GOOD AFTERNOON, EVERYONE.
THANK YOU SO MUCH FOR TUNING IN.
I THINK WE ALMOST HAVE ALL OF
OUR MEMBERS HERE.
SO I'M GOING TO GIVE IT -- WE'RE
ALREADY AFTER NOON SO WE'LL GET
STARTED.
THANK YOU SO MUCH EVERYONE FOR
TUNING IN TODAY.
IT IS MY PLEASURE TO WELCOME
YOU.
A VERY WARM WELCOME TO THE
86th MEETING OF THE ADVOCATES.
WE'RE SO GRATEFUL FOR YOUR TIME
AND EXPERTISE AND APPRECIATE ALL
THAT YOU DO BEHALF OF PATIENTS
ACROSS THE UNITED STATES.
SO I WILL TURN IT OVER TO OUR
FEARLESS CHAIR ANJEE DAVIS TO
GET US STARTED BUT I WANTED TO
FORECAST FOR YOU WHAT WE'RE
GOING TO DO.
WE HAVE A TERRIFIC MEETING
PLANNED FOR YOU.
AS PER THE USUAL WE'LL HAVE A
DIRECTOR'S REPORT FROM OUR
ACTING DIRECTOR DR. DOUGLAS
LOWY.
AN UPDATE AS USUAL AND THEN
JOINED BY DR. PHIL CASTLE WHO'S
THE DIRECTOR OF NIH'S DIVISION
OF CANCER PREVENTION AND TALKING
ABOUT CANCER PREVENTION
RESEARCH.
AND FINALLY OUR LAST SEGMENT OF
OUR MEETING TODAY IS SORT OF
PART OF A SERIES THAT WE STARTED
AT THE LAST MEETING WHICH IS
AROUND EXCEPTIONAL EXAMPLES OF
RESEARCH ADVOCACY IN THE
COMMUNITY WHERE WE HIGHLIGHT
PROGRAMS THAT ARE BRINGING IN
RESEARCH ADVOCATES AND WE WILL
BE TALKING ABOUT THE PIVOT
PROGRAM AT THE UNIVERSITY OF
KANSAS.
SO THAT WILL BE A PANEL
DISCUSSION WITH ADVOCATE.
SOME OF THE STAFF AT THE
UNIVERSITY OF KANSAS AS WELL AS
SOME OF OUR NCI PROGRAM STAFF
WHO HELPED ADMINISTER THAT
INITIATIVE SO WITH THAT I WANT
TO AGAIN THANK YOU FOR YOUR TIME
TODAY.
I KNOW THAT WE HAVE LOTS OF
DIFFERENT FOLKS THAT WORK ACROSS
CANCER RESEARCH BUT ADVOCATES
WEAR MANY HATS AND WE'RE JUST
BUT ONE PIECE OF THE ADVOCACY
PIE.
THAT MAKES YOUR TIME MORE VALUED
AND I APPRECIATE YOU SPENDING
THE TIME WITH US THIS AFTERNOON.
ANJEE I THINK YOU'RE HERE AND
READY TO GO SO WITH THAT I'LL
TURN IT OVER TO YOU TO GET US
STARTED.
>> GREAT.
GOOD MORNING, EVERYBODY.
I'M GOING TO START WITH OUR
HOUSEKEEPING STATEMENTS SO OUR
OPENING STATEMENTS.
AS COMMITTEE MEMBERS I WANT TO
REMIND YOU THAT YOU MUST ABSENT
YOURSELF DURING SPECIFIC
DISCUSSIONS WHEN YOUR
PARTICIPATION AND DID I LOBE
RACIALS ON A PARTICULAR PRODUCT,
PROGRAM OR OTHER SPECIFIC MATTER
WOULD CONSTITUTE A CONFLICT OF
INTEREST OR THE APPEARANCE OF
ONE.
ADD ADVICE THE EXECUTIVE
SECRETARY REGARDING THAT MATTER.
GOVERNING CONFLICT OF INTEREST
BASED ON FINANCIAL HOLDINGS OF
SPECIFIC SPECIAL GOVERNMENT
EMPLOYEES WHICH INCLUDES ALL
MEMBERS OF THIS COMMITTEE WE
MUST DEPEND ON YOU TO
VOLUNTARILY ABSENT YOURSELF
DURING ANY AND OTHER DISCUSSIONS
THAT COULD IMPACT THE STATUS OF
THE HOLDINGS.
WE TRUST YOUR JUDGMENTS IN THESE
INSTANCES.
A QUORUM IS REQUIRED IN WHICH A
VOTE OCCURS.
A MINIMUM OF SIX APPOINTED
EMERGENCIES MUST BE PRESENT TO
VOICE YOUR VOTES.
NEW MEMBERS WHO ARE NOT CURRENT
MEMBERS ARE NOT VOTING UNTIL
THEY'VE BEEN CLEARED.
OUR PUBLIC COMMENT STATEMENT IS
MEMBERS OF THE PUBLIC CAN WISH
TO EXPRESS VIEWS REGARDING ANY
ITEMS DISCUSSED DURING THE
MEETING MAY DO SO BY WRITING MSS
MEETING AND WRITTEN STATEMENTS
BY MEMBERS OF THE PUBLIC WILL
RECEIVE CAREFUL CONSIDERATION.
THANKS FOR BEARING WITH ME AS I
READ THESE TO YOU BUT I WANT TO
WELCOME EVERYBODY.
THIS IS THE LAST MEETING I WILL
BE CHAIRING WHICH HAS GONE BY
REALLY FAST.
I WANT TO SAY A FEW THINGS
BEFORE WE GET STARTED TODAY AND
I WANT TO THANK AMY, PATRICK AND
VINCENT FOR THE WORK THAT
THEY'VE DONE BEHIND THE SCENES
AND THEIR PATIENCE WITH ME
TRYING TO FIGURE OUT I THINK HOW
TO PULL THESE AGENDAS TOGETHER.
TOOK A YEAR VIRTUALLY BUT WE GOT
THERE.
AND THEY'VE BEEN SO DILIGENT IN
PREPARING THESE AGENDAS AND
SPEAKERS FOR US.
NO MATTER HOW DIFFICULT THE
CHALLENGES WERE.
THEY WERE ALWAYS WORKING BEHIND
THE SCENES TO MAKE IT HAPPEN FOR
THIS COMMITTEE.
I WANT TO GIVE MY HEARTFELT
THANKS FOR THEM FOR THE HARD
WORK OVER THE LAST TWO TERMS.
AND THEN I JUST WANT TO SAY
THANK YOU FOR YOUR PATIENCE.
YOU'VE BEEN AMAZING TO WORK
WITH.
AND VERY PATIENT AND ENGAGED AND
I WANT TO SAY THAT WESTE -- WHES
INVITED I HAD JUST BEEN
DIAGNOSED WITH CANCER AND I
LEAVE THIS POSITION -- MY MOM
WAS DIAGNOSED WITH LUNG CANCER.
WE THINK ABOUT THESE COMMITTEES.
WE THINK ABOUT WHERE WE SIT AND
THEY ARE PART OF OUR JOBS BUT
TRULY IT IS AN AD VOTE CAR SEE
ROLE AND OUR ROLE AND VOICE IN
WHAT WE'RE SEEING DURING THIS
CALLS IS TO DRIVE URGENCY AND
PERSPECTIVE AND IN THIS
PARTICULAR COMMITTEE IT'S ABOVE
THE CLINICAL TRIALS -- TACTICAL
EFFORT AND STRATEGIC GOALS OF
NCI.
AGAIN JUST COMMEND THE
LEADERSHIP OF THIS GROUP.
SO PROUD TO BE PART OF IT AND
LOOK FORWARD TO SEEING WHAT WE
DO TODAY AND TODAY I WAS ABLE TO
-- AT MY LAST MEETING WAS GOING
TO BE ABOUT -- AND ABOUT EX'EM N
ADVOCACY.
AS WE THINK ABOUT WHAT WE CAN
ADVICE THIS GROUP AND PROVIDE
PERSPECTIVE THIS IS A PIVOTAL
TIME FOR THIS COMMITTEE.
SO I TURN IT OVER TO DR. DOUG
LOWY.
INVITE HIM TO DELIVER HIS
UPDATES.
LOOK FORWARD TO HEARING FROM
HIM.
HE HAS HAD A FULL PLATE DURING
THIS TRANS SICKS
>> ANJEE, GOOD MORNING TO YOU
AND GOOD AFTERNOON TO EVERYONE
WHO'S IN THE EASTERN TIME ZONE
AND GOOD MORNING TO THOSE OF YOU
WHO ARE WEST OF THE EASTERN TIME
ZONE.
I'M DELIGHTED TO BE ABLE TO TALK
WITH YOU TODAY AND MY REMARKS
WILL LEAVE ENOUGH TIME SO THAT
THERE SHOULD BE ADEQUATE TIME
FOR QUESTIONS AND COMMENTS WHEN
THEY ARE FINISHED.
IT'S BEEN THREE YEARS SINCE THE
LAST TIME I WAS ACTING DIRECTOR
OF NCI.
AND THERE HAS BEEN A LOT OF TURN
OVER IN THE NCRA.
SO I'M GOING TO SPEND A FEW
MINUTES REINTRODUCING MYSELF AND
MY PERSPECTIVE AS NCI DIRECTOR.
BUT BEFORE WE GO THERE I WOULD
LIKE TO HAVE THE NEXT SLIDE AND
IT REALLY IS A THANK YOU SLIDE
TO ANJEE DAVIS AND ANJEE IT IS
REALLY AMAZING HOW CANCER IS
AFFECTING YOU DIRECTLY AND YOUR
FAMILY THROUGHOUT THIS PERIOD
AND I HOPE THAT EVERYONE WILL DO
WELL.
THANK YOU SO MUCH FOR YOUR
LEADERSHIP ON THE NCRA AND YOUR
REMARKS WERE SPOT ON.
JENNIFER PEGHER IS GOING TO BE
CYCLING OFF OF NCRA BUT ALTHOUGH
SHE CAN RUN AS MOHAMMED ALI SAID
SHE CANNOT HIDE AND I'M GOING TO
BE AT THE AACI MEETING IN
OCTOBER AND I LOOK FORWARD TO
SEEING JENNIFER THERE.
AND I WOULD BE REMISS IF I WERE
NOT ALSO GOING TO WELCOME ANNIE
ELLIS WHO WILL BE THE INCOMING
CHAIR OF NCRA AND LOOK FORWARD
TO BEING ABLE TO WORK TOGETHER
WITH YOU.
BEFORE I GO ON TO THE NEXT SLIDE
HOWEVER, I WOULD LIKE TO GIVE A
SHOUT OUT TO MELINDA WHO'S A
MEMBER OF NCRA AND ON-LINE TODAY
SHE AND I HAVE KNOWN EACH OTHER
FOR QUITE A WHILE AND SHE HAS
BEEN AN AMAZING ADVOCATE FOR
CANCER RESEARCH AND MELINDA I
HOPE YOU'RE CONTINUING TO DO
WELL AND I LOOK FORWARD TO
MEETING THE OTHER MEMBERS OF THE
NCRA AS WE GO ALONG.
I'M DIVIDED AND SHOWING ON THE
NEXT SLIDE, I'M TRYING TO COVER
A NUMBER OF DIFFERENT ISSUES.
FIRST CONTINUITY OF NCI
LEADERSHIP.
A COUPLE OF SLIDES ABOUT THE NCI
BUDGET.
BUT AS ALREADY MENTIONED HOLLY
GIBBONS IS GOING TO BE TALKING
MORE IN DEPTH ABOUT THE BUDGET.
AND GIVING YOU SOME RESEARCH
UPDATES AND FINALLY TALKING
ABOUT THE CANCER MOONSHOT.
AND YOU WILL BE HEARING AS
MENTIONED FROM PHIL CASTLE AND
ONE OF THE AREAS THAT HE WILL BE
TALKING ABOUT IS MULTI-CANCER
DETECTION TESTS WHICH REALLY WE
ENVISION BEING PART OF THE NEW
MOONSHOT BUT WE ARE TRYING TO
GET STARTED BY DOING IT ALREADY
IN FY23.
IF I COULD HAVE THE NEXT SLIDE
-- THIS BASICALLY TELLS YOU
ABOUT THE NCI DIRECTOR'S HAROLD
VARNESS WAS THE DIRECTOR.
NED SHARPLESS WHO YOU'VE MET AND
HEARD FROM HAS BEEN THE LEADER
UP UNTIL TWO MONTHS AGO.
TODAY MARKS THE END OF MY SECOND
MONTH AS ACTING DIRECTOR.
AND AS YOU MAY SEE THAT THIS IS
ACTUALLY MY THIRD ONCE IN A
LIFETIME OPPORTUNITY TO BE THE
ACTING DIRECTOR OF NCI.
IF WE COULD DO THE NEXT SLIDE --
I'VE BEEN THE DEPUTY DIRECTOR AT
NCI SINCE 2010.
AND ALTHOUGH THE DIRECTOR IS AN
IMPORTANT POSITION IT'S REALLY
ALSO IMPORTANT TO RECOGNIZE THAT
NCI LEADERSHIP IS FAR MORE THAN
THE DIRECTOR AND THIS JUST GIVES
US A PARTIAL LIST OF PEOPLE WHO
ARE IN LEADERSHIP POSITIONS AT
NCI.
BUT AS YOU ARE AWARE AND YOU'LL
CERTAINLY BE HEARING FROM PHIL
EVEN PEOPLES NAMES WHO ARE NOT
ON THE LIST ARE CRITICALLY
IMPORTANT TO THE PROGRESS THAT
WE MAKE IN CANCER RESEARCH.
THROUGH NCI.
NEXT SLIDE.
THIS SLIDE GOES OVER SOME OF THN
INVOLVED OVER THE LAST FEW
YEARS.
AND I WANT YOU TO TRY TO THINK
ABOUT THEM IN THE CONTEXT OF MY
BEING IN BETWEEN DIFFERENT
DIRECTORS.
SO FOR EXAMPLE IN 2015 THE
PRECISION MEDICINE INITIATIVE IN
ONCOLOGY WAS ANNOUNCED IN
JANUARY OF 2015 BY THEN
PRESIDENT OBAMA.
AND HAROLD VAR NUE WAS THE
DIRECTOR AT THE TIME.
BUT THE IMPLEMENTATION OF THE
INITIATIVE WAS REALLY SOMETHING
THAT I WAS INVOLVED IN AND SO IT
WAS VERY IMPORTANT THAT THERE BE
CONTINUITY AND ONE OF THE KEY
INITIATIVES OF THE PRECISION
MEDICINE INITIATIVE WAS THE
MATCH TRIAL WHICH MANY OF YOU
HAVE HEARD ABOUT AND IT REALLY
WAS A PATH BREAKING TRIAL
BECAUSE IT WAS FOCUSED ON
MOLECULAR ABNORMALITIES AND THE
FASTEST APPROVING TRIAL THAT NCI
HAS HAD.
AGAIN IN 2015 WE INITIATED THE
NATIONAL CRY OH ELECTRON GRAPH
USER FACILITY.
AND THIS WAS SOMETHING THAT
HEROLD DURING THE LAST TWO OR
THREE YEARS AS NCI DIRECTOR HAD
THOUGHT ABOUT BUT THE ACTUAL
DECISION TO DO THIS AT FREDERICK
WAS MADE BY ME WHEN I WAS ACTING
DIRECTOR AND IT'S BEEN AMAZINGLY
SUCCESSFUL.
THERE HAVE BEEN MORE THAN 500
STRUCTURES THAT HAVE BEEN
IDENTIFIED SINCE IT WAS REALLY
STOOD UP STARTING IN 2017.
