>>THESE REGARDING ANY ITEMS
DISCUSSED DURING THIS MEETING
AND DO SO BY WRITING -- PLEASE
MAKE SURE EVERYBODY IS MUTED.
WRITING TO Dr. PAULETTE GRAY
EXECUTIVE SECRETARY OF THE NCAB
WITHIN 10 DAYS OF THE MEETING.
ANY WRITTEN STATEMENTS OR
QUESTIONS WILL RECEIVE CAREFUL
CONSIDERATION.
THE FOLLOWING NCAB SUBCOMMITTEE
MEMBERS ARE PARTICIP PARTICIPATE
MEETING.
[ROLL CALL]
>>THERE'S A QUORUM.
ARE THERE ANY QUESTIONS
REGARDING PROCESS?
>>THANK YOU SO MUCH, EVERYBODY
FOR JOINING US TODAY.
IT'S GOOD TO SEE EVERYBODY.
I HOPE EVERYONE IS DOING WELL.
SO, WE HAVE KIND OF A VERY OPEN
AGENDA TODAY.
I WOULD LIKE TO IF OVER THE
CHARGE OF THIS AD HOC
SUBCOMMITTEE AND THEN HAVE AN
OPEN DISCUSSION WHERE WE'RE
GOING TO GO NEXT AND SO PHIL, DO
YOU HAVE ANYTHING TO SAY BEFORE
WE START.
IT'S ALL YOURS.
>>OK.
ALL RIGHT.
THANK YOU.
>>OTHER THAN SAYING HAPPY NEW
YEAR TO EVERYONE.
IT'S BEEN TOO LONG.
>>THANK YOU, VERY MUCH.
>>ALL RIGHT, SO, I'M GOING TO
REVIEW OUR CHARGE AND THIS IS
ALSO AVAILABLE ON-LINE.
SO THIS SUBCOMMITTEE, THE
PURPOSE OF THE SUBCOMMITTEE IS
TO ADVISE THE NCAB AND THE
DIRECTOR NCI ON STRATEGIC
APPROACHES AND OPPORTUNITIES TOO
ENHANCE NCI'S CONTRIBUTION TO
POPULATION SCIENCE, EPIDEMIOLOGY
AND DISPARITIES.
THE SUBCOMMITTEE WILL BE
RESPONSIBLE FOR IDENTIFYING
OPPORTUNITIES TO ADDRESS
POPULATIONS FACING DISPARITY.
THE MULTI-DISCIPLINARY PROGRAMS
AND RESEARCH, SURVEILLANCE,
PATIENT CARE, PRIMARY
PREVENTION, EDUCATION AND CANCER
CONTROL.
I CAN TELL YOU A LITTLE BIT
ABOUT THE TWO THINGS THAT WE
HAVE TACKLED SO FAR.
THE FIRST WAS THAT WE STUDIED
THE COHORTS, THE NCI COHORTS AND
WE ISSUED A REPORT THAT THEN
HELPED THE NCI WHEN THEY
REISSUED THE COHORT RFA AND
HELPING THEM FOCUS THEIR
ACTIVITIES.
ONE OF THE MAIN ISSUES THAT WAS
CITED IN THAT REPORT WAS THAT
THERE WAS OF A LACK OF MINORITY
COHORTS AND SO FOR EXAMPLE, ONE
COHORT THAT HAS BEEN FUNDED
SINCE THEN IS IS THE HISPANIC
COHORT.
SO, A LOT OF THE RECOMMENDATIONS
HAVE BEEN IMPLEMENTED IN VARIOUS
WAYS AT THE NCI.
THE SECOND TASK THAT WE TACKLED
MOST OF YOU REMEMBER THAT, WE
GAVE OUR REPORT AT THE LAST
MEETING IN DECEMBER WAS TO
ASSESS THE AMOUNT OF RESEARCH
CONDUCTED AT THE NIH AND AT NCI
AND THE UNDERSERVED-UNDER
REPRESENTED GROUPS THAT THE AD
HOC WORKING GROUP HAD
IDENTIFIED.
WE PUBLISHED THAT -- THAT IS
AVAILABLE.
WE PRESENTED THAT AND THAT
REPORT AVAILABLE.
ON THE WEB.
ACTUALLY, THAT TASK WAS DECIDED
LATE 2019 TO FOCUS ON THAT.
I WAS ACTUALLY LOOKING BACK AT
SOME OF MY NOTES AND IT WAS 2019
WHEN WE LAST DECIDED WHAT WE
WERE GOING TO FOCUS ON.
SO, WE DIDN'T HAVE APP
OPPORTUNITY TO TACKLE NEW AREAS.
SO, I HAVE A FEW NOTES FROM WHAT
WAS WRITTEN DOWN QUITE A LONG
TIME AGO.
I WOULD REALLY LIKE TO HEAR BACK
FROM SOME OF YOU IN TERMS OF
WHAT YOU THINK THIS ON
POPULATION SCIENCES EPIDEMIOLOGY
AND DISPARITIES SHOULD FOCUS ON.
NOW, MARGARET MIGHT REMEMBER ONE
OF THE REASONS THAT Dr.
SHARPLESS HAD H HAD SUBCOMMITTEE
BECAUSE MANY OF US SAID, WHERE
IS THE POPULATION SCIENCE INPUT
IN THIS DIRECTION OR THIS, YOU
KNOW, CONCEPT THAT'S COME OUT?
WHERE IS THE I AM PUT?
INPUT?THERE WAS TIRING OF US SAG
THE SAME THING.
SO MARGARET AND I WERE PUT ON
THIS SUBCOMMITTEE.
SO, ANYWAY, WITH THAT LITTLE
BACKGROUND -- HELLO Dr.
BERGINOLI.
IT'S GOOD TO SEE YOU.
THANK YOU FOR JOINING US, WE
WERE JUST SAYING GOING OVER OUR
CHARGE OF THIS SUBCOMMITTEE AND
THE TWO REPORTS THAT WE'VE
ALREADY TACKLED AND WE'RE OPEN
TO KIND OF DISCUSSING WHAT WE
WANTED TO DO NEXT.
>>GREAT.
I HOPE IT'S OK THAT I DROPPED
IN.
>>DO YOU HAVE ANYTHING TO SAY?
>>NO, NO.
THIS IS YOUR MEETING RIGHT NOW.
>>THANK YOU.
WE'RE HAPPY YOU ARE HERE WITH
US.
>>MARGARET, PLEASE.
>>IF YOU RECALL WE BROUGHT UP
SEVERAL TIMES STARTING WHEN THE
ISSUE OF FUNDING FOR TRAINING OF
POPULATION SCIENTISTS, SEVERAL
PROGRAMS THAT WE IN THE CANCER
SCENES IS IS USED TO USE IS SUCH
AS THE KO7 AND THE R25 WERE NO
LONGER AVAILABLE SO WE HAD
DISCUSSED SEVERAL TIMES THE NEED
FOR SPECIFIC FUNDING FOR
EDUCATIONAL PROGRAMS AND
ELEKTRA, YOU WERE ON, I DON'T
KNOW IF YOU STILL ARE ON THE
SECRET FUNDING REVIEW BOARD AND
YOU KNOW THERE THAT WE MANAGED
TO PERSUADE THEM TO FUND THESE
PROGRAMS BUT IT'S AN ISSUE WE IS
SHOULD REVISIT.
>>YES, I REMEMBER.
WE HAD THE GENTLEMAN FROM THE
TRAINING BRANCH COME AND TALK TO
US A LITTLE BIT.
HE SAID THEY WERE DOING THIS AND
THAT AND WE SAID, WELL, A.,
WE'LL GIVE YOU TIME AND WE WANT
TO REVISIT HOW THAT HAS IMPACTED
POPULATIONS SCIENCES.
CHRIS MAR --
CHRISTOPHER -->>BUILDING ON MAS
COMMENTS.
WE HAVE A GOOD UNDERSTANDING
RELATIVE TO OTHER AREAS IN
CANCER RESEARCH, WHAT THE
LANDSCAPE IS FOR POPULATION
SCIENCE TRAINING AND WORKFORCE.
WE HAVE A BETTER SENSE OF THAT
FOR THE CLINICIAN WORKFORCE AND
WE KNOW THERE ARE GAPS.
IF WE REALLY BELIEVE POPULATION
SCIENCE IS A BEDROCK OF CONTROL
OUT EVERYBODY IN THIS MEETING
WOULD AGREE WITH ME ON THAT, WE
DON'T REALLY HAVE A GOOD SENSE
THAT HAVE AND WE DON'T HAVE A
SENSE OF WHERE NCI CAN NIL AND
SPECIFICALLY, JUST AS ONE
EXAMPLE, I REMEMBER SUSAN AND I
HAD A GREAT CONVERSATION.
THERE'S AN INCREASING NUMBER OF
PHYSICIAN AND OTHER CLINICIANS
WHO ARE SEEING PROBLEMS WITH
PATIENTS AND THE POPULATIONS
THEY SERVE AND THEY WANT
TRAINING IN CANCER CONTROL AND
POPULATION SCIENCE, YET OUR
CURRENT MECHANISMS DON'T MEET
THAT NEED.
ONE EXAMPLE AND I COULD THINK OF
OTHERS.
THAT'S A WORTH WHILE EXERCISE
FOR US IS TO A ISSUE ON THE
LANDSCAPE OF CANCER CONTROL AND
SCIENCE FUTURE WORKFORCE AND
WHERE WE MIGHT SEE GAPS AND
WHERE WE MIGHT SEE
OPPORTUNITIES.
>>GREAT.
THANK YOU.
PHIL, I BELIEVE YOU WERE NEXT.
>>SORRY.
THIS HAS BEEN A CONCERN FOR BOTH
KATRINA GOODARD AND ABOUT
POPULATION SCIENCE AND WE ARE
DOING SORT OF A PORTFOLIO
ANALYSIS AT THE MOMENT AND
LOOKING AT GAPS AND TRAINING
OPPORTUNITIES.
I WILL SAY THAT REALLY THINKING
ABOUT TWO DIFFERENT SETS OF
TRAINING, THERE'S THE SORT OF
POPULATION SCIENCE -- POPULATION
CANCER CONTROL SCIENTIST AND
WHAT IS NEEDED TO EXPAND THAT
WORKFORCE AND THERE'S A SEPARATE
GROUP WHICH IS THE
TRANSLATIONAL.
THEY REFLECT WHAT THE DIVISIONS
DO AND OFTEN IT'S NOT OBVIOUS TO
EXTRAMURAL BUT WE ARE TOO
DISTINCT DIVISIONS WITH TWO
DISTINCT GOALS AND WE'RE FOCUSED
ON DISCOVERY AND THE THINGS THAT
WORK AND WE HAND OFF TO DCCPS
AND WE NEED WORKFORCES AND A LOT
OF CANCER CENTERS -- KATRINA
SENT ME A NOTE SAYING SHE'S
DOING THIS ANALYSIS.
WE NEED TO EXPAND THE WORKFORCE
IN BOTH YEARS GREATLY AND TO
DIVERSIFY IT AND WE RECOGNIZE IT
AND WE ARE WORKING ON THAT FIRST
REQUIRES US TO DO A FULL
LANDSCAPE APPAL SIS BUT WE ARE
PARTICULARLY IN THE CANCER
PREVENTION SPACE SO WE HAVE A
HARD TIME GETTING BIOLOGISTS
INTERESTED IN TRANSLATIONAL
RESEARCH TO GO INTO PREVENTION
AND THEY GO INTO ONCOLOGY AND WE
NEED TO BUILD A PATH FOR THEM TO
COME INTO PREVENTION AND
RECOGNIZE THERE'S A LOT OF
OPPORTUNITIES AND
THEY HAVE NCI SUPPORT.
I DON'T WANT TO SPEAK FOR
KATRINA BUT I KNOW WE'RE
THINKING OF NEW RFAs IN THE
FUTURE AND THE IT WOULD BE I AM
HER ENTER IN THAT SO I DON'T
WANT TO TAKE TOO MUCH OF YOUR
TIME BUT WE SHARE YOUR INTEREST
AND CONCERN AND THE NEED TO
BUILD OUT THE WORKFORCE FOR THE
NEXT GENERATION.
>>WE WOULD ADD TO WHAT YOU ARE
DOING OR DO YOU THINK THAT THE
LANDSCAPE PORTFOLIO ANALYSIS
THAT YOU BOTH ARE DOING WOULD BE
ENOUGH OR WHAT CAN WE ADD?
>>WELL, I'D LIKE TO CONDUCT IS
WE -- IF WE CAN GET ON THE
DOCKET AND PRESENT WHAT WE'VE
LEARNED SO FAR AND GET YOUR
INPUT ABOUT YOU KNOW, IF WE
MILLED SOMETHING AND ALSO TO GET
YOUR IDEAS ABOUT HOW TO DEPLOY
OUR CREATE THOSE TRAINING
OPPORTUNITIES SO THAT WE CAN
ACHIEVE THE GOAL THAT WE ALL
ASPIRE TO.
I THINK THAT'S WHAT I WOULD
SUGGEST IS GIVE US THREE MORE
MONTHS.
I JUST THIRD A STRATEGIC
PLANNING OFFICER AND SHE'S BEEN
TASKED TO DO THAT AND SHE'S GOT
GOOD ROOTS IN THIS AREA BECAUSE
THEY WERE THE DEPUTY DIRECTING
OFFER OUR CANCER DEVELOPMENT
PROGRAM AND WE'RE EXPANDING ALL
OF THAT AND THERE'S A LOT OF
PIECES WE CAN PRESENT IN SORT OF
THE FULL SCOPE OF WHAT WE'RE
THINKING AND WHAT WE'RE TRYING
TO DO.
FOR EXAMPLE, WE STARTED TO HAVE
ONE OF OUR CANCER PREVENTION
FELLOWS DETAIL OR ROTATE SO THAT
WE'RE CREATING A POLICY
FELLOWSHIP AND WHICH IS PART OF
POPULATION CONTROL AND WE'RE
THINKING ABOUT AN INTERNATIONAL
COMPONENT TO THE CANCER
PREVENTION FELLOWSHIP AND THINGS
LIKE THAT SO I'D LIKE TO SUGGEST
WE BRING A FULL STORY OR AT
LEAST WHERE WE ARE AFTER THE
NEXT YOU KNOW IN THREE MONTHS
FROM NOW WHEN WE GET TOGETHER
THIS SUMMER.
>>THAT WILL BE JUNE.
>>ARE YOU WEAVING UNDER
POPULATION PLANS IN THIS
TRAINING?
>>ABSOLUTELY.
>>WONDERFUL.
>>AND THAT GOES EVEN INTO THE
INTERNATIONAL COMPONENT OF THE
CANCER PREVENTION FELLOWSHIP AND
THERE ARE CHALLENGES FOR
INTERNATIONAL FELLOWS TO COME TO
THE NCI IS SOMETHING THAT I CAME
IN SAYING WE'VE GOT TO FIGURE
OUT A WAY TO DO THIS SO THE
STORY IS MATURE ENOUGH TO
PRESENTED TO YOU AND GET YOUR
FEEDBACK IF THAT'S OK.
>>THAT'S GREAT.
SUSAN AND KAREN, I DIDN'T KNOW
WHO CAME UP FIRST.
>>THE REPORT THAT WAS DONE IT
WAS LOOKED AT PORTFOLIO OF
RESEARCH.
THE WORKFORCE IS IMPORTANT.
I LOVE THIS AND LOVE WHERE YOU
ARE GOING.
ONE THING THAT CAME UP AT THE
AACR MEETING WAS PERHAPS
THINKING ABOUT SOME GUIDANCE
AROUND WHAT DOES THE SOCIAL
DETERMINANTS AND IF WE CAN WEIGH
IN ON THAT OR PROVIDE GUIDANCE
BUT THERE NEEDS TO BE FOR PEOPLE
TO MOVE FORWARD IN THIS SPACE, I
THINK A LOT OF THE SCRIPTERS AND
RACE AND ETHNICITY ARE FINE AND
A LOT OF THIS GIRLS DOWN TO
SOCIAL DETERMINANTS OF HEALTH
AND I DO WONDER IF IT IT MAKING
SOMETHING IF IT'S A BIG THING TO
TACKLE BUT THERE NEEDS TO BE
SOMEWAY TO CREATE A UNIFIED ON
POPULATION HEALTH.
>>HAVING A COMMON LANGUAGE WE
ALL SPEAK AND WHEN WE SAY, YELL
OH WE ALL RECOGNIZE WHAT THE
COLOR YELLOW IS IS.
THAT'S A BIG CHALLENGE IN MANY
OF OUR SPECIALTIES LET ALONE
TALKING ABOUT SOCIAL
DETERMINANTS OF HEALTH.
COMING UP WITH CODIFIED
VOCABULARY WOULD BE VERY, VERY
HELPFUL EX COMMUNICATING BROADLY
SO I TOTALLY ENDORSE IT.
>>THANK YOU, KAREN.
