERSHIP FOR SENATE
REPUBLICANS SO WE DON'T KNOW
WHETHER MAJORITIES WILL FLIP AND
THERE'LL BE OTHER CHANGES TO
LEADERSHIP WHEN MAJORITIES DO
CHANGE THE OUTGOING MAJORITY HAS
A REAL INTEREST IN GETTING WORK
DONE DURING THE LAME DUCK THAT'S
WHAT THEY HAVE THE OPPORTUNITY.
WILL THE LAME DUCK CONGRESS BE
ABLE TO COMPLETE THE BILLS?
WE'RE GOING TO COME BACK TO
THAT. I DON'T THINK WE WOULD --
I WOULDN'T BET THE HOUSE ON IT
BUT IT'S GOING TO BE A CHALLENGE
AND THERE'S GOING TO BE A LOT OF
EFFORT TO DO THAT. SO HERE'S
WHERE THE APPROPRIATIONS
COMMITTEE ENDED UP WITH THEIR
MARKS ON NIH. FOR THE HOUSE THE
TOP LINE THAT THEY STARTED WITH
IS BELOW THE FY24 ENACTED LEVELS
WE'RE DEALING WITH YOU. YOU
PROBABLY REMEMBER THERE WAS A
LOT OF DRAMA WITH THE HOUSE
WANTING TO GO WITH NOT THE
FISCAL RESPONSIBILITY ACT TOTALS
AND SIDE DEALS THAT WERE AGREED
TO IN JUNE OF 2023. . THEY
WANTED TO PROCEED WITH A LOWER
LEVEL.
THAT CREATED AN ENORMOUS AMOUNT
OF PROBLEMS FROM A BUDGET
PERSPECTIVE. WE ARE STILL UNDER
BUDGET CAPS FROM THE FISCAL
RESPONSIBILITY ACT. FY25 THE
TOPLINE IS 1% ABOVE WHAT
CONGRESS WAS ABLE TO SPEND IN
FY24 BUT THIS IS STILL A PRETTY
AUSTERE BUDGET PROPOSAL. THE
HOUSE PROPOSES FLAT FUNDING AND
DON'T GET EXCITED 261 MILLION
INCREASE. IT CUTS A BILLION
FROM ARPA-H AND THIS WAS VOTED
OUT. THE PROPOSED INCREASE IS
SO LARGE AND VERY NICE TO SEE
BUT IT -- THEY INCORPORATED WHAT
WE'RE GOING TO TOUCH ON LATER,
THE HOUSE IS RESTRUCTURING
REFORM OF NI H AND THAT
CONSOLIDATED MANY INSTITUTES
FROM 27 TO 15.
THERE WERE BUDGETARY
ADJUSTMENTS. THERE IS A LIST OF
ACTIVITIES THAT HAVE PRICE TAGS
ON THEM AS WELL IN THIS BILL BUT
IT STILL WOULD BE A SUBSTANTIAL
INCREASE BUT THAT IS NOT GOING
TO HAPPEN AS WRITTEN. SO KEEP
THAT IN MIND. THAT IS BASED ON
IMPORTANT MESSAGING FOR HOUSE
REPUBLICANS BUT NOT THEIR PLAN
TO MOVE FORWARD. THE SENATE
CAME IN WITH A TOP LINE WITHIN
THE BUDGET CAPS BUT ALSO WITH
THE SIDE DEALS THAT PROPOSED --
SLIGHTLY OVER 2 BILLION DOLLAR
INCREASE FOR NIH AND FOR 266
INCREASE FOR NCI THAT RESTORES
THE MOON SHOT FUNDING GAP. IS
THAT AS THAT FUNDING STREAM
ENDED WE HAD THAT DEFICIT AND
ALSO GIVES US A 50 MILLION
DOLLAR INCREASE. A PROSED FLAT
FUNDING FOR ARPA-H THIS WAS A
BIPARTISAN BILL 25-3. THE MORE
BIPARTISAN THE BILL IS THE
BETTER CHANCE OF GETTING DONE.
I JUST WANT TO TAKE A MOMENT TO
REMIND OURSELVES THAT THERE ARE
GROWING PAINS WITH ALL OF THIS.
WE HAVE STRONG BIPARTISAN
SUPPORT FOR CANCER RESEARCH.
THERE ARE A LOT OF REASONS FOR
THIS. WE HAVE REALLY BENEFITTED
FROM TREMENDOUS ENGAGEMENT FROM
NOT ONLY THE NIH AND THE NCI BUT
ALSO THE RESEARCH COMMUNITY,
PATIENT ADVOCATES, ASSOCIATIONS,
UNIVERSITIES, THESE ARE REALLY
IMPORTANT OPPORTUNITIES THESE
TWO SENIOR APPROPRIATORS ARE
JUST EXAMPLES. THEY ARE BY NO
MEANS ALONE. AND I THINK YOU
ALL KNOW THIS FROM YOUR OWN
CONGRESSIONAL ENGAGEMENT WORKING
WITH THE DELEGATIONS IN YOUR
STATES TELLING THE STORIES OF
RESEARCH IS INCREDIBLY IMPORTANT
AND THAT IS WHAT PEOPLE
REMEMBER. WHEN THEY WALK AWAY
IT. THE CONGRESSIONAL CALENDAR
IS GOING TO BE QUITE DIFFICULT.
CONGRESS HAS BEEN OUT FOR THE
AUGUST RECESS AND WILL BE BACK
NEXT WEEK. THEY HAVE THE VOTE
ON THE STOPGAP RESOLUTION.
THERE'S THE FARM BILL, FLOOD
INSURANCE, WE'LL SEE WHAT WILL
HAPPEN THERE. MAJORITY LEADER
CHUCK SHCHUMER IN THE SENATE IS
DETERMINED TO BRING UP AI. HE
WANTS TO MOVE SOMETHING ABOUT
DEEPFAKES THE MOST CONTINUING
THING THEY'LL DO IS THE
CONTINUING RESOLUTION. WE DON'T
KNOW HOW LONG IT'S GOING TO BE
FOR. NOT WITHOUT DRAMA. THEN
THEY LEAVE. THEN OCTOBER 1ST,
OUR FISCAL YEAR BEGINS I THINK
MOST THE TRADITIONAL PLAY WOULD
BE TO PUT A CR IN DECEMBER.
START THE LAME DUCK CONGRESS
SESSION WHICH BEGINS ON NOVEMBER
12TH AND THEN THEY HAVE TO BRING
IN A STOPGAP OR DECIDE ON
APPROPRIATIONS. THERE'S TWELVE
DIFFERENT BILLS THAT HAVE TO BE
DONE WHETHER THEY GET DONE IN
THE LAME DUCK WE'LL RETURN TO
THAT. SO ANOTHER THING THAT
HAPPENS, IT'S NOT GOING TO BE A
GREAT HOLIDAY SEASON FOR A LOT
OF CONGRESSIONAL STAFF THAT'S
FOR SURE. ON JANUARY 2ND THE
DEBT LIMIT EXTENSION EXPIRES,
THAT FISCAL RESPONSIBILITY ACT
SET BUDGET GAPS AND SET THE DEBT
LIMIT UNTIL AFTER THIS ELECTION.
SO DEBT LIMIT SUSPENSIONS, THEY
CAN EITHER BE SUSPENDED OR
RAISED. CONGRESS HAS DEFAULTED
TO SUSPENSION RECENTLY THAT
GIVES MORE ROOM BECAUSE THERE'S
FACTORS OF WHEN YOU WILL HIT A
DEBT LIMIT. THIS IS THE FIRST
THING THE LAME DUCK CONGRESS
WILL GRAPPLE WITH. THE TREASURY
WILL TAKE WHAT THEY CALL
EXTRAORDINARY MEASURES FROM THE
AS SOON AS THE DEBT LIMIT
EXSPIRES THEY'RE GOING TO HAVE
TO THIS BE A PRIORITY. THEY'LL
HAVE TO HAVE SOME PLANS FOR THE
INAUGURATION OF THE NEXT
PRESIDENT THAT IS OFTEN A
TRIGGER FOR BUDGET DEALS.
THERE ARE ALSO A SERIES OF
PIECES OF LEGISLATION THAT HAVE
TO BE DONE BY THE END OF
DECEMBER. THE NATIONAL DEFENSE
AUTHORIZATION ACT. THERE'S
EMERGENCY FUNDING PROVISIONS,
THERE'S A LOT OF ECONOMIC
PRESSURES THAT WILL BE BROUGHT
TO BEAR IN DECEMBER SO THIS IS
GOING TO BE A TIME TO REALLY
WATCH AND THIS IS GOING TO BE
DOMINATING A LOT OF CONGRESS'S
ATTENTION AT THAT TIME. THE DAY
AFTER THE SUSPENSION, THE 119TH
CONGRESS CONVENES, THE NEW
MEMBERS WILL BE SWORN IN. NEXT
SLIDE, PLEASE. I HAD COFFEE
TAKE INTO CONSIDERATION I SWEAR.
2024 ELECTIONS. ALL I'M GOING
TO SAY ABOUT THIS IS WE KNOW
THERE'S A LOT OF TOSSUPS IN THE
AIR HERE. THE POLITICAL REPORT
IS AS GOOD A RESOURCE AS THERE
IS. I DON'T KNOW WHAT'S GOING
TO HAPPEN. NEITHER DO ANY OF US
BUT THEY'RE WRITING THE
ELECTORAL COLLEGE AS A TOSSUP IN
THE HOUSE. THEY'RE RATING 24
SEATS AS A TOSSUP. THAT GIVES
DEMOCRATS AN OPPORTUNITY TO FLIP
THAT CHAMBER AND ARE SOMETHING
THEY ARE HOPING TO DO. THE
SENATE THERE'S A MAJORITY AS
WELL. DEMS HAVE TO DEFEND A LOT
OF SWEETS.
23 OF THE 34 THAT ARE OPEN THIS
YEAR AND THE SENATE WORKS --
THERE'S THREE CLASSES IN THE
SENATE AND THEY ARE STAGGERED
AND WHEN THEY'RE UP FOR
REELECTION WHEREAS THE HOUSE IS
ALL UP AT THE SAME TIME EVERY
TWO YEARS. YOU CAN REALLY WHEN
YOU THINK ABOUT THAT IT REALLY
DOES HELP YOU UNDERSTAND THE
HUGELY DIFFERENT CULTURE OF THE
WAY THE HOUSE AND THE SENATE
OPERATE. BECAUSE WHEN YOU HAVE
SIX YEARS THAT'S A DIFFERENT WAY
TO APPROACH A LEADERSHIP
SITUATION AND A DIFFERENT
THRESHOLD FOR FUNDRAISING WHAT
WE'RE LOOKING AT IN THE SENATE
IS DEMS DEFENDING WAY FOR SEATS
THAN REPUBLICANS. 3 SEATS IS A
TOSSUP.
SO THERE IS A POSSIBILITY AND
THEY KNOW THAT SENATOR MANCHIN'S
WEST VIRGINIA SEAT IS GOING TO
BE REPUBLICAN VICTOR THERE. SO
THE REPUBLICANS ARE LOOKING AT
THEIR FLIP OF THE SENATE. THIS
WILL FLIP IN 2026. REPUBLICANS
WILL BE DEFENDING 13 SEATS. UP
IN 2026. SO THINGS CAN CHANGE
IN TERMS OF PEOPLE RESIGNING OR
LEAVING CONGRESS BUT THAT'S WHAT
IT LOOKS LIKE NOW. SO BACK, I
SAID WE WOULD COME BACK TO THE
LAME DUCK CONGRESS AND WHETHER
THEY WOULD GET THESE SPENDING
BILLS DONE. I JUST LOOKED HERE
FOR THE PAST FOUR LAME DUCK
CONGRESS'S TO SEE WHAT THEY'VE
DONE. STARTING WITH THE
NORTHEAST RECENT FIRST. THE
REPUBLICANS FLIP THE HOUSE.
THEY PUNTED ALL THE SPENDING
BILLS UNTIL THE NEXT CONGRESS
AND THEY WERE FINALLY ENACTED ON
MARCH 15TH. NOT THE LATEST
WE'VE GOTTEN OUR FUNDING BUT
FAIRLY DEEP INTO THE FISCAL
YEAR. IN 2020 DEMS SPLIT SPLIT
THE WHITE HOUSE AND THE SENATE.
THE OMNIBUS PASSED IN DECEMBER.
IN 2018 THE DEMS FLIPPED THE THE
HOUSE. SOME BILLS WERE DONE ON
TIME INCLUDING OURS AND THAT WAS
A WONDERFUL YEAR. WE GOT OUR
APPROPRIATION ON TIME. THAT WAS
THE FIRST TIME SINCE 1996 THAT
IT HAPPENED. AND THEY WERE SHUT
DOWN FOR 39 DAYS. SEVEN
SPENDING BILLS WERE MOVED TO
FEBRUARY. THE LAME DUCK
CONGRESS PASSED THE FIRST CURES
BILL. AND THEN WE DIDN'T GET
APPROPRIATION UNTIL MAY 5TH. IT
IS POSSIBLE TO REALLY PREDICT
THE MAJORITY -- IF THERE ARE
MAJORITY CHANGES THAT WILL
AFFECT THE LAME DUCK CONGRESSE
CONVERSATIONS AND SO MEMBERS ARE
GOING TO HAVE TO, AND THE
LEADERSHIP IS GOING TO HAVE TO
AT SOME POINT MAKE STRATEGIC
DECISION IN HOW THEY'RE GOING TO
PUSH AND ROLL OVER INTO THE NEXT
CONGRESS. IT'S GOING IS TO BE A
BIG CHALLENGE FOR THEM. SOME OF
THE LATEST LEGISLATIVE THINGS TO
WATCH ARE THE CONTINUING
RESOLUTION, THE FARM BILL, FLOOD
INSURANCE, THERE'S ALSO A
MEDICAID HEALTH EXTENDERS BILL.
AND THE TEMPORARY ASSISTANCE FOR
NEEDING FAMILIES BILL. ONE
THING ABOUT THE EXTENDERS BILL I
WANTED TO MENTION, HUMANLY
SUPPORTED, BIPARTISAN SUPPORT
THERE THAT IS CERTAIN LY GOING O
MOVE AND WHEN YOU HAVE ANYTHING
MOVING IT'S AN OPPORTUNITY FOR
MANY OTHER BILLS AND THESE ARE
TOPICS WHERE THERE'S LEGISLATION
THAT MAY PASS. THINGS LIKE A
VARIETY OF AI TYPES OF
PROVISIONS. TELEHEALTH
EXTENSIONS. THERE'S BEEN A LOT
OF INTEREST IN CONGRESS TO WORK
ON DRUG SHORTAGES, IMPROVING
CLINICAL TRIALS AND THEN THERE'S
I THINK THIS IS UNLIKELY TO PASS
THE NIH SPECIFIC LEGISLATION.
THE NIH REFORMATION ACT. THIS
WAS PUT OUT NOT AS A BILL BUT AS
A FRAMEWORK BY THE HOUSE OF
ENERGY AND XHOCOMMERCE COMMITTE
CATHY MCMORRIS ROGERS IS LEAVING
CONGRESS AFTER IS THIS SESSION.
SHE'S RETIRING.
AND SO THIS PLAN WOULD
CONSOLIDATE 27 INSTITUTES AND
CENTER TO 15. NCI WOULD NOT BE
PART OF THE CONSOLIDATION.
CALLS FOR A COMMISSION TO REVIEW
NIH. A LOT OF THIS IS DUE TO
SOME TRANSPARENCY CONCERNS, SOME
COMMUNICATIONS ISSUES AND A LOT
OF IT IS A POST-COVID ASSESSMENT
OF SOME CONGRESSIONAL
DISSATISFACTION TYPICALLY IN
HOUSE REPUBLICAN COMMUNITIES BUT
THERE ARE ALWAYS
REAUTHORIZATIONS AT AGENCIES
THAT ARE PERIODIC. SOMETIMES
BECAUSE IT EXPIRES. WE JUST
CONTINUE OUR WORK. THE LAST
MAJOR REAUTHORIZATION OF NIH WAS
IN 2006 SO THIS LEGISLATION IS
THROWING OUT A LOT OF IDEAS, IN
FACT, THEY DO CALL FOR
TRANSPARENCY REGARDING INDIRECT
COSTS. WHICH ARE TRANSPARENT
BECAUSE YOU CAN SEE WHAT ARE
DIRECT COSTS AND WHAT WHERE NOT
AND WE DO NOT DECIDE THOSE AND I
CAN TELL YOU WHEN THERE WAS AN
EFFORT TO REALLY SHRINK INDIRECT
COST THERE WAS LANGUAGE THAT
PROHIBITED CONSIDERATION OF
INDIRECT COSTS BY THE AGENCY.
SO THAT IS ABSOLUTELY A FIGHT
THAT'S GOING TO BE A
UNIVERSITIES AND CONGRESS FIGHT.
SO THIS IS SOMETHING THAT IS
PROBABLY GOING TO GET MORE
DISCUSSION. THE -- BUT THIS IS
THE REASON WHY THE HOUSE NUMBERS
IN THEIR PROPOSED BILL ARE NOT
REPRESENTATIVE OF WHAT WE THINK
MIGHT HAPPEN. JUST A WORD ABOUT
CONGRESSIONAL ENGAGEMENT. THIS
IS INCREDIBLY IMPORTANT FOR MANY
REASONS. DR. RATHMELL HAS MET
WITH MANY MEMBERS OF CONGRESS
AND WE HAVE MANY MORE FOR HER TO
MEET WITH. SHE WENT TO A
NATIONAL BRAIN TUMOR SOCIETY. A
SENATOR WHO WAS A TREMENDOUS
BEAST -- BOOSTER. AND WHEN SHE
WAS IN CHICAGO SHE HAD A CHANCE
TO MEET WITH ANOTHER SENATOR.
THESE ARE VERY, VERY MEANINGFUL
TO THE MEMBERS NOT ONLY THE
GEOGRAPHIC IMPACT OF HAVING
CANCER CENTERS AND SPORE
PROGRAMS. BUT ALSO THE ECONOMIC
IMPACT OF NCI INVESTMENTS AND
NIH FUNDING IS VERY IMPORTANT TO
THESE MEMBERS. BUT ALSO, YOU
KNOW, THIS IS PERSONAL. ONE IN
TWO MEN AND ONE IN THREE WOMEN
GETTING CANCER IN THEIR LIFETIME
IS PERSONAL FOR ALL OF US IN
DIFFERENT POINTS OF OUR LIVES
AND SO THIS IS VERY MEANINGFUL
AND SHARING THE STORIES OF YOUR
OWN RESEARCH. SHARING THE
STORIES OF YOUR OWN EXPERIENCES,
THERE'S REALLY -- IT'S
IMPOSSIBLE TO OVERESTIMATE THE
IMPORTANCE OF THIS AND WE THANK
YOU FOR ALL THE THINGS YOU DO IN
THAT REGARD AND TALKING ABOUT
YOUR SCIENCE AND JOINING US IN
ADVANCE THAT HIGHLIGHTS THOSE
EXCITING OPPORTUNITIES. THANK
YOU FOR YOUR TIME IF THERE'S ANY
TIME FOR QUESTIONS, DR. CART
PEN.
>> FANTASTIC PRESENTATION.
GIVEN THE GRAVITY OF THE
UPCOMING MONTHS WE'RE GOING TO
FOREGO QUESTIONS BUT IF ANYONE
HAS A QUESTION FOR MK PLEASE
SEND IT TO PAULETTE. THANKS,
AGAIN, FANTASTIC. NEXT WE HAVE
DR. RATHMELL.
>> WE HAVE ONE MEMBER IN
ATTENDANCE TODAY RETIRING. COME
ON UP HERE. THE MEMBERSHIP OF
THIS COUNCIL, THIS BOARD REALLY
IMPACTS EVERYTHING THAT WE DO
AND YOUR INSIGHTS ARE INCREDIBLY
VALUABLE. JUST TO ACKNOWLEDGE
SUSAN WHO HAS BROUGHT SO MANY
INSIGHTS IN BEHAVIORAL HEALTH
AND EPIDEMIOLOGY AND PUBLIC
HEALTH SO FROM THE CANCER CENTER
WE HAVE APPRECIATED EVERYTHING
YOU HAVE DONE AND SAID AND
PUSHED US ON AND THANK YOU VERY
MUCH. SO IN HONOR WE HAVE A
LOVELY PLAQUE FOR YOU.
>> (APPLAUSE).
>> ALL RIGHT, DR. BARKER, WE
HAVE TO THANK ANN BARKER WHO HAS
JOINED US FROM THE UNIVERSITY OF
CALIFORNIA. I WAS TRYING TO
THINK ABOUT WHAT TO SAY THAT
KIND OF ENCAPSULATES ALL THE
THINGS THAT SHE CONTRIBUTES TO
BUT IT'S LITERALLY EVERYTHING.
EVERYTHING THAT'S COMPLICATED.
EVERYTHING THAT IS PARTICULARLY
HARD I THINK OF AS DR. BARKER'S
SPECIALTY BUT GLOBAL TEAM
SCIENCE REALLY MAKING DATA
ACCESSIBLE ARE REAL STRENGTHS
AND, AGAIN, ALSO REAL COMMITMENT
TO THE NCI. SO WE HAVE A PLAQUE
FOR YOU AS WELL. IT'LL BE IN
THE MAIL, THANK YOU VERY MUCH.
>> AUDIENCE: (APPLAUSE).
>> AND THEN WE HAVE TWO OTHER
RETIRING MEMBERS. DR. N WAS ON
BUT I THINK HAD TO LEAVE. OKAY.
SO -- BUT AS CHIEF EXECUTIVE
OFFICER AND MEDICAL DIRECTOR AT
HEALTH CARE WITH FOCUS ON PAIN
AND HAD REAL SUPPORT FROM THEM
AND GLAD TO HAVE THAT SUPPORT.
WE'LL SEND THAT AS WELL AND ALSO
BUT NOT ABLE TO ATTEND
DR. HOWARD WHO BRINGS THE
PATIENT CARE TRANSLATIONAL
EXPERTISE FROM HIS ROLE AT
PHARMA AND SO REALLY GRATEFUL
FOR HIS SUPPORT AS WELL. SO
WITH FOUR RETIRING MEMBERS WE
HAVE FOUR NEW MEMBERS. WE HAVE
ONE ONLINE. AND WE HAVE THREE
WITH US. ALL PROVISIONAL RIGHT
NOW BUT FAR ALONG THE PROCESS TO
ATTEND SO THERE'S KAREN. VERY
GOOD. SO I WILL START WITH
DR. EDMUNDS IS A PROFESSOR AT
THE SCHOOL OF PUBLIC HEALTH.
SHE HAS EXPERTISE IN CANCER
EQUITY AND IMPLEMENTATION
SCIENCE. THE DOCTOR WORK'S IS
FOCUSED ON CANCER PREVENTION IN
DISADVANTAGED COMMUNITIES AND SO
WE'RE VERY GLAD TO HAVE YOU HERE
AND IN THE DISCUSSION. REALLY
IMPORTANT THAT YOU'RE ON OUR
COMMITTEE. TAMEKA. I KNOW
YOU'RE HERE. THE CHIEF
VISIONARY OF SURVIVOR. SHE
FOUNDED THIS ORGANIZATION IN
2005 AFTER SURVIVING CERVICAL
CANCER IN HER MID-20S AS A
NONPROFIT SHE'S BEEN DISMANTLING
THE DISEASE STIGMA THROUGH THE
RENOWNED SURVIVOR SCHOOL SHE'S
ASKED PEOPLE TO SPEAK OUT. THIS
INCLUDES THE PRESIDENTIAL
RESEARCH AWARD AND FOR THE YOUNG
ADULT AWARD. ALL RIGHT ALICIA
CLARK. SO DR. CLARK IS THE
CHIEF OF THE DIVISION OF
CERVICAL ONCOLOGY AND IN THE
DEPARTMENT OF SURGERY AT THE
MEDICAL COLLEGE IN WISCONSIN AND
IN EPIGENETIC TUMORS AND
AMELIORATE CANCER DISPARITIES.
HER M.D. RESIDENCY IN THE
CINCINNATI COLLEGE OF MEDICINE
AND SHE'S ELECTED TO THE AOA
HONOR SOCIETY. AND LAST. THE
DANIEL LOUIS ENDOWED CHAIR AND
ASSOCIATE PROFESSOR AT THE EMERY
SCHOOL OF MEDICINE AND LEADS THE
BRAIN TUMORS INSTITUTE AND IS
RENOWNED AS NEUROSURGICAL AND WE
GOT TO MEET AT THE BRAIN TUMOR
FOUNDATION AND IS VERY ACTIVE IN
THAT COMMUNITY. SO THANK YOU
VERY MUCH. SO THANK YOU. SO
WELCOME. AND ON WITH THE WORK.
>> GREAT, THANKS, KIM. SO NOW,
IT'S OUR PRESENTATION ON NCI
SUPPORTIVE EARLY CAREER CANCER
INVESTIGATORS BROUGHT TO US BY
DR. BOWING HER, DR. DA HAVE A
KNOW, WHO WORKS IN CANCER
TRAINING. A DEVELOP. BRANCH
WITHIN THE CENTER FOR CANCER
TRAINING AND JESSICA CALENDAR
ZOLA WHO IS A BRANCH DIRECTOR
FOR BRANCH PROGRAMS, CENTER
CANCER HEALTH EQUITIES.
>> THANK YOU FOR THE OPPORTUNITY
TO TALK ABOUT TRAINING. I WILL
GIVE YOU THE SLIDES AND THEN
HAND IT OVER TO MY COLLEAGUES.
SO OF COURSE THE MISSION OF WHAT
WE DO BOTH IN OUR GROUPS IS
DERIVED FROM THE WORKFORCE GOAL
AND THE NCI GENERAL MISSION AND
MY CENTER FOR CANCER TRAINING
HAS THREE GROUPS. ONE OF WHICH
IS FOCUSED ON EXTRAMURAL WORK
AND THEN WE HAVE TWO GROUPS
FOCUSED ON INTRAMURAL WORK AND I
WILL MENTION ONE PIECE OF WORK
THAT COMES FROM OUR PROGRAM AS
WELL SO TOGETHER ACROSS THE NCI,
IN COLLABORATION WITH THE CENTER
FOR CANCER WE OFFER A VARIETY OF
MECHANISMS ACROSS THE EARLY
STAGES OF THE CANCER-Y SIR
CAREERS AS YOU CAN SEE HERE. I
DON'T HAVE TIME TO GO INTO ALL
OF THEM. I WILL TALK ABOUT THE
CHANGE WE MADE RECENTLY AND A
COUPLE OF THOSE MECHANISMS THAT
WE HEARD FROM THE COMMUNITY TO
IMPROVE OUR EFFORTS AS WE WORK
WITH THE PEOPLE IN THIS ROOM AND
BEYOND. ANOTHER WAY TO LOOK AT
THE SNAPSHOT IS BY THE NUMBER OF
ACTIVE MECHANISMS AND THE DOLLAR
AMOUNT. I HOPE YOU HAVE THE
SLIDES IN YOUR FOLDERS. YOU CAN
LOOK AT THEM AT YOUR LEISURE.
THE KEY POINT I WANT TO MAKE
SURE IS WE HAVE A LOT OF
DIFFERENT INVESTMENTS. SOME OF
THESE ARE VERY NICHE. OUR
BIGGEST BUDGET ITEMS ARE THE KO
8 AND THE T32 THOSE ARE OUR
BIGGEST TRAINING MECHANISMS BY
BOTH THE DOLLARS AND THE PEOPLE
INVOLVED AND OF COURSE WE HAVE
SOME MARQUEE TRANSITION AWARDS
LIKE THE F99 AND I WILL TALK
ABOUT THE 91 BRIEFLY IN A
MOMENT. I NEED TO PIVOT NOW TO
THE CANCER TRAINING BRANCH SO
THIS IS REALLY THE MOST
IMPORTANT SLIDE IF YOU TAKE ONE
THING AWAY FROM MY PRESENTATION
IT IS THIS SLIDE WHICH REALLY
SHOWS YOU WHAT DR. RATHMELL SIDE
EARLIER IN HER PRESENTATION.
AND THIS CAN BE SEEN IN THE
DOLLARS AND CENTS. WE HAD A 5%
INCREASE IN FUNDING. WHICH
GIVEN THE CONTEXT AND THE
ENVIRONMENT IN WHICH WE'RE IN IS
A PHENOMENAL TESTAMENT TO
DR. RATHMELL'S STRONG SUPPORT
FOR EARLY CAREER INVESTIGATORS
AND I AM VERY GRATEFUL FOR HER
AS IS THE COMMUNITY AND THE
TEAM. THAT'S REALLY GREAT NEWS.
WE HAD MORE MONEY, WE -- WE WERE
ANTICIPATING ABOUT 210 MILLION
OR SO IN THIS BUDGET WE DON'T
HAVE THE FINAL '24 NUMBERS YET.
WE'RE FINISHING OUT THE YEAR.
MOST OF THOSE FUNDS WENT TOWARDS
INFLATIONARY PRESSURES. SO IT'S
NOT GOING TO BE REFLECTED IN THE
AMOUNT OF MONEY WE HAVE FOR NEW
AWARDS. NOW THE INFLATIONARY
PRESSURES, WHAT'S INSIDE THEM IS
VERY IMPORTANT STUFF IS THE
INCREASE IN STIPENDS AND SUPPORT
FOR OUR EARLY CAREER
INVESTIGATORS, I'M NOT SAYING
IT'S A BAD THING, IT'S JUST A
REALITY AND OF COURSE WE HAVE
THEREFORE INCREASED OUR FUNDING
FOR SOME OF THE MECHANISM BUT IT
ISN'T NECESSARILY REFLECTED IN
THE NUMBER OF NEW AWARDS THAT WE
WERE ABLE TO MEET THIS YEAR.
THAT'S REALLY THE HEADLINE I'M
GOING TO GIVE YOU THAT DEADLINE
FOR KOA. WE HAVE HAD A STEADY
INCREASE OVER THE LAST SEVERAL
YEARS IN THIS MECHANISM
REFLECTING A STRONG COMMITMENT
TO PHYSICIAN SCIENTISTS, WE
ANTICIPATE MAKING 43 COMPETITIVE
AWARDS IN FISCAL 24 THAT NUMBER
IS PERHAPS NOT FINAL WHICH IS ON
PAR WITH WHAT WE HAVE DONE IN
RECENT YEARS AND REFLECTS AN
INCREASE IN THE OVERALL
MECHANISM. THE T32S THE STORY
IS WHAT SIMILAR. WE'VE BEEN
FLATTER BUT WE'RE ACTUALLY
ANTICIPATING MAKING 32 ANY
COMPETITIVE NEW AWARDS. THEY'RE
NOT ALL NEW BUT A MAJORITY ARE
RENEWALS WHICH COMPARES
FAVORABLE. WE DID HAVE A BUMPER
YEAR FOR '22 AND '23 BUT WE'RE
ANTICIPATING MAKING A GOOD
NUMBER OF AWARDS HERE. WHAT
DOES THAT LOOK LIKE IN TERMS OF
SUCCESS RATES? THEY'RE ACTUALLY
PRETTY GOOD. WE HAD A QUESTION
ABOUT WHAT IS THE SUCCESS RATE
FOR 32S. IT'S ABOUT 40%. WHICH
WHEN YOU TALK ABOUT THE OTHER
COLLEAGUES I'M PRETTY HAPPY
ABOUT THAT. WE'VE HAD GOOD
NUMBERS ACROSS OUR MECHANISMS
INCLUDING K 08 WHERE WE HAVE A
25% SUCCESS RATE. WE HAVE BEEN
LOOKING A LITTLE BIT AT OUR
EARLY FELLOWSHIP PORTFOLIOS.
THE FUNDING RATE THERE IS NOT
NEARLY SO HIGH. I WANT TO ALSO
SHOW YOU THIS SLIDE BECAUSE THE
QUESTION I OFTEN GET ASKED IS
WELL WHAT DO YOU DO FOR
CLINICIAN INVESTIGATORS? THIS IS
ACTUALLY ALL THE DATA BUT WE DID
TAKE A SNAPSHOT AND WE DID
SOMETHING SIMPLE WE COUNTED THE
NUMBER OF PEOPLE SUPPORTED WHO
HAVE A DEGREE RECOGNIZING THAT
WE'RE MISSING SOME OF THE OTHER
DEGREES AND SO ON AND AS YOU CAN
SEE, BY HEAD COUNT ACROSS OUR
PORTFOLIO, 45% OF THE PEOPLE WHO
WE WERE SUPPORTING HAVE AN M.D.
DEGREE. THE AWARDING TEND TO
HAVE SLIGHTLY HIGHER FUNDING
VALUE. YOU CAN SEE THE KOH AND
ABOUT HALF OF THE T32 SLOTS THAT
WE HAVE GO TO PEOPLE WITH M.D.
WE ARE FOCUSED ON SUPPORTING
THIS VITAL COMMUNITY AND OTHERS
I'M NOT ABLE TO TALK ABOUT TODAY
BUT WE CONTINUE TO TALK ABOUT
THE COMMUNITY AND TRY TO LEARN
HOW WE CAN DO BETTER. LET ME
TELL YOU ABOUT A THREE CHANGES
THAT ARE COMING OR HAVE COME IN
RECENT MONTHS THAT I THINK ARE
REALLY SIGNIFICANT. THE FIRST
ONE IS A NEW KO 1. THIS IS A
SLIGHTLY DIFFERENT USE OF THE KO
1. THIS ONE IS FOCUSED ON THE
MISSION AREAS OF THE DIVISION OF
CANCER PREVENTION. AND TOGETHER
WITH PHIL AND KATRINA'S TEAMS WE
WORKED ON THIS NEW MECHANISM.
WE'RE BEGINNING TO SEE THE FIRST
NEW APPLICATIONS. WE HAVEN'T
HAD THAT MANY YET. WE'RE VERY
EXCITED ABOUT OFFERING THIS
PARTICULAR AWARD FOR THIS
CRITICAL COMMUNITY AND WE HAVE
HOPED TO HAVE ENHANCED THE
SUPPORT OF THE EARLY CAREER
PATHWAYINGS S IN THOSE TWO
MISSION AREAS.
WE ALSO TOOK A DEEP DIVE ON THE
R EDDED R 00.
I WILL NOT TELL YOU THE WHOLE
PAPER.