BUT IN 20169 CANCER MOONSHOT THE
FIRST PHASE INITIATED BY THEN
VICE PRESIDENT BIDEN AND I WAS
THE ACTING DIRECTOR AND THEN
STARTING IN 2016 ANOTHER ISSUE
THAT HEROLD VARS IN DEALT WITH
WAS TO DO WITH THE SUPPORT
GRANTS FOR THE CANCER CENTERS SO
THE DECISION WAS MADE TO
SUBSTANTIALLY INCREASE THE
SUPPORT FOR THEM AND YOU WILL BE
HEARING LATER TODAY FROM THE
KANSAS UNIVERSITY CENTER.
THEY HAVE JUST GONE THROUGH
THEIR RENEWAL AND HAVE DONE
SPECTACULARLY WELL.
AND THEN IN 2019 DURING THE
SEVEN MONTHS I WAS ACTING
DIRECTORRED IN SHARPLESS HAD
IDENTIFIED THE ISSUE OF THERE
BEING A PREFERENTIAL INCREASE IN
THE NUMBER OF GRANT APPLICATIONS
TO NCI COMPARED WITH THE REST OF
THE NIH.
AND AS A CONSEQUENCE OUR LEVELS
OF SUCCESS AND OUR SO-CALLED PAY
LINES WERE GOING DOWN.
BUT HE HAD NOT HAD AN
OPPORTUNITY YET TO BRING THIS TO
THE A ATTENTION OF CONGRESS AND
I WAS ABLE TO PROVIDE THAT
CONTINUITY IN 2019 AND THIS HAS
LED TO CONS, RECOGNITION ABOUT
THE IMPORTANCE OF OUR PAY LINE
AND SUCCESS RATES FOR FIRST TIME
IN TRYING TO BE AS SUCCESSFUL AS
POSSIBLE THERE.
SO WHAT ABOUT -- THE NEXT SLIDE
TALKS ABOUT THREE CURRENT
INITIATIVES.
ONE IS THE CANCER MOONSHOT.
AND I WILL BE TALKING ABOUT THAT
IN A FEW MINUTES AND IN A LITTLE
BIT OF DETAIL.
BUT THE CANCER CENTERS -- ABOUT
THREE QUARTERS OF THE RESEARCH
THAT THE FUNDING THAT WE --
SUPPORT FOR EXTRAMURAL ACTIVITY
IS ACTUALLY CONDUCTED AT THE NCI
DESIGNATED CANCER CENTERS.
SO WE HAVE FINISHED THE FIRST
TWO PHASES OF THE SUPPORT GRANTS
AND SO WE'RE IN THE PROCESS OF
MAKING DECISIONS ABOUT GOING
FORWARD FOR THE NEXT PHASE AND
THEN THE THIRD -- THE FREDERICK
NATIONAL LAB HAS FOR LAST
SEVERAL YEARS HAVE HAD THE
INITIATIVE WHICH SOME OF YOU
HAVE HEARD A I'LL MENTION ABOUT
IN PASSING IN A FEW MORE SLIDES.
THAT INITIATIVE HAS BEEN VERY
SUCCESSFUL AND WE'RE TRYING TO
THINK ABOUT WHAT ADDITIONAL
SIGNATURE INITIATIVES CAN BE
DEVELOPED.
THE NEXT SLIDE SUMMARIZES SOME
OF THE RECENT ACTIVITIES, THE
AMERICAN ASSOCIATION FOR CANCER
RESEARCH MEETING ACTUALLY TOOK
PLACE BEFORE I BECAME ACTING
DIRECTOR SOD IN AND I DID A
TANDEM PRESENTATION -- BECAUSE
THAT IS WHAT AACR ASKED FOR.
AND THEN I TALKED WITH THE
NATIONAL ASSOCIATION OF CANCER
CENTER DEVELOPMENT OFFICERS AND
PUBLIC AFFAIRS AND MARKETING
NETWORK GROUP AGAIN SHORTLY
BEFORE I BECAME ACTING DIRECTOR
ON APRIL 30th.
AND THEN I TALKED AT -- AND MET
WITH THE BOARD OF DIRECTORS AND
I WILL BE TALKING TO THE AACI
MEETING IN OCTOBER.
SO I'M NOT THE ONLY PERSON WHO
HAS BEEN NEWLY APPOINTED.
AND THE NEXT SLIDE TELLS YOU
ABOUT TWO CRITICAL NEW
APPOINTMENTS.
FIRST ON THE RIGHT -- BR IgA
TTA -- WITTMAN AND DR. WEED MAN
LEADS THE ONCOLOGY BRANCH BUT
SHE IS WIDELY RECOGNIZED AS A
LEA-- ALEADER IN PEDIATRIC CANC.
AND RECEIVED FDA APPROVAL FOR
CHILDREN WITH SEVERE NEURO
FIBROS TO US.
AND * AND GREG REAMAN WE'RE
PRIVILEGED FOR HIM BE TO BE
COMING TO NCI.
HE IS A LONG TIME CANCER
CHILDHOOD RESEARCHER WHO HAS
BEEN AT THE FDA.
AND HE WILL BE ACTUALLY STARTING
IN SEPTEMBER AS THE SCIENTIFIC
DIRECTOR FOR THE CHILDHOOD
CANCER DATA INITIATIVE.
ALTHOUGH HE IS NOT STARTING
OFFICIALLY UNTIL SEPTEMBER HE
WAS AT THE MEETING THAT WE HAD
LAST WEEK OF THE CCDI MEETING
AND HE WILL BE PROVIDE VERY
IMPORTANT LEADERSHIP.
THE NEXT SLIDE TALKS ABOUT THE
OVERRIDING IMPORTANCE OF EQUITY
AND JUST ONE ACTIVITY THAT I
HAVE BEEN INVOLVED IN LAST MONTH
-- AT THE BEGINNING OF THIS
MONTH I SHOULD SAY TO RECOGNIZE
JUNETEENTH AND I WAS JOINED BY
DR. PAULETTE GRAY FROM NCI AND
SHE HAS BEEN THE CO-DIRECTOR
WITH --ED IN AND THE ECONOMIC
COMMITTEE AND I'M NOW THE
CO-DIRECTOR WITH PAULETTE OF
THAT.
AND NIH JUST HAD A TOWN HALL
MEETING THAT ENDED AN HOUR AGO
ON EQUITY AND NCIS GOING TO HAVE
ANALOGOUS MEETING NEXT MONTH.
THE NEXT SLIDE TELLS YOU THAT ON
MY 12th DAY AS ACTING DIRECTOR
I HAD THE OPPORTUNITY TO
PARTICIPATE IN THE HEARING OF
THE HOUSE SUBCOMMITTEE ON
APPROPRIATIONS FOR THE NIH.
AND THE TWO QUOTES THAT ARE
SHOWN ON THE RIGHT JUST TELLS
YOU HOW CRITICAL AND BIPARTISAN
THE SUPPORT IS FOR CANCER
RESEARCH.
AND THE PHOTOGRAPH ON THE BOTTOM
LEFT IS AFTER THE HEARING CHAIR
DELORE ROW AND RANKING MEMBER
COLE CAME OVER TO TALK WITH ME
BECAUSE I HAVE NOPE BOTH OF THEM
FOR A WHILE AND THEY ARE BOTH
STEADFAST SUPPORTERS OF NIH IN
GENERAL AND NCI IN PARTICULAR
AND I'LL HAVE SOMETHING TO SAY
ABOUT THAT IN THE NEW SLIDE.
LET ME WALK YOU THROUGH IT
BECAUSE WHAT IT TELLS YOU IS IN
ORANGE OVER THE LAST FEW YEARS
IS THE PRESIDENT'S BUDGET FOR
EACH YEAR.
AND THEN IN THE BLUE GREEN THAT
IS WHAT WAS ENACTED BY CONGRESS
AND IN EVERY YEAR THE ENACTED
BUDGET HAS BEEN HIGHER THAN THE
PRESIDENTIAL BUDGET.
WHY AM IMMENSING THIS AND
BRINGING THIS TO YOUR ATTENTION?
* BECAUSE THE FY23 BUDGET THAT
CAME OUT A COUPLE OF MONTHS AGO
ACTUALLY FOR NCI IS LOWER THAN
THE ACTUAL ENACTED BUDGET FOR
FY22 BY ABOUT $200 MILLION.
AND AS SHOWN ON THE RIGHT
CONGRESS HAS DECLINED TO CUT
FUNDING FOR CANCER RESEARCH EVEN
IN CHALLENGING BUDGET CYCLES.
AND INDEED LAST WEEK AS SHOWN ON
THE BOTTOM THE HOUSE
APPROPRIATIONS SUBCOMMITTEE CAME
OUT WITH THEIR MARK AND THEY ARE
PROPOSING A $466 MILLION
INCREASE OVER THE ENACTED AMOUNT
FOR FY22 WHICH IS ACTUALLY
$665 MILLION HIGHER THAN THE
PROPOSED BUDGET.
NOW OF COURSE, THE SENATE NEEDS
TO WEIGH IN AND IT'S CRITICALLY
IMPORTANT FOR ADVOCACY
COMMUNITY, CANCER RESEARCH
COMMUNITY AND MANY OTHER
STAKEHOLDERS TO WEIGH IN ON THE
OPPORTUNITIES THAT WE HAVE IN
CANCER RESEARCH BECAUSE THE
BUDGET DOES NOT GET PASSED JUST
BY ITSELF.
BUT IT REQUIRES HEAVY LIFTING ON
THE PART OF MANY DIFFERENT
PEOPLE.
I AM NOT GOING TO TALK ABOUT
ARPA-H BUT HOLLY GIBBONS HAS A
SLIDE ABOUT ARPA-H BUT I WILL BE
HAPPY TO ANSWER QUESTIONS ABOUT
IT DURING THE Q&A PERIOD.
SO THE NEXT SLIDE TELLS YOU
ABOUT ANOTHER ACTIVITY THAT
OCCURRED.
THIS WAS TWO WEEKS AGO.
THE NCI PARTNERED WITH CANCER
RESEARCH UK TO DO REALLY THESE
BIG PROBLEMS IN CANCER.
AND WE PARTNERED 50/50 WITH CRUK
TO BE ABLE TO BE ABLE TO MAKE
FOUR AWARDS.
WE WERE INVOLVED IN THE REVIEW
PROCESS.
AND THESE ARE THE FOUR AWARDS
THAT WERE ANNOUNCED.
THESE ARE SUBSTANTIALLY LARGER
THAN ANY OF THE ORDINARY AWARDS
THAT WE MAKE WHICH IS ONE OF THE
THINGS THAT EXCITED US ABOUT
PARTICIPATING IN THE GRANT
CHALLENGES AND ON THE BOTTOM
LEFT ARE SHOWN THE FOUR
DIFFERENT GROUPS OF WHAT IS
GOING TO BE EXPLORED.
ONE IS THE IMPORTANT AREA OF
CANCER -- ANOTHER IS LOOKING AT
EXTRA CHROMOSOMAL DNA.
THE THIRD IS ENGINEERED TC
THERAPIES FOR CHILDHOOD CANCER
AND THE FOURTH IS TO BETTER
UNDERSTAND WHAT TRIGGERS NORMAL
CELLS TO BECOME CANCEROUS WITH A
LONG-TERM GOAL OF TRYING TO
INFORM CANCER PREVENTION.
IF YOU'RE WONDERING THE
$100 MILLION IS OVER A FIVE-YEAR
PERIOD AND OUR CONTRIBUTION IS
HALF OF THAT.
SO THE ANNUAL INVESTMENT IS
SMALLER BUT ALSO DUDS THIS MEAN
THAT * MONEY IS GOING OUTSIDE
THE UNITED STATES FOR RESEARCH?
AND I CAN ASSURE YOU THAT ABOUT
60% OF THE FUNDING THAT IS BEING
PROVIDED HERE IS IN THE UNITED
STATES.
ACTUALLY WILL BE A NET
INFLOW OF RESEARCH -- FUNDING
INTO THE UNITED STATES BUT THESE
ARE ALL INTERNATIONAL GROUPS AND
WE FEEL THAT THESE INTERNATIONAL
GROUPS ARE GOING TO BE ABLE TO
MAKE SUBSTANTIAL PROGRESS ON
THEIR VARIOUS PROJECTS.
THE NEXT SLIDE IS SOMETHING THAT
I WISH I DID NOT NEED TO TALK
ABOUT BUT IT IS IMPORTANT.
NEXT SLIDE, PLEASE.
AND THIS IS THE INCREASE IN
UTERINE CANCER DEATH RATES HAVE
BEEN RISING AND HIGHEST AMONG
BLACK WOMEN IN THE UNITED
STATES.
THERE WAS A PAPER PUBLISHED BY
MEGHAN CLARKE AND HER COLLEAGUES
FROM THE INTERMURAL PROGRAM AND
THIS HIGHLIGHTS ON THE LEFT SOME
OF THE KEY ASPECTS OF THIS OF
THE FINDINGS.
BLACK WOMEN ARE TWICE AS LIKELY
TO DIE OF UTERINE CANCER
COMPARED WITH WOMEN OF OTHER
RACIAL AND ETHNIC GROUPS.
MOST OF THE MORTALITY INCREASES
A TRIPLABLE TO NONENDO METEORITE
UTERINE CANCER * WHICH
DISPROPORTIONATELY AEFFECTS LOOK
AND NOW HISPANIC WOMEN.
INCREASED 3.5% FOR BLACK WOMEN
AND IN EVEN MORE ALARMING RATE
FOR HISPANIC WOMEN.
AT 6.7%.
THIS ENTITY OF CANCER ONLY
REPRESENTS ABOUT 20% OF UTERINE
CANCER IN TERMS OF INCIDENTS BUT
IT'S MORE THAN 40% OF MORTALITY
RATES.
SO THERE IS AN URGENT NEED FOR
NEW RESEARCH IN THE AFFECTED
POPULATIONS.
I HAD A DISCUSSION YESTERDAY
WITH THE FIRST AUTHOR MEGHAN
CLARKE AND THE LAST AUTHOR OF
THE PUBLICATION -- NICO -- AND
WE'RE GOING TO BE DISCUSSING
THIS WHAT KIND OF RESEARCH NEEDS
IN A COUPLE OF WEEKS IN -- AT
THE NCI AND THEN BROADENING THAT
DISCUSSION PROBABLY TO INVOLVE
OTHERS AS WELL.
THE NEXT SLIDE TELLS YOU TH -- T
IT'S NOT ALL BAD NEWS.
THE CANCER ISSUE IS AN OUTLIER
BECAUSE AS SHOWN HERE ON THE
LEFT AND ON THE RIGHT IS THAT
ANOTHER AFRICAN-AMERICAN MEN AND
WOMEN STILL HAVE HIGHER
MORTALITY RATES THAN OTHER
GROUPS ESPECIALLY FOR
AFRICAN-AMERICAN MEN IN THE LAST
20 YEARS THE GAP IN THE
MORTALITY RATES HAS REALLY
NARROWED BETWEEN BLACK AND
WHITES.
AND THIS IS TRUE FOR ESSENTIALLY
ALL RACIAL AND ETHNIC GROUPS BUT
WITH THE NOTABLE EXCEPTION OF
THE PACIFIC ISLANDERS AND NATIVE
AMERICANS AND THAT IS SHOWN BY
THE ORANGE LINE.
AND WE NEED TO DO MORE SO THAT
THEY CAN BENEFIT FROM THE
ADVANCES THAT WE'VE HAD IN
CANCER RESEARCH.
NEXT SLIDE.