I DO HAVE A QUESTION ON THAT BUT
SUSAN, ARE YOU IN THE SAME AREA
OR DO YOU WANT TO TALK ABOUT
SOMETHING ELSE?
>>SAME AREA AND TALK ABOUT
SOMETHING ELSE.
>>GO AHEAD.
>>SO, WHEN THE NCI WAS STRUGGLE
TO GO DECIDE HOW IT TO APPROACH
ROLL, THEY CONVENED A YEAR LONG
SET OF MEETINGS.
A SMALL GROUP OF FOLKS AND THEY
HAD A LOT OF PEOPLE COME IN,
WHAT IS RURAL, HOW DO WE DEFINE
RURAL?
IT TOOK ALMOST A YEAR BUT THEN
YOU KNOW, THAT DEFINITION IS
SORT OF WHAT'S ACCEPTED BY NCI.
THERE WERE A LOT OF DEFINITIONS
OF RURAL OUT THERE AND NCI
DIDN'T KNOW WHICH ONE TO USE.
THEY COULDN'T START CU STARTINGG
THE NUMBERS AND SHOW US WHEN
THEY DID AND THEY WERE A GREAT
DISPARITY.
THIS IS ALMOST ALONG TO VANE TO
MY MIND.
THERE'S A LOT OF THINGS OUT
THERE AND PEOPLE ARE CALLING
SOCIAL DETERMINANTS OF HEALTH AS
LIKE THE NEW BUZZWORD AND WHAT
WE TALKING ABOUT SOCIAL
DETERMINANTS OF HEALTH AND THEN
HOW DO WE A SUNSHINE THEM
UNIFORMLY AND HOW DO WE LIKE YOU
SAID, ASSESS THE IMPACT ON
OUTCOMES AND HEALTH.
SO, ANYWAY, THAT'S JUST SORT OF
MY HISTORY WITH NCI IN TERMS OF
WHEN THEY WANT SORT OF COME ON A
DEFINITION AND I'M HAPPY IF WE
DECIDE WE WANT TO DO THIS O IF
THIS IS SOMETHING DONE IN THE
SAME FRAME THAT THEY PROCEEDED
FOR RURAL.
I'M HAPPY TO -- HOWEVER.
SO ON THE TABLE.
THANK YOU.
SUSAN, GO AHEAD AND THEN ADD AND
ADD ANOTHER ONE.
>>SOUNDS GOOD.
THANK YOU, ELECTRA.
SO, PHIL, I JUST WANTED GO BACK
TO THE LANDSCAPE ANALYSIS THAT
YOU AND KATRINA AND OTHERS ARE
WORKING ON.
WILL THATTEN COMPASS SOME
ASSESSMENT OF THE T32s FOCUSED
ON TOP SIDE.
SEVERAL OF US LEAD THEM AND I
FEEL LIKE IT'S SUCH A PIPELINE
AND THAT'S ALSO AN AREA TO
IDENTIFY GAPS, YOU KNOW, SO IF
YOU SEE A LOT ARE FOCUSED ON X
BUT NOTHING HAS POP-SI AND DATA
SCIENCE AND MAYBE THAT'S AN
OPPORTUNITY TO HELP US THINK
ABOUT HOW DO WE GET OUR EARLY
INVESTIGATORS COMPETITIVE IN
CANCER PREVENTION AND CONTROL
WORK TODAY.
SO THAT A SUGGESTION OR IF YOU
ALREADY THOUGHT OF, I'M GLAD AND
THE OTHER THING IS -- I WAS ALSO
WONDERING, AND I HOPE YOU GUYS
MAKE SURE TO TAKE CREDIT FOR
SOME THE INNOVATIVE THINGS YOU
DO TO RESPOND TO EMERGING AREAS.
I'M THINKING ABOUT THE
MULTI-LEVEL TRAINING INSTITUTE,
THE IMPLEMENTATION SCIENCE
INSTITUTE, THE DISSEMINATION
ONE.
YOU'VE TRAINED A LOT OF PEOPLE
WHO ARE TRYING TO EARLY PEOPLE
WHO ARE TRYING TO GET A LITTLE
BIT MORE TRAINING AND COMFORT IN
AN AREA AND I PERSONALLY HAVE
PARTICIPATED IN SEVERAL OF THEM
SO I THINK IT'S A GREAT MODEL
FOR ADDRESSING EMERGING AREAS
FOR NEW INVESTIGATORS.
IT DOESN'T HELP WITH THE
KO7-TYPE OF ISSUE BUT I REALLY
DO THINK THAT THAT'S SUCH A
VALUABLE THING THAT YOU ALL HAVE
CUP AND IT SDONE AND IT SHOULD F
WHAT YOU TAKE CREDIT FOR AND
SOMETHING YOU TRANSLATE I LATE
INTERNATIONALLY AS YOU REACH
FURTHER POPULATIONS SO JUST SOME
SUGGESTIONS FOR THAT.
>>GREAT COMMENTS.
>>EXCELLENT.
>>TWO EXCELLENT SUGGESTIONS.
>>YES.
>>DO YOU WANT TO ADD ANYTHING?
>>YEAH.
>>I WANT TODAY GO BACK TO THE
SOCIAL DETERMINANTS OF HEALTH
AND I LIKE THIS IDEA OF THIS
GROUP HELPING TO FRAME THAT IF
THAT'S USEFUL AND TO TAKE IT A
STEP FURTHER, OF THE HARD PARTS,
RIGHT.
SO WE WORK WITH UNDERSERVED
POPULATIONS.
A LOT OF US DO RESEARCH IN THIS
AREA BUT WHERE THE RUBBER MEETS
THE ROAD IS NEXT STEP.
WHETHER IT'S PEOPLE THAT
PARTICIPATE IN OUR RESEARCH
STUDIES, FOR THOSE OF US THAT
LEAD COE TEAMS, YOU KNOW, I
DON'T KNOW, HEARING FROM EACH
OTHER, BEST PRACTICES,
STRATEGIES, OR GAPS IN THIS AREA
OF YOU KNOW, BY DEFINITION
POP-SI RESEARCH TOUCHES PEOPLE
AND YOU ARE ASKING THEM TO
ENGAGE IN SOMETHING, DO
SOMETHING AND THEN YOU KNOW, WE
ARE ALL KIND OF LEFT TO
OURSELVES TO FIGURE OUT SOCIAL
DETERMINANTS OF HEALTH WHEN
ACCESS IS AN ISSUE SO EVEN IF WE
HIGHLIGHT AND BRING THAT TO
LIGHT IT'S ANOTHER SORT OF
PIGGYBACK OFF OF WHAT WAS JUST
DISCUSSED.
SO THAT'S IT FOR ME.
>>THANK YOU, SUSAN.
A LOT OF THE SECOND PART OF WHAT
WE WERE TALKING ABOUT ARE AS YOU
KNOW UNFUNDED MANDATES THAT WE
TAKE.
KAREN, YOU KNOW THAT VERY WELL
TOO.
AND IT'S THE COEs THAT WE DO A
LOT OF UNFUNDED MANDATES.
IT SEEMS LIKE THE MANDATES ARE
BECAUSE IT'S THE RIGHT THING TO
DO AND WE WANT TO DO THE RIGHT
THING FOR THESE POPULATIONS,
YEAH.
THANK YOU, SUSAN.
PHIL, DO YOU WANT TO RESPOND ON
THE INCLUSION OF THE T32s IN
YOUR LANDSCAPE ANALYSIS?
>>IT'S A GREAT IDEA.
MY FOCUS I DON'T WANT TO SPEAK
TOO MUCH FOR KATRINE AND IT'S ON
THE K AWARD AS WHEN THE K AWARD
GOT SORT OF CONSOLIDATED AND I
THINK DID A DISSERVICE AND
THERE'S A CONFLATION OF PEOPLE
TALK ABOUT CANCER PREVENTION AND
IT'S REALLY SORT OF TWO SETS OF
TRAINEES THERE'S THE SORT OF THE
EPI SLASH THE FOLKS INTERESTED
IN CANCER CONTROL AND THAT'S
TYPICALLY WHAT CANCER CENTERS
FOCUS ON BUT WE'RE FACED WITH A
REAL CHALLENGE OF GETTING
BIOLOGISTS AND TECHNOLOGIES
INTERESTED IN CANCER PREVENTION
AND TRANSLATIONAL RESEARCH AND
WE'RE BEING CHOKED OFF HERE BY
NOT GETTING ENOUGH NOT JUST
ENOUGH WARM BODIES BUT IT'S PART
OF IT BUT SOME NEW IDEAS AND
WAYS OF THINKING ABOUT THINGS
AND WE NEED SOME OUTSIDE BOX
KINDS OF IDEAS AND IF WE'RE
GOING TO MAKE SOME REAL PROGRESS
AND SO I REALLY WANT TO KIND OF
CATALYZE.
YOU KNOW, EPIDEMIOLOGY T32 IS
THAT EVEN GOING EARLY ENOUGH AND
I DON'T KNOW HOW EARLY WE CAN GO
BUT -- I DIDN'T THINK ABOUT
EPIDEMIOLOGY WHEN I LEARNED
ABOUT THE CANCER FELLOWSHIP
PROGRAM AND EVEN THOUGH I WAS AT
HOPKINS, IT NEVER OCCURRED THAT
PEOPLE DO THAT KIND OF WORK.
AND I WAS NOT A KID AT THAT
POINT.
I WOULD HAVE BENEFITED EARLIER
OF.
WE CAN'T START TOO YOUNG AND WE
CAN'T START TOO YOUNG TO ADD
DICE VERSE TEE INTO THIS AND WE
NEED TO THINK EARLIER AND
BROADER AND I DON'T CLAIM TO
KNOW HOW TO DO THAT AND THAT IS
WHY YOU ARE ON THIS BECAUSE YOU
ARE THE SMART ONES BUT WE NEED
TO GET AFTER THIS EARLY.
>>CAN I ASK ONE OTHER QUESTION.
ARE YOU ALSO GOING TO
SUPPLEMENTS SUPPLEMENT
OPPORTUNITIES, MINORITY
SUPPLEMENTS AND ON GRANTS AND
YOUR ANALYSIS.
>>WE'LL ADD THAT ON TO THE
LIST.
>>THANK YOU.
>>YOU JUST HIRED ONE OF YOUR
PREVENTION FELLOWS AND SHE'S
FABULOUS.
SO YOU ALL DO A GREAT JOB AND
CROSS EPI PERSON AND YOU ARE
RIGHT, IT REALLY MAKES A
DIFFERENCE AND WORKING WITH MORE
ABOUT THE CANCER CONTROL
RESEARCHER IT'S JUST FABULOUS.
>>GO AHEAD.
>>I WOULD LOVE TO EXPAND THE
CAP SER PREVENTION FELLOWSHIP
PROGRAM WHICH I CAME OUT OF.
WE NEED TO REPLICATE IT INTO THE
EXTRAMURAL COMMUNITY AS WELL AND
I'M LOOKING FOR IDEAS ON HOW TO
DO THAT FOR SURE.
WE HAVE A WORKFORCE ISSUE IN THE
CANCER PREVENTION SPACE AND WE
NEED IF WE'RE GOING TO MAKE
PROGRESS WE HAVE TO -- I NEED
YOUR HELP, ABSOLUTELY, PLEASE.
>>ARE YOU ON MUTE.
>>HELLO.
CAN YOU SEE ME NOW?
>>I CAN HEAR YOU BUT I CAN'T
SEE YOU.
>>IT DOES THAT.
LET ME JUST TAKE MY VIDEO OFF
AND TO NOT DISTRACT YOU AND I'VE
BEEN HAVING THIS PROBLEM YOU CAN
HEAR ME ALL RIGHT.
>>THINKING ABOUT EXTRAMURAL
ENGAGEMENT AND THE MISSION TO
ADVANCE SURVEILLANCE AND
EPIDEMIOLOGY AND GENERAL AND I'M
WONDERING ABOUT THE INTEREST
THIS GROUP MIGHT HAVE IN
ADVANCING MORE INTERSECTION WITH
REGULATORY SCIENCES AND I THINK
IN MY VIEW, THERE'S A LOT OF
ADVANCES AND INTERESTS FROM THE
REGULATORY SCIENCE PART IN
FURTHER ENGAGEMENT WITH
OFF-THE-RECORD STAKEHOLDERS AND
THESTAKEHOLDERS AND CONDUCT OF E
EXTERNALLY CONTROLLED TRIALS FOR
DRUG AND BIOLOGICAL PRODUCTS.
IT'S NOT JUST ABOUT TRIALS AND
IT CAME OUT ON THE FDA WEBSITE
IN FEBRUARY OF 2023.
IT INCLUDES MULTIPLE CITATIONS
AND REFERENCES TO A SERIES OF
RECENT GUIDANCES ABOUT THE
APPLICATIONS OF EPIDEMIOLOGY
QUANTITIVE ANALYTIC APPROACHES
THAT THE AGENCY THINKS ARE
IMPORTANT FOR STAKEHOLDERS.
NOW, I'M BIASES, YOU KNOW,
BECAUSE I COME FROM INDUSTRY AND
IT HAS TO BETTER ALIGN AND
INTERSECT AND UNDERSTAND THESE
THINGS BECAUSE THEY'RE PART OF
POST-DRUG APPROVAL REQUIREMENTS.
WE'RE GETTING APPROVALS BASED ON
SMALLER INDICATIONS BUT THEN
THERE'S A POST APPROVAL
REQUIREMENT TO DO A BROAD
REGISTRY OR EPIDEMIOLOGY
ANALYSIS TO UNDERSTAND EFFECTS
IN SUB POPULATIONS AND WHETHER
THE CONTROLS EFFECTS OF PEOPLE
UNTREATED WITH DRUGS IN THOSE
SUB POPULATIONS AND UNDERSTAND
SERVED POPULATIONS AND SO I
THINK IT'S AN INDUSTRY INTEREST
AND I CAN THINK MAYBE IT MIGHT
BE SOMETHING THAT WOULD DONE BY
INVITING THE AGENTORS OF THE AUA
GUIDANCE TO GIVE A PRESENTATION
AND START A DIALOGUE WITH US
HERE ABOUT ISSUES THEY VIEW AS
IMPORTANT IN THIS FIELD.
>>THANK YOU.
IT'S OUT OF THE BOX BUT I REALLY
LIKE IT.
IT'S INTERESTING.
THANK YOU, HOWARD.
>>WELL, I MEAN, SIGH -- JUST
ONE LAST THING.
I SEE THIS ALSO IN TERMS OF
IMPLICATIONS FOR LARGER GRANTS.
YOU KNOW, WE'RE GETTING MORE OF
THESE LARGER GRANTS BECAUSE
THEY'RE INVOLVING LARGE CLINICAL
TRIALS OR YOU KNOW TRANSLATIONAL
INTO THE CLINIC AND IT COSTS
MORE MONEY.
BUT SOMETIMES THE ANALYTIC
APPROACHES BEING TAKEN, YOU
KNOW, I CAN CITE GOG TRIALS THAT
HAVE BEEN DONE, SURVEILLANCE --
THEY WERE SURVEILLANCE STUDIES
AND CLTB TRIALS I WORKED ON OVER
THE YEARS.
THERE WERE ESSENTIALLY
SURVEILLANCE KIND OF LATE ON
SETS SAFETY STUDIES AND I THINK
THOSE ARE OUTDATED NOW AND
REALLY DID NOT ANSWER SOME OF
THE QUESTIONS THAT THEY WERE
FUNDED TO ANSWER SO I WOULD HOPE
MORE THAN WE WOULD LEARN BETTER
FROM THE REGULATORS ON HOW TO
DESIGN THOSE KINDS OF TRIALS
BETTER TO ADDRESS WHAT IS GOING
ON AND UNDERSERVED POPULATIONS,
HOW TO INCORPORATE THINGS LIKE
YOU MAY HAVE HEARD WHAT'S CALLEY
OF DIAGNOSTIC PROBLEMS THAT
HAPPEN WHEN YOU HAVE EXTERNAL
DIAGNOSIS THAT HAVE A DIFFERENT
DENSITY IT'S CALLED DIAGNOSTIC
DENSITY AND IT'S IN THE
EPIDEMIOLOGY FIELD.
WHERE THE DIAGNOSIS IS REALLY
INFLUENCED BY LIKE THE FREQUENCY
OF HOW MUCH THINGS ARE MEASURED
IN DIFFERENT POPULATION AND
DIFFERENT REGIONS.
SO NOW THERE'S REGIONAL AN LIT
TICKS THAT HAVE BEEN DONE TO
SHOW THAT ZIP CODES WHERE
DIAGNOSTICS ARE DONE AND YOU
FIND EVENTS IN THAT POPULATION.
IT'S JUST ONE EXAMPLE OF WHAT
I'M THINKING OF HERE.
>>WOW, INTERESTING.
THANK YOU.
WE USED TO LOOK AT THAT IN EPI
FROM A INDIVIDUAL BASIS, NOT
FROM A COMMUNITY BASIS OR ZIP
CODE LEVEL SO THERE'S A BUY AS
OUT THERE BUT IT'S INTERESTING
BEING APPLIED TO A WHOLE
POPULATION AND COMMUNITIES.