LET ME TELL YOU TWO PIECES OF
DATA. THE FIRST IS THAT THESE
AWARDEES DO TREMENDOUSLY WELL
WHEN YOU LOOK AT THEIR
DOWNSTREAM FUNDING RECORD. AT
THE TOP OF THE GRAPH WHAT YOU'RE
LOOKING AT IS IN THE RED BAR IS
THE APPLICATIONS FOR R 01
EQUIVALENTS AND IN THE GRAY BARS
THE AWARDS AND K99 AND 00 ALUMS
ARE APPLYING AT 90% RATES AND
GETTING AWARDS AT THE 65% RATE.
IF YOU LOOK AT DISCUSSED BUT NOT
AWARDEDED. THOSE NUMBERS
DECLINE. ONE OF THE REASONS
WE'RE TAKING A GOOD LOOK AT OUR
PORTFOLIO.
THAT'S THE GOOD NEWS AND ALSO WE
KNOW FROM OUR DISCUSSION AND WE
DID SOME INTERVIEWS, 95% OF
THESE FOLKS TRANSITION TO
INDEPENDENCE AND MANY OF THOSE
WERE HELPFUL TO THEM IN THEIR
QUEST FOR AN INDEPENDENT. WHAT
WE DID SOT SEE IS ACCELERATION,
ONE OF THE PURPOSES OF THE
ORIGINAL DESIGN WAS TO CELEBRATE
INDEPENDENCE. BUT WHEN YOU LOOK
AT THE DESIGN AND THE EQUIVALENT
YOU CAN SEE THERE'S NO
DIFFERENCE BETWEEN OUR K99
AWARDEES AND THE THREE DIFFERENT
GROUPS. I PERSONALLY THINK
THAT'S BECAUSE THE WINDOW IS THE
MAIN DETERMINANT. THE NUMBER IS
RIGHT AROUND TEN YEARS AND I
THINK PEOPLE ARE TRYING TO MAKE
THEIR FIRST APPLICATION AS LATE
AS POSSIBLE WITHIN THE ESI
WINDOW. HAVING SEEN THAT, WE
DECIDED TO MAKE A SIGNIFICANT
CHANGE IN OUR K99 WHICH THE
COMMUNITY'S BEEN URGING US TO DO
WHICH IS TO INCREASE THE
APPLICATION ELIGIBILITY WINDOW
FROM FOUR YEAR TO SIX YEARS THAT
MEANS THAT PEOPLE WHO HAVE
FAMILIES DURING THEIR POSTDOC.
WHO MIGHT BE WORKING ON A TYPE
OF SCIENCE THAT REQUIRES A LONG
LEAD TIME OFTEN MINORITIES WHO
TAKE LONGER TO GET GOING THIS
THEIR RESEARCH WILL HAVE A MORE
OPPORTUNITY TO COMPETE BE FOR
THIS AMAZING AWARD THAT HELPS
PEOPLE.
AND WE'RE WORKING ON A PROGRAM
ANNOUNCEMENT THAT WE WILL SEE
SOON THAT WILL INCREASE THE
ELIGIBILITY FROM FOUR TO SIX
YEARS. AT THE SAME TIME WE'RE
ALSO DOING SUNSET RK 22. A LESS
GOOD VERSION OF THE K99. IT
GIVES YOU LESS MONEY, IT GIVES
YOU LESS ATTRACTIVENESS IN THE
MARKETPLACE IF YOU WILL AND IT
HAS AN EIGHT YEAR ELIGIBILITY
WINDOW. SO SINCE WE NOW HAVE A
SIX YEAR WITH THE K99 WE'RE
GOING TO SUNSET THE K22 AND MOVE
THAT BUDGET INTO THE K99. WE
EXPECT MORE AWARDS COMING FOR
THAT MECHANISM THE COMING YEARS.
ONE OF THE PRIORITIES THAT WAS
SHARED. I WANT TO TAKE ONE
MINUTE TO TALK ABOUT THE
INTRAMURAL PROGRAM. OUR OFFICE
LED BY GINSBURG HAS THE MARQUIS
PROGRAMS. AND WE HAVE THE
FELLOWSHIP FOR SCIENTISTS AND
EDUCATION. WE CAN SHARE THE
LINKS BUT THIS PAPER SHOWS YOU
THAT THE LEADERSHIP TRAINING
PROGRAM FOR OUR IN-HOUSE WOMEN
POST-DOCTORAL SCIENTISTS IS
EXTREMELY IMPACTFUL ON THEIR
CAREERS, ON THEIR ABILITY TO GO
OUT AND GET GREAT JOBS AND WE'RE
SUPER PROUD OF THEM. I LIED,
THERE'S ONE MORE SLIDE. WE ALSO
THINK ABOUT PEOPLE OUTSIDE OF
OUR IMMEDIATE CONTACTS. OUTSIDE
OF THE INTRAMURAL RESEARCH
PROGRAMS. WE SUPPORT ABOUT A
THOUSAND PEOPLE AND TOUCH ABOUT
A THOUSAND PEOPLE THROUGH GRANTS
AND OTHER MECHANISMS. THESE ARE
THE TWO PROGRAMS THAT WE
LAUNCHED. WE HAVE INSIDE CANCER
CAREERS WHERE WE TRY TO
ILLUMINATE ALL THE DIFFERENT
CAREERS AND ALSO AN ATTEMPT TO
BRING PEOPLE EARLIER IN THEIR
LIFE, PEOPLE IN HIGH SCHOOL AND
UNDERGRADS INTO THIS WORLD. AND
WE ARE -- WE HAVE LAUNCHED AND
ARE NOW WORKING ON AN AI POWERED
APP THAT WILL -- THAT DOES HELP
EARLY CAREER SCIENTISTS MANAGE
THE LITERATURE AND MAKE SOCIAL
CONNECTIONS AND I WILL NOW LIKE
TO HAND OVER TO MY COLLEAGUES IN
THE CENTER FOR CANCER HEALTH
EQUITY. DR. DA HAVE A KNOW.
>> GOOD MORNING, EVERYONE, I
HAVE TO FIGURE OUT HOW TO
ADVANCE THE SLIDES. THE KEY
BAR. THANKS SO MUCH. GOOD
MORNING, EVERYONE, MY NAME IS
DR. DA HAVE A KNOW AND TODAY IN
THE SECOND PART OF THIS SESSION
MY COLLEAGUE DR. CALENDAR ZOLA
AND I WILL PROVIDE A BRIEF
OVERVIEW OF THE PROGRAM AND
INITIATIVES IN THE TRAINING AS
SUPPORTED BY CCHES. ONE OF
IMPORTANT MISSIONS OF THE CCHES
IS TO ADVANCE I CANNOT SEE THE
SLIDES HERE. ONE OF OUR
MISSIONS IS TO PROMOTE DIVERSITY
IN THE CANCER WORKFORCEADVANCE
HERE. ONE OF OUR MISSIONS IS TO
PROMOTE DIVERSITY IN THE CANCER
WORKFORCE. IT'S NOT WORKING
YET. THE SLIDES, SO, ANYWAY,
AND WE ACHIEVE THIS BY -- WE
ACHIEVE THIS BY ATTRACTING
TRAINING, NURTURING AND
RETAINING TALENTED INDIVIDUALS
FROM GROUPS UNDERREPRESENTED IN
THE BIOMEDICAL SCIENCE. OUR
EFFORTS ARE ALIGNED WITH THE
EMPOWERING ALL OF THE NATIONAL
CANCER PLANS, OPTIMIZING THE
WORKFORCE BY ENGAGING EVERY
PERSON AND ELIMINATING
INEQUALITYINGS -- INEQUALITIES.
OUR FLAGSHIP PROGRAM IS THE CURE
PROGRAM THAT AIMS TO SUPPORT A
CONTINUUM OF COMPETITIVE FUNDING
OPPORTUNITIES FOR INDIVIDUALS
FROM MIDDLE SCHOOL THROUGH
INVESTIGATORS.
LAUNCHED AROUND 25 YEARS AGO,
CURE HAS EVOLVED OVER THE YEARS
AND INCLUDES BOTH INSTITUTIONAL
AND INDIVIDUAL EFFORTS AS LISTED
IN THIS SLIDE. CURE IS THE
PROGRAM THAT GOES BEYOND THE
FUNDING MECHANISM. IT'S ABOUT
CULTIVATING A CULTURE OF
EXCELLENCE. CREATING A PATHWAY
FOR PROGRESS AND FOR A SENSE OF
BELONGING AND COMMUNITY AMONG
THE TRAINEES AND INVESTIGATORS.
A HOLISTIC APPROACH INCLUDES
ENHANCED PROFESSIONAL
DEVELOPMENT OPPORTUNITIES SUCH
AS MENTOR REVIEW, PROFESSIONAL
WORKSHOPS, PEER MENTORING AND
TRA
TRAINING NAVIGATIONS. IN THE
FOLLOWING SLIDESLY SHARE WITH
YOU THE PURPOSE OF EACH
MECHANISM WITHIN THE CURE
PATHWAY AND TRENDS THAT WE HAVE
SEEN IN THE LAST TEN YEARS. THE
FIRST PROGRAM WITHIN THE CURE IS
PROGRAM TO PROMOTE DIVERSITY.
THIS PROGRAMS ARE DESIGNED TO
TRAIN AND DEVELOP THE CAREER
DEVELOPMENT FOR INDIVIDUALS FROM
HIGH SCHOOL TO EARLIER STAGE
INVESTIGATOR LEVELS. THE
SUPPLEMENTS OFTEN SERVE AS THE
GATEWAY FOR INVESTIGATORS TO
ENTER THE NCI RESEARCH
COMMUNITY. WHEN LOOKING AT THIS
SLIDE AND A FEW SLIDES THAT ARE
COMING, NOTE THAT THE ACCESS ON
THE LEFT SHOWS THE NUMBER OF
INVOLVED AND THE AXIS ON THE
RIGHT IS THE BUDGET. THE BLACK
LINE INDICATES THE NUMBER OF
APPLICATIONS WE RECEIVED AND THE
RED LINE SHOWS WHAT WE HAVE
MADE.
AS SHOWN IN THIS SLIDE, IN THIS
GRAPH, THE INTEREST HAS GROWN
SIGNIFICANTLY. THIS YEAR, WE
RECEIVE 28ED 0 DIVERSE
SUPPLEMENTS.
THE NEXT PROGRAM WITHIN THE CURE
IS F31 DIVERSITY. IS A
FELLOWSHIP DEVELOPED TO SUPPORT
TRAINING LEADING TO A PH.D. OR A
DUAL DEGREE AS AN M.D./PH.D. WE
HAVE SEEN AN INCREASE IN THE
NUMBER OF APPLICATIONS RECEIVED
FROM 91 TO 103. THE GREEN LINE
HERE SHOWS THE APPLICATION
RECEIVED THE HIGH SCORE 10-30 AS
YOU CAN SEE WE HAVE NOT BEEN
ABLE TO SUPPORT ALL THE
APPLICATIONS DUE TO THE BUDGET,
THE FLAT BUDGETS. THE CAREER
DEVELOPMENT PORTFOLIO INCLUDES
THREE MECHANISMS. AGAIN, SINCE
2015, IT HAS BEEN NEARLY AN
INCREASE 21% IN THE NUMBER OF
APPLICATION RECEIVED. AND A
RECENT PORTFOLIO ANALYZERS OF
THIS PROGRAM SHOWS THAT 36% ARE
WON AFTER ENDED. MENTIONED THE
HIGHEST INCREASE FOR THE K
APPLICANT WAS THE K 08 WHICH IS
FOR CLINICIAN SCIENTIST THAT
SHOWS THE THE SIGNIFICANT GROWTH
IN THE PORTFOLIO.
AND IT HAS BEEN WORKED SINCE
2018. THE CENTER ALSO SUPPORTS
IN COLLABORATION WITH THE
ADDITIONAL CANCER BIOLOGIC. THE
PURPOSE OF THIS PROGRAM IS TO
ASSIST AND HELP NEW
INVESTIGATORS THAT MAY NEED
EXTRA TIME OR SUPPORT TO DEVELOP
A LARGER RESEARCH PROJECT GRANT
AS R 01.
WE HAVE DECREASED THE NUMBER OF
APPLICATIONS OVER THE YEARS AND
IT IS PROBABLY DUE TO THE
COMPETITIVE ENVIRONMENT AND
STRINGENT PAY LINE WHICH IS
AROUND 10 THIS YEAR OR LAST
YEAR. ANOTHER FLAGSHIP PROGRAM
THAT WE SUPPORT IS THE R 25
SCIENCE OR YES PROGRAM. THAT
WAS TALKED ABOUT IN A VISIT TO
CHICAGO. THIS PROGRAM
INITIATED -- STARTED IN 2017,
ENGAGES IN MIDDLE SCHOOL, HIGH
SCHOOL AND UNDERGRADUATE
STUDENTS AND THEIR TEACHERS.
WITH RESEARCH EXPERIENCES. OUTD
REACH ACTIVITIES AND CURRICULUM
DEVELOPMENT. SINCE ITS
INCEPTION AROUND 2500 HAVE
PARTICIPATED IN THESE ACTIVITIES
CURRENTLY WE HAVE 24 ACTIVE OR
25 ACROSS THE COUNTRY. CHICAGO
IS ONE OF THEM.
AND TWO OF THEM ARE SUPPORTED BY
OTHER ICS THAN NCI FOR FUNDING.
THIS SLIDE PROVIDES A GLIMPSE
INTO DEMOGRAPHICS AND THE CURE
PORTFOLIO. AS YOU CAN SEE ON
THE PIE CHART, AROUND THE PIE
CHARTS ON THE TOP, THE MAJORITY
OF THIS ARE AFRICAN AMERICANS,
34% AND LATINOS. BUT SOME OF
OUR PROGRAMS SUCH AS R 25 HAVE A
SIGNIFICANT REPRESENTATION FROM
OTHER GROUPS INCLUDING AMERICAN
INDIAN AND ALASKAN NATIVE. 14%
FOR THE 25 YEARS AND THEN WE
HAVE THE RURAL AREAS. IN TERMS
OF RESEARCH A LARGE PORTION IS
BASIC CANCER, FOLLOWED BY SOCIAL
AND BEHAVIORAL SCIENCE AT 18%.
AND TRANSLATIONAL AND CLINICAL
AT 17 AND 6% RESPECTIVELY. LESS
THAN 20% OF THE CURE PORTFOLIO
IS FOCUSED ON CANCER HEALTH
DISPARITIES AND AS TRENDS SHOWS
CURE CONTINUE TO ATTRACT A
DIVERSE POOL OF COMPETITIVE
RESEARCHERS AND PHYSICIAN
SCIENTISTS. THIS COMPARES THE
APPLICATION RECEIVED AND ALL
THAT WE HAVE MADE IN 2023 AND
2024. THE LAST TWO YEARS. AS
YOU CAN SEE, ALL OF THE PROGRAMS
EXCEPT R 25, R 21 HAVE INCREASED
IN APPLICATION BUT WE HAVE NOT
BEEN ABLE TO SUPPORT THE
APPLICATION. USUALLY THE BUDGET
SCENARIOS. AND WITH THAT, I
WILL HAND IT OVER TO THE
CO-COUNSEL LOR, THANK YOU.
>> GOOD MORNING, I WILL WRAP IT
UP WITH TWO SLIDES. IN 2018 THE
INTERMURAL WAS LAUNCHED THIS
PROGRAM SUPPORTS INDIVIDUALS TO
COME FROM DIFFERENT BACKGROUNDS
TO COME TO THE NCI AND WORK WITH
INVESTIGATORS WITHIN THE NCI.
NOT ONLY DO WE FOCUS ON MATCHING
THEM TO THE APPROPRIATE RESEARCH
MENTORS WITHIN THE NCI RESEARCH
ENTERPRISE BUT ALSO SUPPORTING
THEM IN THEIR CAREER DEVELOPMENT
BY MATCHING THEM WITH MENTORS
OUTSIDE THEIR RESEARCH GROUPS
AND PEER MENTOR TO SUPPORT THEM
AS WELL. OVER THIS -- OVER
SEVEN COHORTS WE HAVE SUPPORTED
106 SCHOLARS, NOTABLY TEN OF
THEM ARE ONBOARDING THIS WEEK AS
WE SPEAK AND THIS INCLUDES
POSTDOCS. WE HAVE SUCCESSFULLY
AND PROUDLY INCREASED THE NUMBER
OF AFRICAN AMERICAN AND HISPANIC
AS WELL AS NATIVE HAWAIIAN
FELLOWS WITHIN THE NCI PROGRAM
BASED OFF OF AN ANALYSIS
SPANNING FIVE YEARS SO WE'RE
VERY PROUD OF THIS PROGRAM AND
THE SCHOLARS THAT WE SUPPORT.
NOW THIS MIGHT SEEM LIKE A STRAY
BUT THE FACULTY RECRUITMENT WERE
THE FIRST PROGRAM WAS AN NIH
PROGRAM. IT PARALLEL TO THE
CURE PROGRAM IT IS A HOLISTIC
PROGRAM. THAT THE NCI IS
RESPONSIBLE FOR MANAGING,
PARTICULARLY THE FACULTY COHORT
PROGRAM ASPECT OF THIS. WHICH
THE THREE GOALS OF THOSE
PROGRAMS ARE TO ADDRESS CULTURE
WITHIN THE INSTITUTIONS THAT
WERE FUNDED AND RECRUIT DIVERSE
COHORTS OF FUK AND PROVIDE
FACULTY WITH AN ENVIRONMENT OF
SUPPORT THAT ACCELERATES THEIR
CAREER WE'RE TALKING ABOUT ESIS
IN WHICH THE INSTITUTIONS ARE
PROVIDING THEM WITH MENTORSHIP,
LOOKING AT POLICY TO CHANGE THE
OVERALL CULTURE AND CATALYZE
CHANGE IN THE LONG TERM FOR
SUPPORTING THE FACULTY NOT ONLY
THOSE RECRUITED IN THE PROGRAMS
BUT GOING FORWARD. OF THE 181
FACULTY THEY'RE EXPECTED TO BE
ONBOARDED THROUGH THESE PROGRAMS
25 OF THEM, A MINIMUM OF 25 WILL
BE CANCER AND TO DATE, 15
FACULTY HAVE BEEN RECRUITED THAT
HAVE A CANCER FOCUS IN THEIR
RESEARCH AND WE HOPE TO
COLLABORATE WITH THEM AND WORK
WITH THEM TO CONNECT THEM SO
THAT WE SEE THEM IN OUR LONG
POOL IN THE FUTURE. AND SO WITH
THAT, I WILL SAY THANK YOU ON
BEHALF OF MYSELF AND THE FELLOW
SPEAKERS TODAY. WE APPRECIATE
YOUR THIE
TIME AND WE APPRECIATE WE GAVE
YOU A LOT OF CONTENT: THANK YOU.
>> THIS IS GREAT. THANK YOU,
ALL, FOR THAT WONDERFUL
PRESENTATION. WE HAVE AMPLE
TIME FOR DISCUSSION.
>> THANK YOU SO MUCH FOR THOSE
PRESENTATIONS. IT'S REALLY
WONDERFUL TO HEAR ABOUT ALL OF
THE SUPPORT THAT'S GOING ONTO
BRING IN THE NEXT GENERATION OF
RESEARCHERS. I LOVE THE
PROGRAMS. SOMETIMES I WORRY
WHEN YOU SEPARATE A POOL OF
APPLICANTS IT ABSOLVES THE
GREATER GOOD OR THE LARGER
PROGRAMS FROM REALLY DISCUSSING
AND TALKING ABOUT WHAT IS BEING
DONE TO DIVERSIFY SO DR. BOWING
HER I DON'T RECALL YOU
MENTIONING AT ALL THE DIVERSITY
OF THE RECIPIENTS. AND ALSO
IT'D BE GREAT TO HEAR ABOUT THE
DIVERSITY OF THE APPLICANTS. IT
WOULD BE GREAT TO TALK ABOUT THE
DIVERSITY OF INSTITUTIONS. IF
YOU CAN PLEASE SPEAK TO THAT
THAT WOULD BE GREAT.
>> IT'S A CONCERN AND WE DO
SEPARATE THESE TWO THINGS BUT WE
ARE WORKING ON TRYING TO BRING
MORE OF THESE IDEAS INTO MY
PORTFOLIO AS COMPARED TO
MARISSA'S PORTFOLIO. THE -- SO
WE DON'T HAVE A LOT OF DATA.
THESE DATA ARE NOT AS EASY TO
GET AS YOU MIGHT IMAGINE. WE
DID PUBLISH THE K99 DATA AND THE
NUMBERS ARE NOT ENCOURAGING THE
REPRESENTATION OF MY NOORTS IS
NOT WHERE IT SHOULD BE. AND SO
ONE OF THE DISCUSSIONS THAT'S
HAPPENING AT THE MOMENT IS HOW
DO WE ADDRESS IT WITHIN THE NCI,
RIGHT? AND WE CAN TALK ABOUT
MORE OF WHAT THOSE MIGHT LOOK
LIKE. INSTITUTIONAL DIVERSITY
IS ALSO A CHALLENGE. WHEN YOU
LOOK AT THE DATA WE KNOW THAT
THE BIGGEST INSTITUTION CONSUME
THE MOST RESOURCES. WE HAVE A
HANDFUL OF INSTITUTIONS THAT
HAVE SIX OR MORE T32S FROM THE
NCI. THAT IS A CONCERN. I
THINK THAT'S A LOT. AND I THINK
THERE ARE OPPORTUNITIES FOR
BROADENING THAT OUT. WE HAVE
ONE MECHANISM WHICH IS
INSTRUCTIVE IN THIS COON TEXT
WHICH IS OUR F99 MECHANISM
THAT'S OUR GRAD STUDENT AWARD
AND THAT AWARD REQUIRES AN
INSTITUTIONAL NOOM NATION
MEANING THAT ANY INSTITUTION CAN
ONLY SUBMIT ONE CANDIDATE AND
WITH THAT ONE -- WITH THAT AWARD
WE SEE A MUCH BROADER
INSTITUTION NALG PARTICIPATION
THAN WE SEE FLEX WITH THE K99
AWARD WHICH IS MUCH MORE
TRADITIONAL OPEN COMPOSITION.
SO THAT IS STRICT -- INSTRUCTIVE
TO US.
WHETHER WE WANT TO THINK ABOUT
CAPPING THE NUMBER OF GIVEN TYPE
OF AWARDS TO CERTAIN
INSTITUTIONS AND SO ON.
CERTAINLY SOMETHING THAT IS ON
OUR MINDS.
>> YEAH. THANK YOU SO MUCH FOR
THAT RESPONSE AND I DO THINK
THERE PROBABLY ARE QUITE A FEW
LESSONS THAT CAN BE LEARNED FROM
THE WORK THAT THE TEAM IS DOING
AROUND SUPPORT. I THINK THAT'S
GREAT. BUT I THINK ALSO THAT --
THAT'S AN INTERESTING IDEA TO
THINK ABOUT CAPPING THE NUMBER
OF AWARDS AT THESE LARGER
INSTITUTIONS BECAUSE WE HAD A
CONVERSATION TALKING ABOUT THE
FACT THAT THE INDIRECTS ARE OUT
OF OUR CONTROL, RIGHT?
WHICH REDUCES THE AMOUNT OF
FUNDS THAT WE CAN DELIVER. YOU
LOOK AT THE NUMBER OF AWARDS
THAT ARE GIVEN TO THOSE
INSTITUTIONS THAT HAVE VERY HIGH
ENDOWMENTS. THEY HAVE THE
INFRASTRUCTURE. THEY HAVE THE
HOUSE. THEY HAVE THE STOVE
ALREADY. IS THERE ANY WAY THAT
WE POTENTIALLY CAN START TO
DISSEMINATE BROADLY, MORE
BROADLY SO WE CAN START TO BUILD
AN INFRASTRUCTURE TO OTHER
INSTITUTIONS.
>> THE T32 IS ALSO -- HAS ITS --
AN ASPECT TO IT THAT IS NOT THE
INTENTION WHICH IS PEOPLE FEEL
PARTICULARLY AS THEY TRY TO WORK
TOWARDS A CANCER CENTER IS
THAT'S NOT SOMETHING THAT'S
FORMALLY SAID. THAT'S SOMETHING
THE COMMUNITY REFLECTS SO YOU
COULD ARGUE IF YOU'VE BEEN IN A
CANCER CENTER FOR X NUMBER OF
DECADES MAYBE YOU DON'T NEED
THOSE AS MANY ANYMORE. I HEAR
YOU ON THAT.
>> THANKS. DR. HAYES.
>> I HAVE A QUESTION ABOUT THE
K99 AWARDS. YOU SHOWED SOME
DATA ABOUT TRANSITIONING TO R
AWARDS FROM THE K99 AND SOME OF
THE APPLICANTS THAT, YOU KNOW,
IS A REDUCTION FROM THE NUMBER
WHO RECEIVED THE K99. DO WE
HAVE ANY DATA ON WHAT HAPPENS TO
THEM OTHERWISE? WHAT I MANE IS,
-- MEAN IS, THOSE FOLKS ARE
RECRUITABLE.
THAT'S THE ONES YOU WANT IN YOUR
INSTITUTIONS THAT HAVE -- BEEN
GIVEN THE K99. AND NOT TO SAY
ANYTHING POSITIVE OR NEGATIVE
BUT SOME OF THOSE PERSONS ARE
GOING INTO INDUSTRY AND ARE NOT
TRANSITIONING TO R AWARDS
BECAUSE THEY'VE TAKE AN JOB THAT
DOESN'T REQUIRE GRANT SUPPORT.
IS THERE A WAY TO SEE HOW MANY
OVER TIME ARE TRANSITIONING TO
NON GRANT SUPPORTED POSITIONS AS
OPPOSED TO GRANT SUPPORTED
POSITIONS?
>> SO IN THE INITIAL TRANSITION
IS VERY EASY TO ANSWER THAT
BECAUSE WE OBSERVE IT AND THEY
DO TRANSITION TO ACADEMIC
POSITIONS AND THE PORTFOLIO
WHICH IS MANAGED BY OUR SISTER
GROUPS. IT'S PROBABLY LESS THAN
5%. WHEN WE LOOK FURTHER DOWN
THE LINE WE CAN ACTUALLY OBSERVE
A SUSTAINED FUNDING IN OUR
COHORT AND SOME OF THESE DATA
ARE IN THE PAPER BUT OF COURSE
THERE IS SOME ATTRITION AS IN
ANY OF THE, I DON'T WANT TO USE
THE PIPELINE WORD BUT IN ANY OF
OUR PATHWAYS. I THINK FOR THIS
PARTICULAR PATHWAY, THAT
ATTRITION LEVEL IS SIGNIFICANTLY
LOWER THAN, FOR EXAMPLE, OUR F32
PATHWAY OR OTHER PATHWAYS.
>> OKAY, GOOD, THAT'S MY NEXT
QUESTION.
>> WE REALLY SEE THIS AS THE
COHORT AS OUR PI REPLACEMENT OF
COHORT PATHWAY.
>> THANK YOU.
>> GREAT. ANN, I SEE YOUR HAND.
PLEASE UNMUTE.
>> THANK YOU, OLIVER, I DON'T
REMEMBER I DON'T RECALL OF BEING
IN THE POSITION THAT WE'VE BEEN
IN AT THE MOMENT AND WE'RE
ENTERING AN ERA WHERE WE NEED
MORE AND MORE YOUNG
INVESTIGATORS BECAUSE THEY ARE
MORE IN TUNE WITH THE SCIENCE
THAT WE HAVE TO DO GOING FORWARD
AND ESPECIALLY TODAY WE TALK A
LOT ABOUT THIS WHOLE ISSUE OF
WHAT IS AI GOING TO BRING TO
CANCER? UNFORTUNATELY WE DON'T
HAVE THAT MANY TRAINED
INDIVIDUALS ACTUALLY IN A
WORKFORCE IN THIS SPACE. IN
CANCER AND WE'RE GOING TO HAVE
TO DO SOMETHING ABOUT IT AND I
DON'T KNOW HOW WE DO IT. I
DON'T KNOW IF MAYBE LAUREN'S GOT
SOME IDEAS IN THIS REGARD BUT
WE'RE GOING TO HAVE TO HAVE
INVESTIGATORS TRULY UNDERSTAND
WITH VERY SOPHISTICATED
MATHEMATICS. I DON'T KNOW, WE
HAVE LOTS OF THINGS TO THINK
ABOUT HERE BUT I THINK WE'RE
GOING TO NEED SOME REAL EMPHASIS
HERE ESPECIALLY IN THE NEXT FIVE
YEARS AND I WAS WONDERING ARE
WE -- DO WE HAVE A WAY TO PAY
ATTENTION TO THAT?
>> I'M NOT SURE WE HAVE A GOOD
WAY TO PAY ATTENTION TO THAT IN
A HOLISTIC WAY. IT IS ON OUR
MINDS. THE PODCAST IS ONE OF
THEM. WE HAD A RECENT EPISODE
WITH AI AND CANCER RESEARCH.
WE'RE TRYING TO GET YOUNG PEOPLE
WHO HAVE MATHEMATICAL BRAINS TO
THINK OF THEMSELVES AS PEOPLE
WHO ARE CANCER RESEARCHERS. WE
WANT TO BRING PEOPLE WITH THOSE
DISCIPLINES INTO THOSE FIELDS
AND THOSE MID-CAREER BRINGING
THOSE PEOPLE INTO OUR FIELDS.
THERE ARE SOME IDEAS. IT'S NOT
A GREAT TIME TO LAUNCH NEW
PROGRAMS BUT CERTAINLY WE HAVE
THIS ON OUR RADAR AS A REALLY
IMPORTANT AREA OF INVESTMENT. I
AGREE, CANCER RESEARCH NEEDS TO
IMPROVE THE WAY IT COMPETES WITH
THAT TALENT. WE NEED TO SEE
OURSELVES MORE LIKE A SILICON
VALLEY COME -- COMPETING FOR
THAT TALENT.
>> THE GOOGLE AND THE MICROSOFTS
HAVE SIMILAR NEEDS WITH THEIR
HEALTH CARE AND I THINK WE HAVE
SUCH A STRONG PARTNER IN THIS
REGARD.
>> YES. AND WHAT WE ARE
DEVELOPING WITH GOOGLE. YES,
YOU CAN WORK WITH GOOGLE AND
WORK WITH NCI AT THE SAME TIME.
THAT IS POSSIBLE. OR WORK IN
ANY OF THE GREAT INSTITUTIONS
REPRESENTED BY OUR BOARD. WE
NEED TO GET THAT MESSAGE IN.
>> YES. THANK YOU.
>> AS OLIVER MENTIONED AND TO
THE QUESTION, I THINK SOMETHING
THAT WE HAVE TO NOT FORGET IS
NCI CANNOT DO EVERYTHING. WE
NEED MORE HELP AND ASSIST FROM
CANCER CENTERS. THEY HAVE TO
FOCUS MORE ON THESE PROGRAMS AND
ALSO FOCUS ON DIVERSIFYING THE
CANCER FOCUS AND WE ALSO TO
PARTNER WITH THE -- MAYBE THE
PRIVATE SECTOR TO FOCUS ON THESE
AREAS. WE CANNOT DO EVERYTHING
BY OURSELVES.
>> YEAH, I THINK A DIFFERENT WAY
OF THINKING ABOUT IT IN TERMS OF
SAYING NEW PROGRAMS, MAYBE IT'S
REBALANCING, RIGHT, THE
PORTFOLIO.
>> THANK YOU FOR THESE WONDERFUL
PRESENTATIONS. THIS IS AN AREA
NEAR AND DEAR TO MY HEART. THE
CURRENT LANDSCAPE IS A LITTLE
BIT FRIGHTENING FOR DIVERSITY.
I WILL SAY THAT THE WORK THAT
YOU'RE DOING IS VERY HEARTENING
IN THAT WAY, SEE THAT THE NIH IS
INTERESTED IN THIS AREA. AND I
USED NIH'S INTEREST IN DIVERSITY
AS A FLAG I FLY IN A WAY THAT
YOU CAN SAY THAT DIVERSITY HAS A
SPECIFIC SCIENTIFIC PURPOSE AND
IS IMPORTANT TO OUR NATION AND
SO IT IS SOMETHING THAT WE MUST
PURSUE IN ORDER TO BE
SUCCESSFUL. AND SO, AGAIN, VERY
HEARTENED BY THE COMMITMENT
THAT'S THERE. THAT SAID, I
GUESS I HAVE TO ISSUE THIS
CHALLENGE IN THE SENSE THAT I'M
AT INSTITUTIONS, WE ALL SEE
INSTITUTIONS NATIONALLY
INCLUDING OUR INDUSTRIAL
PARTNERS WHEN WE TALK ABOUT THE
GOOGLES AND THE MICROSOFTS, ET
CETERA, WHO ARE MOVING AWAY VERY
QUICKLY AND VERY DISHEARTENING
THAT DIVERSITY IS VALUABLE AND
HAS A BUSINESS CASE AND IS
SOMETHING WE SHOULD BE PURSUING
NOT ONLY FOR THAT BUSINESS CASE
BUT ALSO THAT EQUITY. SO I
GUESS MOVING TO THE QUESTION,
KIND OF PIGGYBACKING ON WHAT
DR. WING FIELD WAS, I THINK
THERE'S REALLY IMPORTANT.
THAT WE DO TRACK THESE DIVERSITY
STATIS
STATISTICS. I THINK IT'S
IMPORTANT THAT WE CONTINUE TO
CARVE OUT WITH THE NIH'S AGAIN,
VERY SCIENTIFICALLY SUPPORTED
INTEREST AND DIVERSITY, MAKE
SURE OUR K99S DO HAVE DIVERSITY
STATISTICS AND SHOW WHAT THE
SUCCESSES OF THOSE INDIVIDUALS
ARE BECAUSE AS OUR COUNTRY
CONTINUES TO DIVERSIFY IF WE DO
NOT BRING EVERYBODY TO BRAER
BEAR WE WILL MISS SOME OF THE
BRILLIANT INDIVIDUALS THAT ARE
GOING TO CREATE THE
BREAKTHROUGHS OF TOMORROW.
AGAIN, IT'S BEEN GREAT TO SEE
THE COMMITMENT TO THAT AND THE
PRESENTATIONS THAT HAVE BEEN
THUS FAR. JI THINK WE REALLY
NEED TO DOUBLE DOWN.