SO THE NEXT SLIDE IS SOMETHING
THAT I'VE TAKEN FROM THE LUNG
CANCER RESEARCH FOUNDATION.
BECAUSE I THINK IT REALLY IS AN
INTERESTING DEPICTION OF THE
ADVANCES IN CANCER TREATMENT FOR
LUNG CANCER.
AND THE BLUE OR THE TARGETED
TREATMENTS THAT HAVE BEEN
APPROVED AND THE BLACK PARTS THE
IMMUNO THERAPY AND THEY ARE ALL
HEAVILY SKEWED TOWARD THE LAST
20 YEARS.
AND MOST OF THEM TOWARDS THE
LAST 10-15 YEARS.
AND I WAS CO-AUTHOR OF A PAPER
PUBLISHED TWO YEARS AGO ON THE
EFFECTIVE ADVANCES IN LUNG CAN
TREATMENT AND POPULATION
MORTALITY.
AND THE REFERENCE IS SHOWN BELOW
BECAUSE WHILE A LOT OF THE
DECREASE IN MORTALITY FROM LUNG
CANCER IS BECAUSE OF DECREASED
TOBACCO CONSUMPTION NOW AS A
RESULT OF ALL OF THE THESE
APPROVALS THERE ALSO IS
SUBSTANTIAL BENEFIT FOR CANCER
TREATMENT.
NEEDLESS TO SAY MANY TOO MANY
PEOPLE ARE DYING FROM CANCER IN
GENERAL AND LUNG CANCER
SPECIFICALLY AND WE NEED TO
REDOUBLE OUR EFFORTS IN ALL OF
THESE AREAS.
THE NEXT SLIDE -- TALKS ABOUT
ONE OF THE AREAS WHERE WE HAVE
NOT BEEN VERY SUCCESSFUL.
AND THAT IS IN PANCREATIC CANCER
RESEARCH.
RECENTLY THERE IS -- HAS STARTED
A PANCREATIC CANCER VACCINE
WHICH TARGETS MUTATIONS IN K-RAS
THAT OCCUR IN MORE THAN 80% OF
PEOPLE WITH PANCREATIC CANCER
AND YOU WILL BE HEARING FROM
DR. CASTLE ABOUT THE
MULTI-CANCER DETECTION SCREENING
MANY OF WHICH INCLUDE SCREENING
FOR PANCREATIC CANCER.
AND THERE ALSO ARE OPPORTUNITIES
FOR TREATMENT.
I'VE HIGHLIGHTED MUTANT KRAS
BECAUSE IT'S SO COMMON IN
PANCREATIC CANCER BUT KRAS WAS
THOUGHT TO BE AN UNDRUGGABLE
TARGET AND LAST YEAR THANKS TO
BREAKTHROUGH RESEARCH -- THE
FIRST FDA TREATMENT FOR MUTANT
KRAS WAS APPROVED FOR LUNG
CANCER WHERE MORE THAN ONE-HALF
OF LUNG CANCERS WITH MUTANT KRAS
HAVE THIS PARTICULAR MUTATION.
AND THE REASON I'M SHOWING G12D
IS THAT G12D ACCOUNTS FOR ABOUT
60% OF THE MUTANT, AS IN PAN YE
YACHTIC CANCER WHEREAS G12C IS
VERY UNCOMMON.
THERE IS INFORMATION SUGGESTING
THAT INHIBITORS MAY ACTUALLY BE
USEFUL EARLY PHASE TRIALS -- FOR
SEVERAL INHIBITORS WILL BE
STARTED IN OVER THE NEXT YEAR.
AND I WILL SIMPLY POINT OUT THAT
ONE OF MY NEIGHBORS HAS
PANCREATIC CANCER.
HE STILL HAS LESIONS.
HE IS DOING WELL.
BUT HE HAS G12D MUTATION AND IT
WOULD BE EXTRAORDINARILY
BENEFICIAL FOR HIM IF THOSE
CLINICAL TRIALS WERE TO BE
SUCCESSFUL.
AND OBVIOUSLY FOR LOTS OF PEOPLE
WITH PANCREATIC CANCER.
SO I WOULD LIKE TO TURN NOW TO
THE LAST TOPIC WHICH IS THE
CANCER MOONSHOT.
AND THIS SLIDE -- THE NEXT SLIDE
TELLS YOU ABOUT THE CURRENT
PHASE OF THE CANCER MOONSHOT
WHICH STARTED IN 2017 WITH
FUNDING.
AND IT REALLY HAS BEEN VERY
SUCCESSFUL BUT IT'S -- WE STILL
HAVE LOTS AND LOTS OF CANCER.
BUT BY VARIOUS METRICS MORE THAN
2,000 PUBLICATIONS ALMOST 50
CLINICAL TRIALS AND MORE THAN 30
PATENT FILINGS.
BUT AS MANY OF YOU ARE AWARE THE
NEXT FISCAL YEAR FY23 IS THE
LAST YEAR WHERE WE HAVE FUNDING
FOR THE CANCER MOONSHOT FOR THIS
PHASE.
AND IT'S REALLY IMPORTANT TO
CONTINUE TO SUPPORT THE MOST
PROMISING INITIATIVES FROM THE
INITIAL CANCER MOONSHOT WHILE
ALSO DEVELOPING ADDITIONAL
ACTIVITIES TO MEET CHALLENGING
NEW GOALS.
SO THE NEXT SLIDE WHICH IS
ANIMATED TELLS YOU ABOUT THE
ANNOUNCEMENT THAT PRESIDENT
BIDEN MADE IN FEBRUARY.
ABOUT SOME OF THE GOALS OF THE
NEXT PHASE OF THE CANCER
MOONSHOT.
THE FIRST GOAL IS TO CUT THE
CANCER DEATH RATE IN HALF.
WITHIN THE NEXT 25 YEARS.
THE SECOND IS TO TRANSFORM THE
MEANING OF CANCER.
AND THE THIRD TO ADDRESS CANCER
ASSOCIATED INEQUITIES.
BEFORE WE LEAVE THIS SLIDE ONE
OF THE THINGS THAT I'VE ASKED
SOME COLLEAGUES TO DO IS REALLY
LOOK CRITICALLY AT WHAT NEEDS TO
HAPPEN TO BE ABLE TO CUT THE
CANCER DEATH RATE AT LEAST IN
HALF WITHIN THE NEXT 25 YEARS.
AND THEY HAVE BEEN -- MEETING
AND I HOPE THEY WILL BE ABLE TO
HAVE A PEER REVIEW PUBLICATION
SUBMITTED IN THE NEXT FEW MONTHS
TO TAKE THESE ASPIRATIONAL GOALS
AND SHOW HOW THEY ACTUALLY COULD
BE FEASIBLE.
THE NEXT SLIDE TELLS YOU ABOUT
FOUR DIFFERENT AREAS THAT I
THINK WE COULD TRY TO GIVE
EMPHASIS TO.
OF TRYING TO MAKE FEASIBLE THE
ASPIRATIONAL GOAL OF THE BIDEN
ADMINISTRATION.
THE FIRST IS TO INVEST IN THE
PIPELINE OF NEW DRUGS FOR CANCER
PREVENTION, INTERCEPTION AND FOR
TREATMENT.
AND I SHOULD ALSO INCLUDE
DIAGNOSTICS.
FOR EXAMPLE WHAT DR. CASTLE WILL
BE TALKING ABOUT WITH THE
MULTI-CANCER DETECTION TEST.
EVEN IF WE CAN DECREASE
MORTALITY OVER THE NEXT 25 YEARS
BY 50% WE WILL NOT HAVE ENDED
CANCER AS WE KNOW IT.
IF WE DON'T MAKE PROGRESS ON
PANCREATIC CANCER AND OTHER
CANCERS WHERE MORTALITY RATES
ARE REMAIN SO HIGH.
SECOND EXPANDING CLINICAL TRIALS
TO SPEED THE EVALUATION OF
CANDIDATE INTERVENTIONS.
ABSOLUTELY CRITICAL AS WE ARE
INVESTING AND EXPANDING THE
PIPELINE WE NEED TO BE ABLE TO
TEST THOSE NEW DRUGS THAT COME
OUT.
THIRD, WE NEED TO ENSURE
EQUITABLE HEALTH CARE DELIVERY.
BOTH OF CURRENT STANDARDS OF
CARE AS WELL AS NEW STANDARDS OF
CARE.
AND SO IMPLEMENTATION RESEARCH
WILL BE VERY IMPORTANT.
AND FOURTH, TO INCREASE THE
DIVERSITY OF CANCER RESEARCH AND
WORKFORCE SO IT CLOSELY
RESEMBLES THE COMMUNITIES THAT
WE SERVE.
THE NEXT SLIDE TELLS YOU THAT
WE'RE ALREADY TRYING TO
JUMP-START THE NEXT PHASE OF THE
MOONSHOT ALTHOUGH WE DON'T
IMAGINE GETTING NEW FUNDING
UNTIL FY24.
SO TWO WEEKS AGO -- AT OUR
NATIONAL CANCER ADVISORY BOARD
AND BOARD MEETING TWO OF THE
PRESENTATIONS WERE MADE ONE WAS
FOR THE CANCER MOONSHOT SCHOLARS
DIVERSITY PROGRAM.
AND THE SECOND WAS THE
FEASIBILITY TRIAL FOR
ASYMPTOMATIC MULTI-CANCER
DETECTION SCREENING THAT
DR. CARS EL WILL TALK TO YOU
ABOUT AND I'M * PLEASED TO TELL
YOU ABOUT THAT OUR ADVISORY
COMMITTEE WAS UNANIMOUS IN THEIR
STRONG ENDORSEMENT OF BOTH OF
THESE PROPOSALS SO WE LOOK
FORWARD IN GOING FORWARD WITH
THEM IN FY23.
AND THEN OTHER KINDS OF
CONTINUITY WHERE THERE ARE
NOTICES OF SPECIAL INTEREST OR
REQUEST FOR INFORMATION FOR
ADAPTING VISUALIZATION METHODS
TO ENHANCE CANCER MOONSHOT DATA.
AND HARM-- AND H-AND THE CHILDHH
CONTINUE TO BE A VERY IMPORTANT
GOAL.
THE NEXT SLIDE -- COMES BACK THE
PREVIOUS SLIDE THAT I SHOWED YOU
AND JUST TO TELL YOU ABOUT
HIGHLIGHT -- TWO ASPECTS.
ONE IS EXPANDING CLINICAL TRIALS
TO SPEED THE EVALUATION OF
CANDIDATE INTERVENTIONS IN
DIVERSE POPULATIONS.
AND THE SECOND ENSURING
EQUITABLE HEALTH CARE DELIVERY.
AND THESE ARE AREAS WHERE THE
CANCER ADVOCACY COMMUNITY CAN
REALLY PLAY KEY ROLES AND THESE
ARE AREAS WHICH WE REALLY NEED
TO DRAMATICALLY EXPAND SO THAT
WE CAN HAVE MORE AND FASTER
INTERVENTIONS FOR THE CLINICAL
TRIALS AND SECOND, WE NEED TO
EXPAND THE IMPLEMENTATION
RESEARCH AND WIDER DISSEMINATION
OF CURRENT AND NEW STANDARD OF
CARE.
WHAT ABOUT ADAPTING CLINICAL
CANCER TRIALS DURING COVID?
AND MANY OF YOU ARE AWARE THAT
THIS WAS ACCELERATED BY THE NEED
TO ADAPT TO THE COVID-19
PANDEMIC.
AND WHAT WE TRIED TO DO IS PUT
THE PATIENT AT THE CENTER OF
CLINICAL TRIALS ACTIVITY.
WHICH THEN PERMITTED REMOTE
CONSENTING.
LABORATORY TESTING DONE AT HOME.
DRUGS DELIVERED AT HOME AND
REMOTE MONITORING AND AUDITING
AND KEITH FLAHARTY AND OTHERS
PUBLISHED A PAPER LAST YEAR
WHICH VERY INFORMATIVE.
SO THE REAL ISSUE IS WHAT CAN WE
CONTINUE DOING?
AND THE IDEA IS TO MAKE THESE
NEW OPERATIONAL PROCESSES
PERMANENT.
AND THIS IS REGARDING -- MORE
AND MORE O'ERAL AGENTS RATHER
THAN AGENTS THAT NEED TO BE
GIVEN -- PARENTALLY AND ADVANCE
PRACTICE -- AND STUDY AGENT
ORDERS AND IT MIGHT BE USEFUL AT
I SUBSEQUENT MEETING TO TALK
MORE IN DETAIL ABOUT WHAT THE
PLANS ARE GOING FORWARD.
THOSE ARE THE CONTINUE -- ARE TI
WANTED TO MAKE.
I WANT TO THANK ALL OF YOU ON
THE NCRA FOR THE INCREDIBLE
SERVICE THAT YOU PROVIDE NOT
JUST ON THE NCRA BUT ALSO FOR
ADVOCATING FOR THE IMPORTANCE OF
CANCER RESEARCH AND REALLY FOR
ITS URGENCY AS WAS MENTIONED
EARLIER BECAUSE EVERY MONTH THAT
WE WAIT IS A MONTH THAT THERE
ARE MANY PEOPLE DYING AND A
MONTH WHERE WE MIGHT HAD BEEN
ABLE TO INTERVENE AND DO
SOMETHING TO HELP PEOPLE EITHER
PREVENT GETTING CANCER, DIAGNOSE
IT EARLIER OR TREAT IT.
SO I LOOK FORWARD TO YOUR
QUESTIONS AND COMMENTS.
THANKS VERY MUCH.
>> THAT WAS A WONDERFUL UPDATE.
THANK YOU SO MUCH.
I'LL OPEN IT UP TO QUESTIONS.
ANY QUESTIONS AND I CAN JUMP IN
AS WELL IF NEEDED.
JENNIFER.
>> YOU'RE MUTED.
>> SORRY.
MY MOUSE WAS NOT WORKING RIGHT.
THANKS, DR. LOWY FOR THAT GREAT
PRESENTATION AND WE'RE LOOKING
FORWARD TO HAVING YOU AT OUR
MEETING IN OCTOBER AS WELL.
I WANT TO THANK YOU FOR YOUR
REMARKS ON DIVERSITY AND
CLINICAL TRIALS.
WE'VE BEEN GATHERING DATA FOR
THE LAST YEAR AND A HALF IN OUR
CANCER CENTER ON DIVERSITY AND
CLINICAL TRIALS.
AND FOUND THAT MANY OF THE -- SO
WE DIDN'T HA HAVE A GREAT RESPO.
ABOUT 36 CANCER CENTERS
RESPONDING BUT FROM THE YEARS TO
19-2020 WE SAW THAT OUR CANCER
CENTERS -- WERE LARGELY FEMALE.
LARGELY WHITE SO I THINK IT'S
VERY IMPORTANT THAT WE AS A
COMMUNITY FOCUS ON DIVERSIFY
CLINICAL TRIALS AND PATIENTS
WANT TO HEAR FROM PEOPLE THAT
LOOK LIKE THEM AND WITH STAFF
RETENTION ISSUES.
THERE IS A LOT OF CHALLENGES
RIGHT NOW.
SO I APPRECIATE YOU RAISING THIS
ISSUE AND BRINGING IT UP.
I LOOK FORWARD TO BEING ABLE TO
SHARE THIS INFORMATION SOON.
OF COURSE LOOK FORWARD TO
WORKING WITH -- EVEN THOUGH I'M
ROTATING OFF BUT SHARING WITH
THE REST OF THE NCRA WAYS THAT
WE MIGHT BE ABLE TO MOVE THE
NEEDLE IN THIS AREA.
BECAUSE I THINK IT'S SO
IMPORTANT THAT WE --
>> THANKS.