THANK YOU, HOWARD.
ANN --
>>THERE WE GO.
>>I THOUGHT WE WERE UNMUTED
AUTOMATICALLY.
SO, I'M COMMENTING ON A POINT
THAT I THINK PHIL MADE EX I
THINK ABOUT IT A LOT AND THAT
IS, YOU KNOW, BACK IN THE EARLY
2000s, WE DID AN ENORMOUS
AMOUNT OF GERM ONE SEQUENCES
THROUGH COHORTS, AS YOU ALL
RECALL, AROUND EVERY CANCER.
AND IN SOME WAYS WE'VE KIND OF
MOVED ON FROM THAT BUT A LOT HAS
HAPPENED SINCE THEN.
IN TERMS OF CHANGES IN GENOMICS
AND TECHNOLOGY, ESPECIALLY
AROUND NOT JUST THE COVERAGE,
THE LEVEL OF COVERAGE IN THE
GENOME BUT THE DEPTH OF COVERAGE
AND ALSO THE ABILITY TO IDENTIFY
ADDITIONAL GERM LINE MUTATIONS
AND CHANGES THAT YOU KNOW, MAYBE
THERE'S STILL CONSIDERED SMALL
CHANGES BUT IN POPULATIONS, THEY
HAVE A BIG IMPACT.
WE'RE MOVING INTO A BETTER VIEW
OF THE WHOLE GENOME BY DOING
SEQUENCES ON THE GENOME AND IT'S
GOING TO TURN UP EVEN MORE
INTERESTING, I THINK,
OPPORTUNITIES FOR US TO
UNDERSTAND WHAT IS IN THE GERM
LINE.
THIS WEEK ALONE, WE LEARNED WE
NOW HAVE PRETTY GOOD EVIDENCE
THAT THEY'RE GOING TO BE TRAITS
INHERITED AT LEAST FOR THREE
GENERATIONS.
DUE TO CHANGES IN METHYLATION
WHICH NO ONE WOULD HAVE GUESSED.
WHEN WE THINK WE KNOW SOMETHING
AND CANCER BIOLOGY WE FIND OUT
WE DON'T KNOW ENOUGH AND SO I
THINK THAT WE'RE LOOKING AT
OPPORTUNITIES THAT WE NEED TO
TIE INTO SCALE KNOWING HOW THESE
THINGS IMPACT AND I THOUGHT THE
REPORT THAT THIS COMMITTEE DID,
THIS SUBCOMMITTEE DID ON THE
CONSORTIA OPPORTUNITIES ARE
ENORMOUS HERE BUT I THINK THAT
WE NEED O START P TO START PAYIO
THIS AND WE SHOULDN'T MOVE
BEYOND GERM LINE THERE'S A LOT
TO KNOW HERE AND THERE'S A LOT
THAT NEEDS TO BE SOLVED AND IT'S
GOING TO IMPACT EVERYTHING WE DO
BECAUSE SO MUCH OF WHAT WE'RE
TALKING ABOUT IN TERMS OF
MINORITY POPULATIONS, I BELIEVE
INCREASINGLY MIGHT VERY WELL
FIND SOME NOM IN TERMS OF
INCREASING KNOWLEDGE IN THE
CHANGES IN THE GENOME THAT ARE
MAYBE MORE SUBTLE THAN WE
THOUGHT ABOUT.
WE NEED DEDICATION TO THIS
BECAUSE WE NEED TO (INAUDIBLE)
THIS BIOLOGY AND I'M NOT WISE
ENOUGH AT THIS MOMENT TO KNOW IF
IT'S A SUPER CO CONSORTIA OR HOE
GET THE POWER TO FIND OUT HOW
IMPORTANT ARE SOME OF THESE
FINDINGS, ESPECIALLY IN THE EPI
GENOMICS IS GOING TO BE
IMPORTANT.
>>THANK YOU, IT THANK YOU, VERY
MUCH.
ANYBODY HAVE ANY COMMENTS ON
EITHER OF THOSE IDEAS?
ANYBODY HAVE ANY NEW IDEAS?
ANY OTHER IDEAS?
MARGARET?
>>I THINK WHAT ANNA SAID IS
VERY VALUABLE.
I THINK TO SOME EXTENT, THE
RESEARCHERS HAVE STARTED
THINKING ABOUT THE IMPORTANCE OF
THIS AND YOU KNOW, TO SOME SMALL
DEGREE THEY'RE DOING IT ALREADY
BUT CLEARLY IT HAS TO BE DI DONN
A LARGE-SCALE.
I LOOKED BACK IN MY NOTES AND I
THINK IT WAS DOUG LOWE ALTHOUGH
IT MIGHT HAVE BEEN Dr.
SHARPLESS, AND THEY ASKED US,
BESIDES WHAT WE'VE ALREADY DONE,
TO REVIEW HOW TO LEVERAGE
MINORITY ENROLLMENT IN TRIALS
AND SPECIFICALLY IN COMMUNITY
TRIALS AND I THINK THAT THAT'S A
MASSIVE TOPIC TO ADDRESS BUT IT
WAS MENTIONED AS PERHAPS
SOMETHING WE NEEDED TO BEGIN TO
LOOK AT.
I SEE ELECTRA YOU ARE NODDING.
>>YES, IT'S ON MY LIST.
RIGHT UNDER THE FUNDING FOR
TRAINEES AND POPULATION SCIENCE,
WHICH YOU HAVE MENTIONED BEFORE.
SECOND WAS CLINICAL TRIAL
ACCRUAL, UNDERSERVED MINORITY
AND ACROSS THE AGE RANGE NOW IS
OUR AND RURAL URBAN POPULATIONS,
ET CETERA.
AND POPULATION SCIENCE AND
IMMUNO ONCOLOGY WAS ON THE LIST
AND THEN BIDIRECTIONAL
COMMUNICATION BETWEEN
RESEARCHERS AND COMMUNITY.
THAT WAS ON MY LIST.
SO WE'VE MENTIONED TWO.
GOOD TO SEE YOU, DOUG.
>>HI ELECTRA, I JUST WANTED TO
RESPOND TO YOUR COMMENTS.
WHEN IT IT COMES TO MINORITY
ENROLLMENT IN NCI SPONSORED
TRIALS, THIS WAS THE
CO-OPERATIVE GROUPS AND ENCORE
TRIALS AS I HAVE MENTIONED IN
THE PAST, OVER THE LAST 20
YEARS, WE HAVE GONE FROM 14%
MINORITY ENROLLMENT TO ABOUT
25%.
THOSE DATA ARE THROUGH 2019 AND
THE LAST TWO YEARS, 20 AND '21,
THE PREPORTION OF UNDER
REPRESENTED MINORITIES WAS EVEN
HIGHER.
AND I THINK THAT YOU KNOW, THIS
WAS PRESENTED IN A WHILE AGO AND
COULD BE PRESENTED AGAIN IF YOU
WERE INTERESTED.
AND THEN IN TERMS OF WOMEN WITH
THE NOTABLE EXCEPTION OF QUITE A
FEW YEARS AGO WHEN WE WERE
ENROLLING FOR PROSTATE CANCER,
WOMEN ACCOUNT FOR 60% OF THE
PATIENTS WHO ARE ENROLLED IN NCI
SPONSORED CLINICAL TRIALS.
>>THANK YOU, DOUG.
I DO WANT TO SAY JUST A COUPLE
OF THINGS BEFORE WE GET TO KAREN
AND JOHN AND THE GAINS THAT WE
SEE AND WE'RE REPORTED BY WARDA
ARE NOT UNIVERSAL ACROSS CAP SER
CENTERS.
AND I CAN SAY THAT WITH GREAT
ASSURITY BECAUSE I VISIT A LOT
OF PLACES AND WE DO ALSO NEED TO
DO FURTHER WORK IN THAT AREA IN
TERMS OF OUR RURAL POPULATIONS
AND ACROSS THE LIFESPAN AND I
ALSO STRONGLY SUGGEST WE MENTION
INSIDE OUR REPORT THAT WE
DISAGGREGATE RACE AND ETHNICITY.
SOMETHING JUST CAME OUT FOR NEW
GUIDELINES FOR THE NIH FOR
REPORTING A RACE ETHNICITY VERY
SIMILAR TO THE 2020 CENSUS WHICH
THERE SOME DISAGGREGATION BUT
NOT QUITE TO THE DEGREE THAT WE
SUGGESTED.
SO, THERE'S STILL A LOT TO LOOK
AT IN THIS AREA AND YOU KNOW I
THINK THE INCORP IS IS A MODEL
FOR SUCCESS THAT I WISH OTHER
PEOPLE COULD REPLICATE BECAUSE
IT'S NOT AND WE ALSO HAVE FDA
TRIALS THAT WE KNOW ARE REALLY
SUFFERING FROM THIS.
KAREN, GO AHEAD, PLEASE.
>>YES, HEAR HEAR.
IT'S A MAJOR ISSUE PARTICULARLY
WHEN WE WERE TALKING ABOUT DRUG
DISCOVERY AND CANCER CARE SPACE
AND DON'T HAVE ADEQUATE
REPRESENTATION SO THANK YOU FOR
THAT.
I DO WANT TO -- IF I CAN GO BACK
TO SOMETHING PHILLIP MENTIONED
ABOUT THE TRANSLATIONAL SCIENCE
AND HAVING THIS BIDIRECTIONAL
COMMUNICATION BETWEEN POPULATION
AND BETWEEN BASIC SCIENTISTS AND
COMMUNITY AND THERE WAS A
SUPPLEMENT THAT CAME OUT A
COUPLE OF YEARS AGO THAT I GOT
AND I LOOKED JUST THAT THE AND I
DON'T KNOW IF ANYBODY LOOKED AT
THAT DATA.
HAVE WE LOOKED, ALL THESE
SUPPLEMENTS COME OUT AND I JUST
DON'T KNOW HOW THAT DATA IS
BEING AGGREGATE AND LOOKED AT
AND EVALUATED.
WE TOOK TWO PROGRAMS AT OUR
CANCER AND IT HELPS UNDERSTAND
THE VALUE OF COMMUNITY
ENGAGEMENT AND THE OTHER THING
THAT IS IMPORTANT AND IN OF THE
ROLES, SOME OF US WHO HAVE BEEN
ADs, WHE WE WERE REALLY
INTENTIONAL THINKING ABOUT BASIC
SCIENTISTS AROUND THE PREVENTION
SIDE THAT WAS ONE OF THE THINGS
THAT CAME UP.
BECAUSE, FRIENDSHIPS, MA LAB A
LOAM I CAN IS MASSIVE.
WE KNOW THAT OBESITY WILL BE THE
NUMBER ONE MODIFIABLE RISK
FACTOR FOR CANCER SO THERE MIGHT
BE INDIVIDUALS WHO ARE DOING
WORK IN ONE AREA THAT MAY NOT
UNDERSTAND HOW IT TRANSLATES TO
CANCER BUT THOSE OF US WHO ARE
ADs OR ADFCOE HAVE HAD THAT ON
OUR MINDS FOR A LONG TIME SO I
DON'T KNOW WHAT DATA HAS BEEN
PULLED TOGETHER AND COLLATED --
I THINK FROM THE SUPPLEMENTS
THAT WITH SHOULD HAVE THAT DATA
BUT IT WOULD BE INTERESTING TO
LOOK AT THAT.
>>YES, I RECALL THOSE
SUPPLEMENTS AND I DON'T REMEMBER
HEARING SORT OF THE END PRODUCT.
I'M SURE IT'S SOMEWHERE.
THERE'S VERY GOOD EVALUATION OF
THESE.
THANK YOU, CARRE KAREN.
>>THANK YOU.
THAT WAS A GREAT CONVERSATION
AND DISCUSSION.
JUST A COUPLE OF THINGS, I AGREE
WITH YOU, ELECTRA, ABOUT THE
TRIAL AND ACCRUAL NUMBERS AND
YOU KNOW IT'S NOT UNIVERSAL AND
I THINK I REMEMBER IN OF THOSE
NUMBERS BEING PRESENTED AND
SPECIFICALLY ASKING THE QUESTION
ARE THESE OF ALL TRIALS OR HAVE
YOU STRATIFIED BY THERAPEUTIC
VERSIONS ALL INTERVENTIONAL AND
THE NUMBERS PLUMMET, RIGHT, WHEN
YOU START TALK ABOUT PER
THERAPEUTIC TRIALS AND I ASK WE
SEE THE STRATIFICATION SO
THAT -- YOU KNOW, IT'S OK TO
KNOW THAT THERE'S A PROBLEM.
RIGHT.
IT DOESN'T HAVE TO ALWAYS BE
PRESENTED TO SAY WE'RE MAKING
PROGRESS.
IT'S OK TO SAY IT BECAUSE IT'S
THE ONLY WAY, RIGHT, WHERE WE'LL
KEEP IT IN FRONT OF US, THAT WAS
THE FIRST THING.
THE SECOND THING IS WE CONSIDER
THE WORKING GROUP AND I DON'T
KNOW IF I'M GET AGO HEAD OF
MYSELF BUT ALL OF THE WORKING
GROUPS, RIGHT.
THE TIMING IS GREAT, RIGHT.
WE CAN REALLY THINK ABOUT HOW
EVERYTHING ALLIANCE, RIGHT, IN
TERMS OF OUR NEW ILLUSTRIOUS
LEADER AND HER THOUGHTS AND
MAKING SURE THAT WE'RE ALIGNED,
RIGHT, WITH THE AGENDA AND WHERE
AWAY WANT TO SEE THINGS GO.
IT'S REALLY IMPORTANT TO TAKE A
LOT OF NOTES TODAY.
AND I HAVE A FEELING WE'RE GOING
TO REVISIT SOME OF THIS IN THE
NOT TOO DISTANT FUTURE TO REALLY
BEGIN TO THINK, HOW DO WE MAKE
SURE THAT EVERYTHING IS ALIGNED
AND THEN FINALLY, HOW EVERYTHING
IS INTEGRATED.
WE'RE GOING TO HAVE TO CONTINUE
TO GET OUT OF THIS SILOED
APPROACH TO THINGS.
IT'S POPULATION HERE AND IT'S
TRANSLATIONAL THERE AND IT'S
CLINICAL HERE AND IT'S BASIC
THERE.
WE'RE ONLY GOING TO GET OUT
THESE ISSUES, RIGHT, IF WE LOOK
ACROSS THE DISCIPLINES TOGETHER.
FINALLY, I KNOW IT'S APP ARDUOUS
TASK BUT WE TALK ABOUT
POPULATION, WE HAVE TO THINK
ABOUT ALL OF US, IT'S A HUGE
STUDY AND HOW DO WE BEGIN TO TAP
INTO THAT ON THE CANCER SIDE.
OF COURSE IT'S LONGITUDINAL SO
IT TAKES TIME BUT THE AMOUNT OF
DATA, THE AMOUNT OF INDIVIDUALS,
THE BIOSPECIMENS THAT ARE
AVAILABLE TO REALLY BEGIN TO
UNDERSTAND POPULATIONS SCIENCE,
I THINK WE HAVE TO FIGURE OUT,
MONICA, HOW DO WE IT TO TIE
DEEPER AND DEEPER INTO THAT
COHORT BECAUSE WE'LL GAIN A LOT
FROM THAT INFORMATION.
THOSE ARE MY COMMENTS.
>>SPLIT ON, JOHN.
THANK YOU.
>>I THINK YOU WILL BE OUR LAST
NOT COMMENT BECAUSE WE HAVE SOME
SUMMARIZING TO DO AND CLOSING
OUT, PLEASE, GO AHEAD.
>>YEAH, JUST LISTENING TO ALL
THIS, I'M STRUCK WITH, IF YOU
LOOK AT OUR RO1 POOL AND THE
SCIENCE THAT WE FUND AND SO MUCH
OF IT IS IS INCREASINGLY AND I
THINK VERY GOOD THING FOR US
BASIC SCIENCE, A LOT OF BASIC
SCIENCE.
AND A LOT OF TRANSLATIONAL
SCIENCE AND WHERE WE PLACE THE
FOCUS AND MANY DECADES FOR NOW
IS ON TRANSLATING THAT TO THE
CLINIC.
BUILDING BETTER CLINICAL TRIALS
FOR THE DOES OT DRUGS AND OTHER
INTERVENTIONS WE MAKE.
WHAT GETS MISSES IS WHAT WE'RE
DISCUSSING TODAY.
HOW YOU TIE ALL THIS THROUGH,
WHAT JOHN WAS TALKING ABOUT, IN
TERMS OF THIS INTEGRATIVE
APPROACH INTO POPULATION
SCIENCE.
IT'S THE LEAST EMPHASIZED AREA I
THINK OF CAR KAREN BROUGHT THIS
UP AS WELL IN TERMS OF GRANTS.
WE HAVE TO CHANGE THAT.