ONE QUICK SUGGESTION IF I MAY ON
THE CURE PROGRAM AND SOME OF
THESE OTHERS WHERE WE HAVE A LOT
OF OTHER APPLICATIONS AND
OBVIOUSLY WE CAN'T TAKE
EVERYBODY. WHEN I WEAR ONE OF
MY HATS I'M A NEUROSURGEON,
THERE IS THIS PROGRAM THEY HAVE
WITH NIDS THAT HAS BEEN
SUCCESSFUL IN TRAINING
NEUROSCIENTISTS. ONE OF THE
BIGGEST SUCCESSES IS MOST OF
THEM CANNOT BE AWARDED THE MONEY
BUT EVERYBODY THAT APPLIES GETS
PUT IN PART OF THIS COHORT OF
INDIVIDUALS WHO CONTINUES TO GET
TRAINING ON GRANT APPLICATIONS,
MENTORING ON SPECIFIC AIMS AND
THEY'VE BEEN ABLE TO SHOE THAT
NOT ONLY AWARDEES HAVE BECOME
SUCCESSFUL AS NEUROSURGEON
SCIENTISTS BUT ALSO THE
APPLICANTS. I AM WONDERING IF
WE CAN CONTINUE, TRACK THOSE
PEOPLE THAT ARE APPLYING AND
MAKE THOSE PART OF A VIRTUAL
COHORT THAT WE CONTINUE TO
MENTOR.
>> SURE AND WE SEE THE SAME
THING IN OUR K99 DATA TO THE
POINT WHERE IT'S A JOKE. WE
HAVE THE EARLY SCIENTIST
PROGRAM. I DON'T KNOW IF YOUR
AWARE OF THIS BUT IT INCLUDES
SOME NEURO SERVICE AS WELL AND
IT TAKES A LOT OF IDEAS AND
TRIES TO BUILD A COHORT. I
WANTED TO RETURN TO YOUR EARLIER
POINT. ONE THING WE HAVE
OBSERVED AND NOTED THE ANECDOTAL
EXPERIENCE IS GRANTS LIKE K99
FOR EXAMPLE, IT'S ALMOST THAT
YOU ARE IN A LAB WHERE PEOPLE
APPLIED AND GOT K99S BEFORE.
YOU'RE GOING TO APPLY FOR A K 99
IF YOUR MENTOR IS WELL-VERSED IN
THAT. THAT IS HARD TO
TRANSPLANT. THE REASON WE'RE
NOT GETTING A MORE DIVERSE POOL
OF APPLICANTS IS THAT THAT
TRADITION IF YOU WILL, DOES NOT
EXIST IN THOSE INSTITUTIONS AND
WE'RE WORK WITHIN THE PROGRAM TO
TRY TO HELP TRANSPLANT SOME OF
THOSE TRADITIONS BUT, YOU KNOW,
PARTNERSHIPS BETWEEN ESTABLISHED
INSTITUTIONS LIKE YOUR OWN,
INSTITUTIONS THAT DO NOT HAVE
THAT HISTORY OF APPLYING FOR
THESE MECHANISMS WOULD BE
FABULOUS AND I WOULD LIKE TO SEE
THE CANCER CENTERS HELP THEIR
COMMUNITY PEERS APPLY FOR K99S.
THAT'S JUST ONE EXAMPLE.
>> I WAS JUST GOING TO SAY ONE
PIGGYBACK THING, I WAS GOING TO
SAY THIS IS A PHENOMENAL EXAMPLE
THAT DOESN'T COST A TON OF MONEY
BUT I WOULD RAISE A HAND IS ONE
OF THE PEOPLE IT BENEFITTED
GREATLY.
>> THAT'S ACTUALLY WHAT I WAS
GOING TO SAY. WE ARE FAMILIAR
WITH THE EARLY ADVANCEMENT
PROGRAM, THIS IS A PROGRAM THAT
IS AN NCI-WIDE ACTIVITY.
MANAGED BY OUR CENTER. AND THE
GOAL IS THAT THE APPLICANT
SUBMIT AND PROVIDE MENTORSHIP
AND HELP THEM TO SUBMIT A
COMPETITIVE APPLICATION. MAYBE
WE CAN DEVELOP A SIMILAR
PROGRAMS FOR FELLOWSHIP AND
DEVELOPMENT AT NCI AND ALSO THE
MODEL THAT DR. RATHMELL
MENTIONED. MAYBE WE CAN PARTNER
WITH THE NCR AND THOSE THAT THAT
HAVE COMPETITIVE SCORES THAT WE
CANNOT FUND THEM, THAT THEY ARE
READY TO SUPPORT THEM. THIS CAN
BE A MODEL THAT WE CAN DISCUSS
>> I JUST WANTED TO COME BACK TO
THE INSTITUTIONS THAT MIGHT BE
MORE PREPARED ALREADY VERSUS
THOSE THAT MAY OR MAY NOT. I
THINK, YOU KNOW, A TON OF
INVESTMENT HAS BEEN MADE, YOU
KNOW, THE MINORITIES AND THE
INSTITUTIONS TO BUILD
INFRASTRUCTURE APPROPRIATELY.
WE STILL HAVE PATHWAYS TO GO, I
UNDERSTAND THAT. BUT I THINK
THERE COULD BE SOME
OPPORTUNITIES TO RETHINK THE
PORTFOLIO AND THE TYPES OF
PROGRAMS. I THINK, YOU KNOW,
LAB-BASED RESEARCH TENDS TO BE
MORE EXPENSIVE THAN DIGITAL
RESEARCH. RIGHT? SO WHY CAN'T
WE THINK ABOUT FOCUSING PROGRAMS
SPECIFICALLY IN THOSE AREAS?
AND I DO AGREE, LEVERAGING THE
INFRASTRUCTURE, PARTICULARLY THE
ADMINISTRATIVE COMPONENTS OF
RUNNING THESE TYPES OF PROGRAMS,
AT THE CANCER CENTERS OR AT THE
LARGER INSTITUTIONS. WHERE I
THINK WE MAY HAVE TO THINK
OUTSIDE THE BOX BECAUSE I THINK
WE'RE ALL READY BUT WE HAVE TO
CONSIDER WHERE CAN WE GET THE
GREATEST RETURN ON INVESTMENT?
AND ALSO ARE WE THINKING ABOUT
THE FUTURE OF SCIENCE? RIGHT?
AND I AGREE WITH ANN WE ARE IN
THE AGE OF DATA AND SO I WOULD
REALLY LOVE TO SEE MORE PROGRAMS
THAT ARE REALLY BRINGING, RIGHT,
EVERYONE, RIGHT, UP TO SPEED.
AS TO WHERE WE ARE IN TERMS OF
DATA ANALYSIS, INFORMATICS AND
ADVANCED DIGITAL TECHNOLOGY SO
JUST A FEW COMMENTS. YEAH.
>> IT STRIKES ME THAT YOU HAVE A
LOT OF DATA TO SAY WHAT WERE THE
PARTICULARS OF SUCCESS. AND MY
ASSUMPTION IS IS THAT A LOT OF
THAT IS GOING TO BE BORN AT THE
HIGH SCHOOL AND COLLEGE LEVEL.
BECAUSE LEARNING, LET'S SAY, AI
OR NOVEL TECHNIQUES, WHEN YOU'RE
IN MEDICAL TRAINING OR IN YOUR
POSTDOC MAY BE TOO LATE AND YOU
MAY NEED FUNDAMENTALS THAT WERE
TAUGHT IN COLLEGE OR MAYBE AT
THE HIGH SCHOOL LEVELS. I
REALLY ENCOURAGE TO LOOK AT THAT
DATA AND MAYBE BOLSTER TRAINING
EARLIER AND FUNDING TRAIN
EARLIER IN THE FUNDING PROCESS
BECAUSE I THINK IT WILL BEAR
FRUIT DOWN THE LINE.
>> THANK YOU FOR THAT COMMENT.
I DO WANT TO SAY I THINK A TREND
A COMMON ELEMENT WE SEE FOR
SUCCESS FOR FELLOWS IS
MENTORSHIP. THAT COMES FROM YOU
AND OTHERS. A MENTORSHIP AND
ENCOURAGING THAT IS SOMETHING
THAT, YOU KNOW, YOU SHOULD THINK
ABOUT, YOU SHOULD DO IS A THEME
WE SEE WITHIN THE KCURE AND ALL
THE PROGRAMS. THAT'S A STRONG
COMMON ELEMENT OF SUCCESS.
>> AND I WILL ALSO MENTION AGAIN
THE R 25, YES. IT STARTS FROM
MIDDLE SCHOOL, HIGH SCHOOL AND
THE TEACHERS. WE HAVE A COUPLE
OF R 25S THAT WERE FOCUSED ON
THIS AND THIS IS WHY WE COULDN'T
SUPPORT THEM. SO HOPEFULLY WE
CAN MORE SUPPORT FROM THE R 25
PROGRAM AND SO WE CAN SUPPORT
MORE AND INVEST IN EARLY
INTERVENTIONS.
>> GREAT. WONDERFUL SET OF
PRESENTATIONS AND GREAT
DISCUSSIONS, THANK YOU, ALL.
>> (APPLAUSE).
>> SO WE'VE EATEN ABOUT TWO
MINUTES INTO OUR COFFEE BREAK.
I WOULD ASK EVERYONE TO BE BACK
AROUND 11:33 IN YOUR SEATS IN SO
WE CAN START PROMPTLY AT 11:35.
GREAT
WE'RE GOING TO GO AHEAD TO THE
NEXT PRESENTATION WHICH IS
CHILDHOOD CANCER DATA
INITIATIVE. THIS NCI'S
DR. BRIDGET WIDEMAN AND ED, SARA
LAER RI, ATTENDING PHYSICIAN AND
MEDICAL DIRECTOR. PEDIATRIC
BRAIN TUMOR PROGRAM. UNIVERSITY
OF WASHINGTON SCHOOL OF MEDICINE
IN SEATTLE AND DIANE THOMAS.
OPERATIONS DIRECTOR.
ANATOMIC PATHOLOGY, NATIONWIDE
CHILDREN'S HOSPITAL IN COLUMBUS.
>> THANK YOU SO MUCH FOR THE
INVITATION TO PRESENT AN UPDATE
ON NCI'S DATA INITIATIVE. IT
STARTED IN 2020, AND I DON'T SEE
THE SLIDES ANYMORE, DO YOU SEE
THEM? LET ME SEE. I DON'T SEE
IT ON THE SCREEN HERE ANYMORE.
BUT IT STARTED IN 2020. AND
SINCE THEN A LOT OF PROGRESS HAS
BEEN MADE. AND DR. RATHMELL
SUGGESTED FOR TODAY SO PRESENT
YOU WITH SOME OF THE PROGRESS IN
HOW THE CCCDI HAS IMPACTED
RESEARCH THAT HAS IMPACTED
PEDIATRIC PATIENTS OF CANCER.
THIS IS A COMBINED PRESENTATION
OF MYSELF, ON BEHALF OF
DR. RAYMOND AND DR. DIANA THOMAS
AND SARA LEERY. I WILL GIVE AN
UPDATE AND THEN THE OTHER
DOCTORS WILL TALK ABOUT THE WORK
ON PEDIATRIC CENTRAL NERVOUS
SYSTEM TUMORS AND I WILL END THE
PRESENTATION WITH AN OVERVIEW
AND UPDATE ON THE RARE CANCER
INITIATIVE. I THINK THE CARTOON
ON THE RIGHT-HAND SIDE REALLY
MOST BEAUTIFULLY SHOWS WHAT THE
CCDI IS ABOUT. TO BUILD A
COMMUNITY AROUND RESEARCH DATA
WITH THE ASPIRATIONAL GOAL TO
LEARN FROM EVERY PATIENT WITH
CANCER BUT ALSO TO BENEFIT EVERY
PATIENT ULTIMATELY. WE HOPE TO
DO SO BY GATHERING DATA FROM
EVERY CHILD, CREATING A NATIONAL
STRATEGY FROM DIAGNOSIS TO
TREATMENT AND DEVELOP A PLATFORM
AND TOOLS OF CLINICAL AND
RESEARCH DATA TO IMPROVE
TREATMENT QUALITY OF LIFE AND
SURVIVORSHIP AND VERY
IMPORTANTLY BY ENGAGING THE
ENTIRE CHILDHOOD CANCER CARE AND
RESEARCH COMMUNITY. THE CCDI
HUB IS A VERY IMPORTANT ASPECT.
THIS PROVIDES A PORTAL FOR
RESEARCHERS BUT ANYONE
INTERESTED IN LOOKING AT THE
PEDIATRIC CANCER DATA THIS
INFORMATION AND YOU SEE THE
STATS HERE HAS VERY, VERY MANY
DIFFERENT TYPES OF DATA THAT ARE
AVAILABLE TO RESEARCHERS TO
ANALYZE, TO PROVIDE A SOURCE FOR
NEW DISCOVERIES THAT MAY IMPACT
LIVES DOWN THE ROAD. THE
MOLECULAR CHARACTERIZATION
INITIATIVE IS AN EFFORT FOR
NATIONAL STRATEGY FOR
APPROPRIATE CLINICAL AND
MOLECULAR CHARACTERIZATION
IDEALLY FOR EVERY CHILD WITH
CANCER. THE CCDI PROVIDES STATE
OF THE ART MOLECULAR
CHARACTERIZATION FOR UP TO THREE
THOUSAND, THAT'S NOT ALL OF THE
CHILDHOOD CANCER PATIENTS. AND
IN ADDITION, THERE'S A CLINICAL
ANNOTATED BIOBANK FOR FUTURE
RESEARCH FOR THE REMAINING
TISSUE. THIS IS A COLLABORATIVE
EFFORT BETWEEN THE NCI, THE CCDI
AND THE ONCOLOGY PRODUCT.THERE'S
A GROUP CALLED PROJECT EVERY
CHILD.
AND AS YOU CAN SEE ON THE
CARTOON A CHILD WITH A NEWLY
DIAGNOSED CANCER CAN ENROLL ON
THE MOLECULAR PROTOCOL AND
UNDERGO STATE OF THE ART
SEQUENCING OF THE TUMOR, ALSO
GERMLINE TESTING, VERY
IMPORTANTLY THE RESULTS ARE
RETURNED WITHIN TWO TO THREE
WEEKS OF SUBMISSION OF THE
SAMPLE TO THE TREATING
PHYSICIAN. THIS IMPACTS
DIAGNOSIS AND TREATMENT AS YOU
WILL SEE FROM THE OTHER DOCTORS
IN A MOMENT. ALL OF THIS DATA
INCLUDING PATHOLOGY DATA AND
CLINICAL DATA THAT COG COLLECTS
GOES INTO THE DATA SYSTEM. THE
CCDI SYSTEM AND IS AVAILABLE FOR
ANALYSIS THE CCDI WAS INTRODUCED
IN 2022 AND SINCE THEN MORE THAN
3,000 PEDIATRIC BRAIN TUMORS
HAVE ENROLLED. RARE TUMORS AND
YOU WILL SEE THE NEXT STEPS WILL
BE RELAPSE TUMORS AND THERE HAS
BEEN A LOT OF WORK GOING INTO
RELAPSE OF REMAINING SAMPLES. I
WILL NOW HAPPENED IT OVER TO
DOCTORS THOMAS AND LAER RI TO
DISCUSS THE TUMORS AND SARA AND
DIANA LET HE KNOW AS I SHOULD
ADVANCE YOUR SLIDES.
>> THANK YOU FOR LETTING ME SHOW
YOU THE INITIATIVES. WE HOPE TO
HIGHLIGHT HOW NCI HAS IMPACTED
THE ABLE TO APPROPRIATELY SDIEG
YOUNG PEDIATRIC PATIENTS AS WELL
AS GUIDE CLINICAL TRIAL DESIGN.
NEXT SLIDE, PLEASE. ONE BACK,
PLEASE. CAN YOU PLEASE REVERSE
ONE SLIDE?
>> SURE.
>> THANK YOU THE COG IS ONE OF
THE CLINICAL TRIAL NETWORKS
INCLUDING 200 HOSPITALS
INCLUDING CANADA AND NEW ZEALAND
AND THIS MAINTAINS A CHILDHOOD
CANCER REGISTRY. PATIENTS
CONSENT AND ENROLL FOR
PARTICIPATION IN THE NCI. NEXT
SLIDE, PLEASE. THE DATA WE ARE
GOING TO PRESENT TODAY INCLUDES
2,170 PARTICIPANTS WITH CNS
TUMORS THAT ENROLLED ON NCI
BETWEEN THE LAUNCH IN MARCH OF
2022 UNTIL THE COG CLINICAL DATA
FREEZE THAT OCCURRED IN DECEMBER
2023 OF THESE SUBJECTS THAT
ENROLLED ABOUT HALF OF THESE
PATIENTS WERE ENROLLED ON THE
RIGHT. YOU CAN SEE THAT LARGER
INSTITUTIONS AND THE OTHER HALF
WERE INSTITUTIONS WITH MUCH
LOWER ENROLLMENTS AND THE CNS
COHORT HAS CONTINUED TO GROW AND
NOW INCLUDES OVER 3,000
PATIENTS. NEXT, PLEASE.
APPROXIMATELY 90% OF NCI
PARTICIPANTS LIVE IN THE UNITED
STATES. AND THIS MAP HIGHLIGHTS
THE GEOGRAPHIC DISTRIBUTION OF
U.S. PARTICIPANTS. EACH SMALL
WHITE DOT HERE IS AN INDIVIDUAL
PARTICIPANT AND THE LARGER
COLORED DOTS REPRESENT THE COG
AFFILIATED HOSPITALS THAT ENROLL
THE PATIENTS. AND IT'S
INTERESTING TO SEE THE PATTERNS
OF PARTICIPANTS IN MORE RURAL
AREAS TRAVELLING TO RECEIVE CARE
AND ENROLL IN NCI. NEXT,
PLEASE. THE CNS COHORT HAS A
MEDIAN AGE OF CLOSE TO 9 YEARS
WITH A SLIGHTLY MALE
PREDOMINANCE AND RACE AND
ETHNICITY ARE SUMMED UP ON THE
RIGHT FOR PARTICIPANT WHO IS
ENROLLED AT U.S. COG SITES AND
ARE REMARKLY SIMILAR TO CENSUS
RACE AND ETHNICITY DATA.
NEXT, PLEADSSE. THIS IS A
BREAKDOWN OF THE CATEGORIES WITH
THE THESE. AND THE CLINICAL
TRIALS HAVE BEEN AVAILABLE FOR
MANY OF THESE PATIENTS HOWEVER,
IN ADDITION, THERE ARE ALSO MANY
RARE TUMORS IN THE NCI COHORT.
NEXT, PLEASE. SO TO PRACTICE
PEDIATRIC PATHOLOGY IN 2024, WE
MAKE AN INTEGRATED DIAGNOSIS AND
THESE ARE ALL PERFORMED IN A
CERTIFIED SETTING AND INCLUDE
DNA METHYLATION, DNA SEQUENCING
AND FUSION PANEL. ALL OF THE
PATIENTS, THE CNS PATIENTS WHO
HAVE RECEIVED NCI TESTING TO
DATE HAVE RECEIVED CLINICAL
REPORTS WITH AT LEAST ONE
CLINICALLY MEANINGFUL RESULT
THAT I TRY TO SUMMARIZE INTO A
SINGLE SLIDE HERE BY THE MAIN
POINT IS THE BROAD
CHARACTERIZATION DONE THROUGH
NCI ALLOWS US TO NOT MISS RARE
DIAGNOSES THAT FOR EXAMPLE
REQUIRE METHYLATION PROFILING
FOR DEFINITIVE CLASSIFICATION.
WHILE ALSO FURTHER REFINING
DIAGNOSES FOR ACCURATE RISK
STRATIFICATION AND THERAPY
SELECTION. NEXT, PLEASE. APART
FROM THE SEMITIC DIAGNOSTIC
TESTING NCI INCLUDES GERMLINE
TESTING FOR ADDITIONAL SCREENING
FOR PATIENTS AND THEIR FAMILIES.
APPROXIMATELY 12% OF PATIENTS
TESTED SO FAR HAVE BEEN FOUND TO
HAVE GENETIC PREDISPOSITION
INVOLVING 49 DIFFERENT GENES AND
EVEN THE MOST COMMON GENES HAVE
GERMLINE MUTATIONS INDICATE
THING BROAD TESTING APPROACH IS
IMPORTANT TO IDENTIFY MANY OF
THESE GENES AND MORE FOCUSSED
TESTING THROUGH IMMEW IN THIS
CASIC CHEMISTRY WOULD HAVE
MISSED THESE RESULTS.
NEXT, PLEASE. THE NCI CNS DATA
ALSO INCLUDES SITE FOLLOW UP ON
PARTICIPANTS. AND AS YOU CAN
SEE A LARGE PROPORTION OF SITES
HAVE CONFIRMED THAT NCI TESTING
HAS HELPED REFINE THEIR
DIAGNOSIS AND ON THE SEQUENCING
RESULTS. NCI RESULTS ARE ALSO
BEING USED FOR CLINICAL TRIAL
ENROLLMENT AND ABOUT 7% THESE
NUMBERS INDICATE IN PART THE
VERY LARGE COHORT OF CHILDREN
INCLUDED IN CNI WITH RARE
DIAGNOSIS FOR WHICH TRIALS ARE
NOT AVAILABLE AND AS WE KNOW
CURRENTLY WE ARE IN A PERIOD OF
TRANSITION IN WHICH MOLECULAR
INFORMATION IS BEING
INCORPORATED INTO TRIAL DESIGN.
AND WITH THAT, I WILL HAND IT
OVER TO DR. LEARY TO DISCUSS THE
USE OF THESE DATA AND CURRENT
AND FUTURE CLINICAL TRIAL
DESIGN.
>> THANK YOU VERY MUCH FOR
HAVING ME AND SO I'M GOING TO
SPEAK BOTH AS A CLINICAL
TRIALIST AND I WORK ON THE CNS
COMMITTEE IN ONCOLOGY TO DEVELOP
A COHORT OF TRIALS FOR TUMORS
AND ALSO AS A PRACTICING
CLINICIAN IN MY OWN BRAIN TUMOR
CLINIC AT SEATTLE'S CHILDREN.
MED YOU LOW BLASTOMA IS ONE OF
THE LARGEST PROPORTION OF TUMORS
AND THE MOST COMMON MALIGNANT
TUMOR IN CHILDREN AND A PERFECT
EXAMPLE OF WHY WE NEED THIS
TESTING FOR BOTH CLINICAL
DIAGNOSES AND CLINICAL TRIAL
DESIGN.
WE NOW UNDERSTAND THAT THIS
TUMOR IS FOR DISTINCT MOLECULAR
GROUPS WHICH REQUIRE TESTING TO
CHARACTERIZE AND BEYOND
DIAGNOSIS THE REGULAR TESTING IS
NEEDED FOR RISK STRATIFICATION.
MEANING SELECTING PATIENTS
THAT -- WHERE WE CAN SAFELY
REDUCE CYTOTOXIC THERAPY AND THE
LONG-TERM IMPLICATIONS OF TOXIC
THERAPY AND SIDE EFFECTS AND
ALSO HIGH RISK GROUPS WHERE WE
NEED TO GIVE THE INTENSIVE
THERAPY TO ACHIEVE CURE AND SO
IF YOU CAN MOVE TO THE NEXT
SLIDE I WILL SHOW THE EXAMPLE OF
WHAT WE DO WITH MED YOU LOW
BLASTOMA FOR RISK
STRATIFICATION. WE USE CLINICAL
RISK FACTORS AS WELL AS
MOLECULAR RISK FACTORS TO
PERFECTLY CATEGORIZE TUMORS FOR
BRAIN INTENSIVE THERAPY. FOR
THE GROUP, IF YOU CAN ADVANCE
THE SLIDES, PLEASE, THE DNA
METHYLATION TESTS IS THE TEST
THAT BEST DESCRIBES THE FOUR
GROUPS. SEQUENCING IS USED AND
ALL OF THIS INFORMATION IS
REQUIRED TO MAKE A DIAGNOSIS.
AND APPROPRIATELY RISK STRATIFY
PATIENTS FOR THERAPY OF MED YOU
LOW BLASTOMA WHETHER ON OR OFF
TRIAL. AND WE HAVE THE CURRENT
TRIALS THAT WE HAVE IN THE
CHILDREN'S ONCOLOGY GROUP. WE
HAVE THE MED YOU LOW BLASTOMA
OPENED FOR LOW AND AT RISK. AND
THERE ARE TWO STUDIES FOR HIGH
RISK DISEASE. AND SO THIS IS
CERTAINLY THE MOST COMPLICATED
RISK STRATIFICATION AND WE HAVE
THEREFORE REQUIRED MOLECULAR
CHARACTERIZATION PARTICIPATION
BECAUSE IT REALLY IS THE ONLY
TEST TO GET CONSISTENT BROAD
INFORMATION THAT WE NEED FOR
DESIGN. WHAT I WILL POINT OUT
IS THAT THE CHILDREN THAT WE SEE
IN THE FIRST MONTHS DID NOT GO
ON TRIAL. THE TRIALS WEREN'T
YET OPEN WHEN WE OPENED THE NC I
BUT WE SEE BASED ON THOSE
NUMBERS THAT EVEN IN THE FIRST
YEAR MORE THAN HALF OF THE
CHILDREN ARE USING THE NCI FOR
THEIR CLINICAL TESTING AND THEY
WILL EXPAND AS MORE TRIALS ARE
AVAILABLE AND AS MORE SITES
REALIZE WHAT A VALUE IT IS TO
THEM. IN OTHER TRIALS THAT WE
HAVE OPEN, ARE LESS COMPLICATED
BUT NO LESS RELIANT ON THE LACK
OF CHARACTERIZATION AND BOTH
HIGH GRADE AND LOW GRADE WE HAVE
TRIALS OF KINASE INHIBITOR
THERAPY THAT ARE OPEN AND THESE
REQUIRE BOTH POSITIVE AND
NEGATIVE SELECTIONS OF THE
PRESENCE OR ABSENCE OF SPECIFIC
GENES WITHIN BOTH HIGH AND LOW
GRADE GLEE OWE MA. NEXT SLIDE,
PLEASE.
ANOTHER DISEASE THAT I WOULD
LIKE TO SPEAK ABOUT UNLIKE MED
YOU LOW BLASTOMA. IN DIFFUSE,
THIS IS ONE OF THE LAST
REMAINING TRULY INCURABLE
CANCERS. WE KNOW IT'S DEFINED
BY A MUTATION IN THE HIS TOME
GENE, THAT INFORMATION CAME FROM
AUTOPSY STUDIES IN THE FAST BUT
ADVANCING SURGICAL TECHNIQUE
EVEN WITH THESE TUMORS THAT CAN
OFTEN BE DIAGNOSED NOW WITH
MOLECULAR CHARACTERIZATION AND
BIOPSY AT DIAGNOSIS. AND WE SEE
THROUGH THE NCI THAT WE
ACTUALLY, THIS IS THE MOST
COMMON HIGH GRADE GLIOMA THAT WE
SEE IN PEDIATRICS AS EXPECTED
AND THE -- WE ALSO UNFORTUNATELY
SEE AS WE START TO GET FOLLOW UP
DATA NOW THAT THE SURVIVAL IS
SMALL AS WE KNOW WITH OVER HALF
OF THE CHILDREN IN THE FIRST
YEAR OF DIAGNOSIS SUCCUMBING AND
THE REST IN YEAR THREE AND ALL
THE TUMORS HAVE ADDITIONAL
MUTATIONS AND THOSE MUTATIONS
ARE TARGETABLE WITH THERAPIES
THAT ALREADY EXIST FOR OTHER
DISEASES. THE CURRENT STUDIES
WE HAVE OPEN ARE ACTUALLY FOR
LESS THAN 5% OF THIS DIAGNOSIS.
WE HAVE THE TRIAL OPEN FOR V 600
THERAPY AND WE DO SEE THAT THE
MUTATIONS CO-OCCUR WITH THE
DIFFUSE GLIOMA BUT WE ALSO SEE
OTHER MULTIPLE MUTATIONS WITHIN
THE PATHWAY WHICH ARE
THERAPEUTIC INDICATIONS. IF YOU
ADVANCE TO THE NEXT SLIDE. THIS
IS NOT COMPREHENSIVE BUT MY OWN
INITIAL ANALYSIS AS WE LOOK AT
THE RESULTS FOR NCI BUT THERE
ARE MULTIPLE OTHER MUTATIONS
THAT OCCUR IN THE 5-10% RANGE
WHICH ALL HAVE THERAPEUTIC
IMPLICATIONS. ONE OF THE THINGS
THAT WAS PARTICULARLY
INTERESTING TO ME IS THAT WE SAW
EFFUSIONS IN 7-8 PATIENTS WHICH
ARE CLEAR IMPLICATIONS TO
THERAPEUTICS AND THAT'S
IMPORTANT TO ME AS A CLINICIAN
BECAUSE THAT'S NOT EVEN A TEST
WAS ROUTINELY RECOMMENDED IN
HIGH GRADE GLIOMA BUT WE DO
IDENTIFY THE OUTLIERS AND THESE
TEST RESULTS CERTAINLY MAY
MATTER TO THESE PATIENTS AND AS
DR. THOMAS MENTIONED, ACROSS
PEDIATRIC TUMORS WE SEE THE
APPLICATIONS FOR THE PATIENT AND
THEIR FAMILIES INCLUDING THE
PATIENTS WHICH HAVE CHECKPOINT
AND IMMUNOTHERAPY. SO THIS IS
REALLY MADE US THINK AND NEXT
SLIDE, PLEASE, ABOUT
IMPLICATIONS FOR HOW WE DIAGNOSE
AND TREAT CHILDREN AND HOW WE
DESIGN CLINICAL RESEARCH TO
ASSESS NOVEL THERAPEUTICS.
THERE ARE STUDIES BUILDING ON
THIS NOW TO LOOK AT THE
PREDISPOSITION AND THEIR
FAMILIES. WE'RE LOOKING TO
CONNECT TO OTHER ROBUST CLINICAL
DATA SOURCES. I CERTAINLY HOPE
THERE IS MORE GENOMIC DISCOVERY
TO COME AND IT DOES GIVE US AN
OPPORTUNITY TO THINK MORE ABOUT
CLINICAL RESEARCH IN ULTRA RARE
TUMOR POPULATIONS. WITH THAT, I
WILL PASS IT BACK OVER TO
DR. WIDEMAN TO TALK ABOUT THAT
AND I WOULD LIKE TO THANK THE
TREMENDOUS AMOUNT OF
COLLABORATION. SORRY, ONE MORE
SLIDE AND HIGHLIGHTING A FEW OF
THE PEOPLE THAT HAVE HELPED
DR. THOMAS AND ME BOTH FROM THE
STATISTICIAN SIDE AND TO PUT
TOGETHER SOME OF THE FIGURES AND
THE DATA PRESENTED TODAY. THANK
YOU
YOU.
>> THANK YOU SO MUCH DIANA AND
SARA AND YOU MADE IT SO CLEAR
HOW COMPLICATED THE TREATMENT IS
AND HOW MUCH MOLECULAR CHARA
CHARACTERIZATION AND NEED AND IT
WAS SAID THAT EVERY TUMOR IS A
RARE TUMOR AND IS REALLY TRUE
AND DESERVES THIS TYPE OF
CHARACTERIZATION. I WOULD LIKE
TO GIVE YOU A BRIEF UPDATE NOW
AND OUR CCDI COORDINATED
PEDIATRIC AND ADOLESCENT CARE
INITIATIVE. THIS IS BUILDING ON
WHAT SARA WAS ELUDING TO FOR
PATIENTS WHO HAVE ULTRA RARE
TUMORS. LESS THAN TWO MILLION A
YEAR AND PATIENTS WHERE THE
STANDARD OF CARE DOESN'T EXIST
WHERE CLINICAL TRIALS ARE NOT
FEASIBLE. AND WE KNOW MANY
INDIVIDUAL EFFORTS ARE ONGOING
BUT WE HAVE PROBABLY TWO OR
THREE HUNDRED ALREADY KNOWN RARE
PEDIATRIC TUMORS AND HOW DO WE
MAKE PROGRESS? SO WE ARE
DEVELOPING AS YOU NOW A CCDI
COORDINATED EFFORT THAT WILL
PROVIDE THE INFRASTRUCTURE TO
SIMULTANEOUSLY STUDY MULTIPLE
RARE TUMORS THIS WILL BE A
FEASIBILITY OF A NATIONAL
OBSERVATIONAL STUDY FOR CHILDREN
AND THOSE ADULTS WITH RARE
TUMORS LONGITUDINALLY. WHAT YOU
HEARD ABOUT THE CHARACTERIZATION
INITIATIVE. THESE PATIENT
CONSIST COME FROM INSTITUTIONS
BUT ANY INSTITUTION ANYWHERE IN
THE COUNTRY.
SO WE HOPE TO GET TO PATIENTS
WITH CANCERS THAT WOULD
OTHERWISE NOT HAVE ACCESS TO
THIS TESTING. WE WILL COLLECT
PROSPECTIVELY IMAGING AND
PATHOLOGY. THE MOLECULAR
CHARACTERIZATION WILL GO THROUGH
THE INITIATIVE THAT SARA AND
DIANA JUST PROTECTED TO YOU.
HOWEVER THERE'LL BE ALSO
RESEARCH MOLECULAR TESTING. WE
WORK A LOT ON IDENTIFYING WHAT
COMMON DATA ELEMENTS DO WE WANT
TO COLLECT ON EVERY PATIENT
ACROSS ALL OF THE COHORTS AND WE
WILL ALSO INCORPORATE PATIENT
REPORTED OUTCOMES. WE HOPE THAT
THE STATE OF THE ART CLINICAL
AND RESEARCH MOLECULAR
PROFILING.
WILL ALLOW US TO MAKE BETTER
TREATMENT RECOMMENDATIONS AND I
THINK SARA AND DIANA GAVE YOU AN
EXAMPLE OF HOW THIS WILL BE
REPRESENTED THROUGH THE
CHARACTERIZATION BUT ALSO
HOPEFULLY IDENTIFY NEW TARGETS,
INFORM NEW TREATMENT TRIALS,
WILL ALLOW FOR MEANINGFUL
COMPARISON ACROSS RARE CANCER
TYPES, POTENTIALLY BE A SOURCE
FOR EXTERNAL CONTROL FOR TRIALS
WHEN RANDOMIZATION IS NOT
FEASIBLE AND THE REGISTRY OF
STRUCTURED AND REAL WORLD DATA
WILL HOPEFULLY INFORM NEW TRIAL
DESIGNS. WE VERY RECENTLY HAD A
CCDI SUPPORTED WORKSHOP HERE AT
THE SAME PLACE WHERE WE ARE
TODAY. WE HAD MULTIDISCIPLINARY
PARTICIPATION FROM WITHIN AND
OUTSIDE OF THE COG DATA
SCIENTISTS AND CLINICIANS AND
HONED DOWN ON THESE DATA TYPES
AND I THINK CAME TO VERY GOOD
AGREEMENT OF THE DATA THAT WE
REALLY WANT FROM A DAILY EVERY
SINGLE PATIENT. WE CURRENTLY
FINALIZING THE COMMON DATA
ELEMENTS. ALSO THE PATIENT
REPORTED OUTCOME MEASURES AND
THE PROTOCOL AND HOPE TO BEGIN
ENROLLMENT ON THE STUDY IN 2025.