I CERTAINLY HOPE AS THE AACI
MEETING THAT I WILL BE ABLE TO
TALK IN MORE CONCRETE TERMS
ABOUT HOW TO DO THINGS.
ONE OF THE REALLY IMPORTANT
DIFFERENCES BETWEEN WHAT THE NCI
DOES AND WHAT THE CANCER CENTERS
DO IS THAT NCI IS A RESEARCH
ORGANIZATION.
AND WE SUPPORT THE RESEARCH THAT
IS CONDUCTED AT THE CANCER
CENTERS.
BUT THE CANCER CENTERS ALSO ARE
HEALTH CARE DELIVERY
ORGANIZATIONS.
AND THEY ACTUALLY HAVE THE
OPPORTUNITIES TO GO BEYOND THE
RESEARCH SO THAT THEY PUT INTO
PRACTICE WHAT THE RESEARCH IS
SHOWING.
AND MY HOPE IS THAT WE WILL BE
ABLE NOT JUST WITH THE NCI
SUPPORTED CANCER RESEARCH
BECAUSE WE'RE DOING REASONABLY
WELL WITH THAT BUT THERE IS A
LOT OF OTHER RESEARCH THAT IS
CONDUCTED BY THE CANCER CENTERS.
IT IS NOT DIRECTLY SUPPORTED BY
N CONTRADICTION AND MY HOPE IS
THAT WE MAY BE ABLE TO HELP *
PROVIDE SOME RESOURCES TO ENABLE
WHAT YOU'RE TALKING ABOUT, JEN.
THANK YOU.
>> YES.
THANK YOU, DR. LOWY.
>> HI, KRISTEN SANTIAGO.
GLAD THAT YOU'RE BACK.
EVERYTHING THAT YOU SAID IS IN
ALIGNMENT AND TRYING TO FIGURE
THINGS OUT.
I HAVE A NAIVE QUESTION WHICH I
CAN PROBABLY GOOGLE SO IF YOU
JUST WANT TO TELL ME GOOGLE IT.
>> I CANNOT IMAGINE THAT YOU'RE
GOING TO HAVE A NAIVE QUESTION.
>> PREPARE YOURSELF.
I'M CURIOUS WHY DEATH RATES HAVE
INCREASED.
>> THE SHORT ANSWER IS WE DON'T
KNOW.
AND I DON'T THINK THAT WE HAVE
-- I THINK THAT WE HAVE NOT BEEN
AWARE OF THIS -- AS -- IT HAS
NOT BEEN ON THE RADAR SCREEN THE
WAY IT SHOULD HAVE BEEN.
BUT YOU KNOW -- THE MORTALITY
RATE PROBLEM -- WAS JUST CALLED
TO OUR ATTENTION LAST MONTH.
IT WAS NOT CLEAR UNTIL THIS
PAPER CAME OUT.
AND PREVIOUSLY THE RECOGNITION
THAT AFRICAN-AMERICAN WOMEN WERE
AT INCREASED RISK WAS KNOWN.
BUT THE INCREASE AMONG HISPANIC
WOMEN IS QUITE RECENT.
AND WE'RE HONESTLY NOT SURE.
WHAT I'M THINKING ABOUTUT
WE REALLY NEED TO INPUT FROM A
LOT OF PEOPLE IS DOING A TCGA
LIKE -- RESEARCH PROGRAM.
SO THAT WE LOOK AT DIFFERENT
COMMUNITIES, HISPANIC,
AFRICAN-AMERICAN AND OTHER WOMEN
SO THAT WE HAVE DETAILED
CHARACTERIZATION OF THEIR
MOLECULAR ABNORMALITIES.
ANOTHER THING THAT YOU MAY OR
MAY NOT HAVE HEARD ABOUT --
OFTEN REFERRED TO AS MOLECULAR
SIGNATURES.
THEY CAN IDENTIFY ACTUAL
ENVIRONMENTAL EXPOSURES.
SO WE WANT TO MAKE SURE THAT
THERE IS NOT SOME KIND OF
OBVIOUS ENVIRONMENTAL EXPOSURE
THAT THESE WOMEN ARE
INADVERTENTLY HAVING THAT MAY BE
LEADING TO IT.
AND WE NEED REALLY GOOD
EPIDEMIOLOGICAL EVALUATIONS AS
WELL.
IF I HAVE NOT TOTALLY BORED YOU
LET ME SAY THAT THIS IS NOT HAD
THE KIND OF ENDOMETRIAL CANCER
WHERE WE'VE MADE PROGRESS.
THE ENDOMETRIAL CANCER
ASSOCIATED WITH OBESITY AND THE
TREATMENT WITH IMMUNE CHECKPOINT
INHIBITORS THAT IS A DIFFERENT
KIND OF ENDOMETRIAL CANCER.
SO WE REALLY NEED TO UNDERSTAND
THIS OTHER FORM MUCH, MUCH
BETTER.
>> THANK YOU.
SO GOOGLE WON'T HELP ME.
>> MAYBE IT WILL.
I MUST CONFESS, I HAVE NOT
LOOKED AT THE UNIVERSITY OF
GOOGLE ON THIS PARTICULAR
QUESTION.
>> THANK YOU.
>> ANNIE.
>> JUST I'M GLAD YOU ASKED THAT
KRISTEN BECAUSE IT'S AN ISSUE
THAT WE'VE BEEN ASKING ON THE
STEERING COMMITTEE FOR OVER --
BLACK PARTICIPANTS BECAUSE MY
FORMER COLLEAGUE -- DOUG -- ON
THE STEERING COMMITTEE NOTICED
THERE WAS A MORTALITY DISPARITY.
AND I WOULD REALLY -- IT'S
IMPORTANT THAT WE SERVE PEOPLE
WHO ARE NOT BENEFITING FROM THE
RESEARCH.
BUT I WANTED DR. LOWY -- THANK
YOU SO MUCH FOR YOUR WONDERFUL
PRESENTATION.
I WANT TO LET YOU KNOW THAT WHEN
I'M MENTORING A NEW RESEARCH
ADVOCATE THE FIRST THING I POINT
TO IS YOUR QUOTE ON THE
IMPORTANCE OF HAVING PATIENT
ADVOCATES AND IT REALLY
ENCOURAGES PEOPLE TO GET
INVOLVED.
MY QUESTION TO YOU IS AS WE KNOW
THAT WHEN MOONSHOTS WAS FIRST
LAUNCHED THERE WAS DISCUSSIONS
AND ROUNDTABLES AND PATIENT
ADVOCATES WERE INVOLVED.
I WOULD LIKE TO HEAR ABOUT YOUR
PLANS TO INVOLVE PATIENT ADD
VOTE INDICATES IN THE REBOOT.
>> MY FEELING ABOUT THIS IS THAT
THERE IS A LOT OF MANY PEOPLE
WHO ARE TALKING WITH DANIEL --
-- THE PRESIDENT HAS DESIGNATED
TO BE THE POINT PERSON IN THE
OFFICE OF SCIENCE AND
TECHNOLOGY.
AND I KNOW AT LEAST SOME
ADVOCATES HAVE BEEN INVOLVED IN
DOING THAT.
I WOULD BE VERY HAPPY AT OUR
NEXT MEETING TO HAVE THAT BE A
SUBJECT.
JUST SO YOU UNDERSTAND WHAT
WE'RE TRYING TO DO IS -- ON THE
ONE HAND BE COGNIZANT OF WHAT
THE WHITE HOUSE WANTS TO DO FOR
THE NEXT PHASE OF THE CANCER
MOONSHOT.
BUT TO TRY TO MAKE IT AS BROAD
AS POSSIBLE.
I THINK THEY HAVE NOT BEEN
PARTICULARLY EXCITED ABOUT
BRINGING -- IN BASIC RESEARCH IN
PART BECAUSE THE HORIZON LINE
FOR BASIC RESEARCH IS RELATIVELY
SPEAKING SO LONG.
BUT I'M LOOKING FORWARD TO
ESSENTIALLY BEING ABLE TO TALK
WITH PEOPLE ABOUT THE
INTEGRATION IF YOU WILL OF THE
NEW PHASE OF THE CANCER MOONSHOT
CONTINUING THE CURRENT PHASE OF
THE CANCER MOONSHOT BUT HOW
INTEGRATED ALL OF THAT IS WITH
THE REST OF THE NCI BUDGET.
OKAY AND WE CAN PUT SOME
SPECIFICITY THERE.
IN THE FUTURE IF YOU WANT.
>> THANK YOU SO MUCH.
KEVIN.
>> THANKS SO MUCH DR. LOWY FOR
YOUR PRESENTATION TODAY.
I THOROUGHLY ENJOYED THE
ADVANCEMENTS.
SOMETIMES AT THE COMMITTEE WE
GET IDEAS AND THINGS THAT ARE
PROPOSED BUT WE DON'T SEE THE
TRACTION AND HOW IT STARTS TO
GET IMPLEMENTED SO I THANK YOU
FOR THAT UPDATE. A QUESTION OR
TWO ON ARPA.
AND IN READING THE REVIEW ON THE
ON THE LEGISLATIVE STAND POINT.
THEY HAVE YET TO DECIDE WHETHER
THEY WANT TO HOUSE THAT.
ONE OF MY QUESTIONS IS I KNOW
THEY ARE FUNDING THIS BUT MOVING
FORWARD IS THERE A GREAT DELAY
THAT IS TAKING PLACE ON THE
HOUSING DECISION OF WHERE IT'S
GOING TO END UP AND HOW FAR AWAY
ARE WE GREAT GETTING
IMPLEMENTATION INTO THAT
PROGRAM?
>> HOLLY CAN BE MORE
AUTHORITATIVE THAN ME.
BUT WHAT HAS HAPPENED IS THAT
THERE IS AN APPROPRIATION BUT
THERE IS NOT AN AUTHORIZATION.
USUALLY THE AUTHORIZATION COMES
FIRST AND THEM THE
APPROPRIATION.
SO FOR FY22 THERE WAS A BILLION
DOLLARS BUT IT CAN BE --
INVESTED OVER A THREE-YEAR
PERIOD.
AND THE ADMINISTRATION PROPOSAL
WAS FOR MORE THAN $4 BILLION FOR
FY23 AND THE HOUSE MARK HOLLY
CAN CORRECT ME IS $2.3 BILLION
AND WE NEED TO SEE WHAT THE
SENATE IS GOING TO DO.
IT MIGHT BE INSTRUCTIVE AT THE
HEARING WHERE I WAS -- BOTH
CHAIR * DELORO AND RANKING
MEMBER COLE SAID THE SAME THING.
WE LIKE THE IDEA OF ARPA-H BUT
WE THINK THAT THE ADMINISTRATION
IS ASKING FOR TOO MUCH MONEY FOR
FY23.
AND IT JUST REMAINS TO BE SEEN
EXACTLY WHAT IS GOING TO HAPPEN
WITH THE AUTHORIZING
LEGISLATION.
THE OTHER QUESTION IS HOW MUCH
CANCER RESEARCH IS GOING TO BE
DONE WITH ARPA-H?
AND TO WHAT DEGREE WILL NCI BE
INVOLVED WITH THAT?
WE WOULD BE ENTHUSIASTIC ABOUT
WORKING WITH ARPA-H IN ANY
CANCER RESEARCH AREA THAT THEY
THINK IS MERITORIOUS.
>> THANK YOU FOR THAT CLARITY.
I APPRECIATE IT.
>> THANK YOU, DR. LOWY.
I AM REALLY INTERESTED.
A LOT OF PEOPLE TALK ABOUT WHAT
MENTIONED ABOUT LEARNING FROM
THE PANDEMIC EXPERIENCE ABOUT
QUICKENING THE PACE OF THINGS.
I MENTIONED HOME EXAMS AND HOME
CONSENTING AND RELIANCE ON ORAL
OPTIONS.
LAST WEEK DOUG HAWKINS SPOKE AT
A MEETING THAT I ATTENDED AND
HAD SOME PRETTY INTERESTING
SLIDES ABOUT FOR PEDIATRIC AAL
PATIENTS ABOUT ADHERENT VERSUS
NONADHERANT OUTCOMES.
PATIENTS THAT ARE AT HOME TAKING
ORAL MEDICINE.
AND NOT BEING COMPLIANT IN THE
SCHEDULING.
AND I WONDER ARE WE ALSO
LEARNING ABOUT THAT AND HOW IF
WE'RE GOING TO HAVE OUR PATIENTS
TAKING ADVANTAGE OF LESS TIME IN
PATIENT AND LESS TIME IN CLINIC.
IS THAT DATA IMPROVING ADHERENCE
ALSO BEING COLLECTED?
>> OVER-ALL YES.
THE CHILDHOOD CANCER INITIATIVE
THE GOAL IS TO LEARN FROM EVERY
CHILD.
AND ONE OF THE THINGS I'M HOPING
DR. ROMAN WHEN HE JOINS WILL BE
ABLE TO PARTICIPATE IN IS JUST
THE KIND OF THINGS THAT YOU'RE
TALKING ABOUT.
BECAUSE I THINK THAT WHEN YOU
LOOK AT IT'S NOT JUST ADHERENCE
TO BEST PRACTICES BUT OUTCOMES.
AND WE -- AND I THINK THAT WE
NEED WHEN WE RECOGNIZE THAT
OUTCOMES ARE NOT AS GOOD WITH
ONE SET OF REGIMENS VERSUS
ANOTHER WE NEED TO CALL THAT TO
THE ATTENTION OF THE PEDIATRIC
ONCOLOGY COMMUNITY.
SO THE SHORT ANSWER IS YES.
THIS IS A REAL ISSUE.
IT'S A VERY IMPORTANT ONE.
>> I WANT TO ASK A QUESTION --
NOW THAT WE'VE LEARNED FROM THE
PANDEMIC AND SORT OF LOOSENING
THE CLINICAL TRIAL DESIGNS.
I WAS ON A RECENT COMMITTEE AND
THERE IS STILL DEBATE ON WHAT
CAN BE LOOSENED AND WHAT
COMMITTEES ARE ABLE TO DO.
ONE STUDY IS ADHERENCE OR
ACCRUAL TO THAT CLINICAL TRIAL
-- PATIENTS NEED TO STAY AT HOME
FOR SOME OF IT AND SO HOW ARE WE
GOING TO CLARIFY THIS?
BECAUSE IT'S IMPORTANT AS WE
START TALKING ABOUT MOONSHOT
GOALS AND SUPPORTING THE
MOONSHOT AND THOSE ADDITIONAL
WORK THAT NCI IS DOING HOW CAN
WE HELP CLARIFY THAT FOR OUR
RESEARCH SCIENTISTS THAT ARE
PUTTING IN FOR CLINICAL TRIALS
RIGHT NOW?
>> I THINK THAT CALLING THAT TO
OUR ATTENTION IS VERY IMPORTANT.
ON SOME LEVEL WE ARE BOUND BY
REGULATORY ISSUES.
ON THE OTHER HAND THE FDA --
CERTAINLY RECOGNIZES THAT WE
NEED TO INSTITUTE SOME CHANGES.
SO IF THERE ARE SPECIFIC ISSUES
THAT YOU THINK ARE GOING TO --
COULD REALLY HELP OPEN THINGS UP
-- I WOULD SUGGEST -- BRING THEM
TO OUR ATTENTION EITHER THROUGH
AMY -- YOU CAN SEND ME AN E-MAIL
-- WE WILL LOOK AT THEM.
THE DIFFICULT WE TRY TO DO
IMMEDIATELY.
THE IMPOSSIBLE TAKES A LITTLE
LONGER.
>> I APPRECIATE THAT.