IF THESE FINDING DON'T GET THE
POPULATION IN TERMS OF RISK AND
HOW WE DEAL WITH THAT, WE'RE NOT
GOING ANYWHERE.
WE CAN MAKE ALL THE DOES DO DRUE
KNOW THE RISK WE CAN'T DO IT IN
A SCIENTIFIC MATTER AND I THINK
WE HAVE PEOPLE OUT THERE NOW WHO
CAN BE TRAINED OR HAVE BEEN
TRAINED TOP DO THIS AND I THINK
WE HAD PLACE REAL EMPHASIS THERE
BECAUSE WE'RE LOSING A LOT OF
GROUND, I THINK, IN TERMS OF
TRANSLATING SOME OF THESE BASIC
FINDINGS TO POPULATIONS.
>>MANY OF US POPULATION
SCIENTISTS HAVE BEEN SAYING FOR
YEARS, YOU HAVE TO INTEGRATE US.
I SAY YOU CAN FIND A CURE FOR
CANCER BUT UNLESS YOU INVOLVE
THE POPULATION SCIENTISTS IT
WON'T BE DELIVERED TO THE
POPULATIONS WHO NEED IT
APPROPRIATELY AT THE RIGHT TIME
AND THE RIGHT WAY IN THE RIGHT
PLACE.
AND I THINK IT'S A GREAT POINT.
REALLY GREAT POINT.
WHEN WE TALKED ABOUT SOME GREAT
THINGS TODAY.
I WOULD LIKE PEOPLE TO START
THINKING ABOUT WHAT OUR MEETING
IN JUNE SHOULD LOOK LIKE.
YES, COVID IS IS A GREAT
EXAMPLE, YES, WE'VE GOT LOTS OF
EXAMPLES.
SO, WE CAN HAVE A MEETING IN
JUNE AND ANOTHER MEETING OF THIS
SUBCOMMITTEE IN JUNE.
I DON'T KNOW IF THE MEETINGS ARE
GOING TO BE FACE-TO-FACE IN JUNE
OR NOT.
WE CAN HAVE A MEETING.
AND WE COULD INVITE SEVERAL
PEOPLE TO COME AND GIVE US MORE
INFORMATION ABOUT THE TOPICS
THAT WE HAVE TALKED ABOUT.
SO, FOR EXAMPLE, PHIL HAS ASKED
FOR PERHAPS HIM AND KATRINA TO
COME TO PRESENT THEIR LANDSCAPE
ANALYSIS AND THAT WOULD REALLY
ADDRESS THE FIRST HALF OF PAGE
OF NOTES THAT I TOOK.
REGARDING SOME OF OUR QUESTIONS
THAT WE HAVE AND WE WOULD ALSO
LIKE PHIL, YOU SAID YOU WOULD
ADD SUPPLEMENTS AND TALK ABOUT
EXPANDING AND REPLICATING THE
CANCER PREVENTION FELLOWSHIP AND
THAT SO THAT IS IS -- THAT'S
WITHIN THING THAT WE COULD HAVE
AT OUR NEXT MEETING IS ONE
PRESENTATION ON THE ANALYSIS OF
TRAINING OPPORTUNITIES FOR
POPULATIONS SCIENCE.
WHAT DO PEOPLE THINK ABOUT THAT?
>>I LIKE THAT.
>>IT'S A GOOD PLACE TO START
BECAUSE IT'S TIMELY AND THERE'S
ALREADY WORK GOING AND THEN I
THINK YOUR LIST ELECTRA, WE JUST
NEED TO MAKE SURE THERE'S
INSTITUTIONAL KNOWLEDGE TO KEEP
THAT LIST GOING SO WE CAN MOVE
FORWARD, YEAH.
>>I'M NOT DONE CHRIS.
JUST A SECOND.
LET'S DECIDE ON THIS TOPIC AND
THEN WE CAN MOVE ON.
I HAVE TO GO OUT OF TIME SO I
CAN KEEP ORGANIZED.
>>PHIL, WILL THAT BE OK WITH
YOU?
>>THAT'S FINE.
ALL RIGHT.
WE CAN TALK ABOUT THIS IDEA.
SO I'M JUST GOING TO LIST THE
OTHER ONES.
PHIL THEY PROBABLY COL HAVE IT
IN THREE MONTHS SO THAT'S WHY I
THINK THIS TIMELINESS IS GOOD
AND HOW LONG YOU THINK YOU WOULD
NEED FOR THIS, PHIL.
THE WHOLE TIME?
WE HAVE ABOUT AN HOUR?
>>LET'S KEEP IT WITHIN A
HALF-HOUR SO YOU CAN DO OTHER
SUBCOMMITTEE BUSINESS.
WE CAN GET TO THE START OF
THINGS IN 30 MINUTES AND HAVE 10
MINUTES OF DISCUSSION?
>>
>>I'M NOT SURE WITH THIS GROUP.
[LAUGHTER]
>>IF YOU WANT TO GIVE US MORE
TIME HOW ABOUT 30 MINUTES OF
REPRESENTATION AND 15 MINUTES OF
DISCUSSION.
>>AND WE CAN SORT OF TALK ABOUT
AND WHAT MAYBE I'LL DO WITH IN
HELP FROM NCI IS IN THE BACK
SORT OF TALK TO FOLKS ON THEIR
TAKE IF THEY'RE PLANNING TO DO
ANYTHING ABOUT THE SOCIAL
DETERMINANTS OF HEALTH THAT
KAREN RAISED AND ALSO THE ISSUE
OF CLIP CAL TRIAL A KUEHL DO WE
WANT TO LOOK AT THAT AND THE --
AND THEN THE EXTRAMURAL
ENGAGEMENT I'LL TALK WITH SOME
MORE FOLKS ABOUT THAT AND YOU
KNOW, HOW DO WE INCOMPETENT
GREAT EPI IN SURVEILLANCE OF
BRINGING THE DRUGS TO MARKET AND
HE WILL HOWARD THAT'S YOUR
COMMENT.
>>ELECTRA, ONE THING TO THINK
ABOUT IS THERE ARE OTHER
SUBCOMMITTEES AS WELL.
THERE'S A CLINICAL
INVESTIGATIONS AND SO WE CAN
ALSO LOOK AT WHERE WE CAN SORT
OF AGAIN INTEGRATE ACROSS OUR
COMMITTEES OF WITH INFORMATION
SO THAT ONE GROUP ISN'T TRYING
TO TOO MUCH SO JUST CONSIDERING
THAT.
>>I'M BRINGING UP THE MAJOR
TOPICS AND THEN MY IDEA IS TO
TALK TO YOU AND OTHER PEOPLE TO
FIGURE OUT WHERE IS THE BEST
PLACE AND THAT THESE WOULD FALL
NOT NECESSARILY IN THIS BUT
ELSEWHERE OR SHE IS ALREADY
DOING THAT THAT'S WHERE I'M
GOING.
BUT THE MAIN AREA WERE SOCIAL
DETERMINANTS OF HEALTH EX
SURVEILLANCE AND AND ANN'S POINT
ABOUT THE SCALING BIOLOGY, EPI
GENOMICS AND INTEGRATED APPROACH
TO POPULATION SCIENCE.
WE DO NEED TO KNOW HOW WE HEAR
BACK ON EVALUATION OF
SUPPLEMENTS SO IN OF THOSE ARE
JUST QUESTIONS THAT WE CAN ASK
AND REPORT BACK.
DOES THAT SOUND LIKE A PLAN,
EVERYBODY?
>>I HATE TO THROW ONE OUT AT
END.
THIS IS A LOT GOING ON WITH THE,
K. AND WELCOME BACK OF THE AREAS
IS ENVIRONMENTAL CARCINOMA OWE
BEGINS AND THAT IS IS A
POPULATION BASED I THINK AREA OF
INTEREST TO THINK ABOUT.
ENVIRONMENTAL INFLUENCES AND
FACTORS.
THAT'S A POPULATION BASED I
THINK.
>>IT IS, IT'S EPI BUT IT ALSO
INCOMPETENT GATES TOXICOLOGY AND
OTHER BASIC SCIENTISTS SO WE CAN
A IS SIS WHAT UPDATES ARE EX
WHAT IS GOING ON IN THAT AREA.
OK SO, WE NEED UPDATES AND WHAT
IS GOING ON.
IF THIS IS APPROPRIATE FOR OUR
COMMITTEE OR IF IT'S ALREADY
BEING UNDERTAKE EP BY NCI.
>>ALL RIGHT.
DOES THIS SOUPED OK TO
EVERYBODY?
I THINK WE WILL NEED A GOOD
AMOUNT OF TIME TO HEAR THE
REPORT AND I REALLY DO AND I
THINK IT'S GOING TO BE VERY
IMPACTFUL AND ACTUALLY SHOW GAPS
AND THEN WITH ALL OF THE THINGS
THAT WE ASKED YOU TO ADD ON TO.
I MEAN THAT MIGHT ADD A LOT OF
TIME.
THIS WILL BE A REALLY MEANINGFUL
AND THEM WE CAN DECIDE IF WE
WANT TO MOVE IN THAT SPACE OR
JUST EP DOERS, YOU KNOW, SORT OF
WHAT YOU FOUND AND DECIDE WHERE
WE WANT TO GO.
AND I'LL TRY TO GET SOME UPDATES
OF THESE OTHER THINGS IN TERMS
OF THEY'RE BEING DONE BY NCI OR
OTHERS OR IF THEY BUILDING IN
OTHER SUBCOMMITTEES OR THEY'RE
STILL ON THE DOCKET FOR US.
SOUNDS GOOD?
I THINK WE HAD A GREAT, GREAT
SUBCOMMITTEE MEETING.
THANK YOU ALL FOR ATTENDING AND
FOR YOUR WONDERFUL
PARTICIPATION.
YOU CAN ARE A FIVE-MINUTE -- A
10 MINUTE BREAK ACCORDING TO THE
CALENDER.
THE AGENDA, BEFORE WE START THE
PLANNING AND BUDGET IS
SUBCOMMITTEE.
ARE WE TO JUST STAY ON HERE?
>>YES, YES.
ALL RIGHT.
THANK YOU, EVERYBODY.
TAKE CARE.
BE WELL.
>>THANK YOU, ELECTRA.
OUTSTANDING MEETING.
>>THIS IS A PUBLIC
MEETING THAT IS IS BEING VIDEO
CAST AND RECORDED.
MEMBERS OF THE PUBLIC WHO MAY
WISH TO EXPRESS VIEWS REGARDING
ANY ITEMS DISCUSSED DURING THIS
MEETING MAY DO SO BY WRITE TO GO
PAULA GRAY WITHIN 10 DAYS AFTER
THE MEETING.
ANY WRITTEN STATEMENTS OR
QUESTIONS SUBMITTED BY MEMBERS
OF THE PUBLIC WILL RECEIVE
CAREFUL CONSIDERATION.
THE FOLLOWING NCAB MEMBERS ARE
PARTICIPATING TODAY.
THE CHAIR Dr. BARKER, Dr.
AND Dr. PASKETT.
ARE THERE ANY QUESTIONS
REGARDING PROCESS?
Dr. BARKER, YOU MAY NOW BEGIN
THE MEETING.
>>THANK YOU, VERY MUCH, JOY.
AND WELCOME.
THIS IS OUR FIRST MEETING FOR
THIS SUBCOMMITTEE IN 2023.
IT SEEMS LIKE A LONG TIME AND A
LOT HAS HAPPENED IN THE LAST
SELF MONTHS SINCE WE LAST MET.
INCLUDING OBVIOUSLY OUR NEW NCI
DIRECTOR AND THANK YOU Dr.
BERTAGNOLLI FOR JOINING US
TODAY.
WE KNOW HER AS MONICA, SO I WILL
FOURTH WITH CALL HER MONICA.
WE APPRECIATE YOU JOINING TODAY,
MONICA, THERE'S A LOT GOING ON.
SO, I'M NOT GOING TO SAY A LOT,
BUT IF YOU ATTENDED THE LAST
SUBCOMMITTEE MEETING I THINK
ELECTRA DID A FABULOUS JOB OF
RECASTING THE COMMITTEE,
REMINDING EVERYONE WHAT THE
CHARGES WAS AND IT OCCURRED TO
ME THAT WOULD BE A GOOD IDEA FOR
THIS COMMITTEE.
THIS IS NOT AN EASY COMMITTEE TO
UNDERSTAND.
WE CAN'T REALLY COME UP WITH
SCIENTIFIC IDEAS, WE'RE TRYING
TO THINK ABOUT HOW CAN WE HELP
THE NCI MOST IN TERMS OF OUR
PLANNING AND BUDGET PROCESS.
THE PURPOSE OF THIS IS TO ASSIST
OF THE DIRECTOR, NCI, AND IT
SAYS, HISS STAFF HERE WILL
CHANGE THAT NOW TO HER STAFF.
ACTUALLY DOES SAY HIS STAFF.
ON ISSUES INVOLVING THE BUDGET
PROCESS AND PLANNING FOR THE
NATIONAL CANCER PROGRAM.
SO THAT'S A LITTLE DIFFERENT
READING OF THE NCI.
SO THE SUBCOMMITTEE PROVIDES
ADVICE ON THE BUDGET PROCESS BY
COMMENTING ON THE PRESENCE
BUDGET AND THAT OUR CHARGE AND
IT'S NOT THAT THE NCI DOESN'T
HAVE A PLANNING PROCESS OR A
BUDGET, IT HAS SEVERAL AND SO
SOMETIMES IT GETS A LITTLE
CONFUSING.
BECAUSE WE DO HAVE THE NCI TO
BUDGET EVERY YEAR THAT'S
REALISTIC EXPECTATIONS OF THAT
PARTICULAR YEAR.
WE SUBMIT THAT AND THEN THE
PRESIDENT LOOKS AT THAT AND HE
CREATES A BUDGET OR SHE CREATES
A BUDGET AND THEN THE NEXT PIECE
IT ALL GOES TO CONGRESS AND THEN
YOU KNOW, NOW, WE HAVE A FEW NO
KNOWNS IN THIS PROCESS, WE HAVE
A LOT OF KNOWN UNKNOWNS AND WE
HAVE EVEN MORE UNKNOWN UNKNOWNS.
IT'S A PROCESS.
AND I WAS AT THE NIXSON LIBRARY
THIS YEAR FOR THE CELEBRATION OF
THE NATIONAL CANCER AGENT AND
RICHARD NIXSON SAID IN AN
INTERVIEW AS HE WAS EXITING HIS
TERM IN OFFICE, NOT A HAPPY
ENDING BUT, HE SAID HE THOUGHT
THE MOST IMPACTFUL THING HE HAD
DONE IN OFFICE WAS THE NATIONAL
CANCER ACT.
AND AS YOU RECALL IF YOU SAW THE
PRESIDENT'S ADDRESS THE NIGHT
BEFORE LAST, HE IS INTERESTED IN
REAUTHORIZATION THE NATIONAL
CANCER ACT.
AND WE'VE BEEN TALKING ABOUT
THAT FOR A LONG TIME, A COUPLE
OF DECADES, AND IF YOU GO BACK
TO THE ORIGINAL NATIONAL CANCER
ACT, YOU WOULD SEE THAT IT IS
REAUTHORIZED AND THERE WOULD BE
SOME CHANGES THAT WOULD BE VERY
INTERESTING I THINK IN TERMS OF
SOME OF THE PROBLEMS THAT WE'RE
FACING IN CANCER.
SO, A LOT OF GOOD NEWS.
I LIKE TO DELIVER GOOD NEWS.
WE SAW THE REPORT THAT CAME OUT
FROM ACS RECENTLY, 33% DECLINE
IN MORTALITY RATE FOR ALL
CANCERS WHICH HAS BEEN ACHIEVED
OVER SEVERAL DECADES NOW AND I
HAVE TO SAY, IT'S PRETTY
IMPRESSIVE.
AND WE'RE SEEING THE IMPACT
WE'RE STARTING AND IT'S HAVING
AN IMPACT AND I THINK THAT CURVE
IS STARTED ING TO GO UP.
BUT IN THIS POINT IN TIME, A LOT
OF THAT HAVE -- INCREASE IN
MORTALITY RATES IS DUE TO
SMOKING SECESSION WE'VE SEEN
ACROSS THE COUNTRY.
THIS IS WHAT WE'RE GOING TO DO.
THERE'S A BIG SURPRISE IN THAT
REPORT.
I DON'T THINK IT SHOULD BE A
SURPRISE.
ANYBODY KNOWS ME I'M A COMPLEX
ADAPTIVE SYSTEMS SCIENCE.
WHEN YOU PUSH ON ONE NODE IN
THIS SYSTEM IT REVERBERATES
THROUGH THE SYSTEM.
THREE OR FOUR YEARS A. WE SAID,
LET'S REALLY RETHINK PSH
SCREENING FOR PROSTATE CANCER
AND THAT'S WHAT WE DID AND ALL
OF A SUDDEN, WE HAVE THIS LATE
PROSTATE CANCER SHOWING UP AND
IT'S JUST DECIMATED OUR
MORTALITY CURVES AND PROSTATE
CANCER.