THE PATIENT HAS TO BE A CHILD OR
ADOLESCENT AND YOUNG ADULT
CURRENTLY DIAGNOSED WITH A RARE
SOLID TUMOR. I ALREADY
MENTIONED THESE PATIENTS WILL
HAVE ACCESS TO THE
AND WE HOPE ONCE WE ESTABLISH
FEASIBILITY THAT WE CAN EXPAND
THE STUDY TO RARE BLOOD CANCERS
IN THE FUTURE.
THANK YOU VERY MUCH FOR
LISTENING, AND BE HAPPY, THE
THREE OF US, TO TAKE QUESTIONS.
>> THANK YOU SO MUCH.
FANTASTIC PRESENTATION.
CRITICALLY IMPORTANT AREA.
DR. HAYES DIXON?
>> THANK YOU, TEAM, FOR THAT
EXCELLENT PRESENTATION.
AS PEDIATRIC ONCOLOGIST I WAS
INVOLVED IN THE FIRST MEETING
BEFORE I STEPPED DOWN TO BE ON
THIS COMMITTEE, YOU GUYS HAVE
DONE A PHENOMENAL JOB WITH WHAT
YOU HAVE.
I REMEMBER ALL THE ISSUES THAT
WE WERE TACKLING, YOU TACKLED
THEM VERY WELL.
THE TWO QUESTIONS I HAVE, NOW
THAT WE MOVED FORWARDOUT SIDE OF
THE COG WE SHOULD BE ABLE TO
FURTHER THE NUMBERS OTHER THAN
THE ONES YOU REPORTED.
HOW ARE MOLECULAR
CHARACTERIZATIONS GOING TO BE
COMMUNICATED TO INVESTIGATORS TO
GETTER INFORM THEM ON CLINICAL
TRIALS OUTSIDE OF THE COG?
HOW IS THAT GOING TO BE
COMMUNICATED?
>> THAT'S AN EXCELLENT QUESTION.
AS WE'VE BEEN DISCUSSING,
ENROLLMENT WILL BE -- WE'LL
ENSURE A PATIENT ENROLLED NEEDS
TO HAVE A DOCTOR, ONE KEY
REQUIREMENT, BECAUSE WE'LL NEED
TO MAKE SURE THAT WE CAN REPORT
THE RESULTS BACK.
FOR PATIENTS WHO HAVE A DOCTOR
WHO DOESN'T FEEL COMFORTABLE
DEALING WITH THE MOLECULAR
RESULTS, WE WILL OFFER THAT WE
CAN HELP THE PHYSICIAN OF THE
INDIVIDUAL PATIENT WITH
COMMUNICATION OF THE MOLECULAR
RESULTS, ONCOLOGY GROUP
PARTICIPANTS THAT WILL BE LESS
OF AN ISSUE BUT WE'LL MAKE SURE
THE SERVICE CAN BE PROVIDED TO A
PHYSICIAN IN A MORE RURAL AREA
AND CANNOT INTERPRET THE
FINDINGS AS WELL.
>> THE OTHER QUESTION IS, WHEN
WE STARTED THIS WE THOUGHT $250
MILLION WAS A LOT OF MONEY BUT
WHEN WE GOT INTO THE AMOUNT OF
EFFORT AND TIME TO COLLECT THIS
DATA, THIS IS A MASSIVE, MASSIVE
AMOUNT OF DATA THAT HAS TO BE
COLLECTED.
I APPRECIATE THAT.
DO YOU THINK THAT -- NEED THIS
GROUP TO HEAR IT -- THAT THE
REMAINING FUNDING IS SUFFICIENT
TO ACCOMPLISH THE GOALS YOU
OUTLINED?
>> THAT'S ANOTHER GREAT
QUESTION.
WE HAVE, YOU KNOW, VERY
DIFFERENT OPINIONS.
THIS WAS GOING TO BE CO-LED FROM
THE INTRAMURAL SIDE, WE WOULD
LOVE TO SEE MANY ENROLLMENTS AND
HAVE THIS PROBLEM.
THE CANCER STUDY WILL BE QUITE
RARE, IF WE WERE ABLE TO, THAT
MIGHT BE A GOOD PROBLEM TO HAVE.
OTHERS HAVE SAID YOU'LL BE
SURPRISED, WE'LL BE ENROLLING
MORE PATIENTS, AND I THINK IT'S
SOMETHING WE'LL HAVE TO MONITOR
VERY CLOSELY BECAUSE, YOU'RE
RIGHT, THE DATA ABSTRACTION
WE'RE PLANNING FROM EVERY
PATIENT DOES TAKE TIME.
IF WE WERE TO GET EVERY PATIENT
WITH A RARE TUMOR IT COULD
BECOME A PROBLEM.
>> THANK YOU.
>> YOU SAID BRAIN TUMOR, I HAD
TO JUMP IN.
THANK YOU FOR THE WONDERFUL TALK
THAT YOU GAVE ON GLIOMA.
IN THE ADULT WORLD WE'RE NOW
MOVING MORE AGGRESSIVELY WITH
TISSUE COLLECTION, AND AFTER
LOOKING LIKE A CRAZY PERSON
TALKING IN MEETINGS ABOUT TRYING
TO GET MULTIPLE BIOPSIES,
TREATMENT BIOPSIES, BRAIN
TUMORS, THERE'S NOW MULTIPLE
PHYSICIAN STATEMENTS IN THE
ADULT BRAIN TUMOR WORLD SAYING
THE ONLY WAY TO MAKE PROGRESS IS
INTERROGATING TISSUE AND
UNDERSTANDING WHAT'S GOING ON.
THE DATA ABOUT CSF NOT
NECESSARILY REFLECTING TUMOR
GENOMICS, IN MOST OF THE CASES,
THOUGH US DID IT -- IT DOES INA
FEW.
THERE ARE HUGE ETHICAL
CHALLENGES IN CHILDREN WITH THIS
BUT TO WHERE WE'RE GOING TO BE
ABLE TO IN SELECT COHORTS, IN
PARTICULAR, AREAS START LOOKING
AT ON-TREATMENT BIOPSIES, WINDOW
OF OPPORTUNITY STUDIES IN THE
PEDIATRIC WORLD AS WELL?
>> AWESOME QUESTION.
SARAH, DO YOU WANT TO
POTENTIALLY RESPOND?
>> YEAH, ABSOLUTELY.
ONE, I DO WANT TO MAKE THE POINT
FOR THE PREVIOUS QUESTION ALSO
THE RESULTS ARE RETURNED TO
TREATING PHYSICIANS, NOT JUST
FOR THE TEAM BEING USED NOW,
THEY CAN BE USED FOR ALL OUR
STUDIES OR CLINICAL PURPOSES.
SEQUENTIAL INFORMATION, WE
STRUGGLE WITH THAT AS WELL.
ONE OF THE THINGS I THINK UP AND
COMING, THERE HAVE BEEN A FEW
PHYSICIAN -- AND PAPERS
PUBLISHED ON THIS, WHAT WE MIGHT
LEARN BY CSF IN BRAIN TUMORS.
SO THAT'S SOMETHING THAT'S VERY
IMPORTANT THAT WE'RE COLLECTING,
AND NEW TECHNIQUES INCLUDING
SOME OF THE SEQUENCING WITHIN
CSF WE DO ACTUALLY PICK UP
MUTATIONS SEQUENTIALLY AND EVEN
WITH BIOPSY YOU'RE PUTTING A
NEEDLE IN A DIFFICULT PLACE,
NONE OF THESE TUMORS -- ALMOST
NONE ARE COMPLETELY RECEPTIVE SO
WE'RE MISSING TUMOR BIOPSIES AND
HAVE FOUND IN SOME CASES WE CAN
DETECT MUTATIONS EVEN WITHOUT
CYTOLOGY POSITIVE IN THE CSF,
AND I HOPE MAKING AN INVESTMENT
IN THAT TECHNOLOGY, THINKING
ABOUT HOW TO DO THAT, LIKE WITH
NCI, WHERE IT CAN REACH ALL THE
POTENTIAL PATIENTS WHO MIGHT
NEED THAT KIND OF TESTING OR BE
ABLE TO USE IT.
>> YEAH, IT WOULD BE FANTASTIC
ALSO TO BEGIN TO THINK ABOUT
COLLECTING LIVING -- LIVE
TISSUE, WHEN AND WHERE YOU CAN
TO BUILD SORT OF A LIVING
BIOREPOSITORY TO STUDY THE
BIOLOGY OF THESE CANCERS.
I THINK THAT WOULD BE A GREAT
OPPORTUNITY AS WELL AS EXTENDING
TO SOME OF THE ADVANCED
TECHNOLOGY SINGLE CELL SPATIAL
FOR THE DATA.
BY RACE AND ETHNICITY, YOU KNOW,
DO YOU SEE DIFFERENCES IN STAGE
OF DIAGNOSIS.
IF YOU STRATIFY BY RACE AND
ETHNICITY OR OUTCOMES.
ALSO, YOU HAVE WHOLE EXOME
EXPENSING DATA ON ALMOST 2,000,
THINKING ABOUT GENETIC
SIMILARITY OR ANCESTRY ANALYSIS,
ARE YOU THINKING ABOUT THAT?
>> GREAT COMMENT.
SARAH, DO YOU WANT TO RESPOND?
OR DIANA, THE COHORT, LARGEST
FROM THE NCI?
>> OUR COHORT THAT WE'RE PUTTING
TOGETHER TO BE A RESOURCE FOR
OTHERS IN THE COMMUNITY.
YEAH, SO CANCER PREDISPOSITION
PROJECT IS GOING TO LOOK MORE AT
THE CONSTITUTIONAL GENOMICS FOR
SURE.
THAT'S NOT MY PERSONAL AREA OF
RESEARCH BUT IT'S A PROJECT ALSO
WITH THIS DATA.
I THINK ALMOST THE SKY'S THE
LIMIT IF WE CAN PUT IT TOGETHER
FOR ALL TYPES OF RESEARCHERS,
BUT SOME OF THE WORK I DO AT MY
OWN INSTITUTION IN TERMS OF
TRIAL ENROLLMENT, TRYING TO BE
INCLUSIVE, THIS IS AN EXAMPLE OF
BEING AS INCLUSIVE AS ANYTHING
I'VE EVER SEEN IN TERMS OF
DEMOGRAPHICS REPRESENTED HERE,
BOTH RURAL AS WELL AS RACIAL.
AND ETHNIC IDENTITIES.
AND I THINK PART OF IT IS IS THE
ACCESSIBILITY THE CHILDREN THAT
TRAVEL FOR TREATMENT DON'T NEED
TO TRAVEL FOR THIS KIND OF
TESTING NECESSARILY.
YOU KNOW, THE TESTING CAN BE
CENTRAL, BUT THE CHILD CAN STAY
AT THEIR INSTITUTION.
I THINK WE NEED MORE OF THAT.
I THINK I'M GOING OFF ON A
TANGENT BUT COULD THIS BE USED,
ABSOLUTELY.
THIS IS GROWING RAPIDLY, EVEN
MORE RAPIDLY THAN THE FIRST 20
MONTHS, WE'RE OVER 3,000 CASES
NOW.
MOST RECENT SIX MONTHS OF DATA
ARE BEING SUBMIT AND UPLOADED
NOW FOR AVAILABILITY.
GENOMICS GO IN EVERY MONTH, AND
CLINICAL DATA FROM THE REGISTRY
GO IN EVERY SIX MONTHS.
AND I THINK THIS IS UNIQUE IN MY
CAREER, AN OPPORTUNITY TO LOOK
AT THIS NUMBER OF PATIENTS WITH
DATA COLLECTED UNIFORMLY.
>> I TOTALLY AGREE.
KIM, IN TERMS OF THINGS WE CAN
DO AND IN TERMS OF
COMMUNICATION, YOU KNOW, ACCESS
TO THESE TYPES OF RESOURCES
ACROSS, YOU KNOW, VARIOUS
ACADEMIC ORGANIZATIONS.
JULIE?
>> IT'S A GREAT PIGGYBACK TO
WHAT I WAS THINKING.
WHAT YOU'RE DOING IS AMAZING.
IT REALLY MATTERS TO THESE
FAMILIES AND PATIENTS.
I WANT TO SAY THANK YOU FOR YOUR
WORK.
SLIDE 14 THAT YOU PRESENTED, THE
HEAT MAP FOR THE UNITED STATES,
THE NUMBER OF SUBJECTS BY ZIP
CODE, WHAT REALLY STRUCK ME IS
THAT BOSTON, SAN FRANCISCO, AND
SOME MAJOR METROS ARE NOT THE
LARGEST SOURCES OF PATIENT
SAMPLES.
PERHAPS YOU COULD HELP ME
UNDERSTAND IF YOU THINK THE
REASON FOR THE CENTERS OF
EXCELLENCE, OFTEN THOSE
PEDIATRIC PATIENTS ARE TREATED,
IS BECAUSE THE STATE IS JUST
WHERE THEY LIVE?
AND THE SECOND, ARE THESE PANELS
ACTUALLY A SUPPLEMENT TO THE
INSTITUTIONS THAT DO NOT DO
GENOMIC TESTING ON THEIR OWN.
INSTITUTIONS DO THIS IN HOUSE,
PROBABLY NOT IN ANY DATASET.
HOW DO YOU HARMONIZE THAT?
WHY I'M INTERESTED, AS A PERSON
FROM INDUSTRY, WE'RE TRYING TO
INCREASE THE NUMBER OF TRIALS WE
PURSUE FOR CHILDREN WITH CANCER.
SOME OF IT FROM OBLIGATIONS,
FROM BOTH FDA AND EUROPEAN
REGULATORS FROM PIPS AND PDARA.
WE LOOK AT CGA, PROTOCOLS, WHICH
PATIENT POPULATIONS WE SHOULD
PRIORITIZE FOR THOSE
APPLICATIONS IN THE STUDIES.
I'M CURIOUS, THE FINAL QUESTION,
IF THIS DATA WILL BE INTEGRATED
INTO TCGA WHICH INDUSTRY LEANS
ON AS THE SOURCE OF THINKING
ABOUT EPIDEMIOLOGY AND
UNDERLYING GENOMICS TO ENROLL?
>> SARAH, DO YOU WANT TO COMMENT
ON THE POTENTIAL SOURCE OF
SAMPLES AND WHO PARTICIPATES IN
THE MCI AND WHO DOESN'T?
>> YEAH, WHAT WE'RE SEEING, DR.
THOMAS, WHAT THIS IS HELPING
LIKE YOU'VE SEEN THE SITES WITH
THEIR OWN TESTING, FROM A LARGE
SITE OURSELVES, WE'RE HIGH
ENROLLING, OUR PHILOSOPHY DOING
OUR OWN TESTING, CLINICAL
RESEARCH, OURS ARE LIKE THAT.
OTHER SITES HAVE WHAT THEY NEED
FOR CLINICAL DIAGNOSIS OR DOING
THEIR OWN IN-HOUSE RESEARCH AND
PRIORITIZE THAT OVER
PARTICIPATION IN THE MCI.
I THINK WE TRIED TO SET IT UP TO
BE REASONABLE FOR SITES LIKE
THAT TO DO BOTH, WHICH IS GREAT.
THE MORE WE DO, THE MORE
RELEARN. -- WE LEARN.
IN TERMS OF INTEGRATING, TUMORS
THAT WEREN'T INCLUDED IN TCGA,
MY HOPE IS FOR PEDIATRICS THESE
PLATFORMS BECOME THE DATA SOURCE
WHERE EVERYBODY WOULD LIKE.
CRE PRESENTED THE CNS DATA, MY
OWN FOCUS IN DATA, THIS IS FOR
ALL.
GROWING IN TERMS OF BEING MORE
INCLUSIVE FOR LOTS AND LOTS OF
PEDIATRIC TUMORS.
SOME FROM INTRAMURAL --
>> SO WE HAVE TWO MORE
QUESTIONS, AND THEY ARE GOING TO
EAT INTO OUR LUNCH HOUR.
BUT THEY ARE FROM TWO
INDIVIDUALS RETIRING FROM THE
BOARD SO I WANT TO OBLIGE THEM.
WE'RE GOING TO START WITH SUSAN
AND GO TO ANN.
>> GREAT PRESENTATION, MAYBE MY
QUESTION IS EASY.
I NOTICED THERE WAS A SMALL
SUBSET OF FOLKS THAT HAD
GERMLINE INHERITED
PREDISPOSITION, SO I WAS
WONDERING HOW DOES THE GENETIC
COUNSELING ASPECT OF THAT WORK,
AND WHAT ARE THE OPPORTUNITIES
FOR CASCADE TESTING WITH
FAMILIES THAT MAY NOT OTHERWISE
HAVE ACCESS?
>> I BELIEVE FOR THE CHILDREN'S
ONCOLOGY GROUP PARTICIPANTS,
IT'S NOT THAT MUCH OF AN ISSUE
BUT WOULD LIKE SARAH OR DIANA TO
COMMENT.
I BELIEVE FOR YOUR PARTICIPANTS,
MOST OF THE SITES WOULD HAVE
ACCESS TO GENETIC COUNSELING; IS
THAT CORRECT?
>> YEAH, AND WE ACTUALLY SET UP,
THE AVAILABILITY THE SITES WOULD
HAVE, MOST OF US ARE FROM LARGER
INSTITUTION US BUT WAS SURPRISED
BY THE QUESTIONS WE'RE GETTING,
EXTREMELY HIGH LEVEL COMPLEX
QUESTIONS PERHAPS NONE OF US
KNOW THE ANSWER TO, AND NOT WHAT
DO I DO WITH THESE RESULTS,
SITES ARE ALREADY SEEKING OUT
THESE KINDS OF RESOURCES AND SO
MY IMPRESSION IS THAT THE
PEDIATRIC ONCOLOGISTS, YOU KNOW,
PRACTICING IN RURAL SITES
ALREADY HAVE BUILT A NETWORK,
SOME THROUGH TCOG, POTENTIALLY
OTHER RESOURCES TO REACH OUT.
THEY DIDN'T HAVE RAPID
TURNAROUND OF TESTING UNTIL THE
MCI.
QUESTIONS ARE MORE CUTTING EDGE
QUESTIONS, NOT THE BASIC WHAT DO
I NEED.
REMEMBER RESULTS ARE GOING BACK
TO CLINICIANS, SO THEY HAVE THAT
DOCTOR/PATIENT RELATIONSHIP,
FEWER QUESTIONS ABOUT WHAT THE
RESULTS MEAN.
>> YEAH, THERE COULD BE AN
OPPORTUNITY TO ENGAGE WITH THE
PATIENT ENGAGEMENT AND CANCER
GENOME SEQUENCING INITIATIVE,
MOONSHOT INITIATIVE, BECAUSE I
KNOW THAT GROUP IS ALSO TACKLING
SOME OF THESE ASPECTS OF RETURN
OF RESULTS AND CASCADE TESTING.
ANN, YOU'RE STANDING BETWEEN US
AND LUNCH.
>> OH MY GOD, OKAY, VERY
QUICKLY.
FIRST OF ALL, CONGRATULATIONS ON
FINALLY DEMOCRATIZING PEDIATRIC
DATA.
IT'S TAKEN US A LONG TIME TO GET
HERE.
I THANK YOU SO MUCH FOR THAT.
THE SECOND THING IN TERMS OF
RETURN OF RESULTS FOR THAT 12%
WHERE YOU'RE SEEING GERMLINE
MUTATIONS IS THAT BEING DONE
REGULARLY?
>> YES.
>> RETURN OF RESULTS, YES?
THAT'S INTERESTING.
.
YOU'RE USING GENETIC COUNSELORS.
>> IT GOES TO THE TREATING
PHYSICIAN.
>> THIS IS A TUMOR WHERE PEOPLE,
YOUNG ADULTS AND YOUNG PEOPLE
LIVE, 72% OR SO SURVIVAL RATE.
WE SET UP A TRIAL A FEW YEARS
AGO, CDM AGILE, A PLATFORM
ADAPTIVE TRIAL.
IT'S DOING VERY WELL.
I'M WONDERING IF THIS MIGHT NOT
BE AN APPROPRIATE APPROACH [
AUDIO DISTORTION ] PARTICULAR
TIME.
IT MAY BE WORTH LOOKING AT.
>> THANK YOU.
I WANT TO MENTION WE'RE VERY
INTERESTED IN THE CCDI TO FOLLOW
THESE PATIENTS, WE'RE WORKING
TOWARDS HAVING SPECIFIC COHORTS
FOR THESE PATIENTS.
I WANT TO BRIEFLY MENTION OUR
WORK IN ESTABLISHING NATIONAL OR
INTERNATIONAL TUMOR BOARDS FOR
CLINICAL AND MOLECULAR TUMOR
BOARDS FOR PATIENTS WHO MAY NOT
HAVE ACCESS TO SOMEBODY WHO
FEELS COMFORTABLE MAKING
TREATMENT DECISIONS AND
RECOMMENDATIONS, SO THAT'S
ANOTHER COMPLEMENTARY PART TO
THE RARE TUMORS INITIATIVE THAT
I JUST DESCRIBED.
WE UNDERSTAND THERE ARE MANY
EFFORTS ONGOING, REACHING OUT TO
MANY OF THE TEAMS THAT ARE CON
CONDUCTING THESE TUMOR BOARDS.
>> THANK YOU FOR THE FANTASTIC
PRESENTATION, HIGHLY IMPACTFUL.
WE'RE NOW GOING TO BREAK FOR
LUNCH.
WITH THE CCR ARTIFICIAL
INTELLIGENCE RESOURCE
OR AIR, SO YOU'LL GET A CHANCE
TO SEE HOW WE'RE COORDINATING
A.I. ACTIVITIES ACROSS NCI AS
WELL AS SPECIFIC ACTIVITIES CCR
IS DOING.
EXCUSE ME.
SO, YOU CAN SEE VISUALLY, THERE
WE ALL ARE.
AND YOU ALREADY HEARD FROM JOHN,
OUR BRIEF BIOS, I WANTED TO TALK
BRIEFLY ABOUT MY ROLE SINCE THIS
IS THE FIRST TIME SINCE I WAS
APPOINTED THAT I'VE HAD A CHANCE
TO TALK WITH THE NCAB.
I AM, AS KIM MENTIONED, THE
FIRST DEPUTY DIRECTOR FOR DATA
SCIENCE AND STRATEGY, STARTED AT
THE END OF JUNE.
AND PART OF MY ROLE IS REALLY TO
ADVISE NCI IN ALL THINGS DATA
SCIENCE AND UNDERSTAND
STEWARDSHIP, HOW WE THINK ABOUT
GOOD DATA SHARING PRACTICES,
PROVIDE SOME STRATEGIC DIRECTION
TO CBIIT, I FEEL PARTICULARLY
HONORED TO MOVE FROM BEING CBIIT
DIRECTOR A NUMBER OF YEARS AGO
TO NOW BEING AGE TO HELP PROVIDE
A LITTLE MORE STRATEGIC
DIRECTION FOR CBIIT.
THINK ABOUT HOW WE'RE GOING TO
INTEGRATE THE NIH PLANS AROUND
DATA SCIENCE INTO NCI.
SOMETHING THAT IS REALLY
IMPORTANT AS WE DO THAT, ALSO
INFORMING WHAT HHS PLANS TO DO
WITH DATA SCIENCE, WHAT HHS IS
PLANNING TO DO WITH A.I.
AND THEN PROVIDE COUNSEL ACROSS
NCI AND NIH AROUND SPECIFIC
ACTIVITIES.
THAT'S A LITTLE BIT ABOUT WHAT
I'M DOING.
A LITTLE BIT ABOUT MYSELF, AS I
JUST MENTIONED, I WAS THE CBIIT
DIRECTOR BACK IN 2013 UNTIL
2017.
THE LAST YEAR OF THAT TIME I WAS
ALSO PRIVILEGED TO BE ONE OF THE
ACTING DIRECTORS, PART OF THE
CANCER MOONSHOT WAS DOUG WAS
ACTING NCI DIRECTOR.
I LEFT NCI IN 2017 TO MOVE TO
DUKE, WHERE I WAS THE VICE CHAIR
FOR THE DEPARTMENT OF
BIOSTATISTICS AND
BIOINFORMATICS, ALSO THE CHIEF
DATA OFFICER FOR THE DUKE CANCER
INSTITUTE.
AND THEN AS YOU HEARD CAME BACK
HERE TO NCI ON JUNE 30, I'M VERY
EXCITED TO BE BACK.
SO THIS PRESENTATION IS ALL
ABOUT A.I.
I THOUGHT IT WOULD BE GOOD TO
GIVE YOU BACKGROUND WHERE A.I.
COMES FROM, WHERE AT LEAST FROM
MY PERSPECTIVE WHERE WE'RE
HEADED.
I THINK IT'S IMPORTANT TO
REALIZE THAT AS LONG AS HUMAN
BEINGS HAVE BEEN -- HAD
COGNITION AND THINKING THERE'S
BEEN DISCUSSIONS OF WHAT DO YOU
MEAN TO HAVE A MACHINE THAT
COULD REPRODUCE THE WAY WE
THINK, SO BACK IN THE 1800s A
NUMBER OF PEOPLE THOUGHT ABOUT
THIS FROM A MATHEMATICAL
STANDPOINT.
A LOT OF LOGIC MODELS CAME OUT
IN THAT POINT IN TIME.
MOVING THROUGH INTO THE
BEGINNING OF THE '60s WHEN I
WOULD SAY COMPUTERS AS WE THINK
OF TODAY WERE STARTING.
THERE WERE APPROACHES TO
THINKING ABOUT A.I. THEN, BUT OF
COURSE WE DIDN'T HAVE THE
COMPUTE CAPABILITY TO MAKE ANY
OF IT REALLY FEEL AND ACT LIKE A
PERSON.
BACK IN THE '40s THERE WAS THE
TURING TEST, CAN YOU PREDICT IF
IT'S A REAL PERSON, AND 2018
FOLKS AT GOOGLE WITH TRANSFORMER
MODELS, BERT IN PARTICULAR.
NOW WE HAVE LARGE LANGUAGE
MODELS, ChatGPT, CHANGING WAIT
WE THINK ABOUT A.I. AND THINKING
ABOUT THEM BEING RELEVANT TO OUR
DAY-TO-DAY LIFE.
SO, THAT'S KIND OF THE HISTORY
AND MAYBE A LITTLE BIT OF WHERE
WE'RE HEADING.
BUT I THINK IT'S REALLY
IMPORTANT THAT WHEN WE'RE
THINKING ABOUT A.I., ONE IS
THERE'S THIS CONCEPT OF BEING
A.I. READY.
SO, ARE THE DATA -- IS IT
SOMETHING THAT WE CAN -- WE CAN
USE THESE MODELS FOR, RIGHT?
ARE THE DATA APPROPRIATE?
DO WE HAVE GOOD DATA?
AND CAN WE USE THAT TO FEED INTO
A.I. SYSTEMS?
I THINK WHAT'S REALLY IMPORTANT
THERE -- OOPS, APPARENTLY I
MOVED THE SLIDE FORWARD.
WHAT'S REALLY IMPORTANT IN
THINKING ABOUT A.I. READY IS THE
DATA QUALITY HAS TO BE THERE,
AND IT HAS TO BE VALUABLE FOR
MANY, MANY THINGS, NOT JUST A.I.
SO, THAT'S ONE OF THE
PRINCIPLES.
ANOTHER ONE IS THINKING ABOUT
HOW DO WE MAKE SURE IN FACT THE
SYSTEMS WE BUILD, THE KINDS OF
DECISIONS THAT THEY MAKE, ARE
TRUSTWORTHY AND ETHICAL.
AND THAT'S REALLY A HUMAN
PROBLEM.
IT'S NOT AN A.I. PROBLEM.
IT'S HOW DO WE MAKE SURE WE'RE
REALLY PUTTING HUMAN BEINGS IN
THE LOOP IN DECISION MAKING.
DIVERSE WORKFORCE, WE'VE ALREADY
HAD DISCUSSIONS ABOUT THAT THIS
MORNING.
IT'S INCREDIBLY IMPORTANT AND
BOTH AROUND WHO COMES UP WITH
THE NEXT SETS OF A.I. MODELS BUT
ALSO HOW DO WE PREPARE EXISTING
WORKFORCE SO IN FACT THEY KNOW
HOW TO USE THE TOOLS THAT ARE
COMING OUT.
SO, IT'S REALLY -- THE WORKFORCE
PART IS REALLY IMPORTANT, AND
THAT'S SOMETHING THAT I'D LOVE
TO TALK MORE WITH YOU AT THE END
OF THE PRESENTATIONS.
SO, PREPARING FOR THE NEXT TWO
PRESENTATIONS, ONE IS THE
OPPORTUNITIES AROUND A.I. ARE,
ONE, HOW DO WE START TO
INTEGRATE GENERALIST A.I. MODELS
INTO EVERYTHING WE DO IN CANCER
RESEARCH?
SO, PART OF THAT, IN MY MIND, IS
THINKING ABOUT WHAT A LOT OF THE
BIG TECH COMPANIES ARE DOING
RIGHT NOW WHERE THEY ARE
GENERATING AND PUTTING A LOT OF
RESOURCES INTO NEW GENERATIVE
A.I. MODELS, NEW A.I.
ALGORITHMS.
HOW DO WE HELP THEM APPLY THAT
IN CANCER RESEARCH?
ANOTHER IS HOW DO WE JUST
COORDINATE ALL THE THINGS GOING
ON RIGHT NOW AND MAKE SURE THAT
WE'RE REALLY THINKING ABOUT IT
AS AN ECOSYSTEM, THINKING ABOUT
ALL THE POSSIBILITIES TOGETHER.
AND I THINK YOU'RE GOING TO HEAR
EXAMPLES FROM JULIE, AND
EXAMPLES FROM BARIS HOW WE DO
THAT.
I'M GOING TO TURN THIS OVER TO
JULIE, AND LET HER TALK ABOUT
THE A.I. WORKING GROUP.
AND THIS DID SEEM TO WORK FOR
ME.
>> OKAY, GREAT.
THANK YOU, WARREN.
IT'S A PLEASURE TO BE HERE TODAY
REPRESENTING THE NCI ARTIFICIAL
INTELLIGENCE WORKING GROUP.
SO, WE USE THE TERM ARTIFICIAL
INTELLIGENCE REALLY TO DESCRIBE
A VERY BROAD COLLECTION OF
COMPUTER METHODS THAT CAN LEARN
PATTERNS IN DATA THAT MIMIC THE
HUMAN BRAIN.
AND THESE METHODS ARE
INCREASINGLY BEING APPLIED BY
CANCER RESEARCHERS AND
CLINICIANS ACROSS THE WHOLE
SPECTRUM OF CANCER RESEARCH,
INCLUDING CANCER SCREENING AND
DIAGNOSIS, DRUG DISCOVERY,
CANCER SURVEILLANCE, HEALTHCARE
DELIVERY, AS WELL AS TO DERIVE
MECHANISTIC INSIGHTS INTO
CANCER.
AT THE NIH ELEMENTS OF
ARTIFICIAL INTELLIGENCE ARE
REALLY EMBEDDED ACROSS OUR WHOLE
PORTFOLIO OF GRANTS AND
CONTRACTS, AS CANCER RESEARCHERS
ARE INCREASINGLY USING THESE
METHODS IN THEIR RESEARCH
ACTIVITIES.
THIS GRAPH SHOWS ABOUT 300
GRANTS THAT RECEIVE FUNDING IN
FY 23 THAT HAVE SIGNIFICANT
COMPONENTS OF ARTIFICIAL
INTELLIGENCE OR WE OFTEN REFER
TO IT AS MACHINE LEARNING.
AND YOU CAN SEE THAT IT'S BEING
APPLIED ACROSS THE SPECTRUM OF
CANCER RESEARCH AT NCI.
TO GIVE A SENSE OF THE BREADTH
OF NCI'S SUPPORT TODAY.
SO, BACK IN 2020, NCI STARTED
THE TRANSNCI ARTIFICIAL
INTELLIGENCE WORKING GROUP WITH
THE REALIZATION WE NEEDED A
GROUP WHO COULD PROVIDE A HUB
FOR COMMUNICATION AND
COORDINATION OF A.I.-RELATED
SCIENTIFIC PROJECTS AND PROGRAMS
ACROSS NCI.
AND WHO COULD WORK TO IDENTIFY
TRANSNCI CANCER RESEARCH
OPPORTUNITIES THAT COULD MOST
BENEFIT FROM THE APPROPRIATE USE
OF A.I.
AND ALSO TO SERVE AS A HUB FOR
CONNECTION AND COORDINATION WITH
A.I. ACTIVITIES OUTSIDE OF THE
NCI.
AND TODAY THIS WORKING GROUP
CONSISTS OF ALMOST 30 MEMBERS
REPRESENTING NEARLY ALL OF NCI'S
DIVISIONS, OFFICES AND CENTERS.
SOME ACTIVITIES THIS WORKING
GROUP CONSIDERS INCLUDE THE
RESEARCH ACTIVITIES EMBEDDED IN
OUR EXTRAMURAL GRANT PROGRAMS,
AS WELL AS THE RESEARCH GOING ON
IN OUR INTRAMURAL RESEARCH GROUP
THAT YOU'LL HEAR ABOUT FROM DR.
TURKBEY IN A FEW MINUTES.
ALSO, THE RESEARCH AND THE
RESOURCES THAT ARE BEING
GENERATED THROUGH OUR NOW
LONGSTANDING COLLABORATION WITH
THE DEPARTMENT OF ENERGY, AS
WELL AS THE DATA SCIENCE
INFRASTRUCTURE SUPPORTED THROUGH
THE CANCER RESEARCH DATA
COMMONS.