EVEN IF IT'S A LITTLE -- PATIENT
QUESTIONS DO STANDARD OF CARE AT
HOME THAT WOULD BE WONDERFUL AND
IF THAT WAS ALL WE WERE ABLE TO
ACCOMPLISH --
>> THERE IS ALWAYS THE DYNAMIC
TENSE -- IF WE DO IT AT HOME IS
THIS GOING TO BE SUBSTANDARD?
SO WE NEED TO PAY ATTENTION TO
QUALITY IN ADDITION TO LOCATION.
>> THANK YOU FOR THAT.
JACQUELYN.
>> HI.
YES.
THIS IS PIGGYBACKING.
I WAS THINKING ABOUT BACK IN
2007 WHEN I WAS ON MY CLINICAL
TRIAL AT MOFFETT EVERY MONTH I
WOULD HAVE TO DRY OUT THERE FOR
BLOOD DRAWS FOR THE FIRST WEEK
OF EVERY MONTH.
AND I REMEMBER AN OLDER
GENTLEMAN SITTING NEXT TO ME
SAYING HE WAS NOT GOING TO BE
ABLE TO COMPLETE THE TRIAL
BECAUSE HE COULD NOT AFFORD TO
DRIVE THAT FAR.
WE WERE NOT ALLOWED TO HAVE OUR
DRAWING DONE AT A COMMUNITY
CENTER OR CLOSER TO HOME.
SO SOMETIMES WHEN WE LOOK AT
ISSUES AROUND ACCRUAL AND
NUTRITION AND ACCESS THERE ARE
PRACTICAL ISSUES ABOUT THE
NUMBER OF VISITS THAT PATIENTS
HAVE TO MAKE.
AND I KNOW THERE IS A LOT OF
TIME SPENT FOCUSED ON MYTHS
SURROUNDING CLINICAL TRIAL
PARTICIPATION.
AND ANOTHER QUESTION I HAVE
BECAUSE I NOW WORK ON THE
INDUSTRY SIDE AND WE'RE LOOKING
AT WHY ARE PEOPLE NOT ENROLLING
IN THE TRIALS AND SOME OF THE
RESEARCH IS ON THE PHYSICIAN'S
SIDE THERE ARE ASSUMPTIONS
AROUND WHO WOULD MAKE THE BEST
TRIAL PARTICIPANT AND COMPLIANT.
IS THERE ANYTHING GOING ON THAT
YOU KNOW OF THAT LOOKS AT
PHYSICIAN BIAS AND ASSUMPTIONS
THAT COME ALONG WITH WHO IS
OFFERED TRIALS BECAUSE THAT IS
WHAT WE'VE LEARNED IS THAT SOME
PATIENTS ARE NOT EVEN OFFERED
TRIALS?
>> YOU'RE BRINGING UP A REALLY
IMPORTANT ISSUE.
MOST OF OUR FOCUS HAS BEEN WITH
NCI SPONSORED TRIALS AND I THINK
THAT THIS IS AN ISSUE THAT I
THINK THAT HAS BEEN LARGELY
OVERCOME.
BUT IT'S NOT BEEN OVERCOME IN
MANY OTHER AREAS AND IMPLICIT
BIAS OR EXPLICIT BIAS ARE THINGS
THAT ARE TERRIBLY IMPORTANT THAT
WE NEED TO THINK ABOUT.
AND YOUR FIRST POINT IS
ABSOLUTELY ON TARGET.
ABOUT 10 YEARS AGO A RELATIVE OF
MINE HAD PANCREATIC CANCER AND
HE WAS VERY INTERESTED IN
PARTICIPATING IN THE RESEARCH.
BUT HE SAID THERE ARE TOO MANY
VISITS.
AND IT'S NOT LIKELY THAT I AM
GOING TO BE CURED.
AND THAT IS NOT HOW I WANT TO
SPEND MY REMAINING TIME.
THIS WAS A MAN WITH A -- HE WAS.
HE UNDERSTOOD WHAT WAS HAPPENING
AND HE WANTED TO PARTICIPATE.
SO WHAT SAY IN TERMS OF THE
PRACTICAL ASPECTS REALLY
RESONATES.
>> DO WE HAVE ANY MORE
QUESTIONS?
IF NOT I WANT TO THANK YOU FOR
YOUR UPDATE AND ANSWERING OUR
QUESTIONS AND LISTENING TO OUR
VIEWS ON WHAT WE CAN DO AROUND
CLINICAL TRIALS.
BUT NEXT I BELIEVE AMY DO YOU
WANT TO TAKE THE BREAK OR DO YOU
WANT TO MOVE TO THE NEXT
SESSION?
>> I WILL DEFER TO YOU.
I KNOW THAT DR. CASTLE IS HERE.
>> OKAY.
I GUESS MAYBE WE'LL GET STARTED
IF THAT IS OKAY.
>> THAT SOUNDS GREAT AND IF WE
HAVE TIME BETWEEN THE NEXT
SESSION I'LL GIVE EVERYONE A
SHORT BREAK.
>> I DIDN'T SEE DR. CASTLE HAD
JOINED SO, THAT IS PERFECT
TIMING.
I WANT TO THANK DR. CASTLE.
AND LOOK FORWARD TO YOUR
PRESENTATION.
>> CAN YOU HEAR ME?
>> YES.
>> GOOD.
THAT IS PROGRESS.
>> THANK YOU FOR THE INVITATION
TO TALK TO YOU AND I LOOK
FORWARD TO THE DISCUSSION.
JUST ONE CAVEATS HERE.
YOU'RE GOING TO SEE SOME
COMPLICATED SLIDES AND I DON'T
WANT YOU TO GET TOO WORRIED.
I WANTED TO ILLUSTRATE THE
BREATH AND DEPTH OF WHAT WE'RE
TRYING TO DO TO PREVENT CANCER.
TO SEE ALL OF THE PROJECT THAT'S
ARE GOING ON.
WE'RE NOT GOING TO GET SUPER
TECHNICAL.
BUT I WANT YOU TO APPRECIATE THE
RESEARCH THAT THE DIVISIONS
SPONSORING AND SUPPORTING.
AND WE'RE TRYING TO GET AFTER
BETTER WAYS TO PREVENT CANCER.
SO WITH THAT CAN I HAVE THE NEXT
SLIDE, PLEASE.
I WANT TO POINT OUT THAT THESE
ARE MY OPINIONS AND DON'T
REPRESENT ANYONE ELSE'S.
MY COMMENTS ARE INFORMAL AND
SHOULD NOT BE TAKENNING AA
SIGNAL OF FUNDING OPPORTUNITIES.
IF I MENTION SPECIFIC PRODUCTS
THAT IS NOT AN ENDORSEMENT AND I
HAVE A FEW DISCLOSURES.
I'VE WORKED WITH SEVERAL HPV
TESTING COMPANIES AND GOTTEN
TESTS AT REDUCED AND AT NO COST
FOR RESEARCH ONLY.
SO MR. SPOCK IS ONE OF MY
FAVORITE PUBLIC HEALTH
SCIENTISTS AND HE FOR THOSE THAT
ARE OLD ENOUGH TO KNOW WHAT STAR
TREK IS.
HE ONCE SAID THE NEEDS OF THE
MANY OUTWEIGH THE NEEDS OF THE
FEW AND THE ONE.
WHEN WE DO PREVENTION WE'RE
DOING PREVENTION IN A WHOLE
POPULATION AND WE WANT TO REACH
EVERYONE.
AND I ADDED THE POINT BELOW
PROVIDED THAT EVERYONE IS
COUNTED EQUALLY.
AND I THINK MR. SPOCK IS A
FOREIGNER ON THE STAR SHIP WOULD
APPRECIATE THAT ADDITION TO HIS
STATEMENT.
IS SO IN THE ONE POINT IN THE
TALK THAT IS GOING TO BE
AUDIENCE PARTICIPATION POINT --
DISCUSSION.
NEXT PLEASE.
SO I'M GOING TO ASK WOULD YOU
RATHER HAVE YOUR CANCER
PREVENTED OR TREATED?
WANT TO HAVE THEIR CAR CERTAIN
PREVENTED PLEASE RAISE YOUR
HAND.
AND THOSE THAT WANTED THEIR
CANCER TO BE TREATED.
YOU HAVE TO CHOOSE ONE.
SO NEXT PLEASE.
I THINK IN MY OPINION THE BEST
CANCER IS THE CANCER THAT NEVER
HAPPENS AND I THINK MOST PEOPLE
FEEL THAT WAY.
AS SOMEONE WHO HAS NOT
EXPERIENCED CANCER DIRECTLY BUT
HAS HAD MY FAMILY DEVASTATED BY
CANCER IT'S -- IT DESTROYS NOT
ONLY -- EVEN IF YOU SURVIVE IT
IT'S DEVASTATING TO THE PERSON,
THE FAMILY, TO THE COMMUNITY.
AND WE NEED TO DO A BETTER JOB
OF PREVENTING IT.
NEXT PLEASE.
ONE OF THE CHALLENGES IN DOING
THIS WORK AND I'M NOT SAYING WE
SHOULD SPEND LESS ON TREATMENT
IS TO GET MORE RESOURCES INTO
PREVENTION.
AND I STILL THINK THIS IS OUR
FIRST LINE OF DEFENSE AND I
THINK EVERYBODY WANTS BETTER
PREVENTION AND IN ORDER TO DO
THAT THE GOVERNMENTS GOING TO
HAVE TO MAKE SOME ADDITIONAL
INVESTMENTS.
MANY CANCERS WE CANNOT PREVENT
AT THE MOMENT.
I WANT TO EMPHASIZE WE NEED
TREATMENT.
I'M NOT SUGGESTING AT ALL THIS
WE REDUCE OUR FUNDING IN
TREATMENT.
ONLY THAT WE SHOULD INCREASE OUR
FUNDING TO DEVELOP NEW WAYS TO
PREVENT CANCER.
NEXT SLIDE PLEASE.
AND THIS ILLUSTRATES THAT WE'VE
NOT MADE A LOT OF PROGRESS.
YOU CAN ARGUE THAT WE'VE MADE
VIRTUALLY NO PROGRESS IN THE
LAST 40 YEARS IN THE PREVENTION
OF CANCER.
WE'VE REDUCED MORTALITY AND SOME
HAS TO DO WITH SCREENING AND
TREATMENT BUT PREVENTING CANCER
IN THE POPULATION WE'VE NOT DONE
SUCH A GOOD JOB.
THERE WAS A BLIP HERE -- I DON'T
KNOW IF THAT WAS RELATED TO SOME
PSA OR SCREENING OR WHATNOT.
BUT WE'VE NOT MADE PROGRESS.
AND THAT IS NOT GOING TO CUT IT
FROM MY PERSPECTIVE.
THERE ARE CHALLENGES TO CANCER
PREVENTION.
THERE IS AN EVENT BIAS AND ONE
OF MY MOTIVATIONS IS TO GET YOUR
HELP IN ADVOCATING FOR BETTER
PREVENTION.
SO ONE OF THE CHALLENGES IS THAT
THERE IS NOTHING TO POINT AT.
THERE IS NO CHAMPION.
THERE IS NOBODY WHO SURVIVED
CANCER.
THERE IS NO CANCER SURVIVOR.
WE PREVENTED IT.
THERE IS NO EVENT.
THERE IS THE PREVENTION PARADOX.
MOST OCCUR IN THE AVERAGE RISK
PERSON.
AND OVER ARCHING MANDATE IS
KEEPING HEALTHY PEOPLE HEALTHY
AND ALTHOUGH WE IN THE FIRST DO
NO HARM THAT IS ASSOCIATED WITH
MEDICAL PRACTICE IT'S MORE
IMPORTANT IN THE PUBLIC HEALTH
ARENA BECAUSE WE PRIMARILY DEAL
WITH HEALTHY PEOPLE.
I TALK ABOUT CERVICAL CANCER --
WHICH IS IF WE DID NOTHING 49
OUT OF 50 WOMEN WOULD NEVER GET
CERVICAL CANCER.
NO SCREENING.
NO HPV VACCINATION 49 OUT OF THE
50 WOMEN WOULD BE PERFECT FINE
SO WHAT WE DO IN THE 49 HAS TO
BE TAKEN IN THE EQUAL
CONSIDERATION.
THERE IS A HIGH BAR.
WHO ARE WE HU -- HURTING AND
HELPING?
BECAUSE OF THAT BECAUSE WE'RE
DEALING WITH A HEALTHY
POPULATION THERE IS LITTLE
TOLERANCE FOR THE INTOLERABLE.
WE CANNOT HAVE SIDE EFFECTS.
AND NO MONEY IN PREVENTION AND
THAT IS PARTICULARLY RELATED TO
PHARMA AND I WANT TO CHALLENGE
THAT NOTION GOING FORWARD.
WITH THE IDEA THAT IF EVERYBODY
NEEDS PREVENTION THEN THERE IS
AN OPPORTUNITY.
BECAUSE THAT IS A BIG
DENOMINATOR.
A LOT OF PEOPLE NEEDING
PREVENTION.
SO MAYBE WE HAVE TO HAVE A
DIFFERENT MODEL FOR RESOURCING
THIS.
BUT THAT SEEMS LIKE SOME BIG
MONEY.
THERE ARE 300 MILLION PEOPLE IN
THE COUNTRY AND HALF OF THOSE
PEOPLE WILL GET CANCER.
THAT SEEMS LIKE A PRETTY
SUBSTANTIAL MARKET.
SO THIS IS AN OUTLINE -- I WANT
TO TELL YOU ABOUT MY FABULOUS
DIVISION OR THE DIVISION I'M
REPRESENTING.
IT'S MORE DOUG'S DIVISION BUT I
REPRESENT THE DIVISION OF CANCER
PREVENTION.
AND TALK ABOUT THE RESEARCH THAT
WE SUPPORT.
AND I WANT TO END WITH A LITTLE
DISCUSSION MULTI-CANCER EARLY
DETECTION BECAUSE THERE HAS BEEN
A LOT OF CHAIRER ABOUT THAT.
>> THIS IS OUR MISSION
STATEMENT.
THE NCI DIVISION LEADS AND
SUPPORTS AND PROMOTES RIGOROUS
INNOVATIVE RESEARCH AND TRAINING
TO REDUCE RISKS, BURDENS AND
CONSEQUENCES OF CANCER TO
IMPROVE THE HEALTH OF ALL
PEOPLE.
YOU CAN SEE THERE IS A SET OF
AREAS, RESEARCH GROUPS -- I'M
FORTUNATE TO HAVE A STRONG
LEADERSHIP TEAM.
I'M GOING TO FRAME MY DISCUSSION
AROUND THIS TRANSLATIONAL
RESEARCH CONTINUUM.
THE NCI DOES A LOT OF WORK FROM
THE BASIC SCIENCE AND I'M SURE
YOU HAVE HEARD FROM DCB AND
OTHERS.
ALL THE WAY TO T4: T3 AND T4 --
I KNOW THAT TINA GOOD FORD HAS
COME TO TALK TO YOU.
HOW DO WE GET THIS TO
COMMUNITIES AND POPULATIONS?
WE TEND IN DCP TO FOCUS ON LATE
T0 TO T2.
AND THAT IS ILLUSTRATED HERE.
DCB IS THE DIVISION OF CANCER
BIOLOGY AND DOES BASIC SCIENCE
AND WORKS CLOSELY AND IN FACT WE
HAVE RFAS THAT IS WE DO
TOGETHER.
AND THEN WE'RE ACTUALLY THE
DIVISION THAT WE'RE MOST ALIKE
WITH IS TCDB.