SO, WE HAVE TO THINK THIS
THROUGH AND WE HAD THIS
CONVERSATION IN THE LAST
SUBCOMMITTEE MEETING.
WHEN YOU PUSH ON ONE NODE IN
THIS SYSTEM YOU BETTER THINK
THROUGH WHAT ARE THE POTENTIAL
OUTCOMES OF MOVING SOMETHING
LIKE SCREENING.
OPENED,SCREENING.THE OPPORTUNITG
RIGHT NOW ON THE OTHER HAND.
I MENTIONED ONE IN THE
SUBCOMMITTEE A FEW MINUTES AGO.
WE HAVE THOUGHT FOR A LONG TIME
THAT THE EPI GENOME IS IMPORTANT
BUT WE HAVEN'T KNOWN WHETHER OR
NOT IT CAN BE ACTUALLY
TRANSFERRED THROUGH THE GERM
LINE.
IT TURNS OUT THAT IT PROBABLY
CAN.
I MEAN, THIS REPORT THAT CAME
OUT THIS WEEK IS CONVINCING.
THIS HAPPENED TO DEAL WELL
METABALOMICS AND IF IT'S TRUE IT
COULD EXPLAIN A LOT.
IT COULD REALLY EXPLAIN A LOT.
IT WOULD CHANGE THE WAY WE
THINK.
WE HAVE MULTIPLE EARLY DETECTION
FOR CANCER WHICH IS TAKING OFF.
LIKE IT OR NOT IT'S TAKING OFF.
AND BEYOND THE GRAIL THAT ARE
TENS IF NOT 20s OF COMPANIES
THAT ARE ACTUALLY PURSUING THIS
IDEA.
SO, A LOT OF THINGS GOING ON AND
A LOT OF I THINK REALLY
INTERESTING ADVANCES THAT COULD
CHANGE THESE FEATURE STATISTICS
IN VERY MEANINGFUL WAYS.
I WOULD STEP BACK FROM THIS AND
I THINK WHAT CAN THIS COMMITTEE
DO?
THAT'S WHAT WE HOPE TO HAVE A
LITTLE TIME TO TALK WITH YOU
ABOUT AT THE END AFTER WE GET
THROUGH A COUPLE PRESENTATIONS
WHICH ARE REALLY QUITE
INTERESTING.
I'M THINKING ABOUT THE FUTURE.
I HAVE MAJOR CONCERNS FOR THE
CANCER INSTITUTE RIGHT NOW.
AS MUCH AS THAT 33% DECLINE IN
MORTALITY IS REALLY IMPORTANT,
IF YOU LOOK AT NUMBERS OF CASES,
THEY'RE GOING TO CONTINUE TO GO
UP.
AS THE POPULATION IS AGING AND
NOT JUST IN THIS COUNTRY BUT
IT'S GOING TO BE A GLOBAL
CRISIS.
I THINK THIS IS GOING TO BE ONE
OF THE ALL-TIME (INAUDIBLE).
AND EVERYBODY KNOWS THAT THERE
ARE COUNTRIES THAT ARE JUST NOW
ENTERING A POINT WHERE THEY HAVE
CONTROLLED A LOT OF THE
INFECTIOUS AGENTS THAT THEY'VE
DEALT WITH FOR DECADES AND NOW
THEY'RE DEALING WITH CANCER AND
WHEN YOU THINK ABOUT THAT ON A
GLOBAL BASIS, IT'S GOING TO BE
PARALYZING AND I WOULD IMAGINE,
THAT THERE ARE COUNTRY OUT THERE
RIGHT NOW THAT ARE BEGINNING TO
LOOK AT THAT AND REALIZE THAT
THEY HAVE A LARGE POPULATIONS
THAT ARE GOING TO ACTUALLY --
THE HEALTHCARE COSTS ALONE ARE
GOING TO EAT THEM ALIVE AND
THEY'RE GOING TO BE HARD-PRESSED
TO KEEP THEIR ECONOMY GOING.
I THINK WE NEED TO THINK ABOUT
THAT, REALLY LONG AND HARD IN
THIS COMMITTEE BECAUSE THE
PRESIDENT IS THINKING ABOUT THIS
AND HE IS NOT TO BE DETERRED ON
HIS CONCERNS FOR DOING MORE
ABOUT CAP SER AND I THINK WE
SHOULD DO EVERYTHING POSSIBLE
THAT WE CAN TO DELIVER FOR HIM
AND FOR OUR COUNTRY AND FOR THE
WORLD.
SO, NCI AT THE CENTER OF THE
UNIVERSE HERE, IN MY OPINION,
AND I THINK THIS COMMITTEE COULD
HELP A LOT IN TERMS OF HOW WE
CAN THINK ABOUT THE FUTURE AND
HOW WE CAN THICK ABOUT GETTING
THE KINDS OF RESOURCE WE SEE
NEED TO FUND THE KIND OF
RESEARCH THAT WE THINK ABOUT AND
TALK ABOUT THAT ARE GOING TO BE
REQUIRED TO CHANGE THESE CURVES,
EVEN REMOTELY TO REACH THE KIND
OF GOAL HE SET FOR US AND THE
NATIONAL CANCER PROGRAM.
SO, I'LL GET OFF MY SOAP BOX
NOW.
I REEL THINK IT'S IMPORTANT THAT
WE TAKE THE COMMITTEES VERY
SERIOUSLY AND WORK WITH THE NCI,
MAKE RECOMMENDATIONS, COME UP
WITH IDEAS TO HELP TO PLAN A
ESPECIALLY FOR NOT JUST THE NEXT
TWO TO THREE YEARS BUT THE NEXT
COUPLE OF DECADES.
THAT'S THE KIND OF PLANNING WE
NEED HERE AND IT'S HARD BECAUSE
WE'RE FUNDED YEAR TO YEAR AT THE
NCI AND IT MAKES IT DIFFICULT
FOR EVERY DIRECTOR HAS BEEN IN
THIS CHAIR.
I THINK ESPECIALLY NOW.
SO, WITH THAT, LET ME SAY THAT
WE HAVE PATRICK McGAREY WITH
US TODAY WHO IS GOING TO -- HE
DOES SUCH A FABULOUS JOB AS THE
EXECUTIVE SECRETARY BUT I HAVE
AN ANNOUNCEMENT GOOD FOR PATRICK
AND BAD FOR US, PATRICK IS IS
RETIRING.
I CAN'T IMAGINE THAT HE IS IS
BUT HE IS AND YOU KNOW, WE'RE
GOING TO -- I'M GOING TO ASK
THIS COMMITTEE PAY HIM A GREAT
DEAL MORE TO STAY BUT I DON'T
THINK IT WILL CONVINCE HIM.
PATRICK, I HAVE TO SAY IS ONE OF
THE MOST DEDICATED PUBLIC
SERVANTS I'VE KNOWN.
HE IS 13 YEARS -- TWO DECADES ON
THE HILL.
HE THOSE HIS WAY AROUND T KNOWSE
POLITICS AND THE POLITICAL
REGIME AND 13 YEARS AT FDA SO HE
KNOWS THE REGULATORY AND 10
YEARS FOR NCI.
I CAN'T TELL WHAT YOU A GIFT
YOU'VE BEEN TO THIS SUBCOMMITTEE
AND HOW YOU HAVE KEPT US SO
INFORMED AND THE WHOLE OF THE
NCIB AND WE WISH YOU WELL AND WE
KNOW YOU WOULDN'T RETIRE AND YOU
WILL HAVE EXCITING THINGS TO DO
WITH YOUR LIFE, I'M SURE, AND WE
HOPE YOU WILL STAY IN TOUCH.
GIVE US ADVICE WHEN WE REALLY
NEED IT.
I'LL STOP THERE AND TURN IT OVER
TO PATRICK WHO WILL TELL US
ABOUT SOME OF THE KNOWN KNOWNS
AND A LOT OF KNOWN UNKNOWNS AND
QUITE A BIT ON THE UNKNOWN
UNKNOWNS.
PATRICK, TAKE IT AWAY.
>>I WENT OFF TRACK.
THANK YOU, VERY MUCH, FOR THOSE
KIND REMARKS AND I SAY THE
GOVERNMENT SERVICE IS SO
REWARDING.
NCI REFLECTS THE BEST IN
GOVERNMENT.
I'M PLEASED THAT I COULD
CONTRIBUTE IN SOME WAY HERE OR
THERE.
I'M HAPPY TO STAY IN TOUCH.
THANK YOU, VERY MUCH FOR THOSE
KIND WORDS.
SO, LET'S DO JUMP IN.
IT'S GO AHEAD TO BE HERE BEFORE
THE SUBCOMMITTEE AGAIN.
I'M GOING TO KICKOFF
PRESENTATION ON THE BUDGET AND
MY NCI COLLEAGUE Dr. PALMARI
WILL FOLLOW WITH THE DISCUSSION
OF THE ANNUAL PLAN.
SO OUR AGENDA BEGINS WITH FISCAL
YEAR 2022, THE YEAR THAT CLOSED
LAST SEPTEMBER.
THEN I'LL MOVE ONTO THE NCI
BUDGET FOR 2023 AND 2024.
SO WHAT YOU ARE SEEING HERE
DISPLAYING THE HIGHLIGHTS OF THE
NCI MAJOR GRANT MECHANISMS, WE
WILL HAVE A FINAL GRANT COUNT ON
MARCH 9th, WHICH IS AN
IMPORTANT BUDGET DATE AND I'M
GOING TO TALK MORE ABOUT LATER
IN THE PRESENTATION.
BUT AS THINGS STAND NOW, OUR
GRANT COUNT WILL LIKELY EXCEED
7500 AWARDS FOR THE FIRST TIME.
MORE THAN HALF OF THESE AWARDS
ARE RO1 OR R37 GRANTS.
JUST A WORD ABOUT R37s, IF AN
EARLY STAGE INVESTIGATORS
APPLICATION, IT'S AN ESI AS WE
USE THE ACRONYM, RECEIVES A PEER
REVIEW SCORE MORE THAN OR BETTER
THAN OR EQUAL TO THE RO1 PAYLINE
THAN THOSE NOT ESI AWARDS ARE
ALLOWED TO CONVERT TO R37, MERIT
AWARDS.
RO1 AWARDS ARE FOR FIVE YEARS
AND R37 RUNS FOR TWO ADDITIONAL
YEARS OF GRANT FUNDING SOMETHING
I'LL ALSO RETURN TO LATER
BECAUSE THAT'S TWO ADDITIONAL
YEARS OF NON COMPETING WHICH
WE'RE HAPPY O RESOURCE BUT THEY
HAVE BUDGET IMPLICATIONS.
SO WE EXPECT A STRONG YEAR FOR
OUR RO1, R37 AND R2 # NUMBERS21S
WITH INCREASED GRANT OUTPUT ON
ALL THREE.
THE R21s ARE THE EXPLORATORY
RESEARCH GRANTS.
PLEASE RECALL THAT 2022, THE
YEAR WE FINISHED AND THE YEAR
THAT THESE NUMBERS REFLECT, WAS
A YEAR WHEN WE HELD STEADY
RATHER THAN INCREASE THE
PAYLINES.
SO, I HOPE YOU CAN APPRECIATE
THAT EVEN IN A YEAR WHEN WE
DON'T INCREASE THE PAYLINES, WE
CAN STILL ISSUE SUBSTANTIALLY
MORE GRANTS WITH THE DOLLARS WE
HAVE.
LET ME TURN TO FY2023 AND THE
FISCAL YEAR WE BEGAN
OCTOBER 1st.
CONGRESS WAS VERY GOOD TO NCI
AND THIS YEAR WE WERE RECEIVING
$408 MILLION INCREASE OVER THE
PRIOR YEAR.
AND ONLY ONCE IN THE PAST 10
YEARS HAVE WE RECEIVED A HIGHER
PERCENTAGE INCREASE THAN THAT
5.9%.
THE INCREASE INCLUDES, WELCOME
BACK THE 408 THERE'S 22 MILLION
FOR THE CURES ACT MOONSHOOT IN
2017 AND THAT LIFTS THE MOONSHOT
AMOUNT OF THE YEAR TO
$216 MILLION AND OF THE FOUR
CONGRESS PROVIDED $150 MILLION
MUST BE SPENT ON COMPETING AND
CONTINUING GRANTS AND WE'LL
CHECK THAT BOX.
NIH GOT A $3 BILLION INCREASE
THAT IS A PLUS 6.5% AND THAT
TOTAL I AM INCLUDES A BILLION
AND A HALF FOR ARPA-H, FOCUS ON
THAT BECAUSE ARPA-H HAS A CANCER
FOCUS IN ADDITION TO A GLOBAL
HEALTH AND THAT IS A HALF A
BILLION DOLLARS INCREASE OVER
THE PRIOR YEAR.
AND THERE AT THE BOTTOM, YOU SEE
KIND OF THE TASK THAT ARPA-H HAS
GIVEN IN A BROAD CO CONTEXT TO
ADVANCE HEALTH AND HEALTH
RESEARCH.
SO, NEXT SLIDE, PLEASE.
THIS IS A CLASSIC TABLE WE USE
YEAR IN AND YEAR OUT.
THE FIRST THING I SEE HERE IS
THAT 30 IN THE 2017 COLUMN.
I MUST HAVE DONE SOMETHING WHEN
I WAS SAVING IT THAT'S A 300 AND
JOY I'LL CORRECT THAT FOR THE
ONE WE DISPLAY FOR THE RECORD.
IS SO, SMALLER OR THERE BUT THE
ORANGE BOXES SHOW THE SEVEN
SUCCESS I HAVE YEARS OF CURES
ACT FUNDING.
START NORTH 2017 AND 2023 IS THE
FINAL YEAR.
WE CALL THAT A CLIFF AND WITHOUT
SOME CONCRETE ACTION, THIS
$216 MILLION YOU SEE THERE WILL
DISAPPEAR AND THAT'S ABOUT 3% OF
OUR BUDGET AND WE'RE KEEPING A
CLOSE EYE ON THAT AND THE
ADMINISTRATION IS AS WELL.
IN THE GREEN BOX WE HAVE THE
$50 MILLION FOR CHILDHOOD CANCER
INITIATIVES THAT IS A 10-YEAR
INITIATIVE AND WE'RE NOT QUITE
HALFWAY THROUGH THAT WITH THE
MONEY WE RECEIVED THIS YEAR.
SO THOSE ARE TWO OF A MORE
MODEST COMPONENTS IN THE LARGER
INCREASE OR BUDGET AMOUNT THE
$7 BILLION MAKING UP A TOTAL OF
$7.3 BILLION FOR THE YEAR THAT
WE'VE ENTERED, YEAR IN THE PAST.
WE ENTERED IT IN OCTOBER 1 BUT
THE APPROPRIATION CAME TO US AT
THE END OF DECEMBER.
NEXT SLIDE, PLEASE.
SO IN THIS SLIDE, I'M DISPLAYING
THE TABLE THAT APPEARED IN Dr.
BERTAGNOLLI'S FEBRUARY
FEBRUARY 6th POST IN NCI'S
BOTTOM LINE BLOG.
IT SHOWS FUNDING POLICIES FOR
2023 AND COMPARED TO LAST FISCAL
YEAR WHAT YOU ARE SEEING IS NCI
RAISING THE PAYLINE FOR RO1 AND
THE ESIRO1s BY 1% TILE EACH
FROM 11% TO 12% FOR RO1 AND 16%
TO 17% FOR ES I-RO1s, WE
EXPECT TO ISSUE 100 ADDITIONAL
RO OR ESI AWARDS COMPARED TO
LAST YEAR.
AND THESE PAYLINE INCREASES ARE
POSSIBLE BECAUSE OF THE GENEROUS
INCREASE WE RECEIVED FROM
CONGRESS.
THIS YEAR, JUST LIKE IN THE
PRIOR YEAR, THE R21 EXPLORATORY
GRANTS WILL REMAIN AT 9%.
BUT TO ENSURE WE CAN MEET THESE
PAYLINE INCREASES, YOU KNOW, 100
ADDITIONAL GRANTS THAT ADDS UP
AND THERE ARE GRANT INCREASES IN
SOME OTHER CATEGORIES, NOT
DISPLAYED HERE, WE'VE HAD TO DO
JUST WHAT WE DID LAST YEAR, ONCE
AGAIN, FUND NON COMPETING AWARDS
AT THE THE 98%.
WITH IN TARGETED EXCEPTIONS YOU
SEE ON THE RIGHT HAND SIDE AND
NCI IS IS MAKING CUTS TO
INVERNAL BUDGETS AND WE'RE OWE
POTION A 2% OFFICES AND CENTERS
AND THIS ALLOWS US TO PRIORITIZE
FUNDING FOR ROS AND ESI
COMPETING AWARDS AND YOU HAVE A
LINK AT BOTTOM OF THE PAGE O THO
THE GRANT FUNDING POLICIES WHERE
THERE'S MORE DETAIL AVAILABLE TO
THE PUBLIC.