THE WORKING GROUP ALSO
COORDINATES OUR PARTICIPATION IN
BROADER NIH ARTIFICIAL
INTELLIGENCE ACTIVITIES,
PARTICULARLY THOSE COORDINATED
OUT OF THE NIH OFFICE OF DATA
SCIENCE STRATEGY, AS WELL AS
COMMON FUND ACTIVITIES SUCH AS
THE BRIDGE TO A.I. PROGRAM.
THE WORKING GROUP ALSO SERVES AS
A RESOURCE TO THE NCI'S
COMMUNICATIONS OFFICE,
GOVERNMENT RELATIONS OFFICE, AND
OFFICE OF ADVOCACY RELATIONS TO
PROVIDE SUPPORT FOR
COMMUNICATIONS, CONGRESSIONAL
BRIEFINGS, AND OTHER
A.I.-RELATED INQUIRIES THAT COME
TO THE NCI.
AND FINALLY, AND MORE BROADLY,
WE PARTICIPATE IN BROADER
TRANS-GOVERNMENTAL ACTIVITIES
INCLUDING THE A.I. COMPONENTS
THAT ARE EMBEDDED IN THE CANCER
MOONSHOT AND ARPA-H, WE
PARTICIPATE IN NSF PROGRAMS, AS
WELL AS BROADER HHS PROGRAMS.
SINCE THE WORKING GROUP STARTED,
BACK IN 2020, THE LATTER
PROVIDED COORDINATION FOR MANY
TRANS-NCI EFFORTS RELATED TO USE
OF A.I. IN CANCER RESEARCH, AND
THAT INCLUDES SEVERAL SAND
PIT-STYLE OR DISCUSSION FORUMS
WHERE WE'VE ENGAGED THE CANCER
COMMUNITY IN INTERACTIVE
SESSIONS ON KEY TOPICS AND A.I.,
SUCH AS DIGITAL TWINS, AND THE
USE OF ETHICAL A.I.
WE'VE ALSO HOSTED SEVERAL
WORKSHOPS ON EMERGING TOPICS IN
A.I. FOR CANCER RESEARCH,
INCLUDING ONE ON RADIATION
ONCOLOGY, HEALTHCARE DELIVERY,
AND MOST RECENTLY THROUGH THE
CANCER MOONSHOT WE HELD A
WORKSHOP ON USING A.I. TO TARGET
UNDRUGGABLE TARGETS, AND THIS
BROAD TOGETHER REPRESENTATIVES
FROM INDUSTRY, ACADEMIA, AND THE
GOVERNMENT, TO DISCUSS HOW WE
COULD COLLABORATE IN THIS SPACE.
WE'VE ALSO COORDINATED
PARTICIPATION IN A.I.-RELATED
FUNDING OPPORTUNITIES, INCLUDING
THOSE COORDINATED BY THE OFFICE
OF DATA SCIENCE STRATEGY, ON
A.I. DATA READINESS, ETHICAL
A.I., AND ADVANCING MULTI-MODAL
A.I.
AND EARLIER THIS YEAR THE NCI
HOSTED A PRIZE CHALLENGE ON
EVALUATING THE DATA IN THE
CANCER RESEARCH DATA COMMONS FOR
A.I. DATA READINESS.
AND FINALLY, RECOGNIZING THE
NEED FOR INCREASED TRANSPARENCY
AND UNDERSTANDING OF THESE
MODELS, WE RECENTLY ADDED NEW
MODEL SHARING REQUIREMENTS TO
OUR INFORMATICS FUNDING
OPPORTUNITIES.
TO MEET THE INCREASING INTEREST
IN INFORMATION ABOUT HOW
ARTIFICIAL INTELLIGENCE IS
ADVANCING CANCER RESEARCH, WE
RECENTLY STOOD UP TWO NEW
WEBSITES ON NCI'S WEB PRESENCE
cancer.gov TO PROVIDE
INFORMATION ABOUT NCI'S
ACTIVITIES.
ONE SITE IS DIRECTED AT THE
PUBLIC TO DESCRIBE ONGOING
OPPORTUNITIES AND RESEARCH AND
SHOWING WAYS THAT ARTIFICIAL
INTELLIGENCE IS BEING APPLIED IN
VARIOUS ASPECTS OF CANCER
RESEARCH.
A SECOND PAGE DIRECTED AT
RESEARCHERS WHO ARE LOOKING FOR
FUNDING OPPORTUNITIES, EVENTS,
RESOURCES TO ADVANCE THEIR USE
OF A.I. IN CANCER.
AND WITH THAT, I'M GOING TO HAND
IT OVER TO DR. TURKBEY TO TALK
ABOUT RESEARCH GOING ON IN THE
CENTER FOR CANCER RESEARCH.
>> ALL RIGHT.
GOOD AFTERNOON, AND THANK YOU
FOR THIS OPPORTUNITY TO
COMMUNICATE OUR RESEARCH.
OUR MISSION IS TO DEVELOP
TRANSLATIONAL A.I. MODELS TO
ENHANCE IMAGING-BASED RESEARCH
OF RESEARCHERS WITHIN NIH AND
SOMETIMES OUTSIDE NIH.
OUR PORTFOLIO IS DIVERSE,
COVERING CLINICAL RESEARCH AND
WE'RE DOING THIS RESEARCH IS
ALSO DIVERSE, RADIOLOGY, DIGITAL
PATHOLOGY, AS YOU CAN SEE LIKE
SEVERAL DIFFERENT MODALITIES ARE
INCLUDED IN OUR RESEARCH.
IN THE NEXT FEW SLIDES I WOULD
LIKE TO SHOW HOW WE CONDUCT
RESEARCH WITH ONE SINGLE
EXAMPLE.
FOR A SUCCESSFUL A.I. PROJECT
YOU NEED TO HAVE A GOOD RESEARCH
QUESTION OR A PROBLEM.
SO IN THIS CASE OUR PROBLEM IS
INCONSISTENT DIAGNOSIS FOR
PROSTATE MRI FOR DETECTING
PROSTATE CANCERS.
WE PUBLISHED THIS RESEARCH IN
2018 AND AS YOU CAN SEE THERE
ARE SIX RADIOLOGISTS, THEY
OUTLINED DIFFERENT AREAS ON THE
SAME PATIENT IMAGES, A BIG
CONSISTENCY STILL GOING ON.
THE QUESTION FOR A.I. CAN A
FULLY AUTOMATED MODEL SOLVE THIS
PROBLEM?
WITH THIS MOTIVATION UTILIZE OUR
INTRAMURAL DATA PLUS WE GET DATA
FROM OUTSIDE NIH, AND WE BUILD
UP A CASCADED MODEL, FULLY
AUTOMATED MODEL WHICH HANDLES
THESE IMAGES ON ITS OWN.
WITHOUT GOING INTO DETAIL, THE
MODELS FINDING CANCER IS 63%,
AVERAGE ACADEMIC RADIOLOGIST IS
40%, IF THIS IS EXPECTED TO
INCREASE, THIS TOOL IS GIVING
ONE FALSE POSITIVE EVERY OTHER
PATIENT, WE WANT MODELS TO BE
TRANSLATIONAL, WE WANT THEM TO
BE ALIVE IN OUR CLINICAL AND
RESEARCH ENVIRONMENT SO WE
DEPLOY THIS MODEL INTO OUR
HOSPITAL, AND NIH CLINICAL
CENTERS ENVIRONMENT.
WHAT HAPPENS IS THE USER SELECTS
THESE THREE IMAGING SEQUENCES
AND PUSHES THIS BUTTON, AND THEN
THE MODEL STARTS TO WORK BEHIND
THE SCENES WE USE A PROCESS
CALLED MONI, DETECTING THE
SEQUENCES, FINES THE ORGAN,
MATCHES, OUTLINES THE CANCER
SUSPICIOUS AREAS.
WITHIN ONE MINUTE AND 20 SECONDS
THIS DATA IS PUSHED BACK INTO
THE HOSPITAL SYSTEM, AND THIS IS
ONE OF THE EXAMPLES.
THE TOP ROW IS THE NAIVE IMAGES,
I READ THIS PATIENT AS NEGATIVE.
AND A.I. MODEL FOUND LESION IN
THE RIGHT PERIPHERAL ZONE OF
THIS PATIENT AND THIS WAS A
GLEASON GRADE 4.
GLEASON 4 PLUS CARS NO, -- CA.
WE DON'T CLAIM ANY OWNERSHIP SO
WE OPEN SOURCE OUR MODEL,
CURRENTLY THIS MODEL IS
PROSPECTIVELY USED IN GUIDING
BIOPSIES FOR THE LAST THREE
MONTHS, AND I JUST RECEIVED
RESULTS, DETECTION CAPABILITIES
80% IN OUR OWN PATIENT
POPULATION.
WE ALSO USED IT FOR RADIOTHERAPY
GUIDANCE AND PSYCHOTHERAPY
GUIDANCE.
MODELS AVAILABLE TO THE WORLD,
THESE ARE THE PLACES CURRENTLY
DOWNLOAD IT AND UTILIZE THE
MODEL FOR THEIR RESEARCH AND
CLINICAL PRACTICE.
AND WE WORK WITH EUROPEAN UNION
COLLEAGUES TO HAVE THIS MODEL AS
A BASE FOR FEDERATED LEARNING
PROJECT, THE HOPE TO TAKE A
MODEL TO AFRICA WHICH HAS A A
LOW-RESOURCE SETTING AS YOU
KNOW.
A.I. IN OUR WORLD IS VERY
DIVERSE.
OUR PROJECT IS NOT POSSIBLE,
THREE BASIC TEAMS, PRODUCTIVITY,
LIKE OBJECT DETECTION-BASED
PROJECTS.
AS YOU CAN SEE WE BUILD SOME
MODELS FOR RESEARCH TO CALCULATE
BASELINE AND TREATMENT FOLLOW-UP
TUMOR BURDEN.
SECOND TEAM IS DIAGNOSTIC
ASSISTANCE, WE BUILD UP THIS
MODEL TO FIND SOLID CYSTIC SOLID
AND NORMAL KIDNEY PARENCHYMA.
THE FINAL IS MORE CHALLENGING
THING, BIOMARKER DISCOVERY, A
COOPERATION, SO WE BUILD THE
MODEL WHICH CAN FIND ASSOCIATION
WITHIN HISTOPATHOLOGY IMAGES,
IMAGES WHICH TELLS US WHICH
AREAS ARE ASSOCIATED WITH
METASTASIS AND BIOCHEMICAL
RECURRENCE.
SO, OVERALL WE ARE VERY CAREFUL
ABOUT DEPLOYING OUR MODELS.
WE WANT MODELS TO BE ALIVE.
WE WANT THESE MODELS TO BE USED
IN CLINICAL AND RESEARCH
PURPOSES.
ALSO WE TRAIN OUR OWN FELLOWS
AND RESEARCHERS WHO APPLY TO US
TO MAKE SURE THAT THEY HAVE GOOD
COMPUTATIONAL CAPABILITIES FOR
THEIR FUTURE RESEARCH.
THIS IS MY TEAM.
ON BEHALF OF MY TEAM I WOULD
LIKE TO THANK YOU ALL FOR
LETTING ME TO PRESENT SOME OF
OUR RESEARCH HERE, AND, AGAIN,
THIS WAS AN IMPORTANT
OPPORTUNITY FOR ME.
THANK YOU SO MUCH.
[APPLAUSE]
>> FANTASTIC.
>> A CASE OF WHAT WE'RE DOING.
>> YEAH, I WAS FASCINATED,
WONDERFUL TO SEE -- WELL, GREAT
PRESENTATION, WONDERFUL TO SEE
THE PARTNERSHIPS.
I MAY HAVE MISSED BUT ONE I
DIDN'T SEE WAS NCI FREDERICK, OR
FREDERICK NATIONAL LABS.
ARE THERE ANY ACTIVITIES THERE,
IT SEEMS LIKE SOME OF THIS
ACTUALLY COULD BE MORE SERVICE
OPPORTUNITIES FOR INDIVIDUALS
OUTSIDE TO LEVERAGE AND I WONDER
IF THERE'S ANYTHING HAPPENING
THERE THAT YOU GUYS COULD TALK
ABOUT.
>> WELL, SO FIRST, ALMOST
EVERYTHING WE DO AT DOE, AT
LEAST TOUCHES FREDERICK AT SOME
LEVEL.
THEY ARE THE POINT OF
INTERACTION WITH A LOT OF DOE
FOLKS BETWEEN -- WITH NCI.
THANKING ABOUT THE RAS
INITIATIVE, THEY REALLY -- THEY
DO SO MUCH A.I. WORK OUT THERE
WITH THE RAS INITIATIVE.
BUT JULI, DO YOU WANT TO TALK
ABOUT TEAMS FOCUSED INTERNALLY
AT FREDERICK?
>> YEAH, SO MUCH GOING ON.
THE OTHER RESOURCE I WANTED TO
MENTION THAT WAS A NEW SITE I
THINK CALLED COMPUTATIONAL
RESOURCES, IT'S A PLACE WHERE
THEY ARE NOW SHARING THE MODELS
AND THE DATASETS THAT THOSE
MODELS WERE TRAINED ON PUBLICLY
THROUGH THIS RESOURCE WITH THE
GOAL IT CAN ULTIMATELY BE A
RESOURCE WHERE OTHERS CAN SHARE
THEIR MODELS AND MODEL TRAINING.
>> GREAT.
ONE MORE QUESTION.
FOR ME A.I. IS, YOU KNOW, IT'S
AKIN TO A CHILD, RIGHT?
YOU TRAIN IT, RIGHT?
AND IF YOU SIT A CHILD IN FRONT
OF A TV THAT PROJECTS ONE THING,
RIGHT, AND VALIDATE IT, THAT
CHILD IS GOING TO DO THOSE
THINGS LATER.
AND SO I THINK AS WE TALK ABOUT
DATA QUALITY, ANOTHER PART IS
REPRESENTATION.
I THINK IF YOU'RE BUILDING
MODELS AROUND PROSTATE CANCER
YOU WANT TO MAKE SURE THAT,
RIGHT, THERE'S A SIGNIFICANT
PROPORTION OF INDIVIDUALS ACROSS
VARIOUS RACIAL AND ETHNIC GROUPS
TO ENSURE THE MODEL WILL PERFORM
AS EFFECTIVELY, RIGHT, ACROSS
THESE POPULATIONS.
AND I'M NOT QUITE SURE HOW
YOU'RE INCORPORATING THIS INTO
HOW YOU'RE BUILDING AND TESTING
THESE MODELS AND VALIDATING THE
>> SO, I'LL TAKE THAT A LITTLE
BIT AND THEN I'LL LET DR. KIBBE
TALK ABOUT WHAT HE DOES.
ONE, WE NEED REPRESENTATIVE
SAMPLES, THAT KIND OF
REPRESENTATION IS EASY TO COUNT.
WHAT I APPRECIATE ABOUT USING
A.I. TO START TO DO FEATURE
DETECTION IN ASSOCIATION WITH
OUTCOMES IS THAT REMOVES A WHOLE
LOT OF BIAS THAT WE CURRENTLY
HAVE IN THE WAY WE THINK ABOUT
TREATING PATIENTS BECAUSE WE'RE
FOCUSED ON OUTCOMES.
WE'RE NOT FOCUSED IN THE MIDDLE.
SO, I THINK THAT'S A GOOD THING.
SO, I'D LOVE TO HEAR IF YOU ALL
AGREE THAT'S GOOD.
>> IF THERE ARE DIFFERENCES IN
OUTCOMES YOU BEGIN TO WONDER IF
YOU CAN USE THAT AS A SURROGATE.
>> WELL, TRUE.
BUT IF YOU SEE PATIENTS THAT ARE
DOING WELL AND DOING POORLY IN
ALL GROUPS, YOU START TO SEE WHY
THEY ARE ALL DOING BETTER, ALL
DOING WORSE, THEN I THINK THAT
BECOMES A GREAT PROGNOSIS THAT
WE MOVES BIASES.
>> CAN I PIGGYBACK?
>> MAYBE THAT'S TOO SIMPLISTIC.
>> WE HAVE KAREN AND ANDREA.
>> I BUTTED IN.
I'M SORRY.
>> COOPERATION, IT'S EQUAL
ACCESS PATIENT POPULATION.
PATIENTS WHO ARE REFERRED TO
WALTER REED, AND ALSO
PROSPECTIVE CLINICAL TRIAL FOR
PROSTATE CANCER SO WE DIAGNOSE
PATIENTS, THEY ARE REFERRED TO
US, WE'RE STUDYING THOSE
IMMEDIATE AND MEDIUM AND
LONG-TERM OUTCOMES UTILIZING
A.I. OUTCOMES.
>> COULD YOU TALK ABOUT
WORKFORCE?
WHICH IS GREAT, AND WE NEED TO
WELL A WORKFORCE BUT IT NEEDS TO
BE DIVERSE FOR MANY REASONS, BUT
I THINK THE MODEL, I'M GLAD YOU
CLARIFIED THE MODEL YOU'RE USING
PARTICULARLY PROSTATE CANCER BUT
ANY CANCER IS REPRESENTATIVE, DO
YOU KNOW WHAT PERCENT?
YOU'RE TALKING ABOUT
PROGNOSTICATION.
WE KNOW AFRICAN AMERICAN
PATIENTS DO WORSE, IS IT A
TREATMENT EFFECT, A BIOLOGIC?
WE WON'T KNOW.
CAN YOU SHARE PERCENTAGES OF
PRIMS.
>> 30 TO 35% IS THE PROPORTION,
AND COMPARED TO THE NCI COHORT
WHICH IS AROUND 15%, BIASED
POPULATION, WE BELIEVE THAT'S
CORRECT.
>> THAT'S GREAT.
>> CLOSER TO REFLECTING
REPRESENTATION.
>> THAT'S GREAT BECAUSE IT'S
OVERREPRESENTED.
ARE THERE WAYS YOU'RE THINKING
PROSPECTIVELY?
I JUST HAD A WONDERFUL TALK FROM
ONE OF OUR MEDICAL STUDENTS,
ACTUALLY AT VANDERBILT, WYATT
COLE TALKED ABOUT A.I. TO HELP
DEMOCRATIZE INFORMATION ON
PROSTATE CANCER TO EDUCATE
PATIENTS, MEN WITH PROSTATE
CANCER IN THE FAMILY BUT HE'S
MENTORED BY SOMEONE NOT IN THE
A.I. SPACE, A UROLOGIESIST BUT
MAY NOT THINGS ABOUT ISSUES
RELATED TO THE QUESTION.
THINK ABOUT TOOLS YOU'RE
THINKING ABOUT DEVELOPING SO AS
YOU ARE HELPING CREATE THE
LANDSCAPE THEY ARE NOT AN
AFTERTHOUGHT BUT PROSPECTIVELY
CONSIDERED THE WAY MODELS ARE
DEVELOPED, WHETHER MODELS ARE
RETRAINED, IT'S GOING TO BE
CRITICAL SO WE DON'T HAVE
GARBAGE IN, GARBAGE OUT.
>> ONE OF THE PARTNERSHIPS IS
WITH THE NIH OFFICE OF DATA
SCIENCE STRATEGY COORDINATING AN
NIH EFFORT TO THINK ABOUT BIAS
INEQUITY IN A.I.
ONE OF THE RECENT FUNDING
OPPORTUNITIES FOR MULTI-MODAL
A.I. HAD A FORWARD GOAL OF
CO-DESIGN EFFORTS, AND ETHICAL
A.I.
WHAT WAS REALLY CRITICAL FOR
THIS PROGRAM WAS TO MAKE SURE
THAT THERE WAS A
MULTI-STAKEHOLDER GROUP AS PART
OF THE RESEARCH SO THAT THOSE
AFFECTED BY THE RESEARCH,
PHYSICIANS WHO ARE CONDUCTING --
TREATING THE PATIENTS AS WELL AS
RESEARCH, WE'RE ALL INVOLVED UP
FRONT IN THE MODEL DESIGN, SO I
THINK THAT'S A SENSE OF STARTING
TO REALIZE THE IMPORTANCE OF
HAVING CO-DESIGN EFFORTS UPFRONT
AND IMPLEMENTING THAT IN A
PROGRAM.
ALSO DID WANT TO MENTION THIS
ALSO IS AN ODS-LED PROGRAM, AIM
AHEAD PROGRAM YOU MAY HAVE HEARD
OF TO MAKE SURE THAT WE'RE
DEVELOPING A WORKFORCE NOT JUST
AT THE BIG CANCER CENTERS AND
BIG ACADEMIC CENTERS BUT AT MORE
BROADLY ACROSS ALL ACADEMIC
CENTERS SO THOSE CAPABILITIES
AND THAT LEARNING CAN BE MORE
DISTRIBUTED.
>> ANDREA AND FRED.
>> ALONG THE SAME THEME, WHEN
AUTOMATIC HAND SANITIZERS CAME
OUT, HAD YOU TO PUT YOUR HAND
UNDERNEATH TO GET THE SANITIZER
TO COME OUT, THEY FORGOT TO
PROGRAM FOR BROWN SKIN.
WHEN I TURNED MY HAND OVER, IT
DIDN'T WORK.
THAT DOESN'T HAPPEN NOW BUT THIS
IS WHEN THEY FIRST STARTED TO
DEVELOP THEM.
ECHOING CONCERNS OF THE PREVIOUS
TWO QUESTIONS, WHEN IT COMES TO
SKIN CANCER, TALKING ABOUT
CANCER, HAVING THAT INFORMATION
IN THE DATABASE WHEN YOU'RE
DIAGNOSING SKIN CANCER AND
BENIGN DISEASE IS GOING TO BE
REALLY IMPORTANT TO HAVE
DIFFERENT SKIN COLORS IN THE
DATABASE OF A.I. OR ELSE IT
WON'T RECOGNIZE X SKIN COLOR,
WHEN YOU'RE TRYING TO GET THE
INFORMATION OUT FOR SOMETHING
LIKE MELANOMA.
THAT WOULD EXTEND TO OTHER
DISEASES NOT NECESSARILY
PREDOMINANT IN AFRICAN AMERICANS
OR LATINOS, ET CETERA, SO
JUST -- WE KEEP ASKING THE SAME
QUESTION, BUT IT'S IMPORTANT TO
MAKE SURE AT THIS STAGE OF
THINGS WE'RE ACQUIRING DATA ON
ACROSS THE SPECTRUM OF
ETHNICITIES SO WHEN THESE
A.I. -- WHEN IT IS DEPLOYED IT
WILL BE ACCURATE.
>> I AGREE.
WHAT I APPRECIATE IS YOU MAKING
SURE WE DO THAT.
SO, I THINK THAT'S REALLY -- I'M
NOT ALWAYS SURE HOW TO MAKE THAT
HAPPEN BUT HAVING YOU ASK THESE
QUESTIONS IS PART OF MAKING SURE
IT HAPPENS.
>> WE'D LOVE TO HELP.
>> THERE'S A CONCEPT, FEDERATED
LEARNING, THE MAIN ISSUE OR THE
CONCERN IS SHARING DATA, WITH
FEDERATED LEARNING YOU CAN MOVE
YOUR MODEL, YOUR DATA CAN STAY.
WITHOUT MOVING THE AMERICAN
DATA, WITH THE SLIDE I SHOWED,
WE WILL FURTHER TRAIN THE MODEL
IN EUROPE AND THEN WE HOPE TO
PUT MORE DIVERSITY IN IT.
WE'LL TAKE THE DATA TO AFRICA
AND FURTHER TRAIN, WE'LL HAVE
MOST IDEAL MODEL.
WE HAVE CAPABILITY OF DEVELOPING
DIVERSE MODELS.
>> QUICKLY, I WONDER, WARREN,
ONE AREA WE HAVE A GREAT NEED IS
MORE LONGITUDINAL DATA, AND I
WAS WONDERING, I MEAN,
ESSENTIALLY TO DEVELOP THESE
MODELS ALONG LONGITUDINAL LINES,
SO IS THERE -- DO YOU HAVE PLANS
FOR THAT IN TERMS OF SOME OF THE
MECHANISMS WE MIGHT USE AT NCI
OR CLINICAL CENTER TO ADDRESS
THIS?
>> SURE.
THANK YOU FOR THE QUESTION.
I THINK THAT'S ONE OF THE HOPES
WITH WHAT WE'RE DOING WITH CCDI
AS WE START TO BUILD THAT
LONGITUDINAL VIEW OF PATIENTS
AND UNDERSTAND HOW TO CAPTURE
DATA AND ANALYZE IT.
WE'RE STILL -- WE'RE NOT AS FAR
ALONG AS I WOULD LIKE WITH CCDI
BUT THAT'S ONE OF THE
OPPORTUNITIES.
IF WE CAN GET IT RIGHT FOR
CHILDREN, WE CAN GET IT RIGHT
FOR YOUNG ADULTS, THEN WE CAN
GET IT RIGHT FOR EVERYONE.
SO I AGREE, UNDERSTANDING THAT
TRAJECTORY OF DISEASE IS JUST SO
IMPORTANT.
>> SO, JULI, WAS YOUR HAND UP?
YOU AND THEN NELO.
>> I KNOW THAT AT LEAST IN THE
MOMENT IN OTHER SECTORS THE COST
OF BUYING CHIPS AND
COMPUTATIONAL CAPABILITIES IS
SOMETHING THAT'S VERY TOP OF
MIND.
I KNOW AS WE LOOK AT THE
INFLATION ADJUSTED BUDGET THAT
WAS WELL PRESENTED EARLIER
TODAY, ONE OF THE AREAS I'M
WONDERING ABOUT IS HOW IS
INFRASTRUCTURE BEING PAID FOR
CURRENTLY?
IS THAT SOMETHING WE NEED TO
THINK ABOUT IN THE NCI BUDGET?
IS THAT AN NIH BUDGET LINE OR
ARE ALL THE CENTERS POOLING IN
TO GIVE YOU RESOURCES TO ACQUIRE
CAPABILITIES THAT YOU NEED?
CURIOUS HOW WE SHOULD BE
THINKING ABOUT BUDGETING AS THE
RESULT OF THE NEED TO BUY CHIPS,
COMPUTE, AND INFRASTRUCTURE.
>> YOU'RE ASKING AN INSIGHTFUL
QUESTION BECAUSE YOU CAN SPEND
ANY AMOUNT OF MONEY IN BUILDING
A.I. INFRASTRUCTURE.
AGAIN, THAT'S AN OPPORTUNITY FOR
US TO REALLY PARTNER WITH
INDUSTRY.
WE HAVE I THINK A PRETTY BIG
OPPORTUNITY TO WORK WITH, YOU
KNOW, NAME YOUR FAVORITE TECH
COMPANY, TO GET THEM EMBEDDED,
HAVE THEM WORK ON REALLY
IMPORTANT PROBLEMS FOR US.
BUT TO YOUR QUESTION, YOU KNOW,
WE DON'T HAVE AS MUCH
INFRASTRUCTURE FOR DOING A.I.
LEARN ITSELF AND TRAINING AS WE
PROBABLY NEED BUT I THINK WE
HAVE ENOUGH.
>> YEAH.
SO WE HAVE VERY STRONG HPC
CLUSTER, BIOWULF, AT NIH, OPEN
TO ALMOST EVERY RESEARCHER WITH
SYMBOLIC COST, AND IN ADDITION
TO THAT THE LAB HAS THEIR OWN
HIGH POWERED COMPUTATIONAL
COMPUTERS.
TO DEVELOP MODELS, YES, YOU NEED
THAT TYPE OF INFRASTRUCTURE BUT
TO RUN THESE MODELS YOU WON'T
NEED THAT.
>> ONE LAST QUESTION FROM NELO
BECAUSE WE NEED TO MOVE ON.
>> I'LL BE QUICK.
I'M A CLINICAL RESEARCHERS.
MANY YEARS AGO I HAD THE
OPPORTUNITY TO PARTICIPATE IN A
WORKSHOP THAT ASCO PUT ON, AT
VEIL, WE SPENT A WEEK, NETWORK,
LEARNED SKILLS, POPULATED FROM
THE IVORY TOWERS.
THIS YEAR THE SAME WORKSHOP IN
EUROPE WAS A VERY DIFFERENT
EXPERIENCE.
AND SO SATISFYING BECAUSE IT WAS
NOT JUST IVORY TOWERS IN EUROPE
BUT ALSO, YOU KNOW, POLISH
INVESTIGATORS AND OTHERS FROM
EASTERN EUROPE, GAVE THEM THE
OPPORTUNITY TO LEARN AND
NETWORK.
THIS AREA WOULD BE VERY RIPE FOR
THAT KIND OF A WORKSHOP, YOU
COULD HAVE SENIOR LEADERS TEACH
WHERE PEOPLE COULD NETWORK AND
GO FOR A FEW DAYS AND REALLY
LEARN WHAT IS A.I. AND HOW CAN
WE APPLY IT.
>> GREAT COMMENT.
>> I'LL JUST SAY THAT'S PART OF
WHAT AIM HEAD IS DOING,
PARTNERING WITH AIM AHEAD, I
THINK WE CAN DO SOME OF THAT.
BUT WE NEED TO ALSO ADD MORE OF
A CANCER FLAVOR TO AIM AHEAD.
>> THANK YOU ALL SO MUCH.
FANTASTIC PRESENTATION.
[APPLAUSE]
>> FINAL PRESENTATION TODAY IS
AN UPDATE ON THE NCI COMMUNITY
ONCOLOGY RESEARCH PROGRAM,
NCORP, AND NATIONAL CLINICAL
TRIALS NETWORK, NCTN.
PRESENTATION WILL BE BROUGHT TO
YOUS BY DR. PHIL CASTLE,
DIRECTOR OF DIVISION OF CANCER
PREVENTION AND JIM DOROSHOW,
DIRECTOR FOR DIVISION OF CANCER
TREATMENT DIAGNOSIS.
>> THANK YOU, JOHN.
ON BEHALF OF THE NCI AND
DIVISION OF CANCER PREVENTION,
I'M PLEASED TO PRESENT THE
UPDATE ON NCI COMMUNITY ONCOLOGY
RESEARCH PROGRAM.
THIS IS REALLY A FLAGSHIP
PROGRAM FOR THE INSTITUTE AND
YOU'LL SEE WHY HERE, WHY IT'S SO
CRITICAL TO THE FUNCTION OF THE
NCI.
SO, NCORP OVERVIEW, IT'S A
MERGING OF TWO COMMUNITY
PROGRAMS THAT EXISTED
PREVIOUSLY.
ONE IS C COP, STARTED IN 1983,
SOME OF MY STAFF WERE HERE TO
START THAT, AND THE NCI
COMMUNITY CANCERS CENTER GRANT
IN 2017, WE MERGED THOSE WITH
THE FOLLOWING GOALS.
ONE TO ENROLL PATIENTS IN
TREATMENT ADVANCED IMAGING
CLINICAL TRIALS THAT ARE
DEVELOPED THROUGH THE NCTN, BY
THE DIVISION OF CANCER TREATMENT
AND DIAGNOSIS.
AND THEN SUPPORT INCLUSION OF
HEALTH-RELATED QUALITY OF LIFE
CORRELATIVE STUDIES IN NCTN,
TREATMENT TRIALS, AND AGAIN I
WANT TO EMPHASIZE WHY THIS IS SO
IMPORTANT, IN 2022 WE HAD 18
MILLION CANCER SURVIVORS, WHICH
WAS MORE THAN 5% OF THE U.S.
POPULATION.
BY 2040 WE EXPECT THERE WILL BE
26 MILLION CANCER SURVIVORS, 7%
OF THE POPULATION.
1 IN 14 PEOPLE WILL BE WALKING
AROUND AS A CANCER SURVIVOR.
WE HAVE TO THINK MORE ABOUT NOT
JUST TAKING CARE OF THE TUMOR
BUT TAKING CARE OF THE WHOLE
PERSON.
ENGAGE IN LARGE AND DIVERSE
PATIENT POPULATIONS, RECEIVING
CARE IN A VARIETY OF COMMUNITY
ONCOLOGY SETTINGS, STUDIES ON
CANCER CONTROL, PREVENTION, CARE
DELIVERY.
AND TO GENERATE A BROADLY
APPLICABLE EVIDENCE BASE THAT
CONTRIBUTES TO IMPROVED PATIENT
OUTCOMES AND REDUCTION IN CANCER
DISPARITIES.
BEFORE I GET INTO THE MEAT OF
THIS I WANT TO TAKE A MOMENT
HERE TO HONOR THE LATE WARDA
MCCASKILL-STEVENS WHO MADE
SEMINAL CONTRIBUTIONS, WE HOPE
HER LEGACY WILL GROW THROUGH THE
COMMUNITY SUPPORTED BY THE K12
PROGRAM NAMED AFTER HER, AN
EXCITING PROGRAM MONICA BROUGHT
IN A YEAR AGO.
FIRST I WANT TO ACKNOWLEDGE
BRANDY HECKEN STODDARD, WHO
STEPPED IN TO THE NCORP AND HAS
DONE AN AMAZING JOB.
THE NCORP IS SEVEN RESEARCH
BASES INCLUDING FIVE COOPERATIVE
GROUPS, WHO CANCER CENTER-LED
RESEARCH BASES.
THERE'S 32 COMMUNITY SITES, 14
UNDERSERVED MINORITY SITES, AND
TOTAL, AND I'LL EXPLAIN IN THE
NEXT SLIDE, THERE ARE MORE THAN
A THOUSAND CLINICAL SITES IN
NCORP THROUGH AFFILIATES.
50% OF THESE HUBS SHOWN HERE IN
THE DOTS AND THE TRIANGLES HAVE
AFFILIATE SITES THAT ESSENTIALLY
CREATE A NATIONAL NETWORK.
HERE IT'S ILLUSTRATED, I HOPE
THIS WORKS.
YES, IT DOES.
YOU CAN SEE THE NUMBER OF SITES
PER STATE GOING FROM ONE TO
NINE, TO 15 ABOVE, WE HAVE A FEW
HOLES HERE THAT WE NEED TO THINK
ABOUT FILLING.
AND SOME OF THESE STATES ARE
LESS REPRESENTED THAN OTHERS.
BUT THIS IS HOW WE GET TO THOSE
THOUSAND SITES.
LET'S TAKE THE MONTANA ONE HERE,
WHICH IS THE MONTANA NCORP, WITH
ALL THESE AFFILIATES IN A SPOKE
AND HUB, NOT PERFECT BUT YOU GET
THE IDEA.
AND THEN HERE'S ANOTHER EXAMPLE.
THIS IS BAPTIST HEALTH NCORP
MINORITY AND UNDERSERVED.