WE FOCUS ON PRIMARY AND EARLY
DETECTION AND ON THE THINGS THAT
WORK WE HAND THOSE OFF TO DCCP S
AND THEY FOCUS ON THE
TRANSLATION OF PRACTICE AND INTO
THE COMMUNITY AND HOW TO
ACCELERATE ADOPTION AND
IMPLEMENTATION.
SO WE FOCUS IN THREE AREAS AND I
WILL TALK ABOUT ALL OF THEM.
PREVENTATIVE AGENTS.
SCREENING AND EARLY DETECTION
AND SYMPTOM SCIENCE PREVENTION
AND MANAGEMENT.
AND THEY ARE ALL IMPORTANT AS
I'M SURE YOU APPRECIATE.
PREVENTIVE AGENTS CAN BE PRIMARY
AND SECONDARY PREVENTION.
SECONDARY PREVENTION IS
SOMETIMES WE CALL INTERCEPTION.
SCREENING AND EARLY DETECTION.
WHO'S AT HIGH RISK.
TWO HAS EARLY CANCER AND WE WANT
TO PREVENT ADVANCED STAGE CANCER
AND MORTALITY.
AND AN IMPORTANT AREA IS SYMPTOM
SCIENCE AND THE IDEA IS THAT A
LOT OF SYSTEM MANAGEMENT IS
TRIAL AND ERROR AND WE WANT TO
BRING THE SAME LEVEL OF SIGH
INNINGS TO THE MANAGEMENT OF
SYMPTOMS AS WE WOULD BRING TO
TREATMENT OR EVEN PREVENTION SO
WE WANT TO MOVE TO A PRECISION
SYMPTOM SCIENCE MODEL.
SO THERE ARE LOTS OF CAUSES OF
CANCER.
AND SOME OF THEM ARE OBVIOUSLY
AVOIDABLE.
SOME OF THEM CAN BE PREVENTED IN
A SECONDARY WAY THROUGH
INTERVENTIONS.
OBESITY REMAINS -- TOBACCO
REMAINS THE MOST IMPORTANT AND
WE CANNOT DO ENOUGH IN THAT
SPACE IN TERMS OF POLICY CHANGE
AND BEHAVIORAL CHANGE TO REDUCE
TOBACCO DEPENDENCE AND
PREVENTING YOUNG KIDS FROM
STARTING TOBACCO.
OBESITY IS THE COMING EPIDEMIC.
IT'S BEEN HERE FOR A WHILE AND
IT WILL CONTINUE AND HOW DO WE
MITIGATE THE EFFECTS OF OBESITY
REMAINS TO BE DETERMINED.
AND THERE ARE OTHER CAUSES.
FROM A RESEARCH PERSPECTIVE I
ALSO HAVE AN APPOINTMENT IN
CANCER EPIGENETICS AND FOCUS ON
HPV MYSELF FROM AN ESPECIALLY EC
PERSPECTIVE.
SO THIS LOOKS COMPLICATED BUT
IT'S NOT INTENDED TO BE.
WHEN WE THINK ABOUT CANCER
PREVENTION WE'RE THINKING ABOUT
THESE EARLY STAGES BEFORE PEOPLE
GET CANCER.
SO TO ME THIS IS THE -- WHILE WE
STUDY THESE PRECURSERS OR
PRECANCER OR MUTATIONS EARLY
MUTATIONS WE'RE TALKING WHEN THE
BIOLOGY PREVENTION.
CAN WE MITIGATE THEM.
NEUTRALIZE THEM BEFORE THEY
BECOME CANCER.
IN THIS PROGRESSIVE SCHEME AND
THIS IS A CARTOON -- THIS IS NOT
REALLY WHAT ALWAYS HAPPENS OR
IT'S MORE COMPLICATED IN SOME
WAYS AND LESS IN SOME WAYS BUT
AS YOU GET TO THESE MORE SEVERE
ABNORMALITIES THE RISK IS SHOWN
AND THE COLOR BECOMES HIGHER AND
I'M USING THE COLORS DO DENOTE
THE INCREASED RISK.
IT'S BASINGLY THE STEP BEFORE
INVASION.
* IT BREAKS THROUGH AND IS WHAT
YOU SEE IN THE EARLY PHASE.
SO I WANT TO PROMOTE THIS IDEA
OF SCREENING AWARENESS AND
VACCINATION FOR EVERYBODY OR
SAVE CAMPAIGN.
STOPPING CANCER BEFORE IT
STARTS.
AND ON THE LEFT HERE I WANT TO
HIGHLIGHT THE PARALLELS BETWEEN
COVID AND CANCER.
AND I'M SURE DR. LOWY TALKED
ABOUT WHY THE HPV VACCINE IS
DIFFERENT THAN THE COVID VACCINE
AND THAT IS NOT THE POINT.
WE HAVE THESE TOOLS AND WE NEED
TO USE THEM AND AT THE SAME TIME
WE HAD IN THE FIRST TWO YEARS
THAT WE HAD THE DEATHS DUE TO
COVID TWICE THE NUMBER OF PEOPLE
DIED DUE TO CANCER AND THAT IS
GOING TO KEEP COMING UNLESS WE
GET BETTER AT PREVENTING IT AND
HERE ARE SOME OF THE WAYS TO
PREVENT IT BUT WE NEED MORE
WAYS.
PARTICULARLY THOSE LIKE
PANCREATIC CANCER AND OVARIAN
CANCER WHICH ARE HIGHLY LETHAL.
SO LET ME TALK ABOUT RESEARCH
AND THESE ARE BUSY SLIDES.
I'M GOING TO DISTILL THEM.
I WANT YOU TO APPRECIATE THE
GREAT WORK OF MY DIVISION AND
THE RESEARCH THAT WE SUPPORT IN
THE EXTRAMURAL COMMUNITY.
-- PREVENTATIVE AGENT
DEVELOPMENT.
AND WE HAVE -- SOME EXAMPLES OF
SOME OF THE PROGRAMS THAT WE
HAVE IN PLACE TO SUPPORT THAT.
CAP IT -- AND THEN PREVENT IS A
PRECLINICAL PROGRAM TO HELP
INVESTIGATORS MOVE THINGS FROM
THE LAB TO START MOVING THEM
TOWARDS HUMANS.
AND N CORP IS OUR NATIONAL AND
INTERNATIONAL NE NETWORK FOR LAR
TRIALS.
AND THERE IS EDRN WHICH IS THE
EARLY DETECTION RESEARCH NETWORK
IN ITS 21st YEAR AND I'LL
SHOW YOU SOME OF THE PROGRESS
THERE AND WE'VE ESTABLISHED OR
GOTTEN APPROVALS TO ESTABLISH
THIS CANCER SCREENING RESEARCH
NETWORK WHICH WE'RE DOING AT
DDCPS.
THAT WAS JUST APPROVED BY THE
BSA THREE WEEKS AGO.
AND THEN AGAIN SOME THINGS COULD
GO INTO N CORP THAT COME OUT OF
THE CRS
AND THE SYMPTOM SCIENCE IS THE
AREA THAT WE HAVE NOT MADE AS
MUCH PROGRESS BUT WILL BE MAKING
PROGRESS GOING FORWARD WHICH IS
IS TO ESTABLISH PROGRAMS TO
SUPPORT THE DEVELOPMENT OF
BETTER SYMPTOMS PREVENTION AND
MANAGEMENT.
AND THE BEST OF THOSE CAN GO
INTO N CORP FOR VALIDATION.
AND WE WANT TO REDUCE CANCER
INCIDENTS AND MORTALITY AND THE
R IMPROVE THE QUALITY OF LIFE.
THESE ARE ALL THINGS THAT WE
SHARE ON THIS CALL.
IS SO JUST A LITTLE DEEPER DIVE
IN THE PIPELINE.
CAP IT IS A NEW PROGRAM JUST
COMING OUT NOW FOR TARGETING
AGENT DISCOVERY.
REALLY UNDERSTANDING BIOLOGY OF
EARLY CHANGES AND FIGURING OUT
HOW WE NEUTRALIZE THOSE
CARCINOGENIC CHANGES.
AND PROMISING AGENTS OR
APPROACHES CAN GO INTO THE
PREVENT PROGRAM WHICH IS THE
PRECLINICAL PROGRAM.
AND IT GOES THROUGH A VARIETY OF
EVALUATIONS AND WE HAVE A GO, NO
GO BECAUSE PREVENTION TAKES A
LONG TIME TO DEMONSTRATE AND
IT'S EXPENSIVE.
SO WE HAVE TO BE CRITICAL.
WE CANNOT JUST THROW CAUTION TO
THE WIND AND TAKE EVERYTHING
FORWARD.
IT HAS TO CUT THE MUSTARD -- AND
PARTICULARLY BECAUSE WE'RE GOING
TO BE PUTTING IT IN HEALTHY
HUMANS.
SO THE BAR IS VERY HIGH.
SO HERE IS ONE OF THE BUSY
SLIDES.
LOOK AT THE TARGET.
THESE ARE VACCINE OR VACCINE
LIKE APPROACHES.
THIS IS IN THE PREVENT PHASE.
AND JUST I WANT TO POINT OUT
JUST FOCUS ON THE TARGETS DON'T
WORRY ABOUT THE AGENT OR THE
STATUS.
THE TARGET POPULATION IS
PROBABLY OF INTEREST TO THIS
GROUP.
THE ONLY THING THAT IS NOT A
VACCINE IS THE NICOTINE
ANTIBODY.
PEOPLE HAVE BEEN FLOATING THE
IDEA OF A ANYBODY SEEN VACCINE
BUT THE PROBLEM IS GETTING GOOD
RESPONSES TO THAT -- IF YOU
ENARE INJECT NICOTINE AS A
VACCINE.
YOU GIVE PEOPLE OF THE ANTIBODY
THE IMMUNE RESPONSE THAT THEY
NEED.
YOU CAN SEE THE DIVERSE NUMBER
OF ORGANS THAT WE'RE TARGETING
IN EXPAND.
MOST OF THESE WON'T WORK.
THEY WILL FAIL.
BUT WE HAVE FOR MORE SPECIFIC.
WE HAVE TO -- IT HAS TO -- WE
HAVE TO SET A HIGH BAR.
SO WE MIGHT MISS SOMETHING.
BUT WE CANNOT HAVE DANGEROUS
THINGS IN HEALTHY POPULATIONS.
IT'S NOT GOING TO WORK.
SO THESE ARE EARLY PHASE
CLINICAL TRIALS.
AND WE SEE WE HAVE TWO ON COME
OH RECTAL.
ONE THAT IS SUPPOSED TO WORK
AGAINST COLON AND LUNG.
THESE HAVE BEEN THROUGH PREVENT
SO THE PROGRAM IS WORKING.
YOU CAN SEE THE PYRAMID.
FEWER THINGS IN E EARLY PHASE.
MAYBE ONE OR TWO OF THOSE WILL
GET INTO LATE PHASE AND THAT IS
HOW IT SHOULD BE.
AVENUE ALWAYS WILL BE.
BUT WE'RE VERY' EXCITED ABOUT
THE FACT THAT WE HAVE A ROBUST
PROGRAM IN CANCER PREVENTIVE
VACCINES.
THIS SHOWS YOU THE GEOGRAPHICAL
REPRESENTATION.
THIS IS THE EARLY PHASE CLINICAL
TRIAL.
AND EARLY PHASES ARE ABOUT
SAFETY AND EARLY READ OUTS LIKE
BIOLOGICAL MARKERS.
NOT EFFICACY PER SAY.
ALTHOUGH IN A PHASE II TRIAL YOU
MIGHT GET A HINT OF EFFICACY
DEPENDING ON HOW IT'S DESIGNED.
YOU'VE PROBABLY HEARD OF N CORP
AND HOW THIS HIGHLIGHTS THE
NATIONAL AND INTERNATIONAL
REPRESENTATION.
I'M SURE YOU'VE HEARD OF THE
TRIAL.
YOU SEE THE CUMULATIVE
ENROLLMENT AS OF NOW WE'RE
PASSED 50% AND I CANNOT REMEMBER
WHAT THE NUMBER IS.
BUT HERE THE Y AXIS IS THE
NUMBER OF SITES OPENED ACROSS
THE COUNTRY WHICH IS GOOD
BECAUSE THAT MEANS THAT WE'RE
GETTING CLOSER TO A
REPRESENTATIVE POPULATION.
WE HAVE 20% AFRICAN-AMERICANS
ENROLLED IN THIS TRIAL.
COMING TO THE BIOMARKER WORLD
HERE IS THE EDRN.
OUR BIOMARKER DISCOVERY OR PART
OF WE HAVE LABORATORIES AND
CENTERS ACROSS THE COUNTRY.
WORKING ON A VARIETY OF TUMORS
TO GET MARKERS THAT ARE
ASSOCIATED WITH EARLY CANCER.
AGAIN DO NOT GET CAUGHT UP IN
THE COMPLEX SLIDE HERE.
I JUST WANT TO CALL OUT THE EDRN
AND ALL THAT THEY'VE DONE AND
HERE ARE EXAMPLES OF FDA
APPROVED TESTS AND YOU CAN READ
THESE LATER AND LOOK THEM UP AND
SEE WHAT IS HAPPENING.
NEXT SLIDE IS A LIST OF CLIA
TESTS.
NOT TO GET INTO THE SPECIFICS.
JUST TO HIGHLIGHT THAT WE'RE
DOING A LOT AND NOT ALL OF THESE
ARE GOING TO WORK.
NOT ALL WILL BE USED BUT THE
BIGGER THE BASE THE MORE THAT
WILL MAKE INTO IT IN THE PUBLIC
FOR THE PUBLIC GOOD.
AND THAT IS A WORTHWHILE GOAL.
SO WE TALK ABOUT PREVENTIVE
AGENTS AND BIOMARKERS.
AND WHAT I CALL MY HOLY GRAIL
THE PRECISION CANCER PREVENTION
AND I'LL EXPAND THAT A LITTLE
LATER IF WE KNOW THE BIOMARKER
THAT TELLS THE PERSONS AT RISK
WE MAY KNOW SOMETHING ABOUT HOW
TO MITIGATE THAT RISK AND WE MAY
BE ABLE TO COMBINE THOSE TWO TO
MITIGATE CANCER RISK AND THAT
MOVES US AWAY FROM CUTTING
PEOPLE.
OR BLADING OR USING PHYSICAL
METHODS TO REDUCE RISK.
AND I'M SURE YOU ALL KNOW THAT
MANY WOMEN FOR EXAMPLE BRCA
CARRIERS HAVE -- THE MASTECTOMY
AND THAT IS THE ONLY RISK
REDUCTION.
AND 100 YEARS FROM NOW PEOPLE
WILL LOOK BACK AND SAY THAT THAT
WAS BARBARIC AND I HOPE WE GET
TO THAT POINT WHERE WE LOOK IN
THE PAST AND SAY THAT IS -- YOU
GUYS DID WHAT?
NEXT SLIDE, PLEASE.
SO AS I SAID SYMPTOM MANAGEMENT
AND TOXICITY SITS IN OUR
DIVISION.
I'M VERY EXCITED ABOUT THIS
BECAUSE I'VE WATCHED FAMILY
MEMBERS GO THROUGH CANCER.
MY WIFE IN 2013 WAS DIAGNOSED
WITH STAGE 4 ENDOMETRIAL CANCER
AND BEFORE SHE PASSED AWAY IT
WAS A MANAGEMENT OF SYMPTOMS.
A FULL-TIME JOB AND IT WAS
HIT-AND-MISS.
AND I THINK WE CAN APPLY THE
SAME SCIENTIFIC RIGOR FOR
ONCOLOGY AND PREVENTION TO THIS
FIELD.
SO AT THE BASE OF THIS LIKE THAT
T0 IS UNDERSTANDING WHY PEOPLE
GET SYMPTOMS.