SO, THIS IS A FLASH BACK.
I'M SHOWING YOU HERE A SLIDE I
PRESENTED LAST YEAR.
IT'S NOT EXACTLY THE SAME SLIDE.
IN JUNE I SHOWED THE RED AND THE
GREEN AND THE BLUE COMPONENTS
AND 27 INCREASE IN '21 AND
'22 WAS $39 MILLION INCREASE AND
I ADDED IN GOLD THE 2023 PIECE
WHICH IS IS $28 MILLION SO YOU
SEE ACROSS THESE YEARS
$169 MILLION IN TOTAL INCREASE
FOR NOT COMPETING GRANTS.
AND NOW LET'S MOVE TO THE NEXT
SLIDE OF AND THIS IS A COMPLEX
DISPLAY AND IT'S NEARLY DESIGNED
TO SHOW THE MULTI YEAR
CONSEQUENCES OF ALL THESE
COMMITMENT TO GRANTS.
AND HOW THEY COMPOUND ACROSS THE
YEARS.
AND HERE YOU SEE LOOKING FROM
LEFT TO RIGHT, $75 MILLION WE
START INSIDE 2020 WILL OF COURSE
FOR FIVE SUCCESS I HAVE YEARS IF
IT'S AN RO1 OR IT WOULD BE SEVEN
YEARS IF IT WAS AN R-37 MERIT
AWARD FOR ESI WE HAVE THOSE
COSTS NOW I WANT TO BE CLEAR NOT
# HUNDRE100% OF THE $73 MILLIONE
PAYLINE AND THAT'S THE MOST
PROMINENT ONE BUT THERE ARE
OTHER SMALLER DRIVERS IN THERE
AS WELL AND THEY ADD TO THE
TOTAL, YOU ARE SEEING THE TOTAL
INCREASE AND THEM YOU GET OUT OF
THE GREEN AND WE ADD THOSE YEARS
AND BLUE AND WE ADD THOSE YEARS
AND NOW WE'RE STARTING FIVE OR
IN SOME CASES SEVEN YEARS OF
ADDITIONAL COMMITMENT AND YOU
CAN SEE IF YOU LOOK FROM TOP TO
BOTTOM, YOU CAN SEE HOW THOSE
COSTS ADD UP AND COMPOUND ACROSS
THE YEARS.
AND THERE'S A COUPLE OTHER
FACTORS THAT ARE ALSO WORTH WILE
CONSIDERING.
EVERY YEAR WE DRIVE TO MAKE MORE
AWARDS.
I MENTIONE MENTION 100 ADDITIONS
FOR ESI AND RO1 AWARDS AND SO
THAT WHAT WE HAVE THE LAST YEAR
OF AN EXPIRING GRANT COHORT,
THOSE DOLLARS AREN'T SUFFICIENT
TO FUND THE NEW LARGER COHORT.
AND THEN YOU CONSIDER INFLATION
AS WELL.
WHICH ALSO DEFLEETS THE BUYING
POWER SO THEN YOU ARE A PICTURE
OF THE COST STRUCTURE OF MAKING
A ONE-YEAR INITIAL COMMITMENT ON
COMPETING AND HOW IT PLAYS OUT
INTO NON COMPETING AWARDS AND
LET'S MOVE TO THE NEXT SLIDE,
PLEASE.
AND I JUST WANT TO OFFER THIS AS
A ALTERNATIVE VIEW, OUR FRIENDS
IN OEFIA OFFICE DEVELOPED THIS
AND I'M NOT GOING TO RUN THROUGH
IT AGAIN.
IT'S MERELY ANOTHER ILLUSTRATION
OF WHAT HAPPENS ACROSS THE YEARS
FOR WHEN WE MAKE A COMMITMENT A
COMPETING YEAR WHAT HAPPENS AND
THE COST AND HOW THEY DO
COMPOUND.
THIS IS ALL WORTH WHILE DOLLARS
WE'RE PUTTING OUT THERE FOR
SIGNIFICANT RESEARCH BUT THERE'S
A COST STRUCTURE AND THAT WE
FACE.
NEXT SLIDE, PLEASE.
AND NOW TURNING TO '24, YOU ARE
SEEING CONTACT FROM A MEMO CO
AUTHORED BY OMB DIRECTOR AND
NATIONAL ECONOMIC COUNCIL
ADVISER AND THE MEMO RELATED TO
A DRAMA OVER THE DEBT CEILING.
IT WAS A WHITE HOUSE SAYING
WE'RE SHOWING THE AMERICAN
PUBLIC OUR BUDGET SO,
REPUBLICANS CAN DO THE SAME BUT
I'M NOT WAITING INTO THAT AND
I'M TRYING TO FIND OUT THAT HERE
WE ARE ON PAGE ONE OF THE MEMO,
WE'RE TOLD THAT PRESIDENT JOE
BIDEN WILL RELEASE A BUDGET ON
THE NINTH OF MARCH AND AT THE
SAME TIME, WE'LL HAVE A DISPLAY
OF WHAT THE FINAL GRANT COUNT IS
IS FOR NCI SO THAT'S A DATE WE
CAN WATCH.
YOU CAN CALL THAT CLEARLY A
KNOWN UNKNOWN O WE DON'T KNOW
WHAT THAT BUDGET AMOUNT IS BUT
WE KNOW IT'S COMING AND IT'S
RELATIVELY AROUND THE CORNER
MONTH FROM TODAY.
SO, ALL I WANT TO EMPHASIZE IS
THE ENVIRONMENT AND CONGRESS AND
A NEW CONGRESS WE HAVE A DIVIDED
CONGRESS.
OF COURSE, THE DEMOCRATIC PAR
PARTY HAS THE WHITE HOUSE WITH
PRESIDENT BIDEN BUT WE HAD A
DEBT CEILING CRISIS IN THE SAME
ERA A DECADE AGO THAT WAS A
STORMY PERIOD AND YOU HAVE TO
ASK YOURSELF WHETHER OF HISTORY
MAY NOT REPEAT ITSELF BUT THE
SIMILARITIES MAKE YOU WONDER
ABOUT THE POSSIBILITY OF DEJA
VU.
TO BRING THE DISCUSSION TO A
CLOSE, I WANT TO SPOTLIGHT HOW
MUCH CANCER DISCOVERY AND THE
NEEDS OF CANCER PATIENTS ARE
PRIORITIES FOR PRESIDENT BIDEN
AND FIRST LADY JOE BIDEN.
THEY WILL EMPHASIZE ADDRESSES TO
THE NATION BY PRESIDENT JOE
BIDEN AND 2021, IN HIS FIRST
ADDRESS TO THE JOINT SESSION OF
CONGRESS WE LEARNED CANCER WOULD
BE A PRIORITY FOCUS OF THE JOE
BIDEN ADMINISTRATION AND WAS AN
EX OWE OF WHAT HE SAID
THROUGHOUT THE CAMPAIGN AND I'VE
HIGHLIGHTED IN YELLOW SOME OF
THE KEY MESSA PASSAGES N-2022 TE
STATE OF THE UNION THE BOX ON
THE RIGHT, HE ANNOUNCE THE HIS
PLAN TO SUPER CHARGE THE CANCER
MOONSHOT SETTING THE CHALLENGE
FOR NCI AND ALL OF GOVERNMENT
FRANKLY TO CUT CANCER DEATH IN
HALF IN 25 YEARS.
THURSDAY NIGHT TWO DAYS AGO, WE
HEARD FROM THE PRESIDENT, AGAIN,
FOR THE THIRD TIME IN THREE
YEARS IN ADDRESS TO CONGRESS AND
THE NATION WE WITNESSED A BRIGHT
SPOTLIGHT ON EVIDENCE CA OF CAN.
HE HAD 13 TIMES REFERENCE TO CAP
SER.
MORE THAN HE REFERRED TO THE
ECONOMY AND INFRASTRUCTURE,
COVID-19, CHINA, AND EVEN MORE
TIMES THAN HE MENTIONED
REPUBLICANREPUBLICAN OR DEMOCRA.
RONALD REGULARONALD REAGAN STARG
HUMAN APP STORIES ABOUT CANCER.
THERE WERE FOUR OF THEM.
A FAMILY FROM NEW YORK WITH A
4-YEAR-OLD THAT SUFFERED FROM
KIDNEY CAP SER, A BREAST CANCER
SURVIVOR AND ARIZONA NURSE IN
THE FIRST CANCER CLINIC ON A
NATIVE AMERICAN RESERVATION AND
A HERO WHO ENDED A MASS SHOOTING
THAT HE HAD POSTPONED HIS
COLLEGE TO CARE FOR HIS MOM
DYING OF CANCER.
IT'S COMPELLING EVIDENCE OF THE
DIE DENBIDEN'S COMMITMENT TO CA
AND THE WORK OF NCI AND IN THE
HOURS BEFORE THE STATE OF THE
UNION, THE WHITE HOUSE RELEASED
A FACT SHEET ON ITS AGENDA FOR
THE YEAR AHEAD AND THE FIRST
AGENDA TOPIC WAS CANCER.
I'LL POST OF THE LINK TO THAT
FACT SHEET IN THE CHAT.
IT INCLUDES TACKLING THE BIGGEST
SINGLE DRIVER OF CANCER DEATHS
WHICH IS SMOKING.
PROVIDING PATIENT NAVIGATION
SUPPORT FOR EVERY AMERICAN
FACING CANCER AND BRINGING
AMERICA'S CANCER RESEARCH SYSTEM
INTO THE 21st CENTURY AND THEN
JUST A MOMENT MORE FINALLY ON
THE THIRD POINT, IT DESERVES
MORE DISCUSSION BECAUSE WITH IT
THE ADMINISTRATION ANNOUNCED A
PLAN TO REFRESH, AS Dr. BARKER
MENTIONED THE NATIONAL CANCER
ACT AND PART OF HIS PLAN IS
ALSO, I WANT TO QUOTE, TO WORK
WITH CONGRESS TO LOCK IN THE
STRONG INVESTMENT AND CANCER
RESEARCH THAT WAS PASSED IN 2016
AS PART OF THE 20th CURES ACT
CANCER MOONSHOT WHICH EXPIRES
THIS YEAR.
AND THAT BRINGS US BACK TO THAT
BAR GRAPH AND THE CLIFF FOR
2023.
SO WE DON'T HAVE SPECIFICS BUT,
CLEARLY THERE'S AN OBJECTIVE
THAT HE HAS IN MIND AND THE
ADMINISTRATION HAS IN MIND TO
ADDRESS THAT AND CONTINUE CANCER
MOONSHOT FUND NORTH SOMEWAY OR
FORM AND WE'LL LEARN MORE ABOUT
THAT ON THE NINTH OF MARCH I'M
AT MY END.
AND I'LL TURN IT OVER TO
QUESTIONS OR MEAN YOU WANT TO
HEAR FROM DIANNE AND WE'LL HAVE
QUESTIONS COLLECTIVELY.
>>SO, I THINK WE'LL TAKE A
COUPLE QUESTIONS HERE IF THERE
ARE ANY.
I'LL ASK THE FIRST ONE.
LET ME JUST ASK THIS TO THE
POSITIVE WAY, I'M TRYING TO
THINK OF A POSITIVE WAY TO FRAME
THIS.
WE'VE TALKED IN THIS COMMITTEE
FOR THE LAST COUPLE OF YEARS
ABOUT THIS GOAL, WE HAD TO GET
THE PAYLINE TO 15% BY 2025.
I'M NOT GOING TO ASK YOU,
PATRICK, IF YOU THINK THAT'S
GOING TO HAPPEN BUT I'M GOING TO
ASK YOU WHAT YOU THINK IT WOULD
TAKE TO MAKE THAT HAPPEN?
>>IT WILL PROBABLY TAKE ANOTHER
MOON SHOOT COMMITMENT AND IT
TAKES DOLLARS.
THERE'S NO ESCAPING THAT.
I'LL SAY HOPEFULLY, WE DON'T GET
TO PRINT THE DOLLARS WE GET TO
RECEIVE THEM FROM CONGRESS.
IF THAT'S WHAT IT TAKES AND --
YOU KNOW, WE WILL KNOW MORE IN A
MONTH WHEN WE HAVE THAT BUDGET
ANNOUNCEMENT FOR ALL OF
GOVERNMENT, INCLUDING NCI FROM
THE WHITE HOUSE.
>>I POINT THIS OUT BECAUSE IT'S
ONE OF THE MOST CRITICAL POINTS
I THINK IN THE NCI.
I'VE SEEN FOR A VERY LONG TIME
IN TERMS OF A BUDGET THAT IS
NECESSARY, NOT TO MOVE BACKWARDS
AND I'M HOPING THAT IS GOING TO
BE POSITIVE NEWS BECAUSE YOU
KNOW, WE REALLY DO HAVE OTHER
ISSUES TO DEAL WITH HERE OTHER
THAN JUST FUNDING THE RESEARCH
GRANTS THAT WE FUND.
YOU MENTIONED INFRASTRUCTURE FOR
EXAMPLE.
I'D LIKE TO COME BACK TO THAT
WITH A COMMITTEE BECAUSE I THINK
IT'S A KEY ISSUE.
LET'S SEE IF THIS ARE OTHER
QUESTIONS.
SEEING NONE, EVERYONE IS HAPPY
WITH THE BUDGET.
LET ME ASK ANOTHER QUESTION AND
I'M ASKING YOU TO THINK WITH US
A LITTLE BIT ABOUT THIS BUT YOU
KNOW, I'M FAMILIAR WITH THE
BIOMEDICAL PRICE EVERYBODY
DOESN'T PAY ANY ATTENTION TO IT
IF YOU LIVE IN THE ACADEMIA YOU
SHOULD KNOW ABOUT THIS AND SO,
WHERE ARE WE THOUGH IN TERMS OF
APPLYING REALISTIC INFLATION
NUMBERS TO OUR GRANTS AND WHAT
I'M ASKING WHAT'S IS OUR
SPENDING POWER IN THAT BUDGET
THINKING ABOUT REAL DOLLARS
VERSUS ARE WE DOING WELL IN THAT
REGARD OR HOW DO YOU THINK ABOUT
THE PURCHASING POWER WITHIN THAT
BUDGET?
>>SO ACROSS THE YEARS, WE HAVE
HAD A 40% INCREASE IN OUR BUDGET
AND SO THAT IS AHEAD OF
INFLATION AND AHEAD OF THE
BIOMEDICAL PRICING AND SO WORE
INTO SOME CHALLENGING INFLATION
YEARS AND IN A YEAR OR TWO, WITH
INFLATION, A LOT CAN HAPPEN TO
EFFECT YOUR PURCHASING POWER.
WE'VE BEEN BLESSED BY LOW
INFLATION BUT WE KNOW INFLATION
IS COOKING UP AND HOW LONG IT
WILL SUSTAIN IS A QUESTION SO
IT'S A IMPORTANT QUESTION TO ASK
AND ONE TO STAY ON TOP OF
BECAUSE AN INCREASE THAT SOUNDS
GOOD MAY BE JUST BEATEN LARGELY
UP BY THE DRIP, DRIP, DRIP OF
INFLATION.
>>LAST YEAR, OBVIOUSLY -- I
WOULD HAVE POST RIGHT NOW INTO
THE CHAT THAT LINK I PROMISE,
SORRY.
I DIGRESS TODAY THAT.
>>THANK YOU.
>>THANK YOU, PATRICK.
I POINT THAT OUT BECAUSE, YOU
KNOW, LAST YEAR'S INFLATION
NUMBERS WEREN'T GOOD AND IF YOU
LOOK AT THE BIOTECH INDUSTRY,
THE FARM INDUSTRY AND THE TECH
INDUSTRY RIGHT NOW EVEN IF
HEALTHCARE SHARE CUTTING STAFFED
AND ALL THE DISCOVERY WE MAKE
DEPEND ON WE SEE A HUGE PULL
BACK IN ALL THOSE SECTORS AND
THE BIOTECHNOLOGY INDUSTRY HAS
BEEN DECIMATED IN THE LAST FEW
YEARS SO IT'S SMOG THINK ABOUT
IN TERMS OF HOW OUR -- HOW WE
CAN SPEND OUR MONEY AND WHERE
ARPA-H CAN HELP AND WE CAN GET
HELP ON SCALE AND THESE STICKY
PROBLEMS WE HAVE IN THAT REGARD
SO WE'LL MOVE ON AND THANK YOU
VERY MUCH ON WE HALF OF OUR
SUBCOMMITTEE AND IT'S A PLEASURE
TO WORK WITH YOU.