AND YOU CAN SEE HERE AGAIN THAT
IT'S A NETWORK OF CLINICAL
SITES.
THAT'S HOW WE GET TO OVER A
THOUSAND CLINICAL SITES ACROSS
THE U.S.
THIS IS THE BREAKDOWN.
I'M NOT GOING TO READ THROUGH
ALL THIS.
WE HAVE A VARIETY OF PEOPLE
INVOLVED, ALMOST MORE THAN 4,000
PHYSICIAN-SCIENTISTS, ALMOST
5,000 RESEARCH STAFF, DIFFERENT
HEALTHCARE SYSTEMS, STAND-ALONE
INSTITUTIONS, 383 COMMUNITY
AFFILIATES, 98 MINORITY
UNDERSERVED AFFILIATES, 441
COMMUNITY SUBAFFILIATES AND SO
FORTH, ALL SORTS OF CLINICAL
SITES.
YOU'LL HAVE ALL THIS
INFORMATION.
I DON'T WANT TO DWELL ON IT BUT
TO GIVE A FLAVOR OF THE
DIVERSITY NOT JUST OF THE PEOPLE
WE RECRUIT BUT PEOPLE INVOLVED
IN NCORP WITH BOOTS ON THE
GROUND.
NOT THE CRITICAL PIECE OF THE
NCORP, WHICH IS WE'RE WORKING
WITH COMMUNITY ONCOLOGISTS, SO
WHATEVER WE DO WITH THEM THEN
CAN GO INTO ROUTINE PRACTICE,
WE'RE NOT JUST TESTING HOW TO DO
BETTER CARE BUT THEN HOPEFULLY
IMPLEMENTING BETTER CARE THROUGH
THEIR ENGAGEMENT.
THIS IS AN IMPORTANT
RELATIONSHIP, JIM WILL TALK
ABOUT THIS A BIT MORE.
WE WORK CLOSELY WITH NCTN.
WE USE A LOT OF THEIR
INFRASTRUCTURE LIKE THE CIRB AD
OTHER INFRASTRUCTURE ESTABLISHED
BY MEGAN AND JIM.
WE SPLIT THIS UP, NCTN FOCUSES
ON LATE PHASE TREATMENT TRIALS,
PRIMARY ADVANCED IMAGING.
ON THE CANCER CONTROL QUALITY OF
LIFE PREVENTION SCREENING
TRIALS, CANCER CARE DELIVERY, WE
DO A LOT OF THIS WORK WITH OUR
GOOD COLLEAGUES IN DCCPS WHO
HEAD UP THE CANCER CARE
DELIVERY.
HERE IS THE OVERLAP HERE.
WE CONTRIBUTE ALMOST 30% AS
YOU'LL SEE IN THE FOLLOWING
SLIDE TO THE TREATMENT TRIALS AT
THE NCTN, OR THE NCORP, WE, THE
NCORP CONTRIBUTES ALMOST 30%.
AND HERE'S THE NUMBERS OVER THE
LAST FIVE YEARS.
THIS IS JUST TO DEMARC WHERE
COVID IS AND I PUT AN ASTERISK
HERE BECAUSE THIS IS NCORP
FISCAL YEARS, WHICH STARTS LATE
IN THE CALENDAR YEAR.
SO, OUR CALENDAR FOR NCORP
STARTS IN AUGUST, SO 2019
STARTED IN AUGUST.
I HOPE I'VE NOW CONFUSED YOU
COMPLETELY.
YOU CAN SEE NUMBERS FROM 2019 TO
2023, ALL SORTS OF DIFFERENT
CATEGORIES, CANCER PREVENTION
AND CONTROL FROM NON-NCORP
SITES, CPC CANCER PREVENTION AND
CONTROL FOR NCORP, TREATMENT
TRIALS HERE, AND MINORITY
CONTRIBUTIONS TO TREATMENT
TRIALS.
SO MORE THAN 3,000, ALMOST 35 --
MORE THAN 3500 COME FROM
NCORP-RELATED GROUPS
CONTRIBUTING TO THE TREATMENT
TRIALS.
THIS IS A BREAKDOWN OF SOME OF
THE ACTIVITIES WITHIN THESE
DIFFERENT GROUPS.
AND THE NUMBER HIGHLIGHTED HERE
IN YELLOW IS QUALITY OF LIFE
NUMBERS SO WE CONTRIBUTE IN SOME
CASES MORE THAN 3,000
PARTICIPANTS ON QUALITY OF LIFE
MEASURES.
YOU HAVE TMIST IN RED, OTHER
CANCER PREVENTION CONTROL IN
GRAY, QUALITY OF LIFE IN THE
DARKER GRAY, TREATMENT TRIALS IN
BLUE.
PERHAPS THE MOST IMPORTANT PART
OF THE NCORP IS OUR CONTRIBUTION
TO DIVERSITY AND
REPRESENTATIVENESS OF OUR
POPULATIONS.
YOU CAN SEE HERE THAT IN
TREATMENT TRIALS NCORP
CONTRIBUTES 25% OF MINORITIES,
AND OF COURSE AS YOU WOULD HOPE
AND EXPECT THE MINORITY BASES
CONTRIBUTE 43% OF MINORITIES IN
TERMS OF THEIR TOTAL
CONTRIBUTION.
AND LOOKING AT CANCER PREVENTION
AND CONTROL YOU SEE THE SAME
PATTERNS HERE.
THIS HIGH NUMBER OF 72 IS
RELATED TO HISPANIC POPULATIONS
BEING ENROLLED IN TMIST AND
INTERNATIONAL SITES.
SO, NCORP FOR THOSE THAT ARE NOT
DEEPLY SORT OF EMBEDDED IN
NCORP, MAY BE A BIT OF MYSTERY,
HOW DO YOU GET A STUDY GOING IN
NCORP?
I ASKED BRANDI TO PUT THIS
TOGETHER BECAUSE I THOUGHT IT
WAS IMPORTANT TO UNDERSTAND
THERE'S TWO PATHS.
ONE IS WITHIN THE NCORP, YOU
DEVELOP A PROPOSAL, BASES HAVE
BEEN FUNDING, YOU BRING
SOMETHING FORWARD.
IT'S NOT THE ONLY WAY YOU CAN
GET INTO NCORP.
SO, THE TRADITIONAL PATH THE
INVESTIGATORS WITHIN THE
RESEARCH BASE WORKING GROUPS
DEVELOP A CONCEPT THAT IS VETTED
WITH THE OTHER RESEARCHERS AND
COMMUNITY MEMBERS.
THEN YOU HAVE TO GET THE
RESEARCH BASES TO APPROVE.
AND THEN IT'S SUBMITTED TO THE
NCI REVIEW, REVIEWED BY THE
STEERING COMMITTEE, AND MOVES TO
PROTOCOL DEVELOPMENT.
YOUR OWN WAY IS TO BRING YOUR
OWN R01 FUNDING TO THE NCORP,
SAME PATHWAY BUT USE THE NCORP
INFRASTRUCTURE HOPEFULLY TO
REDUCE OVERALL COSTS OF DOING
THE STUDY.
THIS WAS A PRIORITY FROM 2015,
THIS CAME OUT OF A STRATEGIC
PLANNING PROCESS, REALLY LOOKING
AT SYMPTOM MANAGEMENT, QUALITY
OF LIFE STRATEGIC PRIORITIES.
AS YOU CAN SEE THE FIRST TIER IS
COGNITIVE IMPAIRMENT,
NEUROTOXICITY, CARDIOVASCULAR
TOXICITY, FATIGUE IN
CANCER-SPECIFIC PAIN, THE SECOND
ORDER OF PRIORITIES IS SLEEP
DISORDERS, BONE AND HEALTH
TOXICITY, METABOLIC TOXICITY,
PSYCHOLOGICAL STRESS.
THESE ARE SOME EXAMPLES.
I'M NOT GOING TO DRAG YOU
THROUGH ALL THIS, I'LL TRY TO
KEEP TO TIME.
WE HAVE ACTIVITIES ONGOING OR
COMPLETED TRIALS IN COGNITIVE
IMPAIRMENT, LIKE A RANDOMIZED
PHASE 3 TRIALS OF -- I CAN NEVER
GET THE NAME RIGHT, MOMANTIN AND
WHOLE BRAIN RADIOTHERAPY WITH
AND WITHOUT HIPPOCAMPAL VOIDANCE
IN PATIENTS, NRG, C COG TRIAL
LOOKING AT THIS DRUG.
THIS IS THE UNIVERSITY OF
ROCHESTER LOOKING AT WAYS TO
TREAT CIPN, ANOTHER ONE IN THE
ALLIANCE CIPN, AND
CARDIOTOXICITY FOR CHILDHOOD
CANCER SURVIVORS, TOXICITY.
THIS IS A SMALL LIST OF THINGS
THAT GO ON IN THE NCORP.
OBVIOUSLY THE NCORP HAS BEEN
ACTIVE IN SCREENING TRIALS.
YOU'RE FAMILIAR WITH TMIST,
WHICH WE JUST HIT, CLOSE TO
HITTING OUR 108th ENROLLMENT
TARGET.
WE'RE AT 140 AS OF TWO WEEKS
AGO, OR A WEEK-AND-A-HALF AGO.
THIS IS BEING RUN BY ECOG-ACRIN,
AND THIS IS 2D VERSUS 3D
MAMMOGRAPHY FOR FOUR YEARS, AND
NRG LOOKING AT FIVE VERSUS
TEN-YEAR COLONOSCOPY FOR 1 OR 2
NON-GRADE ADENOMAS TO ESCALATE
FOLLOW.
THIS CAME OUT OF THE REVIEW OF
THE TMIST TRIAL, WE'VE
IMPLEMENTED ACROSS THE DIVISION
OF CANCER PREVENTION NOT JUST
WITHIN NCORP BUT ACROSS THE
DIVISION NEW SCREENING TRIAL
REQUIREMENTS, SAMPLE SIZED
APPROPRIATELY JUSTIFIED,
ELIGIBILITY CRITERIA DEFINED.
RECRUITMENT PLANNING OVERALL
MINORITY RECRUITMENT PLANS HAVE
TO BE DETAILED.
NON-ENGLISH SPEAKERS HAVE TO BE
INCLUDED.
WE HAVE TO MAKE ACCOMMODATIONS
FOR THAT, OBVIOUSLY.
AND PATIENT ADVISORY BOARDS FOR
ANY TRIALS OVER 10,000.
AND THEN WE SET UP MILESTONES
AND MONITORING AND WE'VE SHUT
DOWN ONE TRIAL OR PIVOTED FROM
SORT OF AN ACTIVE FOLLOW-UP TO A
PROSPECTIVE STUDY.
WE PUT STRINGENT CRITERIA, YOU
HAVE TO HIT THESE LOW LEVEL
BENCHMARKS BUT YOU HAVE TO HIT
THEM SO IF YOU HAVEN'T HIT 10%
OF YOUR ACCRUAL BY 25% OF THE
ACCRUAL TIME, YOU GET A YELLOW
FLAG.
YOU GET TWO YELLOW FLAGS, WE'LL
SHUT YOU DOWN BECAUSE YOU CAN'T
DO IT.
THAT'S THE POINT.
OTHERWISE THESE THINGS GO ON
FOREVER AND WE DON'T ACHIEVE OUR
GOALS, UNFAIR TO PARTICIPANTS
TOO.
SO WE HAD TO PUT IN SOME NEW
RULES.
WE ALSO -- NCORP SUPPORTS THE
CANCER CARE DELIVERY PORTFOLIO,
THERE ARE 30 PROTOCOLS, 12 OPEN,
9 CLOSED TO ACCRUAL, 9
COMPLETED, ADDRESSING A BROAD
RANGE OF CARE DELIVERY GAPS,
GUIDELINE ADHERENCE,
EXPENDITURES, ACCESSIBILITY,
DECISION MAKING, IMPLEMENTATION
SCIENCE, CASE MANAGEMENT, SO
FORTH.
AND THIS IS SORT OF A BREAKDOWN,
30 APPROVED PROTOCOLS, 18
RANDOMIZED, 13 PRACTICES
RANDOMIZATION, ACCRUALS 12,000
NON-PATIENTS, 2300 PRACTICES,
839 MINORITY PATIENT ACCRUAL,
23.4%.
JUST TO BRING THIS TO A CLOSE I
WANT TO EMPHASIZE THE NCORP IS A
COMMUNITY ACADEMIC PARTNERSHIP
INCREASING DIVERSITY OF ACCRUAL
AND GENERALIZABILITY OF RESULTS.
AGAIN, BECAUSE WE HAVE THE
COMMUNITY ONCOLOGISTS AND
COMMUNITY INVOLVED, IT REALLY WE
HOPE WILL LEAD TO FASTER
ADOPTION OF EVIDENCE GENERATED
BY NCORP BECAUSE WE'RE TALKING
TO PEOPLE DELIVERING CARE,
GRADING THE EVIDENCE WE WANT
THEM TO IMPLEMENT.
ADOPTION OF IMPROVED CLINICAL
PRACTICE AND CARE, FOCUS ON
IMPORTANCE OF QUALITY OF LIFE,
INCORPORATING PATIENT EXPERIENCE
AND DEVELOPING INTERVENTIONS TO
IMPROVE THE CANCER EXPERIENCE.
AND I AGAIN WILL SAY THIS ON A
PERSONAL NOTE, SO THIS IS THE
8-YEAR ANNIVERSARY OF MY WIFE
PASSING, QUALITY OF LIFE IS A
REAL THING.
WE HAVE TO TAKE CARE OF THE
WHOLE PERSON, NOT JUST THE
CANCER, WHICH IS WHAT HAPPENED
TO MY WIFE A LOT OF FOCUS ON THE
CANCER, NOT ENOUGH FOCUS ON HER
QUALITY OF LIFE, AND I CAN'T --
I WASN'T AS A CANCER RESEARCHER
WASN'T FULLY SENSITIZED UNTIL I
HAD TO WATCH IT UP CLOSE AND
PERSONAL.
FOCUS ON -- I'M SORRY, NCORP IS
TRANSNCI COLLABORATION, WE WORK
WITH DCTD, DCCPS, OPENING A
PROTOCOL WITH CCHE.
YOU'LL BE SEEING THIS IN THREE
MONTHS BECAUSE WE'RE COMING BACK
FOR RECOMPETITION, AND DECEMBER
BOARD MEETING, A WAY TO PRIME
YOU FOR THIS IS COMING.
I WILL SAY ONE OF OUR
ASPIRATIONS FOR THE NCORP IS
INCUBATOR PROGRAM TO HELP NEW
APPLICANTS COMPETE SUCCESSFULLY
TO JOIN NCORP.
IT'S VERY CHALLENGING TO BE ON
THE OUTSIDE AND TO COMPETE
SUCCESSFULLY.
WE'RE HOPING NOT ONLY THAT WE
GET MORE DIVERSE GROUP OF
CLINICAL SITES INVOLVED WITH
NCORP, WITH DIFFERENT
INVESTIGATORS, AND ALSO KIND OF
RAISE THE LEVEL OF COMPETITION,
SO WE HAVE GOOD PERFORMERS, NOT
SO GOOD PERFORMERS IN NCORP SO
WE'RE HOPING THIS RAISES THE BAR
AND TAKES NCORP TO ANOTHER
LEVEL.
WITH THAT I'LL SAY THANK YOU
VERY MUCH.
OH, WAIT, ONE MORE SLIDE.
I'M STEALING SOMEBODY ELSE'S
LINE FROM EARLIER, QUESTIONS TO
THINK ABOUT AS WE GO DOWN THE
ROAD.
HOW CAN WE EXPAND TO ENGAGE MORE
PEOPLE IN CLINICAL TRIALS WHERE
THEY LIVE?
BETTER ENGAGE THE LEAD ACADEMIC
PERFORMANCE SITES IN CANCER
CONTROL AND PREVENTION TRIALS?
HOW CAN WE BETTER COLLABORATE
INTERNATIONALLY CONDUCT CANCER
PREVENTION AND CONTROL TRIALS?
HOW CAN WE REDUCE WORKLOAD AT
SITES ENHANCING RESEARCH IMPACT
OF OUR TRIALS?
HOW CAN WE CONNECT DATA AND
BIOSPECIMENS FROM TRIALS AND
QUALITY OF LIFE TO CONTRIBUTE TO
RESEARCH AND HELP OUTSIDE
INVESTIGATORS WITH GREAT IDEAS
ENGAGE WITH THIS NETWORK.
I'LL TURN IT OVER TO JIM AND
THEN WE'LL DO 15 MINUTES AFTER
THAT.
>> YES.
>> THANK YOU.
[APPLAUSE]
>> I BELIEVE JIM IS IN THE
VIRTUAL ROOM.
>> I'M HERE.
I'D LIKE TO THANK THE NCTN
PRESENTATION AND THANK THE NCAB
FOR MY ABILITY TO GIVE THIS
PRESENTATION.
BEFORE I START IT'S REALLY
IMPORTANT THAT I NOTE WITH GREAT
APPRECIATION THE HUNDREDS OF
THOUSANDS OF PATIENTS WHO HAVE
PARTICIPATED IN THE NCTN TRIALS
OVER MORE THAN THREE OR FOUR
DECADES.
WITHOUT THEIR PARTICIPATION
THERE WOULD BE NO PRESENTATION
TODAY, AND MAJOR ADVANCES WOULD
NOT HAVE OCCURRED.
I THINK IT'S EQUALLY IMPORTANT
TO SAY THAT WE WOULD NOT HAVE AN
NCTN WITHOUT THE TENS OF
THOUSANDS OF HEALTHCARE WORKERS,
RESEARCH NURSES, DATA MANAGERS,
ADVOCATES, AND PRINCIPAL
INVESTIGATORS AND OTHER
INVESTIGATORS WHO HAVE WORKED
TIRELESSLY TO MAKE THIS NETWORK
SOMETHING OF NATIONAL
IMPORTANCE.
I ALSO HAVE TO CALL OUT THE
OPERATIONS CENTERS, STAFF
CENTERS, ALL THE OTHER
COORDINATING CENTERS THAT ARE
THE GLUE FOR THIS NETWORK.
I'LL MENTION THEM BUT I THINK
THEY NEED TO BE CALLED OUT
SPECIFICALLY.
THEY DO A GREAT JOB.
AND THE LAST FIVE YEARS AS
YOU'LL SEE BECAUSE OF THE
PANDEMIC HAVE REALLY NOT BEEN
EASY.
COULD I HAVE MY NEXT SLIDE.
BEFORE WE START MUCH AS PHIL DID
I'D LIKE TO TALK ABOUT THE
TRANSFORMATION OF THE FORMER
COOPERATIVE GROUP PROGRAM INTO
THE NCTN AFTER EXTENSIVE
INTRAMURAL REVIEW AND INPUT IN
2014.
WITH THAT INPUT, WE CHANGED THE
PROGRAM INFRASTRUCTURE IN A
MAJOR WAY TO HELP HARMONIZE
VARIETY THROUGH REMOTE
COLLABORATIONS, TO FOCUS ON
QUESTIONS THAT ARE NOT WELL
SUPPORTED IN THE COMMERCIAL
ENVIRONMENT, TO PRIORITIZE
TRIAL, INCORPORATE INNOVATIVE
SCIENCE IN CLINICAL TRIAL
DESIGN, AND PROVIDE LARGE SCALE
TESTING HE MOLECULARLY TARGET
AND DEFINED AND INCORPORATE INTO
THE NCTN PORTFOLIO, WITH GREATER
EMPHASIS ON TREATMENT OF RARE
TUMORS.
FINALLY, VERY IMPORTANTLY, TO
MAINTAIN COMMITMENT TO CONDUCT
TRIALS IN DIVERSE AND SPECIAL
POPULATIONS.
NEXT SLIDE.
THERE ARE SIX MAIN COMPONENTS TO
THE NCTN FUNDING PROGRAM.
THE U.S. COOPERATIVE GROUP
OPERATION CENTERS, GROUP STATS
AND DATA MANAGEMENT CENTERS,
CANADIAN COLLABORATING TRIALS
GROUP, ALL OF THE LEAD ACADEMIC
PARTICIPATING SITES, ALL OF
THEIR AFFILIATES WHICH COME IN
AT GREATER THAN 2,000 SITES
CONDUCTING TRIALS OF THE NCTN.
OUR IMAGING AND CORE SERVICE
CENTERS AND INTEGRATED
TRANSLATIONAL SCIENCE AWARDS FOR
PILOT PROJECTS.
IT'S IMPORTANT TO NOTE THAT
UNDER A SEPARATE RFA WE ALSO
FUND TUMOR BANKS FOR EACH OF
THESE GROUPS SO CRITICAL
SPECIMENS, CORRELATIVE STUDIES,
SOME NEEDED FOR ELIGIBILITY, ARE
COLLECTED AND MAINTAINED AND
ORGANIZED FOR SEPARATE USE
DURING THE CONDUCT AND AFTER
COMPLETION OF THE TRIALS.
FINALLY I CANNOT EMPHASIZE
ENOUGH WHAT DR. CASTLE HAS JUST
PRESENTED TO YOU, THE CRITICAL
IMPORTANCE OF OUR NCORP SITES IN
THE MAINTENANCE OF OUR ACCRUAL
GOALS FOR TREATMENT TRIALS.
THEY ARE ESSENTIAL.
NEXT SLIDE.
SOMETHING THAT IS NOT AS WELL
UNDERSTOOD IN THE EXTRAMURAL
COMMUNITY BECAUSE IT'S NOT
GRANTS FUNDED ARE SERIES OF
CONTRACTS, DIVISION OF CANCER
TREATMENT AND DIAGNOSIS
MAINTAINS NOT ONLY FOR OURSELVES
BUT OTHER CLINICAL TRIALS
NETWORKS ACROSS THE NCI.
AND THESE CONTRACTS SUPPORT
INFORMATION SECURITY, STUDY
ADMINISTRATION AND LOGISTICS,
CLINICAL DATA CAPTURE AND
REPORTING.
IN FACT, ENROLLMENT AND CLINICAL
TRIAL DATA MANAGEMENT SYSTEMS
ARE AT THE HEART OF OUR DATA
MANAGEMENT.
PROVIDE REGULATORY MONITORING
AND REPORTING.
INCLUDING INVESTIGATOR
CREDENTIALING.
AND NCI, CIRB AND REGULATORY
SUPPORT INCLUDING MAINTAINING
UPDATED 1572 FORMS FOR ALL OF
THOSE INVESTIGATORS ACROSS ALL
THOSE SITES.
AS WELL AS SPONSORSHIP OF IND
ACTIVITIES ON SELECT NCTN
TRIALS.
WE ALSO PLAY AN IMPORTANT ROLE
IN TERMS OF AUDITING FUNCTION
FOR DATA QUALITY AND CONTROL,
AND FOR THE MAINTENANCE OF
CORRELATIVE SCIENCE STUDY DATA.
NEXT SLIDE.
I'D LIKE TO TAKE MY CHANCE NOW
TO PROVIDE YOU WITH SOME
PERSPECTIVE ON VARIETY OF
INVESTIGATIONAL STUDIES CARRIED
OUT BY THE NCTN.
YOU'RE ALL FAMILIAR WITH THE
CONCLUDED NCI MATCH, PEDIATRIC
MATCH STUDIES, WHICH WERE
ESSENTIAL AND PROVIDED AN
IMPORTANT INPUT INTO HOW TO
CONDUCT STUDIES NATIONALLY.
BUT WE HAVE RECENTLY OPENED AND
ARE CONDUCTING SUCCESSOR TRIALS
TO MATCH, INCLUDING
ComboMATCH, MYELOMATCH,
PATIENTS FROM DIAGNOSIS THROUGH
RECURRENCE FOR ALL STAGES OF
AML, MDS, PILOT PROGRAM CALLED
I-MATCH, ACCRUED WELL TO TRY TO
UNDERSTAND WHAT KIND OF
MOLECULAR PLATFORM WE NEED TO
ENHANCE I/O THERAPY GOING
FORWARD.
ALL OF THIS COULD NOT BE DONE
WITHOUT A CENTRAL MOLECULAR
CHARACTERIZATION LABORATORY
SERIES THAT GOES ON AT THE
FREDERICK NATIONAL LAB, ALSO AT
MAJOR ACADEMIC SITES ACROSS THE
COUNTRY.
BUT THAT'S NOT AT ALL THE
COMPLETE SPECTRUM OF WHAT GOES
ON IN THE NCTN.
MULTI-MODALITY TRIALS NEVER
CONDUCTED BY INDUSTRY AND STUDY
OF ROLE OF WEIGHT LOSS IN
TREATMENT OF EARLY BREAST
CANCER, EVALUATION OF DOSE
ESCALATION THERAPY, PLUS OR
MINUS ADT IN INTERMEDIATE
PROSTATE CANCER, WE ALSO DO
COMBINATIONS OF CHEMOTHERAPY AND
IMMUNOTHERAPY, FOR COLON CANCER,
AND STUDIES IN SPECIAL
POPULATIONS, SPECIAL
INITIATIVES.
AYA TRIALS HAVE BEEN A MAJOR
FOCUS AT THE LAST AND CURRENT
FUNDING PERIODS.
STUDIES TO BROADEN ELIGIBILITY
AND OUTREACH TO DIVERSE
POPULATIONS, I WANT TO CALL TO
YOUR ATTENTION AN EFFORT
CONDUCTED BY A WORKING GROUP OF
THE CLINICAL TRIALS ADVISORY
COMMITTEE THAT WILL LITERALLY
CHANGE THE ENTIRE DATA
MANAGEMENT PROFILE FOR STUDIES
NON-IND REQUIRING, AS YOU'LL SEE
ABOUT 40% OF OUR TRIALS IN WHICH
AS OF JANUARY 1, 2025,
REQUIREMENTS WERE WHAT WAS
DEEMED TO BE BY AN EXPERT PANEL
COMPLETELY UNNECESSARY DATA
ELEMENTS, NO LONGER WILL BE
SUBMITTED IN THESE TRIALS, AND
WE'LL EVALUATE WHETHER OR NOT
THAT ENHANCES THE ABILITY FOR US
TO ACCRUE AND FOR US TO CONDUCT
STUDIES MORE RAPIDLY.
WE'RE IN THE MIDST OF EFFORTS TO
DECENTRALIZE OUR CLINICAL
TRIALS.
THERE ARE INCREDIBLY IMPORTANT
DATA SHARING ACTIVITIES, NCTN
AND NCORP, IN THE PROCESS WHICH
WE TRY TO PROVIDE ACCESS TO OUR
BIOSPECIMENS AND AS I WILL TOUCH
ON AT THE END I COULD NOT GIVE
THIS PRESENTATION WITHOUT SAYING
SOMETHING ABOUT PRAGMATIC ALUM.
I COULD NOT PROVIDE THIS
PRESENTATION WITHOUT SAYING
SOMETHING ABOUT THE IMPACT OF
COVID-19.
YOU SEE WHERE I TERMED IN PRIOR
PRESENTATIONS, THE GRAND CANYON
OF ACCRUAL.
SO BETWEEN THE FIRST AND SECOND
AND THIRD QUARTERS OF 2020,
ACCRUAL TO NCTN DROPPED
PRECIPITOUSLYA TESTAMENT TO
CHANGE IN NCTN AND NCORP ALLOWED
GREATER ENHANCEMENT AND ABILITY
FOR LOCAL SITES TO DO THEIR
TRIALS BY TELEMEDICINE FOR US TO
MAKE WITH THE FDA APPROVAL MAJOR
CHANGES IN STUDIES THAT ALLOWED
A MUCH MORE LENIENT PERSPECTIVE
ON LOW GRADE ADVERSE EVENT
REPORTING.
WE INITIATED REMOTE CONSENT AND
AUDITING TECHNIQUES, AND
IMPORTANTLY FOR THE FIRST TIME
BEGAN SHIPPING ORAL AGENTS
DIRECTLY TO PATIENTS FROM OUR
INVESTIGATIONAL SITES, THE
PATIENTS IN RULE SITES DID NOT
HAVE TO DRIVE IN SOME CASES
HUNDREDS OF MILES TO PICK UP
THEIR ORAL MEDICATIONS.
WHAT WE HOPE IS THAT THE ORANGE
BAR THAT YOU SEE WHICH IS OUR
ACCRUAL FOR 2024 AS OF VERY
RECENT DATE WILL ACTUALLY REACH
THE ACCRUAL RATE AND PERHAPS
EXCEED ACCRUAL RATE IN 2021
WHICH WILL GET US BACK TO
TRAJECTORY THAT IS MUCH MORE
CONSISTENT WITH OUR ACCRUAL
GOALS OVERALL FOR THE NETWORK.
NEXT SLIDE.
LET'S TALK ABOUT CHARACTERISTICS
OF THE COHORT BY A PHASE IND AND
CANCER TYPE.
NOT UNEXPECTEDLY, MAJORITY OF
THE ACCRUAL IN NCTN IS TO PHASE
3 AND PHASE 2/3 CLINICAL TRIALS
AS I ALLUDED TO EARLIER, IT'S
IMPORTANT TO POINT OUT, PERHAPS
NOT SOMETHING EVERYBODY
UNDERSTANDS, 40% OF TRIALS ARE
IND EXEMPT WHICH DOES ALLOW US
THE ABILITY TO MAKE SIGNIFICANT
CHANGES IN CLINICAL TRIAL DESIGN
AND DATA ELEMENT REPORTING AND
OTHER ASPECTS OF TRIALS TO
SIMPLIFY, DECENTRALIZE, MAKE
ACCRUAL EASIER FOR 2,000 SITES
CRITICAL TO OUR SUCCESS.
ON THE RIGHT SIDE OF THE GRAPH
YOU SHOULD NOT BE SURPRISED WITH
THE FACT OVER 60% OF THE
PEDIATRIC ACCRUAL IS TO A.L.L.,
WHERE MOST OF THE PATIENTS ARE.
IF YOU LOOK AT THE ADULT
CANCERS, WHAT YOU SEE IS AGAIN
NOT UNEXPECTED.
THE MAJOR DISEASES REST
GASTROINTESTINAL, GASTROURINARY,
INTESTINAL, MAJOR SITES FOR
ACCRUAL.
NEXT SLIDE.
WHAT ABOUT DEMOGRAPHIC OVERVIEW?
WELL, WE HAVE 68% WHITE RACE,
25% ARE NON-WHITE, AND/OR
HISPANIC/LATINO IN ETHNICITY.
I WOULD LIKE TO POINT OUT THAT
AS A SIGNIFICANT CONTRAST WITH
OUR PHARMA COLLEAGUES OVER 36%
OF OUR PATIENTS ARE AGE 65 AND
OLDER, SOMETHING YOU WOULD NOT
EXPECT TO SEE IN A PHARMA TRIAL.
APPROXIMATELY 16% OF PATIENTS
ENROLLED ARE FROM RURAL AREAS.
NEXT SLIDE.
LET'S GET TO THE NITTY-GRITTY.
MIDDLE GRAPH, MIDDLE PORTION OF
THE TABLE, YOU SEE ABILITY
AVERAGE NUMBERS FOR 60 MONTHS OF
THE FIRST FIVE-YEAR STUDY PERIOD
OF THE NEW NCTN FROM MARCH OF
2014 TO FEBRUARY OF 2019.
COMPARE THAT TO THE 65 MONTHS OF
THE ONGOING ACCRUAL FOR SECOND
PERIOD OF ACCRUAL.
I THINK IN MY OPINION AT LEAST
THE MAINTENANCE OF THE NUMBER OF
CONCEPTS THAT WERE APPROVED AND
TRIALS ACTIVATED GIVEN THE
PANDEMIC IS REALLY QUITE
EXTRAORDINARY AND A TESTAMENT TO
ALL OF OUR INVESTIGATORS.
LOOK AT THE ACTUAL NUMBERS.
I THINK A LARGE PART OF THE DROP
IN SCREENING PATIENTS WAS
BECAUSE OF THE CLOSURE OF THE
MATCH TRIAL AND PEDIATRIC MATCH
TRIAL.
WITH RESPECT TO ACTUAL
INTERVENTION ACCRUALS, ABOUT WE
ESTIMATE 10 TO 11% OF THAT DROP
WAS DIRECTLY RELATED TO THE
COVID-19 PANDEMIC DATA WHICH I
SHOWED PREVIOUSLY.
NEXT SLIDE.
I'D LIKE TO TAKE THIS CHANCE TO
BRIEFLY HIGHLIGHT JUST TWO OF
THE QUITE REMARKABLE
ACHIEVEMENTS OF THE NCTN.
AS OUTLINED IN THE NEW ENGLAND
JOURNAL, IN 2023, ENERGY GY 018
A RANDOMIZED TRIAL THAT WAS
PLACEBO CONTROLLED WHETHER OR
NOT THE ADDITION OF
PEMBROLIZUMAB STANDARD OF CARE
PACLOTAXOL, MADE A DIFFERENCE IN
PROGRESSION-FREE SURVIVAL.
REGRESSION FREE SURVIVAL, THE
DATA FROM THIS TRIAL WAS USED TO
OBTAIN FDA APPROVAL ON JUNE 17
OF THIS YEAR FOR THE USE OF
PEMBROLIZUMAB IN ENDOMETRIAL
CANCER, A MAJOR ACHIEVEMENT FOR
THE NCTN.
NEXT SLIDE.
ALSO WITH RESPECT TO THE CONDUCT
OF COLLABORATIVE TRIALS IN
SPECIAL POPULATIONS, HATS OFF TO
THE SOUTHWEST ONCOLOGY FOR
INITIATING A TRIAL THAT WAS
NCTN-WIDE TO EVALUATE WHETHER OR
NOT ADDITION OF IMMUNOTHERAPY IN
THIS CASE NIVULOMAB FOR
HODGKIN'S DISEASE INCLUDING A
COHORT AGE 12-17, 24% OF THE
PATIENT POPULATION, ALMOST A
THOUSAND PATIENTS.
WHAT COULD MAKE A DIFFERENCE IN
TREATMENT OF THIS CLASSICAL
DISEASE FOR WHICH ONLY MAJOR
CHANGES BECAUSE OF THE EFFECT OF
CHEMOTHERAPY CAN BE DISCERNED.
I'M DELIGHTED TO REMIND YOU THAT
THESE RESULTS WERE PRESENTED AT
2023 ASCO, THE SURVIVAL OF
NIVOLUMAB HAD MAJOR EFFECT, IN
THIS POPULATION FEW
IMMUNE-RELATED ADVERSE EVENTS
OCCURRED, PERHAPS EVEN MOST
IMPORTANT LESS THAN 1% OF
PATIENTS RECEIVED RADIATION
THERAPY I WHICH CAN HAVE LONG M
ADVERSE EVENTS OVER TIME.