BECAUSE NOT EVERYBODY GETS THE
SAME SYMPTOMS.
NOT EVERYBODY GETS A SYMPTOM FOR
A GIVEN TREATMENT AND PEOPLE
HAVE SYMPTOMS RELATED TO HAVING
CANCER ITSELF.
SO WE REALLY NEED TO DO A BETTER
JOB OF UNDERSTANDING WHO GETS
ONE.
WHY DO SOME PEOPLE GET MORE
ADDICTED TO OPIOIDS THAN OTHERS.
THAT IS ALSO IMPORTANT.
SO THEN WE NEED TO CHARACTERIZE
CLINICAL SYNDROME FOR TOXICITY
AND SYNDROMES -- WE GET BETTER
AT COLLECTING DATA.
AND PUTTING THOSE TO THE IN A
COMBINED MEASURE.
AND IT'S REALLY IMPORTANT THAT
WE TALK TO OUR PATIENTS AND
UNDERSTAND WHAT THEY ARE GOING
THROUGH AND COLLECT THAT
INFORMATION.
THERE IS NO OTHER WAY TO MAKE
PROGRESS ON THIS.
I CANNOT BE MORE STRON STRONG
SUPPORTIVE OF THIS AREA.
CANCER PATIENTS AND CANCER
SURVIVORS HAVE SIGNIFICANT
SYMPTOMS THAT PREVENT THEM FROM
GETTING THE NEXT THERAPY.
RIGHT
SO THERE IS A THING CALLED
CLINICAL PERFORMANCE AND THE
ONCOLOGIST LOOKS AT THE PATIENT
AND SAID YES YOU CAN GO TO THE
NEXT THERAPY.
NO YOU CANNOT.
BASED ON THEIR HEALTH AND
WELL-BEING.
SO THE BETTER WE TAKE CARE OF
OUR PATIENTS THE MORE LIKELY
THEY ARE GOING TO GET TO THE
NEXT LINE OF THERAPY AND EVEN
SURVIVE LONG ENOUGH TO GET TO
THERAPIES THAT HAVE NOT BEEN
INVENTED TODAY BUT WILL BE
TOMORROW.
SO THERE IS A REALLY IMPORTANT
INTERACTION BETWEEN BETTER
SYMPTOM MANAGEMENT, SURVIVORSHIP
AND ALSO THERAPY EFFICACY.
AND I'M NOT TALKING ABOUT A
SINGLE THERAPY.
I'M TALKING ABOUT THE FULL
COURSE OF MANAGING CANCER.
WE'RE ALSO LOOKING "AT ISSUES"
AROUND CANNABIS.
BOTH AS THE USE AND ABUSE.
AND THERE IS GOING TO BE A NEW
FUNDING OPPORTUNITY AROUND THIS.
THIS WAS A WORKSHOP THAT LED TO
THIS FUNDING OPPORTUNITIES.
* I KNOW THAT WE TALKED ABOUT A
BIOLOGICAL MODEL FOR PRECISION
CANCER MANAGEMENT BUT I WANT TO
BROADEN IT.
INCLUDING SOCIAL DETERMINANTS.
AND THE DEVELOPMENT AND
TARGETING.
CONSIDER AND I THINK YOU WERE
TALKING ABOUT THIS -- THE BASIC
SCIENCE THAT HAS FUELED OUR
PREVENTION.
SEVERAL EXAMPLES RELATED TO
PEOPLE OF AFRICAN DESCENT.
ON CO-TYPE DX.
HPV35 IS NOT INCLUDED IN THE
CURRENT VACCINES.
AND ITSELF KNOW FROM PERSONAL
EXPERIENCES WHEN WE'VE DONE SOME
WORK IN NIGERIA TO COMPARE
RESEARCH THAT THERE WAS NOT A
REPRESENTATIVE GROUP OF
AFRICAN-AMERICANS IN THE
DATABASE.
AND AN INCLUSION MODEL WILL
IMPROVE REPRESENTATIVENESS IN
RESEARCH REDUCING THE A FOR
MENTIONED BIASES.
IT'S NOT JUST WHAT YOU DELIVER
BUT TO WHOM AND HOW AND WHERE.
AND WE'LL TALK MORE ABOUT THAT
IN THE NEXT SLIDE.
I THINK WE CAN ALL AGREE THAT IT
ONLY WORKS FOR A FRACTION OF THE
POPULATION AND WE WILL NEED NEW
STRATEGIES TO REACH EVERYBODY.
THIS IS LAYING IT OUT.
THE WHO.
LOOK AT POPULATION RISK.
CONSIDER BENEFITS TO HARMS.
THE WHAT IS THE BIOLOGICAL
TARGETING.
THE MODE OF DELIVERY.
WE DON'T HAVE TO DO THINGS JUST
THROUGH INJECTION OR ORALLY.
WE CAN THINK ABOUT DIFFERENT
WAYS OF DELIVERING THE SAME
INTERVENTION THAT MAY BE MORE
APPLICABLE AND AMENABLE TO HIGH
RISK POPULATIONS OR UNDERSERVED
POPULATIONS AND REDUCE THE HARMS
FOR THE THE SAME INTERVENTION.
AND THEN ACCESSIBILITY.
THERE ARE OTHER THINGS THAT WE
CAN DO.
FIT TESTING AND I'LL TALK ABOUT
THIS LATER.
THE IDEA OF BUNDLING.
IF YOU OFFER SELF-COLLECTION HPV
TESTING TO A WOMAN AT HOME WHAT
CAN YOU OFFER TO HER AND HER
FAMILY OR HER HOUSE MATES.
IF THERE IS A MAN THERE THEY
PROBABLY NEED FIT TESTING AND
THESE TEND TO CORRELATE.
THIS IS THE MODEL THAT I WANT TO
PUT FORWARD.
WE DO WANT TO HIT THAT
BULL'S-EYE.
A LOT OF DATA HERE AND I'M GOING
TO TAKE YOU TO THE RED.
SO WHEN WE DO SELF-COLLECTION
AND WE USE A PCR TEST WHAT WE
SEE IS THE SELF-COLLECTED SAMPLE
-- ON HER OWN WITHOUT A PELVIC
EXAMPLE WORKS JUST AS WELL AS
THE PROVIDER COLLECTED SAMPLE
AND I'VE DONE STUDIES ALL OVER
THE WORLD AND I'VE TALKED TO
PEOPLE -- THE ONE THING THAT
WOMEN WORRY ABOUT IS THAT THEY
WILL DO IT AS WELL AS THE
PROVIDER.
OTHERWISE THEY LOVE IT.
I'VE DONE THIS IN LIVE AUDIENCES
BUT I'VE GIVEN TALKS -- HUNDREDS
OF TALKS AND TALKED TO THOUSANDS
OF PEOPLE AND I ASK ALL THE TIME
HOW MANY WOMEN LIKE HAVING A
PELVIC EXTRA AND NOBODY HAS YET
RAISED THEIR HAND.
SURPRISE, SURPRISE.
HOW MANY MEN LIKE A PROSTATE
EXAM.
NO ONE RAISES THEIR HAND FOR
THAT EITHER.
WE LOOKED AT DIFFERENT
STRATEGIES TO REACH UNDERSERVED
WOMEN.
IF WE MAIL KITS TO THEM WE CAN
GET AN INCREASE IN PARTICIPATION
IN SCREENING BY 13%.
BUT IF WE DO MORE ACTIVE
ENGAGEMENT A DOOR-TO-DOOR
STRATEGY WE CAN GET TOWN A 40%
INCREASE IN SCREENING.
I'VE DONE A LOT OF WORK IN
MISSISSIPPI AND OTHER PLACES ON
SELF-COLLECTION.
I'M GOING TO SUMMARIZE.
THE FIRST TIME WE DID THIS STUDY
IN 2009 AND 2010 -- AND THE
BOTTOM LINE WAS WOMEN WERE FOUR
TIMES MORE LIKELY TO CHOOSE AND
COMPLETE SELF-COLLECTION.
WHEN WE DID A SECOND STUDY --
WOMEN WERE FIVE TIMES MORE
LIKELY TO SELECT CHOICE THAN
CLINIC BASED SCREENING AND AMONG
THOSE WOMEN WERE 20 TIMES MORE
LIKELY TO DO AND COMPLETE
SELF-DETECTION.
THIS IS THEIR CHOICE SO IT'S NOT
JUST HYPOTHETICAL.
THEY ARE ACTUALLY VOTING WITH
THEIR FEET IF YOU WILL.
NEXT SLIDE.
SO WE'RE WORKING CLOSELY WITH
THE FDA TO TRY TO GET
SELF-COLLECTION TESTING APPROVED
SO IT CAN BE REIMBURSED AND
PROVIDED TO ALL WOMEN AND
IMPORTANTLY TO THOSE WOMEN WHO
DON'T COME TO CLINIC BECAUSE
THEY DON'T HAVE RESOURCES OR
THERE ARE GEOGRAPHICAL BARRIERS.
AND I LEFT OUT A SLIDE BUT WE
CAN THINK ABOUT THIS FOR OTHER
DISEASES.
AS I SAID FIT COULD BE ADDED TO
SOMETHING LIKE THIS AS PART OF A
COMMUNITY OUTREACH.
AND THE FIT COULD BE FOR THE
WOMEN.
FOR THE HUSBAND.
WE CAN THINK ABOUT SMOKING
PREVENTION AND CESSATION IN THE
SAME VISIT.
AND BY THE WAY THERE IS SOME
EVIDENCE THAT YOU CAN MEASURE
HIGH PIE LORI.
WE CAN THINK ABOUT * NOVEL --
DONE BY PREPARATION FOR PSA FOR
MEN WHO ARE AT HIGH RISK FOR
PROSTATE CANCER.
YOU GET THE IDEA.
ONCE YOU'VE OPENED THE DOOR TO
AN UNDERSERVED PERSON OR FAMILY
THEY HAVE A LOT OF NEEDS AND
THINK OF THIS AS A MODERN
VERSION OF THE HOME VISIT.
YOU'RE PROBABLY TOO YOUNG TO
REMEMBER THIS BUT I REMEMBER
HOME VISITS FROM MY
PEDIATRICIAN.
SO THIS WOULD BE A DIFFERENT
KIND OF DELIVERY BUT THE IDEA
THAT IS WE CAN DECENTRALIZE AND
DEMOCRATIZE INTERVENTIONS
RELATED TO PREVENTION AND GET
MORE PEOPLE TO DO PREVENTIVE
SERVICES AND THIS SHOULD NOT
STOP AT CANCER.
IT SHOULD GO TO CHRONIC DISEASES
LIKE DIABETES AND CARDIOVASCULAR
DISEASE.
AGAIN A BUSY SLIDE.
BUT I WANT TO COME BACK TO A
POINT.
WE RECOMMEND OUR PEOPLE US USE O
MAX FINISH.
-- TAMOXIFEN.
WE * WOULD REDUCE THOSE
TOXICITIES AND ACHIEVE THE SAME
RESULTS.
SO WE HAVE FOUR STUDIES LOOKING
AT BIOMARKERS RELATED TO WHETHER
THIS IS GOING TO WORK.
SO I WANT TO TALK ABOUT
MULTI-CANCER EARLY DETECTION AND
ONLY TO SAY THAT THERE IS A LOT
OF CHATTER AND THERE IS A LOT OF
UNKNOWN.
AND I'M SURE YOU HAVE HEARD
ABOUT THIS AND ARE EXCITED ABOUT
IT AND AS A PUBLIC HEALTH
NONPHYSICIAN PhD I NEED TO
SPEAK UP ABOUT THIS AND RIGHT
SIZE IT.
SO THIS IS WHAT IT FEELS LIKE
AND WE CALL THIS THE TSUNAMI.
AND THERE ARE LOTS OF COMPANIES
ENTERING THE SPACE.
AND THE CARTOON -- IT SAYS I
THINK I WOULD LIKE TO HAVE AN
MCED TEST DOC BUT WHICH ONE?
EACH TARGET DIFFERENT CANCERS
AND THERE IS A LOT OF DIRECT TO
CONSUMER -- AND HOW DO THEY SORT
THROUGH ALL OF THE NOISE?
IF YOU DON'T KNOW WHAT THIS IS
IS MULTI-CANCER EARLY DETECTION
-- LOOKING FOR SIGNALS FOR ONE
OR MORE CANCERS IN THE EARLY
CANCER IN THE BLOODED WITH IDEA
THAT IF WE CAN INTERVENE SOON
ENOUGH WE CAN PREVENT MORTALITY.
THE MULTI-CANCER EARLY DESECTION
ASSAYS MEASURE DIFFERENT THINGS
IN THE BLOOD FOR DIFFERENT
CANCER.
A POSITIVE IS A SIGNAL FOR
CANCER BUT DOES NOT DIAGNOSE
CANCER.
SOME POINT TO A TISSUE OF ORIGIN
BUT NOT PERFECTLY SO.
WE DON'T KNOW WHETHER PEOPLE
WILL ACCEPT IT OR WHAT THE
CONSEQUENCES ARE OF THAT.
IT'S ALSO A MOVING TARGET AS THE
COMPANIES CONTINUE TO REFINE THE
TESTS AND ALGORITHMS TO FIND A
POSITIVE OR NEGATIVE RESULT.
I JUST WANT YOU TO APPRECIATE
THAT AND THIS IS JUST A SUBSET.
-- THIS IS WHAT I COULD FIT ON
ONE SLIDE.
THEY TARGET VERY DIFFERENT
CANCERS WITH VERY DIFFERENT
TECHNOLOGIES.
AND I WILL TELL YOU RIGHT NOW
NOT A SINGLE ONE OF THESE
TECHNOLOGIES HAS BEEN VALIDATED.
SHOWN TO SAVE A SINGLE LIFE.
NOT A SINGLE ONE.
AND I'M GOING TO PAUSE THERE FOR
A MOMENT TO LET THAT SETTLE IN.
VERY EXCITING BUT UNPROVEN
TECHNOLOGY.
THERE ARE MANY UNKNOWNS ABOUT
SCREENING WITH THESE
TECHNOLOGIES INCLUDING
POPULATION BENEFITS AND HARMS.
IT'S UNKNOWN IF SCREENING A
POPULATION OF HEALTHY PEOPLE FOR
CANCER WITH MCED ASSAYS WILL
RESULT IN REDUCTION OF
MORTALITIES.
DOES THIS SAVE LIVES AND THERE
IS NO ANSWER FOR THAT.
HERE ARE SOME POTENTIAL HARMS.
OR UNKNOWNS.
WHAT KIND AND HOW MANY
DIAGNOSTIC TESTS ARE NEEDED.
WHAT HAPPENS IF THE TO POSITIVE
TEST DOESN'T FIND CANCER?
HOW MANY PEOPLE WILL BE
SUBJECTED TO UNNECESSARY
INVASIVE PROCEDURES AND SUFFER
FROM VARIOUS COME REPLICATIONS
FROM THOSE PROCEDURES.
WILL PEOPLE STOP TAKING STANDARD
OF CARE SCREENING WHICH WE KNOW
REDUCES MORTALITY IF THEY GET A
NEGATIVE MCED TEST.
WILL THE BLOOD TEST MAKE
SCREENING MORE ACCESSIBLE OR
EXACERBATES -- DISPARITIES.
THESE ARE CANCERS THAT IN A
PERSON'S LIFETIME WOULD NEVER
KILL THEM AND IF WE DIDN'T
DETECT THEM THE PERSON WOULD BE
BETTER OFF ALL AROUND BECAUSE
IT'S NOT GOING TO KILL THEM.