I MENTIONED OUR -- I ASKED FOR
THIS PRESENTATION BECAUSE EVERY
YEAR WE HAVE LOOKED AT OUR
BUDGET FOR WHAT WOULD IT TAKE TO
OPTIMIZE OUR CANCER RESEARCH IN
ANY GIVEN YEAR AND FROM 1971
WHEN PRESIDENT NIXON SAID
ESSENTIALLY, I WANT TO GO -- I
WANT TO GO ON RECORD AS SAYING,
I WANT TO KNOW WHAT IT'S GOING
TO TAKE TO MAKE THIS HAPPEN AND
I WANT TO KNOW THE BUDGET AND I
CAN GO TO CONGRESS WITH THAT AND
HE WAS TALKING TO PEOPLE THEN
LIKE TED KENNEDY AND PAUL PAUL
RODGERS AND PEOPLE IN THIS REAL
MOVEMENT FOR WHAT WAS THE
NATIONAL CANCER ACT AND SO HE
DEVELOPED SOMETHING CALLED THE
IDEA OF THE BYPASS BUDGET WHICH
WAS REAL FOR NCI IT'S A HUGE
NUMBER, EVERY SINGLE YEAR TO SIT
DOWN AND FIGURE OUT THIS IS WHAT
WE THINK WOULD REALLY OPTIMIZE
PROGRESS IN CAP SER RESEARCH AND
THIS IS WHAT IT COSTS.
UNFORTUNATELY, NOT EVEN THAT
MANY DECADES LATER, THAT BUDGET
YOU KNOW, DIDN'T ANY LONGER FIND
ITS WAY INTO THE PRESIDENT'S
OFFICE AND WE HAVEN'T HAD THAT
BUDGET FUNDED EVER SINCE I'VE
BEEN AROUND AND SO IT'S A
PLAINTIFF AND TO LOOK AT
INFRASTRUCTURE AND TO LOOK AT
THE WORKFORCE AND LOOK AT
EVERYTHING AND SEE WHERE DO WE
NEED TO SPEND OUR MONEY AND HOW
CAN WE REALLY MOVE THIS WHOLE
FIELD FORWARD AND SO, DIANNE HAS
THE HONOR OF DOING THAT AND THEY
KNOW WHEN I WAS THERE IT'S A LOT
OF WORK FOR A LOT OF PEOPLE AND
SHE'S OUR DIRECTOR OF CRS AND
SHE WILL TELL US ABOUT THIS
YEAR'S PLANNING BUDGET FOR THE
NCI WHICH IS THE PREVIOUSLY
CALLED THE BY PASS BUDGET.
IT'S ALL YOURS.
>>THANK YOU.
THANK YOU, EVERYONE FOR GIVING
ME THIS OPPORTUNITY.
WE USUALLY DO THIS AT THE
SEPTEMBER NCAB MEETING BUT THIS
YEAR THE FY '24 ANNUAL PLAN EX
BUDGET PRO POSAL WAS RELEASED ON
SEPTEMBER 15th SO IT WAS AFTER
THE SEPTEMBER MEETING AND BEFORE
Dr. BERTAGNOLLI TOOK THE HELM
OF THE NCI.
SO I'M GOING TO TAKE A FEW
MINUTES TO WALK YOU THROUGH THIS
YEAR'S PLAN.
SO NEXT SLIDE, PLEASE.
AS YOU HAVE ALREADY DISCUSSED
BUT JUST FOR THE SAKE OF
COMPLETENESS TO REWIND EVERYONE
AGAIN THAT THE NATIONAL CANCER
ACT GIVES NCI THE AUTHORITY TO
DO THIS AND THE LANGUAGE THERE
WAS REALLY -- IT GIVES US THE
ABILITY TO PROVIDE OUR
PROFESSIONAL JUDGMENT EACH YEAR
ON THE BUDGET NEEDED TO
ADMINISTER THE NATIONAL CANCER
PROGRAM AND IT WAS INTENDED TO
BE DELIVERED DIRECTLY TO THE
PRESIDENT FOR REVIEW BY
CONGRESS.
AGAIN, AS WAS ALREADY ALLUDED TO
IT WAS SIGNED INTO LAW TO 1971
AND NOW THE PRESIDENT IS TALKING
ABOUT REAUTHORIZING IT.
IN 2022 THE NCI CELEBRATED OR
COMMEMORATED THE ANNIVERSARY OF
THE SIGNING WITH A YEAR LONG
ENGAGEMENT CAMPAIGN AND WE'RE
BUILDING ON THE MOMENTUM AROUND
ENGAGING EVERYONE IN THE
COMMITMENT TO CANCER RESEARCH.
SO, THE PLAN IN ITS ESSENCE,
WHAT WE PREVIOUSLY USED TO REFER
TO AS THE BY PASS BUDGET AND WE
REBRAND IT AS THE NCI ANNUAL
PLAN AND BUDGET PROPOSAL
CONTAINS TWO MAIN COMPONENTS
EVERY YEAR.
THE FIRST IS THE IMPORTANT
PROFESSIONAL JUDGMENT BUDGET,
AGAIN, REALLY THIS IS MEANT TO
BE AN ASPIRATIONAL BUDGET
PROPOSAL TO COMMUNICATE THE
OPTIMAL FUNDING NEEDED EVERY
YEAR TO MAKE PROGRESS AGAINST
CANCER AND THE ANNUAL PLAN
NARRATIVE THE DYNAMIC STRATEGIC
PLAN GIVES US THE CHANCE TO
DISCUSS OUR PRIORITIES SUCH AS
SUPPORTING INVESTIGATORS
INITIATED RESEARCH AND RAISING
THE RO1 PAY LINES AND HIGHLIGHT
SCIENTIFIC OPPORTUNITIES.
IT ALSO FULFILLS THE
CONGRESSIONAL REQUIREMENT THAT
WAS INCLUDED IN THE 21st CENTS
RECURES ACT THAT EACH AND EVERY
NIH OFFICE INSTITUTE AND CENTER
HAVE A STRATEGIC PLAN.
SO, THE PLAN THAT WE PUT OUT
EVERY YEAR FULFILLS THAT
REQUIREMENT.
NEXT SLIDE, PLEASE.
SO THE PLAN IS RELEASED TWO
YEARS AHEAD OF TIME SO BUILDING
ON WHAT PATRICK WAS SAYING, WE
RELEASED THE FY24 ANNUAL PLAN IN
SEPTEMBER OF FY '22.
SO IT'S TWO YEARS AHEAD OF TIME.
AND THAT RELEASE REALLY ALIGNS
WITH THE TIMING OF THE FOURTH
COMING PRESIDENT'S BUDGET.
SO WHEN WE RELEASED THE FY24
ANNUAL PLAN AND BUDGET PROPOSAL
IN THE FALL, WE'RE WAITING THEN
THE 2024 PRESIDENT'S BUDGET
WHICH PATRICK JUST TOLD US WILL
BE RELEASED ON MARCH 9th.
IT WILL PRE-EMPT THAT TO BE PART
OF THE CONSIDERATIONS.
THIS YEAR'S PLAN INCLUDES A
MESSAGE FROM THEN ACTING
DIRECTOR DOUG LOWY, THE PJB OR
THE PROFESSIONAL BUDGET BUDGET
TABLE AND NARRATIVE.
STORIES FROM PATIENTS AND
RESEARCHERS AND IT'S INTEGRATED
WITHIN THE CANCER.GOV ENTERPRISE
WEBSITE SO IT COVERS NCI
SCIENTIFIC VISION AND PRIORITIES
ACROSS THE PORTFOLIO.
IN ADDITION THE ANNUAL PLAN
INCLUDES HIGHLIGHTED SCIENTIFIC
OPPORTUNITIES.
IN THE PAST FEW YEARS, WE'VE
BEEN FOCUSING ON HIGHLIGHTING
THREE OR FOUR OPPORTUNITIES IN
SOME DEPTH AS OPPOSED TO LISTING
DIFFERENT OPPORTUNITIES.
I'M GOING TO TALK ABOUT THE
HIGHLIGHTED SCIENTIFIC
OPPORTUNITIES ON THE NEXT SLIDE.
BUT BEFORE I DO THAT, I WANTED
TO MENTION, COULD YOU GO BACK,
PLEASE?
THANK YOU.
I WANTED TO MENTION THAT THERE'S
ALSO APP EXECUTIVE SUMMARY WHICH
IS PART OF THE ANNUAL PLANNED
PACKAGE THAT YOU CAN DOWNLOAD
FROM CAP SER.GOV.
THE AT A GLANCE DOCUMENT
INCLUDES THE DIRECTOR'S MESSAGE,
PROFESSIONAL BUDGET TABLE,
BUDGET NARRATIVE AND KEY MESSAGE
WHICH THIS YEAR INCLUDES SEVERAL
OPPORTUNITIES TO BUILD ON THE
SUCCESS OF THE CANCER MOONSHOT.
THANK YOU, SO, THE HIGHLIGHTED
SCIENTIFIC OPPORTUNITY NOT --
APPARENTLY MY DOG WANTS TO
COMMENT.
WE TOOK THE APPROACH TO USE
IMAGES AND FACTOIDS SEEN ON THIS
SLIDE TO CAPTURE THE PROBLEM OR
THE CHALLENGED THAT EACH OF THE
TOPICS IS TRYING TO ADDRESS SO
IF YOU START AT THE TOP-LEFT,
THE MAP HIGHLIGHTS OPPORTUNITIES
PLAN HIGHLIGHTS CANCER SCREENING
THROUGH DETECTION AND IT WAS
LAUNCH TO TEST A SIM TO THE ACHE
MULTI CANCER DETECTION AND THE
NEXT TOPIC MOVING DOWN,
ADDRESSES HARNESSING THE POWER
OF CELL THERAPY TO TREAT SOLID
TUMORS.
AND SO AS YOU KNOW, THERE ARE
FDA APPROVED THERAPIES FOR
LIQUID TUMORS BUT WE DIDN'T HAVE
THE SAME SUCCESS IN SOLID TUMORS
SO THE CONTENT FOCUSES ON THE
NEED FOR MORE RESEARCH TO
OVERCOME BARRIERS TO CELL
THERAPY FOR SOLID TUMORS AND IT
ALSO INTRODUCES THE CANCER
ADOPTIVE CELLULAR THERAPY
NETWORK WHICH IS FOCUSES ON
EARLY STAGE CLINICAL TESTING OF
NOVEL CELL THERAPIES FOR SOLID
TUMORS.
THE THIRD TOPIC ADDRESSES NCI'S
CONTINUING FOCUS TO INCREASE
HEALTH EQUITY.
AND IT'S FOCUSED ON THE
CONNECTION BETWEEN PERSISTENT
POVERTY AND INCREASED CANCER
RISK AND MORTALITY.
CANCER DEATH RATES ARE 12%
HIGHER IN COUNCIL TEE THAT'S
POVERTY THAN OTHER U.S. COUNTIES
AND THE MAJORITY OF THOSE
COUNTIES AS DEFACTOID ARE IN
RURAL AREAS.
IT WAS DISCUSSED IN THE PREVIOUS
SUBCOMMITTEE.
NCI IS FUNDING RESEARCH TO
UNDERSTAND HOW FACTORS SUCH AS
EXPOSURE TO CAP SER CAUSING
AGENTS, INCREASE STRESS, AND
LACK OF ACCESS TO QUALITY
HEALTHCARE AMONG OTHERS CAN
INTERSECT TO EFFECT CANCER
OUTCOMES FOR PEOPLE LIVING IN
YEARS OF PERSISTENT POVERTY.
WE'RE WORK TO GO BETTER
UNDERSTAND THIS PROBLEM AND
WE'RE ALSO TESTING INTERVENTIONS
AT THE INDIVIDUAL, THE
COMMUNITY, AND THE POPULATION
LEVEL TO TRY TO EFFECT CHANGE
AND CANCER OUTCOMES IN THESE
COMMUNITIES.
THE FINAL TOPIC ADDRESSES THE
PROBLEM OF TACKLING
TRADITIONALLY UNDRUGABLE CANCER
TARGETS WITH NEW APPROACHES TO
DRUG DESIGN.
AND Dr. BARK ERA LEWDED TO
THIS WHEN SHE COMMENTED ON THE
PROMISE THAT WE'RE NOW REALIZING
OF ALL OF THE RESEARCH INTO
GENOMICS AND SO WE THINK THE
LONG-TERM INVESTMENTS AND
UNDERSTANDING CANCER AND A PRIME
EXAMPLE IS THE RAS ON KA GENE
ARE PAYING OFF.
RESEARCHERS HAVE THE ABILITY TO
COMBINE MORE KNOWLEDGE ABOUT
CANCER BIOLOGY THAN EVER BEFORE.
WITH IMPORTANT ADVANCES IN MA
DISH ENAL AND IMAGING AND SO
THAT WE CAN ENVISION A FUTURE
WHERE NO CANCER TARGETS ARE
CONSIDERED UNDRUGABLE.
BEFORE WE TURN TO THE BUDGET,
THE ANNUAL PLAN COVERS THE
ENTIRETY OF NCI'S PORTFOLIO FROM
THE FUNDAMENTAL CANCER BIOLOGY
THAT WE SUPPORT TO POPULATION
LEVEL CANCER CONTROL, AND
BUILDING A DIVERSE AND INCLUSIVE
WORKFORCE AND SUPPORTING KEY
INFRASTRUCTURE SUCH AS THE
CANCER CENTER PROGRAMS AND THE
CLIP CAL TRIALS NETWORKS SO THE
ANNUAL PLAN IN THE WEBSITE
COVERS ALL OF NCI'S PRIORITIES
FOR THESE AREAS.
NOW TURNING TO THE BUDGET.
THE FY24 PROFESSIONAL BUDGET
PUGET IS REALLY WHAT WE WERE
REFERRING TO AS A BOLD REQUEST
FOR CANCER RESEARCH AND IT'S
REALLY INTENDED TO CAPITALIZE ON
ALL OF THE OPPORTUNITIES TO
ACHIEVE THE PRESIDENT'S GOALS OF
ENDING CANCER AS WE KNOW IT FOR
ALL PEOPLE WHICH PATRICK
HIGHLIGHTED IN HIS TALK AND THE
NUMBER OF TIMES AND IMPORTANCE
TO THIS PRESIDENT.
IT BUILDS ON THE SUCCESSES OF
THE CANCER MOONSHOT AND IT
INCLUDES FUNDING FOR INCREASING
THE PAYLINE.
CONTINUING NCI'S COMMITMENT TO
ELIMINATE CANCER DISPARITIES AND
EXPAND CLINICAL TRIALS AND
CANCER CARE DELIVERY RESEARCH.
THE NEXT SLIDE, PLEASE.
THE BUDGET TABLE AND THAT BOLD
REQUEST OF NEARLY $10 BILLION.
SO THE FY24 PROFESSIONAL BUDGET
PROPOSAL IS FOR $10 BILLION AND
IT BEGINS WITH THE FY23
PROFESSIONAL BUDGET BUDGET ASK
AND REQUEST A $2.4 BILLION
INCREASE OVER THAT ASK.
THAT IS ABOUT A $2.7 BILLION
INCREASE OVER THE FY '23 ENACTED
BUDGET OF $7.3 BILLION SO AS YOU
KNOW, WE DIDN'T HAVE THE ENACTED
NUMBER WHEN WE PUT THIS
PROFESSIONAL BUDGET TOGETHER
EACH SUMMER.
AGAIN, AS YOU CAN SEE ON THE
TABLE, IT INCLUDES MONEY FOR ALL
YEARS OF THE PORTFOLIO, AND THEN
SOME ADDITIONAL KEY FUNDING FOR
CLINICAL RESEARCH.
SO, THIS GRAPH JUST LET'S YOU
TRACK THE BUDGET REQUEST OVER
THE LAST FIVE YEARS SO YOU CAN
SEE THE COMPARISONS I NOTED
BETWEEN '23 AND THE '24 PJB AND
THE LAST SLIDE.
THE PJB PROPOSALS FOR THE LAST
FIVE YEARS ARE SHOWN IN RED AND
THE ENACTED BUDGETS ARE SHOWN IN
BLUE.
AS PATRICK ALREADY TALKED ABOUT,
BUT I WANTED TO KNOW HEIT AS
WELL, THIS IS THE LAST YEAR FOR
MOONSHOT FUNDING THROUGH THE
CURES ACT SO THE FY '23 ENACTED
BUDGET OF $7.3 BILLION INCLUDES
THAT $2.6 MILLION FOR THE CURES
ACT FUNDING AND ALL SHOWN ON
THIS SLIDE, INCLUDES THAT MOON
SHOOT FUNDING WHICH WE'LL LOSE
IN FY '24.
THIS YEAR'S PLAN ALSO INCLUDED A
NEW BUDGET INFO GRAPHIC THAT WE
WANTED TO PUT INTO HELP TO
EXPLAIN WHY WE NEED SUSTAINED
ANNUAL BUDGET INCREASES TO FUND
MORE RESEARCH PROJECTS GRANTS
AND RAISE THE PAYLINE.
IT'S THE LAY VERSION OF THE
TABLE THAT PATRICK SHOWED YOU.
USING THE SAME KIND OF STAIR
STEP APPROACH ONLY INVERT INSIDE
THIS GRAPHIC.