WE BELIEVE THIS IS THE STUDY
THAT REPRESENTS A KEY STEP FOR
HARMONIZING PEDIATRIC AND ADULT
THERAPY, CLASSIC HODGKIN'S
DISEASE, AND WE THINK ADDITION
OF NIVOLUMAB IS POISED TO BE A
NEW STANDARD FOR TREATMENT OF
ADVANCED STAGE CLASSICAL
HODGKIN'S DISEASE.
NEXT SLIDE.
I COULD NOT MAKE THIS
PRESENTATION WITHOUT
HIGHLIGHTING THE INCREDIBLE
BROAD EFFORT ACROSS THE NCTN
GROUPS AND LEADERSHIP, NCI
LEADERSHIP, AND FDA TO MODERNIZE
TRIAL BASED ON PRELIMINARY STUDY
BY LUNG MAP GROUP, RANDOMIZED
SMALL RANDOMIZED PHASE 2 TRIAL
THAT SUGGESTED COMBINATION WAS
BETTER THAN INVESTIGATOR CHOICE
IN SECOND LINE NON-HODGKIN'S
LYMPHOMA, SECOND LINE THERAPY
FOR ENHANCED LUNG CANCER, EXCUSE
ME.
THIS IS AN AREA THAT NEEDS
IMPORTANT ADVANCES IN TREATMENT
SINCE THERE'S SO MANY PATIENTS.
GOAL WAS TO DEVELOP A STUDY LESS
BURDENSOME FOR PATIENTS AND
INVESTIGATORS THAT WOULD ALLOW
RAPID ACCRUAL AND WAS MUCH MORE
REPRESENTATIVE, A REAL WORLD
POPULATION.
AND PRIMARILY AND IMPORTANTLY,
TO SERVE AS MODEL FOR FUTURE
CANCER CLINICAL TRIALS.
THIS HAS BEEN A MAJOR EVENT IN
MY DEVELOPMENT AS A CLINICAL
INVESTIGATOR, BECAUSE IT'S
REMARKABLE TO SEE ALL OF THESE
GROUPS CAME TOGETHER, TRIAL
COULD BE PUT TOGETHER IN LESS
THAN 200 DAYS, INITIALLY 700
PATIENTS, THE TRIAL WAS AMENDED
TO 800.
ENROLLMENT AS OF 8/3, 2024, WAS
87% OF THE SAMPLE SIZE
PROJECTION, LEADING TO IMPORTANT
OUTCOME WE'LL LEARN QUICKLY AND
MAY LEAD TO NDA FOR THIS LARGE
PATIENT POPULATION.
LASTLY I CANNOT CONCLUDE WITHOUT
POINTING OUT RESULTS OF THIS
LANDMARK PAPER BY JOE UNGER AND
COLLEAGUES, PUBLISHED LAST YEAR,
2023, IN THE GACO.
AND THIS STUDY WHICH EVALUATED
POSITIVE RANDOMIZED TRIALS, SOME
SINCE 1980, MOSTLY 1990,
ANALYZED OVER 100,000 PATIENTS,
DEMONSTRATED THAT THESE STUDIES
WERE HIGHLY CITED, AND WERE PART
OF THE CANCER CURE GUIDELINES
RECOMMENDED AS FAVORABLE
TREATMENT OVER 90% -- OVER 87%
OF THOSE STUDIES.
ESTIMATED TO HAVE AGAIN
GENERATED 14.2 MILLION LIFE
YEARS TO PATIENTS WITH CANCER
THROUGH 2020.
AT A FEDERAL INVESTMENT COST PER
LIFE YEAR GAINED THROUGH 2020 OF
$326.
I DON'T THINK ANYTHING BETTER
DEMONSTRATES RETURN ON
INVESTMENT THAN THESE DATA.
THANK YOU SO MUCH FOR THE CHANCE
TO MAKE THIS PRESENTATION.
[APPLAUSE]
>> FANTASTIC!
THANK YOU SO MUCH, PHIL AND JIM.
AMAZING WORK ON THE CLINICAL
TRIALS SIDE.
WE WANT TO OPEN THE FLOOR FOR
QUESTIONS FROM THE BOARD.
KAREN?
>> SO AMAZING PRESENTATIONS.
THANK YOU BOTH VERY MUCH.
AS A RADIATION ONCOLOGIST WHO
SPECIALIZES IN HEME, ARTIFACTS
RELATED TO RADIATION DATES BACK,
AND WE'VE REVOLUTIONIZED THE WAY
WE TREAT.
CAN ADDITIONAL EXPENSE ADDED
FROM GOING TO SECOND AND THIRD
LINE SYSTEMIC THERAPIES WHICH
ADD BURDEN TO PATIENTS IN COST
AND TOXICITY, I WANT TO POINT
THAT OUT.
I DID WANT TO --
>> EXCEPTION NOTED.
>> YES, SIR.
OKAY.
THANK YOU.
THANK YOU, SIR.
SO, I LOVE THAT WE'RE
HIGHLIGHTING THE ABILITY TO
REALLY REACH PEOPLE WHERE THEY
ARE.
THAT'S THE IMPORTANCE OF THE
NCORP.
AND ONE OF THE CHALLENGES AS YOU
MAY KNOW, PHIL, I ACTUALLY AM ON
THE EXECUTIVE STEERING COMMITTEE
FOR WAKE FOREST BASED, 100%
SYMPTOM MANAGEMENT AND CCDR,
IT'S WHAT WE DO, BUT PART OF THE
CHALLENGES COMES FROM LENGTH OF
TIME TO GET A STUDY THROUGH.
I DIDN'T -- I DON'T KNOW IF YOU
TALKED ABOUT THAT.
CAN YOU TALK ABOUT HOW LONG IT
TAKES FOR REVIEW PROCESS TO GET
A STUDY ACTIVATE AND THE OTHER
IS RESOURCES BECAUSE YOU
MENTIONED WANTING TO HAVE MORE
HISPANICS OR INDIVIDUALS NOT
ENGLISH SPEAKERS BUT THERE'S NOT
RESOURCES FOR TRANSLATION THAT I
KNOW OF, THAT'S BEEN A HUGE BEAR
ARE FOR OUR SITES, IF YOU CAN
SPEAK TO BOTH OF THOSE THINGS.
>> SO I CAN'T SPEAK TO THE TIME
TO OPEN.
MAYBE JIM CAN.
I'LL ASK BRANDI TO SPEAK TO
THAT.
WE PAY MORE ATTENTION AND
INTENTION TO DIVERSE POPULATIONS
AND NON-ENGLISH SPEAKERS.
IN TMIST EVERYTHING IS ENGLISH
AND SPANISH.
>> AND FRENCH BECAUSE OF THE
CANADIAN SITE.
>> OH, YES, OKAY.
SO IT'S -- I MEAN, THESE ARE
TOUGH THINGS.
JIM?
>> DR. DOROSHOW, DO YOU WANT TO
COMMENT ON ORWG GUIDELINES?
>> SOME OF YOU KNOW, NOT ALL, IN
THE CONTEXT OF THE 2014 CHANGES
THAT WE MADE TO THE DEVELOPMENT
OF THE NCTN WE HAD ANOTHER CTAC
WORKING GROUP ON OPERATIONAL
EFFICIENCY WHICH CUT OUR
TIMELINES AND ESTABLISHED
GUIDELINES FOR THE TIMELINES.
WE IMPROVED GUIDELINES DOWN TO
THE -- I WOULD SAY THEY ARE
BETTER BUT ARE UNACCEPTABLY
LONG, ESPECIALLY COMPARED TO
INDUSTRY TRIALS.
THERE ARE MANY REASONS.
PERHAPS I'LL BE INVITED BACK TO
GIVE YOU AN ESTIMATE, WE
TRACK -- ONE OF THE THINGS WE
DID THAT WAS VERY GOOD THAT VERY
FEW PEOPLE KNOW IN RESPONSE TO
THE CHANGES RECOMMENDED WE HAVE
AN ELECTRONIC GANTT CHART WHICH
CHARACTERIZEs FOR EVERY TRIAL
IN NCTN AND ECTN VARIOUS
COMPONENTS OF TIME, DOESN'T
START IN COOPERATIVE GROUPS, IT
STARTS WHEN LETTERS OF INTENT
ARE SUBMITTED TO NCI.
PREVIOUS TIMEFRAMES ARE ALSO TOO
LONG BUT WE DON'T TRACK THOSE.
WHAT WE DO TRACK I CAN TELL YOU
IS THAT ONE OF THE MAJOR
COMPONENTS THAT WE FOUND THAT
ACTUALLY -- TWO THINGS HAVE SET
IT BACK.
ONE CONTINUES TO BE A PROBLEM.
TWO THINGS THAT SET US BACK WERE
OBVIOUSLY THE COVID ENVIRONMENT,
WHICH A LOT WHICH REALLY
MANDATED THAT WE MAKE EXCEPTIONS
TO THE TIMELINE, PEOPLE JUST
DIDN'T HAVE STAFF TO GET THESE
STUDIES OUT AND READY.
THE SECOND PART OF THAT OVER THE
LAST COUPLE YEARS THE TIMELINE
TO GET DRUG COMMITMENTS FROM
PHARMA IS JUST STRETCHED OUT
LONGER AND LONGER BECAUSE --
WELL, I WOULD HAVE TO ONLY
SPECULATE WHY THAT'S TRUE BUT IT
IS TRUE.
>> WHAT ABOUT FOR NON-TREATMENT
TRIALS?
WE'RE SYMPTOM MANAGEMENT, STILL
TAKING OVER 300 DAYS.
>> YEAH, SO NCORP ADAPTED THE
OEWG GUIDELINES FOR NCORP TRIALS
IN 2018.
AND SIMILARLY WE'VE HAD A LOT OF
ISSUES BECAUSE OF COVID AND
EXTENSION.
I WILL SAY THAT RECENTLY
WE'VE -- WITH RECOMPETITIONS
COMING UP WE HAVE TAKEN A HARD
LOOK AT WHAT THOSE ORIGINAL
GUIDE LINES WERE AND SENT OUT
LETTERS TO FIGURE OUT WHY SOME
OF THESE STUDIES HAVE THAT HAVE
BEEN ON THE BOOKS A WHILE
HAVEN'T YET BEEN ACTIVATED.
A LOT HAS TO DO WITH
CONTRACTING, OR GETTING AGENTS
READY AND AVAILABLE, THE COMPANY
THAT WAS GOING TO SUPPLY ISN'T
GOING TO SUPPLY ANYMORE, OR THEY
DOUBLED THE PRICE AND NOW CAN'T
AFFORD THAT VERSION, THEY HAVE
TO GET A DIFFERENT.
SO EVERY CLINICAL TRIAL HAS A
STORY.
AND WE HAVE TO ADAPT TO MAKE IT
WORK BUT WE ARE TRYING TO TAKE A
HARD LOOK AND SHORTEN TIMELINES
WHERE POSSIBLE.
I WILL SAY ON THE GRANT SIDE OF
THINGS WHERE 25% OF NCORP TRIALS
ARE FUNDED, WE RECENTLY STARTED
HAVING KICKOFF MEETINGS WHEN WE
KNOW AN NCCOR GRANT IS GOING TO
GET FUNDED WITH ASSOCIATION WITH
R01, WITH THE PROGRAM OFFICER,
PROJECT SCIENTIST, WITH RESEARCH
BASE AND WITH THE STUDY P.I. TO
MAKE SURE EVERYBODY IS ON THE
SAME PAGE, EVERYBODY KNOW WHAT
IS THEY ARE SUPPOSED TO DO.
>> GREAT.
>> THAT DOESN'T MEAN WE CAN'T DO
BETTER, KAREN.
I THINK MAYBE WE SHOULD -- I
DON'T KNOW WHETHER IT'S A
WORKING GROUP BUT WE NEED TO
TAKE A DEEP DIVE AND LOOK AT
WHERE WE CAN CUT THE TIME
BECAUSE IT'S EVERYBODY.
HOW TO DO BETTER WILL TAKE A
COLLECTIVE TO SOLVE IT.
THANK YOU FOR RAISING THAT
POINT.
>> WE HAVE TIME FOR TWO MORE
QUESTIONS.
I'M GOING TO GO WITH CHRIS AND
AJA.
>> THANKS.
SORRY I CAN'T BE WITH YOU IN
PERSON, BEST WISHES FROM ANN
ARBOR.
YOUR TEAMS, GRANTEES,
CONGRATULATIONS.
IT'S SUCH IMPORTANT WORK AND
GREAT TO SEE THE WORK.
I WANT TO DOVETAIL AND ECHO PHIL
AND KAREN'S DISCUSSION.
A WORKING GROUP HERE TO
ACCELERATE THE OPPORTUNITY FROM
CONCEPT TO RECEIPT OF TRIAL IN
COMMUNITY WOULD BE A GREAT WORK
GROUP TO THINK ABOUT.
A COMMENT AND QUESTION.
THE FIRST IS A COMMENT, I THINK
AS WE THINK ABOUT HISTORICALLY
WE HAD LABS AND NCORP, THAT MADE
SENSE FIVE OR TEN YEARS AGO.
NOW WITH CONSOLIDATIONS,
ACADEMIC STUDIES AND COMMUNITY
SITES HAVE BECOME BLURRIER,
RELATIONSHIPS ARE FAR MORE
FLEXIBLE AND I WONDER RIGHT NOW
WE HAVE SOME DISTINCTIONS IN
TERMS OF WHAT TRIALS CAN OPEN
WHERE, ET CETERA, THERE MIGHT BE
CONFUSION ABOUT THAT BUT I
WONDER IF THERE'S AN OPPORTUNITY
TO MAKE IT -- MAKE MORE TRIALS
AVAILABLE ABE CROSS BOTH LABS
AND NCORP IN THE FUTURE.
THAT'S A COMMENT.
THE SECOND POINT, PHIL, YOU
THINK OF WE ISSUING NCORP, WE
OFTEN SEE THOSE NUMBERS OF SITES
IN THE PRESENTATIONS BUT I
WONDER HOW MANY OF THOSE SITES
PUT PARTICIPANTS ON A STUDY.
SO I THINK WE WANT TO GET TO THE
NEXT STEP NOT JUST COUNTING
PHYSICAL LOCATION WHERE IS
PATIENTS MAY RECEIVE CARE BUT
ACTUALLY HOW MANY SITES GO ON TO
ACTUALLY OPEN STUDY, ACCRUE
PATIENTS TO A STUDY, APPROACH
PATIENTS IN STUDY.
I HOPE THOSE METRICS CAN BE
BUILT INTO THE NEXT RFP.
THANKS VERY MUCH.
>> I'LL COMMENT THAT THE OPEN
BUT NOT ACCRUED IS A LITTLE MORE
CHALLENGING TO GET AT, AFTER MY
RECENT -- MY FIRST RPPR REVIEW
OF THE NCORP PROGRAM.
IN MEG MOONEY'S PRESENTATION TO
THE BOARD WITH NCTN
RECOMPETITION SHE HAD THE NUMBER
OF SITES THAT CONTRIBUTED
PARTICIPANTS FROM NCORP TO
TREATMENT TRIAL ACCRUAL, 623
SITES.
>> ONE LAST QUESTION.
>> REAL QUICK.
DR. CASTLE, I WANT TO THANK YOU
FOR PUTTING THE QUESTIONS FOR US
AT THE END.
WHEN WE SIT IN THE BOARD ROOM
IT'S GREAT TO HAVE PEOPLE THAT
CAN'T TO HEAR BACK FROM US.
PART WAS HOW DO WE ENGAGE
PEOPLE.
I DIDN'T SEE IN THE PRESENTATION
WHO IS DOING THE NCORP STUDIES
FROM DEMOGRAPHIC STANDPOINT.
ONE WOULD ASSUME THAT NCORP
INVESTIGATORS MIGHT SKEW MORE
DIVERSE THAN, SAY, GENERAL NCI
OR MAYBE NCTN INVESTIGATORS BUT
I DIDN'T SEE THAT DATA.
I MAY HAVE MISSED IT.
I WONDERED IF THAT'S ONE OF THE
STATED GOALS OF NCORP, USING
THAT AS A WAY OF INCREASING
DIVERSITY OF PEOPLE BEING --
PARTICIPATING IN NCTN, IF THAT
CAN BE TRACKED AND REPORTED IT
COULD BE FANTASTIC AND MAY
FURTHER DRIVE ENGAGEMENT IN
TRIALS.
>> YOU'RE SPOT ON.
WE HAVE 15 MINUTES, AND I WENT
OVER, BUT IF YOU REALLY WANT
THOSE DATA WE CAN PRODUCE THOSE.
I AGREE WITH YOU THAT THE
DIVERSITY SHOULDN'T JUST BE AT
THE PATIENT -- THEY GO HAND IN
HAND, ROUND AND ROUND.
AND AS KIM AND OTHERS HAVE SAID
THROUGHOUT THE DAY, WE REALLY
WANT TO CREATE THIS NEW COHORT
OF INVESTIGATORS THAT REALLY
REPRESENT THE PEOPLE WE'RE
TRYING TO HELP.
AND I THINK THAT'S WHERE THE
RUBBER MEETS THE ROAD.
SO, LOOK FORWARD TO WORKING WITH
ON YOU THAT.
WE'LL GET YOU SOME OF THAT DATA
AND YOU'RE SPOT ON, I AGREE WITH
YOU.
>> IT'S A GREAT QUESTION, AND
ULTIMATELY WE'VE GOT TO MOVE ON.
THERE ARE ADDITIONAL THE
QUESTIONS, I CAN SEE PEOPLE
LOOKING AT ME.
WE'VE GOT TO MOVE ON.
THIS WILL COME BACK AROUND, I'M
SURE.
>> YES, I WILL SEE YOU IN THREE
MONTHS.
>> INCREDIBLY IMPORTANT TOPIC.
THANK YOU BOTH.
[APPLAUSE]
THE BOARD WILL NOW CONSIDER
ONGOING AND NEW BUSINESS.
THERE WERE TWO SUBCOMMITTEE
MEETINGS LAST EVENING, CHAIRS
WILL GIVE REPORTS.
DR. RICHARD BOXER IS FIRST.
>> WE HAD A MEETING LAST NIGHT,
FOR AN HOUR AND 15 MINUTES.
WE WERE ABLE TO EXTEND IT, AS
CONVERSATIONS AROUND HERE ALWAYS
DO.
AND THAT'S GOOD STUFF BECAUSE
THE -- WE HAD A ROBUST,
INCREDIBLY INTERESTING
CONVERSATION ENGAGING EVERYONE
WHO WAS IN ATTENDANCE.
THE IDEA OF THE EXPERIMENTAL
THERAPEUTICS SUBCOMMITTEE WAS TO
CONSIDER HOW TO FOSTER
COLLABORATION AMONG ADVOCACY
GROUPS, ACADEMIA, PRIVATE
INDUSTRY, NCI, AND THE FDA.
WE WERE TRYING TO THINK OF ONE
DIFFERENT -- DIFFERENT WAYS TO
COLLABORATE AND TO BRING PEOPLE
TOGETHER IN ORDER TO FOSTER THE
KIND OF COLLABORATION AND
CONVERSATION THAT IS SO
IMPORTANT TO DO SEVERAL THINGS
THAT WE LISTED IN THE PREVIOUS
MEETINGS BUT INVOLVED AND
MATURED THEM IN THIS MEETING.
THE CONCEPT TO BRINGING TOGETHER
LEADERS WHO DISCOVERED,
DEVELOPED, FINANCED NEW
TREATMENTS OF CANCER WAS
FUNDAMENTAL CONCEPT.
WITH THE NCI DEEP EXPERIENCE AND
EXPERTISE AND RESOURCES THAT CAN
ACCELERATE BRINGING NEW
EXPERIMENTAL TREATMENTS TO
PATIENTS WHY HAS INDUSTRY THAT
FUND INDUSTRY NOT REALLY -- NOT
HAVING GOOD CONVERSATIONS OR
GETTING INVOLVED IN THE
INNOVATION AT THE NCI?
AND FUNDAMENTALLY WE WANTED TO
TRY TO BUILD RELATIONSHIPS
BETWEEN INFLUENCE VCs WHO CAN
BUILD AND FINANCE NEW COMPANIES
TO DEMYSTIFY THE NCI SO
INNOVATION CAPITAL AND
ENTREPRENEURS CAN PARTNER WITH
THE NCI MORE OFTEN TO CREATE
DISCOVERY COLLABORATIONS WITH
INVESTIGATORS, WITH EXAMPLES
GIVEN, TO IMPROVE ACCESS AND
DEMOCRATIZE ACCESS TO DISCOVERY
TOOLS, TO LICENSE PROMISING
EXPERIMENTAL MEDICINES INTO NEW
COMPANIES THAT CAN DRIVE
PRODUCTS FORWARD TO THE
INTRAMURAL AND EXTRAMURAL
PROGRAMS.
IT BROUGHT -- ONE OF THE FIRST
THINGS WE LEARNED TODAY, THIS
MORNING, FROM KIM WAS HER FIRST
QUESTION, WHAT SHE SAYS SHE
NEEDS TO KNOW WITH THE NEW
CENTER FOR EXTERNAL AFFAIRS AND
A FOCUS ON COMMUNICATION.
WHERE WOULD YOU LIKE TO SEE
MORE?
I THINK OUR COMMITTEE IS LOOKING
TO ANSWER THAT, AT LEAST
PARTIALLY ANSWER THAT, BY
INCREASING COMMUNICATION BETWEEN
ALL THE DIFFERENT PLAYERS
WHETHER ADVOCACY GROUPS OR
ACADEMIA AND NCI, BUT VERY
IMPORTANTLY TO INDUSTRY THAT IS
FUNDING A LOT OF THE NEW
EXPERIMENTS THAT BRING CARE AND
IMPROVED DIAGNOSTICS AS WELL AS
THERAPEUTICS TO THE CANCER
PATIENTS.
ROSE, OUR EXECUTIVE EXPECT,
POINTED OUT INTEREST IN NEW
THERAPIES IN THE PUBLIC DOMAIN,
INDUSTRY INVESTMENT CAN ENABLE
OPPORTUNITIES IN THE AREA.
NCI IS INTERESTED IN BETTER
UNDERSTANDING INTERESTS OF
INVESTORS AND ENCOURAGING THEM
TO PROVIDE MORE SUPPORT IN THIS
SPACE.
WE'RE FORTUNATE IN HAVING JULIE
GRANT AS A MEMBER OF THE GRANT
BECAUSE JULIE HAS AN ENORMOUS
AMOUNT OF CREDIBILITY WITHIN THE
VENTURE CAPITAL COMMUNITY BUT
ALSO IS EXTREMELY INTERESTED IN
HELPING THE NCI WITH, YOU KNOW,
EXTERNAL FUNDING AS WELL AS
EXPERIMENTS, AND SHE SAID IN THE
PRIVATE SECTOR WE OF THEY LOOK
AT THINGS IN TERMS OF ADDITIONAL
THREE ZEROES AFTER THE AMOUNT OF
MONEY THAT IS OTHERWISE GIVEN BY
THE NCI.
SHE POINTED OUT FOR EXAMPLE ONE
PARTICULAR COMPANY HAS RAISED
$500 MILLION FOR ONE PRODUCT, AT
LEAST ESTABLISHING AN AREA
WITHIN WHAT THEY FOUND TO BE
PARTICULARLY ADVANTAGEOUS FOR
THE PATIENT.
SO, WHAT WE WANTED TO DO AT THE
LEVEL OF THE EXPERIMENTAL
THERAPEUTICS COMMITTEE TO FOSTER
AN OPPORTUNITY TO BRING TOGETHER
IN A SMALL WORKSHOP BUT LATER ON
A MUCH LARGER WORKSHOP BUT
INITIALLY SMALL WORKSHOP THAT
COULD ACT IN MANY RESPECTS AS A
PILOT FOR THE NCI IN GENERAL TO
BRING TOGETHER AND HAVE
COMMUNICATION BETWEEN THE
PRIVATE SECTOR, PARTICULARLY
VCs THAT FUND THE PRIVATE
SECTOR AND SENIOR LEVEL PEOPLE
IN THE NCI.
FOR EXAMPLE, JULIE MENTIONED
THAT IN THE CONVERSATION WITH
ONE SENIOR PERSON IN THE NCI HE
JUST COULDN'T UNDERSTAND WHY THE
SMALL COMPANIES THAT WERE
LOOKING INTO DIFFERENT PRODUCTS
THAT COULD EVENTUALLY LEAD TO
HOPEFULLY CARE FOR THE PATIENT
NEVER EVEN OPENED THEIR E-MAILS.
THEY NEVER EVEN KNEW WHAT WAS
GOING ON IN THE NCI AND DIDN'T
REALLY WANT TO TALK ABOUT IT
BECAUSE AS JULIE EXPLAINED, AND
OTHERS PIPED IN, THAT PEOPLE IN
THE PRIVATE SECTOR DON'T EVEN
WANT TO CALL THE GOVERNMENT.
THEY ARE TRAINED NOT TO TALK TO
THE GOVERNMENT.
SO THAT THE ACCESS OF
INFORMATION AND COMMUNICATION IS
IN DEEP TROUBLE.
AND THAT REALLY COULD AND DOES
INHIBIT NEW DISCOVERIES.
SO, FINALLY WE THOUGHT THAT BY
HELPING PEOPLE OUTSIDE THE NCI
FIND THE FRONT DOOR, BREAKING
THROUGH FOR DISCOVERY AND
BREAKING DOWN SILOS, AND FILLING
THE GAPS THAT VCs HAVE, AND
ALIGNING THE INCENTIVES OF
PRIVATE SECTOR AS WELL AS
NATIONAL CANCER INSTITUTE, BUT
IN ADDITION TO NOT JUST PRIVATE
SECTOR BUT INVOLVING PRIVATE
SECTOR WITH THE FDA AND WITH
ACADEMIA, AND ADVOCACY GROUPS
COULD LEAD TO WHAT WE ALL WANT,
WHICH IS BETTER CARE FOR THE
CANCER PATIENTS.
>> THANKS, RICK.
WE CAN OPEN THE FLOOR FOR
QUESTIONS.
ADDITIONAL INSIGHTS FROM OTHER
MEMBERS OF THE SUBCOMMITTEE?
ANDREA?
>> YES, GREAT JOB SUMMARIZING
BUT AS FAR AS ACTION ITEMS, KEN,
WE WANTED TO FIGURE OUT IF THERE
WAS A WAY TO ESTABLISH QUARTERLY
SEMINAR OR SOME WAY TO HIGHLIGHT
PRINCIPAL INVESTIGATOR AND
PRESENCE OF INDUSTRY AND SO THAT
THERE COULD BE A DIALOGUE OR NOT
NECESSARILY EVEN A DIALOGUE BUT
AN UNDERSTANDING OF WHAT IS AT
CUTTING EDGE NOW SCIENTIFICALLY
AND WHAT INDUSTRY IS INTERESTED
IN SUPPORTING, THAT THAT MIGHT
BE A WAY TO START THE
CONVERSATION.
>> I LIKE THAT.
I WAS STRUCK WHEN YOU SAID
PEOPLE IN INDUSTRY MIGHT BE, YOU
KNOW, NOT JUST LESS INTERESTED
IN TALKING TO US BUT DISSUADED
FROM TALKING TO GOVERNMENT.
WHERE THERE ARE OPPORTUNITIES TO
BREAK THAT WALL DOWN I THINK
THAT WOULD BE REALLY IMPORTANT.
I DON'T KNOW IF THAT'S A
SYMPOSIUM THING OR ANOTHER WAY
OF CONVENING PEOPLE TO HAVE THE
DIALOGUE.
>> COULD JULI SPEAK TO THAT?
>> I'LL SAY PERHAPS IT'S
BUILDING RELATIONSHIPS.
I THINK IN THE SAME WAY THERE'S
A LOT OF COMPLIANCE NECESSARY TO
MAINTAIN AUTONOMY
IMPORTANT IN TERMS OF CONFLICT
OF INTEREST.
A LOT OF US TRAINED IN
FOR-PROFIT CENTER STARTED IN
LABS OR INSTITUTIONS, A FLUED
SYSTEM BUILD THROUGH
RELATIONSHIPS.
MEDICINES APPROVED BY FDA, THEY
ARE THE SAME PEOPLE.
AND SO I THINK IT'S WHAT THE
COMMITTEE IS TALKING ABOUT HOW
DO WE FIND THE RIGHT NEXUS TO
BUILD RELATIONSHIPS THAT ARE
APPROPRIATE, WITHIN THE CONFINES
OF GUIDANCE, ALSO ALLOW THE
REALLY EXCEPTIONAL KNOWLEDGE
WITHIN THE NCI TO PERMEATE OUT
INTO THE PRIVATE SECTOR AND VICE
VERSA WHERE APPROPRIATE.
THAT CONVERSATION WAS PART OF
WHAT WE WERE TALKING ABOUT AT
THE COMMITTEE.
AND WE BELIEVE IT'S INCREDIBLY
IMPORTANT FOR THE NCI AND NCB TO
DO THIS APPROPRIATELY AND WE
ALSO KNOW THAT IT'S IMPORTANT TO
REALLY FIND THE RIGHT SUBSTANCE
OF THOSE CONVERSATIONS THAT ARE
ABOUT ADVANCING THE SCIENCE AND
CLINICAL CARE AND NEW MEDICINES
UNDER THE COMMITTEE OF EMERGING
THERAPEUTICS WHICH COULD BE A
GREAT NEXUS OF THESE INVESTORS
THAT FUND NEW THERAPIES THROUGH
START-UPS.
AND THE INVESTIGATORS WHO HELP
DRIVE TRIALS THROUGH THE TRIAL
NETWORKS THAT WERE SO
ARTICULATELY DESCRIBED.
A LOT OF SUBSTRATE COULD BE
BUILT THROUGH THOSE
RELATIONSHIPS AND HOPEFULLY
BRING BETTER MEDICINES TO
PATIENTS FASTER.
SO, YEAH, IT'S BRINGING PEOPLE
TOGETHER TO BUILD RELATIONSHIPS
>> ONE OTHER THING THAT WAS
SUGGESTED, AND THAT IS THAT
INVESTIGATORS DON'T HAVE A
FUNDAMENTAL KNOWLEDGE OF HOW TO
BRING THEIR PRODUCT, THEIR
DISCOVERY, TO MARKET.
AND IT'S A CULTURAL CHANGE.
AND SO IT WAS SUGGESTED THAT
WOULDN'T IT BE A GOOD IDEA TO
HAVE AN OPEN FORUM OR
ROUNDTABLE, MAYBE EVEN ONE
PERSON, BUT HAVING PREVIOUS NCI
DIRECTOR, FOR EXAMPLE DR.
SHARPLESS, OR MAYBE RICK, WHO
HAS BEEN AWAY FOR A WHILE, BUT
IN THE PRIVATE SECTOR, TO BE
ABLE TO TEACH INVESTIGATORS THE
INTRAMURAL, EXTRAMURAL, OR
OTHERS, PERHAPS, BUT IN ANY CASE
HOW TO DO IT, HOW TO GET FROM
POINT A, BRILLIANT DISCOVERY, TO
POINT B, INTO THE PATIENT.
>> MAY I ASK, I ALSO MAYBE JUST
TO RAISE ONE OTHER TOPIC THAT
WAS RAISED IN THE SUBCOMMITTEE,
I DO THINK TIES TO THE LAST
CONVERSATION ABOUT TRIALS.
I THINK THERE'S A NUMBER OF
OTHER IDEAS THAT CAME FROM THESE
EXPERIMENTAL THERAPEUTICS
COMMITTEE THAT RELATED TO
CENTERS AND PHARMACEUTICAL
DISCOVERY, AT VANDERBILT, FOR
EXAMPLE, IS THAT A WAY?
WE TALKED ABOUT WAYS TO
ACCELERATE CLINICAL TRIALS, IS
THERE DUPLICATIVE REVIEWS?
CAN WE USE SMALL PHARMA, VERY
SMALL ORGANIZATIONS THAT CAN
DECIDE WHO TEN ENABLE SOME
EXPERIMENTATION RAPID PUSH
FORWARD.
IT WAS A VERY BROAD CONVERSATION
ACROSS ALL THE DIFFERENT
CONSTITUENTS WHICH MAKES ME
QUITE EXCITED WHAT COULD COME AT
THIS INTERSECTION OF THE
EXECUTION OF EXPERIMENTAL
THERAPEUTICS WITH ALL THESE
STAKEHOLDERS, IT WAS A GREAT
CONVERSATION, THANK YOU TO
EVERYONE FOR ATTENDING.
A VERY ROBUST DIALOGUE.
>> YOU HAD A GREAT IDEA, ABOUT
HOW -- FOR CLINICAL TRIALS
MERGING ACADEMIA AND NCI AS WELL
AS THE PRIVATE SECTOR BECAUSE OF
THE COST OR THE PAYMENT.
>> YEAH, SO THIS YEAR WE HAD A
SUBCOMMITTEE MEETING FOR
CLINICAL INVESTIGATION
SUBCOMMITTEE AND WE GOT FEEDBACK
FROM DR. MOONEY WHO SET OUT
QUESTIONNAIRES, NONE OF THIS WAS
SURPRISING.
WE AT THE CANCER CENTERS WERE
NOT BEING COMPENSATED THAT WOULD
MATCH WHAT INDUSTRY GIVES US TO
ENROLL CLINICAL TRIALS AND THIS
CREATES HUGE HURDLES ESPECIALLY
IN TODAY'S FUNDING ENVIRONMENT.
AND JOHN, TO WHAT YOU SAID,
CLINICAL REVENUE IS NOT
SUSTAINING US THE WAY IT WAS SO
THE QUESTION WAS COULD WE
LEVERAGE THE 20+ YEAR
INFRASTRUCTURE OF CLINICAL
TRIALS THROUGH THE ECTCN WITH
VENTURE CAPITAL AND NEW
COMPANIES AND BRING THAT
TOGETHER BEING ABLE TO USE IT AS
A HIGHWAY, THIS WHOLE STRUCTURE
THAT EXISTS AS WITH A WAY TO
SUPPLEMENT THE AMOUNT OF MONEY
INSTITUTIONS ARE GETTING.
WE ALSO RECOGNIZE THE TIMELINE
QUESTION THAT WE JUST BROUGHT
UP, KAREN JUST BROUGHT UP, IS
GOING TO BE KEY BECAUSE 300 DAYS
OR 200 DAYS IS NOT ENOUGH FOR
INDUSTRY.