AND THE ENTIRE GRAPHIC IS SHOWN
ON THE LEFT OF THE SLIDE AND I
APPRECIATED IT'S VERY HARD TO
SEE HERE AS IT'S A LONG VERTICAL
GRAPHIC, SO I ENCOURAGE YOU TO
VIEW IT ON CANCER.GOV.
BUT STARTING AT THE TOP OF THE
GRAPHIC, WE HIGHLIGHT THE IDEA
OR THE CONCEPT THAT EVERY YEAR
WE RECEIVE MANY, MANY RESEARCH
PROPOSALS AND WHEN WE FUND THE
PROPOSAL IT'S A MULTI-YEAR
COMMITMENT.
NOW I KNOW THAT AWFUL YOU ARE
FAMILIAR WITH THE CONCEPT OF OUT
YEAR COSTS BUT MANY OF OUR
AUDIENCES ARE NOT SO THIS WAS
OUR ATTEMPT TO GIVE THEM A
VISUAL TO UNDERSTAND THIS
CONCEPT SO THE MAIN PANEL OF THE
GRAPHIC WHICH IS IN LARGED HERE,
ATTEMPTS TO PROVIDE PEOPLE WITH
THAT VISUAL TO UNDERSTAND THE
CONCEPT OF THE OUT YEAR COST AND
SHOW WHY IN ORDER TO FUND MORE
NEW GRANTS EACH YEAR WE NEED
MORE MONEY EACH YEAR.
AND AS THE GRAPH POINTS OUT AT
THE BOTTOM, SUSTAINED YEARLY
BUDGET INCREASES ALLOW US TO
FUND MORE GRANTS EACH YEAR WHICH
ALLOW US TO DO SUPPORT MORE NEW
IDEAS.
SO THAT WE DON'T MISS ANY
EMERGING OPPORTUNITIES IN CANCER
RESEARCH.
NEXT SLIDE.
FINALLY, AS IN PAST YEARS, THIS
YEAR'S PLAN SHARES THE
EXPERIENCES OF RESEARCHERS AND
OF PATIENTS WHO HAVE
PARTICIPATED IN NCI CLINICAL
TRIALS.
AND I WANT TO TAKE JUST A MINUTE
TO TELL YOU ABOUT JUSTIN'S
STORY.
JUSTIN AND HIS FAMILY HAVE BEEN
PART OF THE NCI NATURAL HISTORY
STUDY SINCE THE MID 19 - 1990s.
JUSTIN WAS DIAGNOSED WITH VHL
SYNDROME WHEN I WAS SIX YEARS O
HIS 20s WERE MARKED WITH
FREQUENT SURVEILLANCE SCAN,
TRIPS TO THE HOSPITAL AND
SURGERIES.
AND HE THOUGHT THIS WAS THE WAY
THAT THE REST OF HIS LIFE WOULD
BE BASED ON WATCHING HIS
FATHER'S EXPERIENCES.
AND THEN HE JOINED AN NCI PHASE
2 CLINICAL TRIAL LED BY
INTRAMURAL INVESTIGATORS IN THE
CENTER FOR CANCER RESEARCH AT
THE NIH CLINICAL CENTER AND IN
JUSTIN'S OWN WORDS T. IT CHANGED
HIS LIFE.
AFTER BEING ON ON THE DRUG FOR A
PERIOD OF TIME, JUSTIN, IN HIS
EARLY 30s, FELT COMFORTABLE TO
TRAVEL INTERNATIONALLY FOR THE
FIRST TIME, TO GET MARRIED, AND
AS THE SLIDE SAYS, TO FILL
OPTIMISTIC ABOUT HIS FUTURE.
SOME OF YOU MAY KNOW THAT THE
NCI INTRAMURAL PROGRAM PLAYED A
ROLE IN UNRAVELING THE BIOLOGY
OF VHL TUMORS AND IDENTIFYING
THE VHL GENE IN THE 1990s AND
TWO NCI EXTRAMURAL RESEARCHERS
WON THE PRIZE IN 2019 FOR THEIR
WORK ON HYPOXIA INDUCE ABLE
FACTOR WHICH IS A CRITICAL
COMPONENT OF VHL TUMOR FORMATION
AND THE TARGET OF.
SO WHILE WE HAVE NOT ACHIEVED
DIRECT TARGETING OF VHL, THE
DECADES OF RESEARCH TO
UNDERSTAND THE BIOLOGY OF THE
FORMATION OF VHL MEDIATED TUMORS
LED TO 2092 IS FDA APPROVAL OF
BELL SOOT A FAN TO TREAT THE
TUMORS.
MANY SO IN CLOSING, THE FY24
ANNUAL PLAN HAS A NUMBER OF KEY
MESSAGES.
IT STARTS WITH A BOLD
ASPIRATIONAL BUDGET PROPOSAL
REALLY DESIGNED TO CAPITALIZE ON
THE SCIENTIFIC OPPORTUNITIES
BEFORE US.
TO END CANCER AS WE KNOW IT FOR
ALL.
TO BUILD ON THE SUCCESSES OF THE
CANCER MOONSHOT AND TO CONTINUE
TO INCREASE OUR INVESTMENTS IN
INVESTIGATOR INITIATED AWARDS.
THANK YOU.
>>THANK YOU, DIANNE.
THAT WAS ABSOLUTELY ONE OF THE
BEST PRESENTATIONS I'VE HEARD OF
WHAT I CONTINUE TO CALL THE BY
PASS BUDGET BUT WE'RE NOW
CALLING THE -- WHAT ARE WE
CALLING IT NOW?
>>ANNUAL PLAN.
>>THE ANNUAL PLAN, OK.
GOOD.
I'M WITH THAT.
WHAT IS REALLY INTERESTING AND
WHAT WE WANTED DO WITH THE
COMMITTEE TODAY IS TO SHOW YOU
WHERE WE ARE, WHAT THEY SORT OF,
AS PATRICK MENTIONS, SOME OF THE
KNOWN AND UNKNOWNS AND A LOT OF
UNKNOWN UNKNOWNS.
WHERE WE COULD BE WITH THE RIGHT
KIND OF FUNDING.
I POINT OUT TO YOU, $10 MILLION
SOUNDS LIKE A LOT OF MONEY,
RIGHT.
IF YOU LOOKED AT THE COST OF
CANCER AND THE INCREASE COMING
AND IF YOU LOOK AT THE COST OF
BUBIOLOGICS SO THIS COMMITTEE
NEEDS TO THINK ABOUT HOW DO WE
GET TO THAT $10 MILLION AND WE
CAN'T GET THERE OVER THE NEXT 25
YEARS, RIGHT.
THE PRESIDENT HAS CHALLENGES TO
REDUCE CANCER BY 50% IN THE NEXT
A 25 YEARS.
SOMEONE SOMEWHERE, I'M HOPING IN
THE NCI, NEEDS TO SIT DOWN AND
FIGURE OUT IF IT IT TOOK THIS
MANY DECADES TO GET WHERE WE
ARE, WHICH IS A PRETTY GOOD
REDUCTION IN CANCER, WE'RE JUST
SEEING THIS CURVE I AM FACT US
IN TERMS OF UNDERSTANDING THE
BIOLOGY OF CANCER, THAT'S GOING
TO BE TRANSFORMATIVE, NO
QUESTION.
SO, HOW CAN THIS COMMITTEE HELP?
I GUESS IS ONE OF THE QUESTIONS
WE WANT TO ASK OURSELVES.
AND I'M WONDERING IF THERE ARE
ANY IDEAS FROM THE COMMITTEE
THAT AREAS WHERE WE THINK WE CAN
HAVE MONICA ACTUALLY, NOT JUST
GET THE RESOURCES WE NEED AND
THINKING ABOUT EVERYTHING FROM
THE FOUR YEARS THAT WERE
HIGHLIGHTED WHICH ARE THE
INVESTMENTS IN THIS ANNUAL PLAN,
TO SOMEONE OTHER AND YOU CAN SEE
THEM COMING INVESTMENTS ARE
GOING TO BE REQUIRED IN NEW
BIOLOGY AND INFRASTRUCTURE.
IF YOU RUN A CAP SER C A CANCERU
THINK ABOUT THAT.
I USED TO CHAIR THE CANCER STUDY
SECTION YEARS AGO AND YOU GO TO
A SITE AND EVERYONE EXPLAINS EXS
ABOUT THE OVERHEAD.
YOU ASK IF THEY LIKE HAVING THE
LIGHTS ON AND THE ELECTRICITY
THAT THEY GET AND ALL THE OTHER
THINGS THEY GET.
THEY DON'T THINK ABOUT THAT.
WE HAVE TO THINK ABOUT THE
INFRASTRUCTURE BECAUSE IT'S
CRITICAL AND COST OF CANCER
RESEARCH IS GOING UP EVERY
SINGLE DAY.
SO LET'S -- AS A COMMITTEE, AS
INDIVIDUAL MEMBERS OF THIS
COMMITTEE WITH CERTAIN
RESPONSIBILITY TO MAKE SURE THAT
WE GET THIS DONE, WHAT ARE YOUR
IDEAS?
WHAT KINDS OF THINGS CAN THIS
COMMITTEE HELP Dr. BERTAGNOLLI
WITH?
I KNOW YOU ARE OUT THERE AND YOU
MUST HAVE GO AHEAD IDEAS?
WHAT KINDS OF THINGS CAN WE DO?
ANY ANALYTICS YOU WOULD LIKE TO
SEE FROM NCI?
ANY NOT KIND OF QUESTIONS ABOUT
HOW FAR THOSE EMPHASIS AREAS ARE
SELECTED IN TERMS OF HOW THOSE
COMMITMENT OF DOLLARS COME IN?
I KNOW IF YOU ARE NOT A CPA AND
YOU MAY NOT HAVE YOUR MBA BUT
YOU HAVE TO THINK ABOUT THE
BUDGET EVERY SINGLE DAY AND I
HAVE TO SAY, DIANNE, THAT IS ONE
OF THE BEST REPRESENTATIONS I'VE
SEEN OF A BUDGET, I DON'T KNOW
HOW MANY VIEWS YOU'VE GOT THAT
HAVE BUT IT'S REALLY WELL
PRESENTED AND VERY CRISP,
ON-LINE AND IT USED TO BE A
DOCUMENT ABOUT THIS THICK AND NO
ONE READ IT HONESTLY.
EVERYONE CAN LOOK AT THIS ONE
AND UNDERSTAND IT AND GO TO WORK
TO HELP US GET IT, I HOPE.
WHAT DO YOU GUYS HAVE IN TERMS
OF IDEAS?
>>ELECTRA.
>>DISRUPTER.
I AM CONTINUING MY DISRUPTER
ROLE.
SO, DECEMBER WORKING GROUP
PRESENTED A REPORT THAT SAID
THAT THE INVESTMENTS BOTH BY NIH
AND THE NCI IN RESEARCH IN
VARIOUS UNDER REPRESENTED
POPULATIONS IS IS WOEFULLY
APPROXIMATE LOW.
I WOULD LOVE TO SEE THAT
HIGHLIGHTED ACROSS ALL OF THOSE
THOSEHIGHLIGHTED CATEGORIES IN E
PLAN.
I DID NOT SEE.
I SAW IT IN THE LOVELY, I LOVE
THOSE PICTURES, THE FOCUS ON PER
IS CYSTCYST APARTMENT PERSIST AI
LOVE TO BE WRONG BUT I DIDN'T
SEE THE CORPORATION OF THE
FINDINGS IN THE RECOMMENDATION
THAT'S WE PRESENTED AND IS NOW
ON-LINE IN SEPTEMBER.
THAT'S MY PIECE.
>>MAYBE WE CAN CHALLENGE PEOPLE
THAT CREATE THESE REPORTS TO
THINK ABOUT WHAT IS THE BUDGET
IMPACT?
WHAT DO YOU ASSESS -- WHERE DO
YOU ASSESS THE COSTS WILL COME
FROM IF.
>>YEAH, I MEAN WE SUGGESTED
SOME TARGETING FUNDING AREAS.
I MEAN SOME FO ANTI-SEMITISM, EY
REALLY NEED TO A, BE MORE
INCLUSIVE AND MORE DIRECT IN
THEIR INCLUSION OF THESE
POPULATIONS IN THE REGULAR
RESEARCH THAT THEY'RE DOING AND
IT'S JUST NOT THOUGHT OF AND
WHAT A BETTER WAY FOR PEOPLE TO
INCREASE THIS RESEARCH IS TO
SAY, YOU KNOW, THIS IS A
HIGHLIGHT, THAT'S WHAT IS SOME
OF OUR MONEY IS FOCUSING ON AND
YOU KNOW, I THINK YOU WILL GET
PEOPLE FOCUSING ON THAT AREA.
I DON'T KNOW IF ANYBODY ELSE
WANTS TO ADD TO THAT.
>>O ONE THING TO NOTE, IF YOU
LOOK AT PATRICK SLIDES THE CURES
ACT IS A BIG DIFFERENCE.
I CHAIRED ONE OF THOSE
COMMITTEES AND IT CHANGED
EVERYTHING.
THE REGULATORY PROCESS AND THE
WAY WE FUND SCIENCE AND HOW
WE'RE ACCOUNTABLE IN SCIENCE AND
I HAVE TO SAY, IF YOU THINK YOU
DON'T HAVE AN IMPACT, AS A
SCIENTIST, OR IF YOU THINK YOU
DON'T HAVE AN IMPACT AS AN
ADVOCATE OUT THERE, YOU CAN.
AND THE CURES ACT IS A PERFECT
EXAMPLE OF THAT.
YOU HAVE AN ADMINISTRATION THAT
IS LISTENING HERE AND TRYING TO
REALLY CHANGE THAN THIS WHOLE
DYNAMIC FOR CA CANCER INCLUDING
FUNDING AND $10 MILLION IS, I'M
TELLING YOU, IT'S NOT VERY MUCH.
AND IT'S A B1 SELF-BOMBER THAT
COST $745 MILLION SO THAT IS IS
1010 OF THOSE TO FUND THE MEDICL
CANCER INSTITUTE.
I WILL
YOU A FEW BOMB
FEW BOMBERS, I WILL.
ANYONE WANT TO SUPPORT ME?
WE CAN TAKE A BIT OF THAT AND
APPLY IT TO CANCER IS.
MONICA, I WANT TO GIVE YOU A
CHANCE TO SAY ANYTHING.
I HAVEN'T ASKED YOU TO COMMENT
BECAUSE I KNOW YOU ARE
LISTENING.
ANY LAST WORDS?
>>WELL, I KNOW THAT TIME IS
BRIEF.
LISTEN, I REALLY LOOK FORWARD TL
SESSION.
NOW I LOOK FORWARD IN THE VERY
NEAR FUTURE TO SOME REALLY
SUBSTANTIVE CONVERSATIONS AND
ENGAGEMENT WITH THIS GROUP OVER
EXACTLY THE ISSUES THAT I TALKED
ABOUT.
WHAT ARE OUR STRATEGIES?
WHAT ARE OUR APPROACHES?
WHAT IS IT REALLY TAKE?
WHO SHOULD BE DOING THE WORK?
WHO AND HOW SHOULD THE WORKING
DONE?
YOU KNOW, ALL OF THOSE THINGS,
IT'S ONE THING TO SAY LET'S
INCREASE THE R PG POLL.
THERE ARE SO MANY OTHER PLAYERS
OF NUANCE THAT HELP US ACHIEVE
THE SOCIETAL AIMS WE HAVE.
LECTOR JUST BROUGHT OUT A BIG
ONE THAT AREN'T JUST GOING TO
FLOAT OUT OF THE RPG POOL,
RIGHT.
SO IT'S STRATEGIZING TO
UNDERSTAND HOW TO MAKE PROGRESS
THERE THAT I RALLY LOOK FORWARD
TO WORKING WITH YOU TO DO AND I
THINK WE HAVE SOME IDEAS AND
WE'LL BE DISCUSSING HOW WE CAN
WORK TOGETHER SOON.
>>AND SEVERAL OF YOU HAVE SENT
ME SOME IDEAS AND I'LL ACCEPTING
SOME OF THOSE ALONG TO Dr.
BERTAGNOLLI AND IF YOU HAVE
ADDITIONAL IDEAS, SEND THEM TO
ME AND WE'LL MAKE SURE THAT WE
GET THEM IN FRONT OF OUR NEW
DIRECTOR AND ON THAT NOTE, I
THINK WE'RE EXACTLY -- I'M
GIVING YOU BACK 30 SECONDS OR
SO.
SEE EVERYBODY NEXT TIME,
HOPEFULLY AND WE'LL HAVE AN IDEA
SESSION AND I'M GOING TO CHARGE
CHALLENGE YOU ALL TO COME WITH
YOUR IDEAS.
SEE YOU ON THE OTHER SIDE, HERE.
>>THE NCBA SUBCOMMITTEE
MEETINGS HAVE CONCLUDED AND WE
WILL TRANSLATE TO THE NCAB OPEN
SESSION THAT WILL BE AT 1:15.
>>THANK YOU, AGAIN, KATHERINE.
>>THIS SESSION WILL NOW END.