SO IT REQUIRES RECONFIGURATION
BUT COULD BE A WAY TO LEVERAGE
ASSETS THAT ONLY THE NCI HAS
GENERATED OVER DECADES WITH THIS
NEW WAY OF DOING RESEARCH WHICH
IS REALLY THE WAY FORWARD
CONSIDERING HOW MUCH MONEY IS IN
THE PRIVATE INDUSTRY.
>> WE DECIDED WE WERE GOING TO
WORK IN BETWEEN NOW AND THE
DECEMBER MEETING AND BRING TO
THE NCAB FOR APPROVAL, WE HOPE,
THAT WE WILL HAVE SOME FORM OF
COMMUNICATION, WORKSHOP, SOME
KIND OF METHOD BY WHICH WE COULD
BRING TOGETHER THE GROUPS THAT
ARE SO ESSENTIAL TO ULTIMATELY
THE PATIENT.
>> IT SOUNDS LIKE A WORKSHOP,
FIRST OF ALL, TO GET THE RIGHT
PEOPLE IN THE ROOM, A GOOD
SAMPLING OF THE RIGHT PEOPLE
TALKING TO EACH OTHER TO FIGURE
OUT HOW YOU DO THE KIND OF
MATCH-MAKING AND THINGS, YOU
KNOW, THAT PEOPLE ARE EXCITED
ABOUT.
>> GREAT DISCUSSION.
NOW THE NCAB MEMBERS HAVE TO
VOTE TO ACCEPT THE REPORT FROM
THE AD HOC SUBCOMMITTEE ON
EXPERIMENTAL THERAPEUTICS THAT
WAS JUST PROVIDED BY RICK.
IS THERE A MOTION?
A SECOND?
FURTHER DISCUSSION?
BEING NONE LET'S VOTE.
ANY NAYS?
ABSTENTIONS?
IT'S UNANIMOUS.
OKAY.
WE'LL MOVE TO THE NEXT
SUBCOMMITTEE REPORT, BROUGHT BY
DR. WINKFIELD, WHO CHAIRS AD HOC
SUBCOMMITTEE ON POPULATION
SCIENCE, EPIDEMIOLOGY,
DISPARITIES.
KAREN?
>> THANK YOU, JOHN.
I WANT TO THANK THE MANY FOLKS
WHO ATTENDED.
WE HAD A LOT OF THE
REPRESENTATION, NCI, THAT WAS
WONDERFUL TO HAVE THEM IN THE
AUDIENCE.
ONE OF THE THINGS THAT I TRY TO
DO IS TO REMIND FOLKS OF THE
PURPOSE OF THE SUBCOMMITTEE
REALLY TO HELP ADVISE, ALSO TO
EVALUATE NEW POTENTIAL
APPROACHES, BARRIERS THERE MIGHT
BE.
WE'RE TALKING ABOUT NEW TYPES OF
RESEARCH.
WE WERE VERY EXCITED AND HONORED
TO HAVE DR. CHERYL BOYCE GIVE A
PRESENTATION ON THE ComPASS
PROGRAM, MANY OF YOU MAY HAVE
HEARD OF IT, COMMUNITY
PARTNERSHIPS TO ADVANCE SCIENCE
FOR SOCIETY, ComPASS PROGRAM,
FUNDED THROUGH THE COMMON FUND
WHICH WE HEARD ABOUT EARLIER,
THE FIRST AWARDS COMING FROM THE
COMMON FUND.
YOU KNOW, THE ABILITY TO RETHINK
HOW WE DO RESEARCH IS AN
INCREDIBLE OPPORTUNITY TO
ADVANCE RESEARCH AROUND HEALTH
EQUITY.
I SAY THAT BECAUSE THERE'S SOME
ESTIMATES THAT IF WE INDEED WERE
TO REDUCE HEALTHCARE
DISPARITIES, CANCER DISPARITIES,
WE COULD MEET THE PRESIDENT'S
MOONSHOT GOAL OF REDUCTION OF
50% DECREASE IN CANCER DEATHS
WITHIN 25 YEARS, JUST BY
REDUCING THE DISPARITIES OR
ELIMINATING DISPARITIES.
PART OF THE CHALLENGE WE KNOW
THERE'S LOTS OF STRUCTURAL
BARRIERS.
IF WE HAD UNIVERSAL HEALTH CARE
COVERAGE MAYBE THAT WOULD BE
SOMETHING BUT THAT'S NOT WHAT
THE NCI DOES.
WE DO RESEARCH.
PART OF THE CHALLENGE IS HOW DO
YOU DO RESEARCH ON STRUCTURAL
BARRIERS?
AND SO HAVING DR. BOYCE COME WAS
INCREDIBLE BECAUSE THE ComPASS
PROGRAM, JUST LAUNCHED ACTUALLY
TWO YEARS OLD NOW, IS A REAL
WONDERFUL IDEA TO THINK ABOUT
REENVISIONING HOW RESEARCH IS
DONE.
WHAT THEY DECIDED TO DO WAS
LEVERAGE PARTNERSHIPS ACROSS
MULTIPLE SECTORS TO DEVELOP AND
EVALUATE COMMUNITY-LED HEALTH
EQUITY STRUCTURES INTERVENTIONS
TO REDUCE HEALTH DISPARITIES AND
DEVELOP MODELS FOR COMMUNITY-LED
AND CROSS-CUTTING STRUCTURAL
INTERVENTION RESEARCH ACROSS THE
NIH AND OTHER FEDERAL AGENCIES.
SO, THIS IS REALLY ALMOST AN
ALL-OF-GOVERNMENT APPROACH,
RIGHT?
THEY DID LEVERAGE THE EXPERTISE,
COMMUNITY PARTNERS DEVISED FROM
LOTS OF ORGANIZATIONS INCLUDING
USDA FOR EXAMPLE, TO SAY WHO ARE
THE PEOPLE WE NEED AT THE TABLE,
WHO DO WE NEED TO INVITE TO
CONSIDER THIS AWARD MECHANISM.
BEFORE THEY LAUNCHED THIS RFA
THEY SAID, WELL, LET'S GO TO THE
COMMUNITIES THAT HAVE BEEN MOST
DISENFRANCHISED AND ASK WHAT
THEY THINK IS NEEDED TO HELP
ADVANCE THE SCIENCE AND RETHINK
AND REENVISION HOW RESEARCH IS
DONE IN THIS AREA.
NIH CONDUCTED EIGHT LISTENING
SESSIONS IN 2021 TO SOLICIT
INPUT.
THEY HAD TRIBAL COMMUNITIES,
DIFFERENT ORGANIZATIONS,
ADVOCACY GROUPS WERE THERE.
THEY REALLY SAID WHAT ARE THE
THINGS THAT YOU ALL THINK WE
NEED TO DO DIFFERENTLY IN THIS
ARENA?
MANY OF THE DISCUSSION THEMES
WERE AROUND COMMUNITY OWNERSHIP.
WE HAD SOME CONVERSATIONS ABOUT
THE FACT OFTENTIMES RESEARCH IN
THE IVORY TOWER IS DONE FROM AN
IVORY TOWER MENTALITY, DONE TO
THE COMMUNITY INSTEAD OF HEARING
FROM THE COMMUNITY ABOUT WAYS
THAT WE CAN ENVISION RESEARCH
THAT WILL ACTUALLY HAVE AN
IMPACT ON THE COMMUNITIES WE
SERVE.
THIS IS REALLY AN IDEA FLIPPING
THINGS ON ITS HEAD, WHERE YOU
REALLY PUT THE POWER IN THE
HANDS OF THE COMMUNITY,
COMMUNITY ORGANIZATIONS, IT
HELPS NOT ONLY WITH BUILDING
TRUST BECAUSE AS WE KNOW WE HAVE
INSTITUTIONS, WE KNOW HOW TO
WRITE GRANTS AND CAN SAY
WHATEVER, BUT THERE'S LACK OF
ACCOUNTABILITY IN TERMS OF
HOLDING PEOPLE'S FEET TO THE
FIRE SAYING ARE YOU ACTUALLY
PARTNERING WITH THIS PARTICULAR
ORGANIZATION, OR IS THIS
HELICOPTER RESEARCH, WHERE
YOU'RE JUMPING IN AND JUMPING
OUT WHEN THE PROJECT IS DONE
LEADING TO LACK OF
SUSTAINABILITY.
THIS BOOTS ON THE GROUND
APPROACH GAINING INSIGHT FROM
COMMUNITY FIRST LED TO THIS
OPPORTUNITY TO REALLY DEVICE
THIS ComPASS PROGRAM,
INNOVATIVE APPROACH, THE MONEY
GOES TO THE COMMUNITY-BASED
ORGANIZATION, NOT TO THE
ACADEMIC INSTITUTION.
IT REALLY FLIPPED THINGS ON ITS
HEAD AND REALLY WHAT THEY WERE
ABLE TO DO IS FUND 25 DIFFERENT
PROGRAMS, ACTUALLY CALLING
CHESIs, COMMUNITY LED
INTERVENTION STRUCTURAL, CHESI
IS THE TERMINOLOGY USED, THERE
ARE 25 OF THESE.
IT REALLY IS SPECTACULAR.
IT WASN'T INTENDED TO DO THIS,
THEY WERE ABLE TO NOT ONLY BE
ALL OVER THE COUNTRY SO SHE
SHOWED A MAP OF WHERE ALL THESE
CHESIs ARE LOCATED, EVERYWHERE
IN THE COUNTRY, BUT THEY HAVE
FIVE TRIBAL COMMUNITIES THAT
WERE INCLUDED, WHICH WAS
SPECTACULAR, OFTENTIMES WE KNOW
OUR AMERICAN INDIAN AND
INDIGENOUS POPULATIONS GET LEFT
OUT OF RESEARCH OFTEN BUT FIVE
TRIBAL INSTITUTIONS APPLYING
BECAUSE THEY MAY NOT NECESSARILY
HAVE THE TRUCK TO DO R01-LED
RESEARCH, THIS WAS A WONDERFUL
WAY TO OPEN THE DOOR.
AND IN FACT EVEN THOUGH THEY
ONLY FUNDED 25 OF THESE, THERE
WAS LOTS OF INTEREST, THEY HAD
OVER 25 -- 2400 PEOPLE GET ONTO
CALLS THAT WERE INTERESTED IN
THIS PARTICULAR NEW MECHANISM,
IT SHOWS THERE'S AN OPPORTUNITY
TO REALLY RETHINK HOW RESEARCH
IS DONE.
AGAIN, THE RESEARCH PROJECT, THE
PROGRAM IS RELATIVELY NEW, ONE
OF THE THINGS THEY ARE GOING TO
IMPLEMENT ARE THESE PROGRAMS
HERAs, HEALTH EQUALITY
RESEARCH ASSEMBLIES, LARGER
GROUPS PULLING TOGETHER FOR EACH
OF THE REGIONS.
NCI IS GOING TO HELP LEAD, FROM
WHAT I UNDERSTAND.
AN ANNOUNCEMENT ON SEPTEMBER 10
WILL TALK ABOUT THAT BUT, AGAIN,
OPPORTUNITY TO HAVE INPUT AND
EXPERTISE TO HELP WITH THE
PROGRAMMATIC FLOW, TO HELP WITH
PERHAPS METHODOLOGIC RESEARCH,
EXPERTISE, AND SO IT'S GOING TO
BE FASCINATING TO SEE HOW THIS
IS DONE.
THIS IS THE 10-YEAR PROGRAM
THOUGH, RIGHT?
TWO YEARS FOR PLANNING, WHICH IS
GREAT.
WE HEAR ABOUT UG3, UH3.
I LOVE MECHANISMS THAT PUT THAT
IN.
ComPASS PROGRAM IS ONE OF
THEM.
TWO YEARS OF PLANNING FOR THE
DEEP DIVE, THE NEEDS OF THE
COMMUNITY, MILESTONES, MORE
MILESTONES BASED, OTA MECHANISM,
FOLKS MIGHT REMEMBER THE CEAL
TEAMS, COMMUNITY ENGAGED
ALLIANCE AGAINST DISPARITIES
WHICH ALLOWS FLUIDITY.
AS THINGS ARISE, YOU DEAL WITH
COMMUNITY, THINGS MAY CHANGE,
YOU CAN PIVOT WITHOUT HAVING TO
GO THROUGH ENTIRE NEW GRANT
REVIEW PROCESS.
SO THIS IS A REALLY WONDERFUL
OPPORTUNITY TO RETHINK RESEARCH.
ONE THING WE THOUGHT ABOUT AS A
COMMITTEE, IS THERE A WAY TO
LEVERAGE THIS INFRASTRUCTURE TO
ASK CANCER-RELATED QUESTIONS AND
TO PARTNERS WITH THEM THROUGH
SUPPLEMENTS OR OTHER WAYS WE
MIGHT BE ABLE TO LEVERAGE
AMAZING OPPORTUNITY THAT'S GOING
TO BE GOING INTO LOOKING AT
SOCIAL DETERMINANTS OF HEALTH,
WHICH WE ALSO KNOW IS AN
NIH-WIDE INITIATIVE, HOW DO YOU
ACTUALLY, YOU KNOW, MEASURE
THOSE, RIGHT?
HOW DO WE DO THE DEEP DIVE AND
INFLUENCE POLICY?
THIS ComPASS PROGRAM, PLEASED
TO HAVE IT PRESENTED, GRATEFUL
FOR DR. BOYCE AND TEAMS.
ONE OF THE THINGS IT HELPED US
SAY, IS THERE ANY WAY WE CAN
LEVERAGE PREEXISTING OR WHAT'S
GOING TO BE EXISTING RESOURCE
POTENTIALLY TO REALLY REENVISION
WHAT WE'RE DOING IN THE CANCER
SPACE.
THERE WAS ONE OF THESE CHESIs
THAT IS CANCER SPECIFIC,
ARKANSAS CANCER CONSORTIUM I
BELIEVE IS THE NAME OF IT.
ONLY ONE PROJECT IS REALLY
FOCUSED ON CANCER SPECIFICALLY,
BUT THAT'S INTENTIONAL.
IT'S THINKING ABOUT BROAD
STRUCTURAL BARRIERS.
TRANSPORTATION IS THE NUMBER ONE
BARRIER TO CANCER CARE.
CAN WE LEVERAGE THAT?
THAT WAS THE BULK.
WE WANTED TO FOCUS ON NEXT
STEPS, THINGS TO BRING BACK TO
THE LARGER GROUP.
AGAIN, OUR HOMEWORK SIMILAR TO
THE HOMEWORK FROM THE LAST GROUP
OF IS REALLY OVER THE NEXT
COUPLE MONTHS WE'LL BE HAVING
SOME INTERIM MEETINGS TO REALLY
START TO DO A DEEP DIVE IN TERMS
OF THINKING OF WHAT ARE OTHER
ORGANIZATIONS WE NEED TO THINK
ABOUT PARTNERING WITH, LEARNING
FROM, AND HOW DO WE MAKE SURE
WE'RE PULLING IN THE EXPERTISE
THAT'S NEEDED TO HELP TO START
TO THINK ABOUT POPULATION HEALTH
IN A VERY DIFFERENT WAY.
SO, I'M GOING TO LEAVE IT AT
THAT.
I DIDN'T KNOW IF THE OTHER
COMMITTEE MEMBERS OR FOLKS OR
SUBCOMMITTEE MEMBERS OR FOLKS
THERE WANTED TO ADD ANYTHING TO
THAT.
>> ADDITIONAL INSIGHTS FROM THE
SUBCOMMITTEE?
QUESTIONS FROM THE BOARD?
PLEASE USE YOUR MIC.
>> VERY COMPREHENSIVE SUMMARY,
NOTHING TO ADD TO THAT.
>> OKAY.
KIM?
>> I WANT TO ASK A QUESTION
ABOUT THIS ComPASS PROGRAM.
IT DOES SOUND LIKE IT'S EARLY,
FROM YOUR SENSE OF HEARING THIS,
I WASN'T THERE, I WILL LEARN
MORE SOON, THAT WAS JUST RAMBLE.
IS THIS THE PERFECT TIME TO
ALIGN WITH THEM OR IS IT TOO
EARLY?
DO THEY KNOW ENOUGH ABOUT WHAT
THEY ARE DOING FOR US TO
LEVERAGE EFFECTIVELY?
>> I DID GET THE SENSE THEY WERE
BUILDING THE PLANE AS THEY ARE
FLYING.
BUT I WAS INVOLVED WITH NIH CEAL
TEAMS EARLY ON, WE HAD TO MOVE
QUICKLY.
IF SOME WAYS THE CONVERSATION
WAS TO BE IN LINE WITH THE
SPIRIT OF THIS AWARD, MAYBE WE
GO TO THESE GROUPS, HERAs
FORMED, OR CONSORTIUMS,
INDIVIDUAL CHESIs, AS YOU'RE
THINKING ABOUT THE
INFRASTRUCTURE ISSUE, IS THERE A
CANCER-RELATED QUESTION YOU CAN
ASK, RIGHT?
SOMETIMES PUTTING THE SEED IN
PEOPLE'S MINDS EARLY IS REALLY
IMPORTANT.
SO, YES, I THINK IT IS VERY
EARLY.
THERE'S NOT THE INFRASTRUCTURE
THAT'S BUILT.
IT'S STILL COMING TO FRUITION.
BUT I WOULD SAY WHY NOT PUT THAT
QUESTION IN PEOPLE'S MINDS NOW
BECAUSE THEY ARE CREATING A
COMMON DATA MODEL SO PERHAPS WE
CAN PUT IN A FEW THINGS WE'D
LIKE TO KNOW, THESE FEW THINGS,
MAYBE CANCER SCREENING, ET
CETERA, AND POTENTIALLY USE THIS
AS OPPORTUNITY TO DO EDUCATION,
MY THOUGHT.
WE TALKED ABOUT THAT BECAUSE I
THINK ONE OF THE THINGS I LOVED
ABOUT WHAT THEY DID IS USING
USDA, FOLKS DON'T THINK ABOUT
FOOD INSECURITY, THINGS WE'VE
DONE IN THE PAST TO LEVERAGE
NON-TRADITIONAL PARTNERS TO
RETHINK CANCER, CANCER RESEARCH,
CANCER EDUCATION, USING
PROGRAMS, REALTORS TO PUT
INFORMATION OUT.
IT'S AN OPPORTUNITY EARLY ON TO
START TO KIND OF PUT SOME SEEDS
INTO THIS PROGRAMMATIC WORK, YOU
KNOW, WE MIGHT BE ABLE TO GET
GOOD DATA OUT OF LONG TERM.
>> FANTASTIC.
YES, LUIS?
>> I LIKE THE COMMENT THAT WE
COULD CUT CANCER DEATHS BY 50%
MAYBE BY SCIENCE BUT
IMPLEMENTATION IN DISPARITIES
CAN DO THE SAME THING.
SO IT CUTS THROUGH EVERYTHING TO
THE PRACTICAL POINT.
AND DOING BOTH COULD REALLY GET
US TO THAT GOAL WHICH WOULD BE A
HUGE SUCCESS.
>> IT WILL BE HARD TO DO THE
FORMER WITHOUT THE LATTER.
>> WELL, IT'S WHERE YOU PUT YOUR
MONEY.
>> YEAH, YEAH.
FANTASTIC.
IF THERE'S NO FURTHER QUESTIONS
OR DISCUSSION, WE AGAIN NEED TO
VOTE TO ACCEPT THE REPORT THAT
WAS PROVIDED BY DR. WINKFIELD
FROM THE AD HOC SUBCOMMITTEE.
IS THERE A MOTION?
>> MOTION TO ACCEPT.
>> SECOND.
MOVED AND SECONDED.
FURTHER DISCUSSION?
THERE BEING NONE WE NEED TO
VOTE.
ARE THERE ANY NAYs?
ANY ABSTENTIONS?
IT'S UNANIMOUS.
FANTASTIC.
SO, PRIOR TO ADJOURNING THE OPEN
SESSION, ARE THERE ANY OTHER
ISSUES THAT THE BOARD MEMBERS
WOULD LIKE TO SHARE?
RICHARD, RICK, YOU MENTIONED
SOMETHING EARLIER ABOUT
SOMETHING YOU WANTED TO BRING
UP.
>> I WASN'T SURE THIS WAS THE
APPROPRIATE TIME.
I DON'T KNOW IF ANYTHING WILL BE
THE APPROPRIATE TIME.
>> THIS IS OPEN SESSION, JUST
REMEMBER THAT.
>> OKAY.
WELL, THIS HAS TO DO WITH BOARD
MEETINGS.
IS THAT APPROPRIATE?
OKAY, GOOD.
ALL RIGHT.
SO, I'VE HAD PREVIOUS EXPERIENCE
IN THE NCAB, AND THINGS I
LEARNED IN THOSE 7 1/2 YEARS I'M
TRYING TO -- I'D LIKE TO BRING
TO THIS BOARD.
AND THAT IS THAT WHEN I LOOKED
AT THE BOARD OF SCIENTIFIC
ADVISORS CHARTER, THE BOARD OF
THE SCIENTIFIC ADVISORS
APPOINTED BY THE NCI DIRECTOR,
AND OF COURSE IS FOCUSED ON
RESEARCH PRIORITIES, BUT
SPECIFICALLY DOES NOT INCLUDE
DELIBERATION ON MATTERS OF
PUBLIC POLICY.
WHEREAS THE NCAB WHICH IS
APPOINTED OF COURSE BY THE
PRESIDENT, DOES IN FACT FOCUS ON
AND MAKES RECOMMENDATIONS
RESPECTING THE FUTURE DIRECTIONS
AND PROGRAM AND POLICY EMPHASIS
OF THE INSTITUTE.
WHAT I EXPERIENCE TODAY, THIS
MORNING AND THIS AFTERNOON, WERE
REALLY OUTSTANDING CONVERSATIONS
BY VERY INVOLVED AND VERY WELL
REALLY SMART PEOPLE WHO HAVE A
LOT TO OFFER THE NCI DIRECTOR.
AND I THINK IN MY EXPERIENCE,
PAST EXPERIENCE ANYWAY, THERE
WAS NEVER A MEETING WITH THE BSA
AND NCAB WERE MEETING TOGETHER
BECAUSE THERE REALLY WASN'T
NECESSARILY A CROSSOVER OF THEIR
CHARTERS.
AND SO I WOULD LIKE TO SUGGEST
TWO THINGS.
ONE, THAT THE NCAB MEETS LIKE WE
DID TODAY, WITHOUT THE BSA SO WE
CAN FOCUS ON POLICY.
AND, TWO, I WOULD LIKE TO
SUGGEST THAT WE MEET IN PERSON
RATHER THAN OVER ZOOM.
PREVIOUSLY I WAS TOLD, WELL,
WEATHER IS LOUSY IN THE WINTER.
BUT QUITE FRANKLY, I'M NOT
SUGGESTING WE HIT THE IWO JIMA
BEACHES, WE JUST HAVE TO GET A
SWEATER ON.
I THINK THE BENEFIT OF THE
INTERACTION IN PERSON IS SO MUCH
STRONGER.
HERE COMES PAULETTE.
>> HERE SHE COMES.
>> IT'S SO MUCH STRONGER.
>> HERE SHE COMES.
>> WOULD YOU PLEASE DISCONNECT?
[LAUGHTER]
NO, NO, NO, NO, NO.
ANYWAY, I JUST THINK -- I HELPED
CREATE THE TELEMEDICINE 1 YEARS
AGO FOR TELEDOC, I'M A BIG
ADVOCATE -- 12 YEARS AGO, BUT
THERE'S NOTHING LIKE BEING IN
THE SAME ROOM, BEING ABLE TO
INTERACT AND HAVE IDEAS PASSED
BACK AND FORTH, AND HAVE ACTIVE
DISCUSSIONS, LIKE WHAT HAPPENED
TODAY, AS WELL AS LAST NIGHT OF
COURSE FOR OUR SUBCOMMITTEES.
THERE'S A BIG DIFFERENCE.
AND THE CHAIR RECOGNIZES
PAULETTE GRAY.
>> RICK, I CAN APPRECIATE YOUR
THINKING.
BUT WE'RE TALKING ABOUT MARCH --
FEBRUARY AND MARCH.
THE WEATHER IN THIS AREA CAN BE
HORRIFIC.
I SPECIFICALLY REMEMBER WHEN
RICKLAUSNER WAS HERE, WE HAD A
MEETING SCHEDULED IN FEBRUARY.
HE CALLED ME AT 4:00 THAT
MORNING, CALLED ME THAT MORNING,
LATE THAT NIGHT, EARLY THAT
MORNING, AND I SAID, YES, THE
MEETING WILL BE HELD.
IT'S 4:00.
I'M ON MY WAY TO THE MEETING
SITE.
WE HAD ANOTHER ONE, A FEW YEARS
LATER, WE HAD TO LITERALLY
CANCEL THE MEETING.
WE CANCELED MORE MEETINGS IN
FEBRUARY THAN WE HAVE ANY OTHER
TIME.
SO, THAT GIVES YOU THREE TIMES
TO MEET, FACE TO FACE, AND NCAB
WITHOUT BSA NUMBERS, THAT'S
DURING THE MONTH OF JUNE,
SEPTEMBER, AND DECEMBER.
IF YOU CANNOT SURVIVE FEBRUARY
THEN SO BE IT.
>> THERE IS MARCH.
[LAUGHTER]
>> MARCH IS A STAND-ALONE BSA
MEETING.
SO YOU CAN'T ATTEND THAT ONE
UNLESS YOU COME AS A LOCAL
PERSON AND JUST WANT TO OBSERVE
>> YOU'RE OFFERING THREE.
>> THREE IN PERSON ALONE.
NO, NO, NO.
NOT ALONE.
IF YOU WANT TO HAVE ALL OF THE
NCAB MEMBERS BE ALONE THAT WOULD
BE FEBRUARY, JUNE, SEPTEMBER,
AND DECEMBER.
CURRENTLY, THE JUNE MEETING AND
THE DECEMBER MEETING IS A JOINT
MEETING.
>> WE HAVE TWO ANNUAL NCAB ONLY?
>> MEETINGS.
>> WELL, THAT'S BETTER THAN -- I
STILL BELIEVE, YOU HAVEN'T
CONVINCED ME THAT IN-PERSON
ALONE MEETINGS WHETHER WE HAVE
DEEP POLICY CONVERSATIONS LIKE
THIS IS NOT AS GOOD AS BEING
WITH BSA, WHICH IS LIKE 25 OR 50
MORE MEMBERS, WHATEVER IT IS, AT
THE TABLE.
>> I'M CONFUSED.
WHY CAN'T YOU HAVE DEEP POLICY
CONVERSATIONS OR DISCUSSIONS
DURING JOINT MEETINGS?
>> WELL, IT DIDN'T SEEM TO LEND
ITSELF WHEN THERE WERE SO MANY
INDIVIDUALS.
IT JUST SEEMS LIKE -- THAT MORE
IS DISCUSSED AND MORE PEOPLE WHO
ARE POLICY ORIENTED AS OPPOSED
TO RESEARCH ORIENTED ARE ABLE TO
HAVE THESE IDEAS PASS AMONG
THEM.
I DON'T WANT TO BE THE ONLY
PERSON TALKING.
NILO?
>> THAT'S THE NCI DIRECTOR
DECISION.
IF DR. RATHMELL, KIM,
ASCERTAINED SHE NO LONGER
PREFERRED TO HAVE JOINT
MEETINGS, THEN THAT'S FINE.
THE ONLY THING THAT SHE WILL
NEED TO DO IN THAT REGARD IS TO
GIVE SEVEN DIRECTOR REPORTS A
YEAR AS OPPOSED TO FIVE.
>> KIM?
>> WELL, IT'S MORE THAN THAT.
IT'S A LOT OF DIRECTOR REPORTS.
I GUESS -- IT'S TWO THINGS THAT
WE'RE TALKING ABOUT HERE.
NUMBER ONE, I AGREE FACE TO FACE
IS DIFFERENT.
AND SO DR. GRAY AND I HAVE
TALKED ABOUT THIS A LOT, HOW TO
TRY TO MAXIMIZE THE NUMBER OF
TIMES THAT WE'RE TOGETHER
WITHOUT HAVING TO, YOU KNOW,
IT'S ALSO A FISCAL
RESPONSIBILITY THING TO SAY, YOU
KNOW, IF WE HAVE TO CANCEL A
WHOLE MEETING WE LOSE A LOT OF
MONEY.
SO THAT'S WHERE WE'RE COMING UP
WITH HAVING FACE-TO-FACE DURING
GOOD WEATHER AND VIRTUAL, ALWAYS
VIRTUAL OPTION, DURING THE
TOUGHER WEATHER MONTHS.
WE'VE TALKED ABOUT SHIFTING THE
CALENDAR.
AS YOU KNOW WE'RE PLANNED OUT
TWO YEARS IN ADVANCE SO IT'S A
LITTLE BIT HARD BUT NOT
IMPOSSIBLE.
IT'S A DIFFERENT QUESTION ABOUT
SEPARATING.
WE SHOULD PROBABLY TAKE THAT
OFFLINE AND THINK ABOUT IT.
THAT'S IT'S FIRST IT'S BEEN
DISCUSSED, I DON'T KNOW THE
HISTORY IF THEY WERE APART AND
THEN BECAME TOGETHER.
BUT THERE ARE POTENTIALLY PROS
AND CONS TO BOTH.
>> I'VE BEEN SNOWED IN HERE IN
APRIL FOR STUDY SECTION, HERE
FOR FIVE DAYS, UNPLEASANT
BECAUSE I ONLY PACKED FOR A DAY
AND A HALF.
YEAH, GO AHEAD, KAREN.
>> I JUST WANT TO SAY THIS HAS
BEEN -- I'VE BEEN ON THE NCAB
SINCE 2021, THIS IS MY FIRST
MEETING IN PERSON I'VE BEEN AT
JUST NCAB ALONE, A HUGE
DIFFERENCE.
A LOT OF RESEARCH IS PRESENTED,
RIGHT?
BACK TO BACK, WITH THE BSA, IT
BECOMES DIFFICULT, BUT FOR US TO
HAVE CONVERSATIONS WHAT DO WE
FUNDAMENTALLY NEED TO DO
DIFFERENTLY AT THE NCI, HOW DO
WE CHANGE PEOPLE'S PERCEPTIONS
OF THE ORGANIZATION, THIS HAS
BEEN A WONDERFUL OPPORTUNITY,
I'LL SAY THAT.
I HEAR WHAT YOU'RE SAYING.
I'M FROM NEW YORK SO I KNOW
WEATHER.
EVEN THOUGH THINGS -- IT'S HARD
FOR STAFF, PEOPLE WHO LIVE HERE
TO GET THEIR, PROBABLY EASIER
FOR FOLKS TRAVELING IN,
DEPENDING WHAT CITY, BUT I'M
GLAD YOU'RE LOOKING AT SHIFTING.
THIS HAS BEEN A WONDERFUL
MEETING, AFTER THREE YEARS TO BE
IN THE ROOM AND HAVE THIS
CONVERSATION HAS BEEN GREAT.
>> LAST COMMENT, DR. CLARK?
OH, KIM.
PUSH YOUR BUTTON.
>> MORE OF A QUESTION AND
CLARIFICATION FOR THE NEW PEOPLE
IN THE ROOM WHO MAY NOT EXACTLY
FOLLOW WHAT'S GOING ON.
SO, IS THE ASSUMPTION I'M
LOOKING AT THE FUTURE MEETINGS,
SO IN DECEMBER WHEN WE SAY JOINT
THAT WOULD BE --
>> NCAB, BSA.
>> IN PERSON?
>> UH-HUH.
>> OKAY.
AND IN FEBRUARY WE'RE LOOKING AT
JUST NCAB VIRTUAL?
AND THEN JUNE AGAIN JOINT IN
PERSON?
AND THEN SEPTEMBER NCAB IN
PERSON?
OKAY.
THANK YOU.
>> THAT'S WHERE WE ARE NOW.
>> A COMMENT I WAS GOING TO MAKE
IN TERMS OF HAVING FACE-TO-FACE
INTERACTION, THERE ARE OTHER
OPPORTUNITIES.
I THINK WORKSHOPS AND THINGS
LIKE THAT ALSO GIVE US
OPPORTUNITIES THROUGHOUT THE
YEAR TO GET TOGETHER.
IT'S NOT EXACTLY WHERE WE CAN DO
REAL POLICY WORK BUT IT'S WHERE
WE CAN DEVELOP SOME
RELATIONSHIPS.
>> YEAH, TWO MORE COMMENTS,
SUCCINCT BECAUSE WE WANT TO MAKE
SURE WE HAVE TIME FOR THE CLOSED
SESSION.
FRED AND NELO.
>> IN TERMS OF JOINT MEETINGS,
AT THE END OF THE DAY EACH BOARD
VOTING ON THE IMPORTANT ISSUES
THAT ARE DISCUSSED, SO IT SEEMS
LIKE TWO MEETINGS GOING ON IN
ONE LOCATION, AND, YOU KNOW, IN
TERMS OF PARTICIPATING IN THE
DISCUSSIONS FOR THE OTHER BOARD,
THAT MIGHT BE -- I'M NOT SURE
HOW IMPORTANT THAT IS, YOU KNOW,
WHETHER WHAT I SAY CAN INFLUENCE
BSA MEMBERS' VOTING DECISION,
THINGS LIKE THAT.
US SITTING AROUND THE TABLE AND
HAVING THE DISCUSSION TO ME IS
MORE PRODUCTIVE THAN THE JOINT
MEETINGS.
>> LAST COMMENT, NELO?
>> I WANT TO ECHO WHAT KAREN
SAID, WE JOINED AT THE SAME
TIME.
JUST IN TERMS OF PLANNING.
>> WONDERFUL.
SO, I THINK THIS IS GREAT
DISCUSSION.
AND WE'LL HAVE ADDITIONAL TIME
TO TALK ABOUT THESE THINGS,
MAYBE IN THE NEXT MEETING.
SO, THIS CONCLUDES THE OPEN
SESSION.
THERE'S NOW 13-MINUTE BREAK.
ONLY BOARD MEMBERS AND
DESIGNATED NCI STAFF SHOULD
RETURN.
MEMBERS WHO ARE ATTENDING
VIRTUALLY SHOULD SIGN OFF AND
SIGN BACK ON TO THE OTHER LINK
YOU RECEIVED, AROUND 3:27 OR SO.
USING YOUR NEW WEBEX LINKS.
THANK YOU