SO WE'RE CONSIDERING A LARGE
RANDOMIZED CLINICAL TRIAL.
THIS WOULD AT LEAST START OFF WE
THINK WITH TWO ASSAYS THAT ARE
THE FURTHEST ALONG AND EACH
WOULD BE ITS OWN STUDY AND
COMPARED TO THE STANDARD OF CARE
SCREENING ARM.
SO EVERYBODY GETS STANDARD OF
CARE.
AND THEN THEY GET TWO DIFFERENT
MULTI-CANCER EARLY DETECTION AND
BECAUSE THIS IS A PLATFORM --
RANDOMIZED CONTROLLED TRIAL
YOU'LL SEE WE CAN ADD ANOTHER
ARM TO THE TRIAL.
IF ANOTHER ONE EMERGES.
BUT IF WE HAVE GOT TWO OR THREE
OF THESE IN THE MARKET WE WOULD
KNOW THEN WHAT SURROGATES ARE
AND WE CAN MAKE SIMPLER TRIALS
TO EVALUATE THESE TECHNOLOGIES.
THIS IS JUST TO ILLUSTRATE THAT
THEY TARGET DIFFERENT CANCERS SO
THEY ARE NOT -- DIRECTLY
APPLICABLE.
IT'S THE OVER-ALL CANCER
MORTALITY REDUCTION THAT WE'RE
MEASURING.
SO THIS IS PART OF A BIGGER
PROGRAM.
AND WE'RE GOING TO MAKE
INVESTMENTS INTO UNDERSTANDING 9
BIOLOGY OF THESE MARKERS.
DO THEY DO IT FOR EVERYBODY?
AND ALSO TO UNDERSTAND THE
NATURAL HISTORY.
THESE BIG COHORT STUDIES.
WE CAN UNDERSTAND WHEN THESE
MARKERS TURN ON PRIOR TO A
CANCER DIAGNOSIS WITHOUT DOING A
CLINICAL TRIAL.
AND THEN THESE SAME COHORTS
COULD BE USED FOR VALIDATION OF
SOME OF THE TECHNOLOGIES.
WE'RE DEVELOPING A REFERENCE SET
TO CONFIRM PERFORMANCE BEFORE
THEY GO INTO HUMANS AND THEN I
WANT TO CALL OUT OUR BIOMARKERS
GROUP BECAUSE THEY'VE BEEN
INVOLVED IN THIS AREA FOR FIVE
YEARS THROUGH A LIQUID BIOPSY
CONSORTIUM.
THE DIVISION OF CANCER
PREVENTION HAS BEEN SUPPORTING
THE TECHNOLOGY DEVELOPMENT FOR A
FEW YEARS.
AND THEN THE RANDOMIZED CONTROL
TRIAL THAT I DISCUSSED -- NOW IF
ANY OF THEM WORK -- IT'S REALLY
A LUNAR LANDING FOR US BECAUSE
WE'RE GOING TO SEE CANCERS AT
STAGES WE'VE NEVER SEEN THEM
BEFORE BECAUSE WE DON'T HAVE
SCREENING TESTS FOR MANY OF
THESE CANCERS SO THAT WILL FUEL
PRECLINICAL DEVELOPMENT OF BASIC
AND PRECLINICAL DEVELOPMENT THAT
MAY LEAD TO NEW THERAPIES.
WE MIGHT DEVELOP THERAPIES THAT
WOULD PREVENT PROGRESSION TO
LATE STAGE CANCER THAT WOULD BE
MUCH MORE TARGETED.
SO IT WILL DRIVE A TREMENDOUS
AMOUNT OF INNOVATION IF THEY
WORK.
BIG CAVEATS.
WE DON'T KNOW IF THEY WILL WORK
BUT IF THEY DO THE BIG IMPACT
WILL BE DOWNSTREAM.
THE LUNAR LANDING -- IF I THINK
ABOUT GOING TO THE MOON THAT IS
INCREDIBLE.
THINK ABOUT IT 50 YEARS AGO --
SO I THINK IT COULD BE QUITE
LIKE THAT.
SO I WANT TO HIGHLIGHT SOME
ADDITIONAL PRIORITIES.
AS I SAID WE SPEND A LOT OF TIME
THINKING ABOUT BIOLOGICAL AND
POPULATION RISKS AND HOW THAT
INFORMS INTERVENTIONS SO WE
COULD BE MUCH MORE TARGETED AND
THEREFORE HAVE BETTER BENEFITS
TO HARMS TO THOSE THAT WE DO
INTERVENE ON.
OBESITY REMAINS A PLAGUE IN
WESTERN COUNTRIES PARTICULARLY
THE UNITED STATES AND CERTAINLY
CONTRIBUTES TO THE BURDEN OF
CANCER BUT WE DON'T KNOW HOW AND
WHY.
IF WE COULD WE COULD MITIGATE
THE EFFECTS.
WE SHOULD NOT RELY TOTALLY ON
BEHAVIORAL INTERVENTIONS TO
ACHIEVE THIS GOAL AND EVEN IF WE
COULD THERE ARE COHORTS THAT --
GENERATIONS OF PEOPLE THAT HAVE
BEEN EXPOSED TO OBESITY FOR
DECADES AND THE EFFECT THAT'S
ARE ALREADY IN PLACE SO WE HAVE
TO COME UP WITH STRATEGIES THAT
ADDRESS THE DOWNSTREAM EFFECTS
OF OBESITY.
HEALTH DISPARITIES ARE NEAR AND
DEAR TO ME.
I'VE BEEN WORKING IN MISSISSIPPI
FOR YEARS AND THE IDEA OF
BUNDLING INTERVENTIONS TO REACH
THE UNDERSERVED POPULATIONS IS
NEAR AND DEAR TO MY HEART.
I THINK I'VE MADE THIS POINT --
THE IMPORTANCE OF SYMPTOM
SCIENCE AND PRECISION SYMPTOM
MANAGEMENT.
TO UNDERSTAND WHAT CAUSES
SYMPTOMS DUE TOO CANCER AND
TREATMENT.
BASED ON THAT BIOLOGY CAN WE
IDENTIFY AND REDUCE THE
SYMPTOMS.
WE ARE INUNDATED WITH NEW
TECHNOLOGIES MULTI-CANCER EARLY
DETECTION IS JUST ONE OF THOSE.
ARTIFICIAL INTELLIGENCE IS ONE
OF THOSE.
SYNTHETIC BIOMARKERS.
AND THEN I THINK IMMUNOLOGY IS
REALLY IMPORTANT AS ONE OF THE
BIG IMPACTS OF THE DISCOVERY IS
THAT IT TELLS US THAT THERE IS
SOMETHING THAT GOES WRONG WITH
THE IMMUNE RESPONSE TO
PRESHOWERSERS AND EARLY
MUTATIONS.
AND SO IF WE CAN UNDERSTAND THAT
WE CAN DEVELOP A WHOLE NEW ARRAY
OF PREVENTIVE STRATEGIES THAT
OVERCOME THAT IMMUNE SUPPRESSION
THAT PROBABLY OCCURS FAIRLY
EARLY.
THE CANCER PREVENTION
FELLOWSHIP.
I WANT TO HIGHLIGHT THAT WE HAVE
A 35-YEAR-OLD PROGRAM -- THAT
HAS TRAINED HUNDREDS OF FELLOWS
THAT ARE IN INFLUENTIAL
POSITIONS ALL OVER THE UNITED
STATES.
WE'RE VERY PROUD OF OUR FAMILY
AND I'M ONE OF THE GRADUATES.
NOW LEADING THIS DIVISION.
AND WE'RE GROWING IT.
WE'RE THINKING ABOUT
INTERNATIONAL PROGRAMS AND A
POLICY BASED FELLOWSHIP.
THIS IS NEAR AND DEAR TO MY
HEART AND I WILL BE ACTING
DIRECTOR FOR A SHORT PERIOD OF
TIME.
WE ARE PROUD OF THE PROGRAM AND
WHAT THIS COHORT OR MULTIPLE
COHORTS HAVE ACCOMPLISHED.
WITH THAT A THANK YOU SLIDE.
THE CARTOON SAYS I'LL HAVE AN
OUNCE OF PREVENTION.
GIVE ME A POUND PLEASE.
WITH THAT I'LL TAKE QUESTIONS.
>> BEFORE WE OPEN UP TO
QUESTIONS.
I WANT TO START OFF BY SAYING
THAT WAS AN EXCELLENT
PRESENTATION.
YOU PACKED THAT.
YOU'RE ON THE LIST OF PEOPLE
THAT I WOULD LIKE TO TAKE OUT TO
LUNCH.
>> YOU CANNOT TAKE ME OUT TO
LUNCH BUT I WILL TAKE YOU OUT TO
LUNCH.
I'M HAPPY TO GO TO LUNCH ANY
TIME.
YOU COME BY AND I'LL TAKE YOU TO
LUNCH.
>> NICOLE, YOU GO FIRST.
>> THANK YOU, ANJEE AND THANK
YOU, PHIL.
THIS WAS AN AMAZING TALK.
A LOT OF QUESTIONS.
>> I WORK FOR THE AMERICAN BRAIN
TUMOR ASSOCIATION.
AND JUST SOME OF THE THINGS THAT
YOU WERE TALKING ABOUT
ESPECIALLY WITH THE EARLY
DETECTION MCED TEST.
IT'S BEEN SOMETHING THAT OUR
ORGANIZATION HAS BEEN TALKING
ABOUT BECAUSE BRAIN TUMORS DON'T
HAVE SCREENING.
WE DON'T HAVE PREVENTION.
THE ONLY RISK FACTOR IS IONIZING
RADIATION.
SO IT'S CHALLENGING WHEN WE HAVE
PATIENTS THAT COME TO US WITH
HOW DID THIS HAPPEN?
WHAT CAUSED THIS?
NO WARNING UNTIL THEY HAVE
SYMPTOMS OF A CESAR.
SO SOMETHING LIKE THIS * WOULD
BE A HUGE GAME CHANGER IN THE
BRAIN TUMOR SPACE AND WE SAW A
POSTER FROM A COMPANY THAT WAS
PRESENTING THIS AND THEY HAD A
COHORT OF 2094 PATIENTS AND 247
OF THOSE WERE BRAIN CANCER
PATIENTS.
JUST SEEING THAT GOT US EXCITED
BUT APPRECIATE YOUR LEVERAGING
EXPECTATIONS OF JUST TRYING TO
SET THOSE -- NOT RED FLAGS BUT
BEING CURBS THAT THIS HAS NOT
BEEN PROVEN TO EXTEND LIVES IN
ANY WAY YET.
AND WE'RE CAUTIOUSLY HOPING THAT
THERE IS GOING TO BE SOMETHING
POSITIVE COMING FROM THIS
BECAUSE IT COULD BE A BRAIN
CHANGER.
-- GAME CHANGER FOR BRAIN
PATIENTS.
>> THIS IS A GOOD ILLUSTRATION
THAT DETECTION OF BRAIN CANCER
IS NOT THE SAME AS BENEFITING
BRAIN CANCER PATIENTS AND THIS
IS ALSO NEAR AND DEAR TO MY
HEART -- MY MOTHER DIED OF BRAIN
CANCER AT AGE 35 SO I GET IT.
I REALLY DO.
>> I'M SORRY TO HEAR THAT.
>> AND A LONG THE LINES OF BRAIN
TUMORS WE ALSO HAVE A LOT OF
PATIENTS AND THIS IS DIFFERENT
FROM OTHER CANCERS THAT HAVE
NONMALIGNANT BRAIN TUMORS.
AND WE DON'T CALL THEM MALIGN
FOR A REASON -- BENIGN FOR A
REASON.
* I'M WONDERING IF THESE KIND OF
TESTS WOULD BE ABLE TO DETECT
NONMALIGNANT AS WELL ASTHMA
LIGAMENT TUMORS *.
I'M CURIOUS.
AS I DON'T KNOW HOW THEY ARE
DETECTING.
BUZZ ANY INDICATION?
>> IT'S A GOOD RESEARCH QUESTION
BECAUSE I COULD GET -- WE WOULD
NOT BE ABLE TO PROVE IN EITHER
CASES WE BENEFITED THE
POPULATION BUT THE FIRST THING
IS CAN YOU IDENTIFY BLOOD
SIGNATURES THAT ARE DIFFERENT
BETWEEN THE TWO.
THAT IS A GREAT STARTING POINT.
I'M GOING TO MAKE A NOTE OF THAT
BECAUSE IT'S A GOOD QUESTION.
CANCERRERS OF THE BRAIN.
TUMOR -- MALIGNANT VERSUS
BENIGN.
AND I DON'T KNOW.
ONE OF THE KEY THINGS THAT
PROBABLY WOULD FUEL THIS IS
CREATE AN A APPROPRIATE BIOBANK
THAT RESEARCHERS COULD COME IN
AND COMPANY THAT.
BECAUSE YOU'RE PROBABLY
CONNECTED TO COHORTS THAT THE
AVERAGE RESEARCHER WOULD NOT
EVEN KNOW WHAT DOOR TO KNOCK ON.
>> GREAT.
I WOULD LOVE TO JOIN YOU AND
ANJEE AT LUNCH.
>> AND MY HAND WAS UP NOT TO
JUST GET IN ON THE FREE LUNCH --
THANK YOU AGAIN DR. CASTLE --
>> JUST PHIL PLEASE.
>> THANK YOU SO MUCH.
I SPOKE RECENTLY AND A COMMENT
AND THEN A QUESTION.
I SPOKE RECENTLY -- AND FROM MY
PERSPECTIVE -- I WOULD RATHER
NOT HAVE THE CANCER SO
PREVENTION IS IDEAL AND THEN THE
NEXT WOULD BE I WOULD WANTED
EARLY DETECTION.
AND THEN BARRING THAT I WANT
DETECTION SO HOPEFULLY THERE ARE
INTERVENTIONS THAT CONTROL.
PREVENTION IS REALLY THE HOLY
GRAIL.
FROM THE OVARIAN CANCER
COMMUNITY AND WE'VE HAD A LOT OF
DIRECT TO CONSUMER MARKETING
THINGS THAT WERE NOT READY FOR
PRIME TIME AND ONE OF THE THINGS
THAT COMES TO MIND -- WE'RE ALL
EXCITED ABOUT THESE MULTI-CANCER
PANELS AND ASSAYS BUT WE'RE
DISCOVERING THAT THERE WAS A
HUGE -- EARLY DETECTION TYPE OF
SCREENING -- APPROACH WHERE
THERE WAS A STAGE SHIFT --
>> THAT IS A GREAT EXAMPLE OF --
A LOT OF PEOPLE ARE SAYING THEY
WANT THE REDUCTION OF THE
ADVANCED CANCER AS THE EARLY END
POINT AND WE'RE SAYING NO.
YOU HAVE TO SHOW MORTALITY
BENEFIT.
IF YOU'VE HOPE MORTALITY BENEFIT
THEN YOU CAN DO SURROGATES.
BUT UNTIL YOU VALIDATE THE
SURROGATES WE DON'T THINK SO.
>> AND THE AUTHORS CAME AND
SPOKE TO THE COMMUNITY ABOUT THE
LEAD TIME THAT YOU WOULD PLEAD
TO HAVE AND I THINK IT WAS LIKE
SEVEN YEARS.
AND WE DON'T EVEN KNOW WHERE
THAT IS GOING TO BE AND HOW TO
FIND IT AND HOW TO INTERVENE.
SO MY QUESTION TO YOU -- IS ALSO
ARE THE MULTI-PANEL -- TESTS DO
THEY HAVE THE SAME SENSITIVITY
AND SPECIFICITY THRESHOLDS THAT
WE HEAR FOR SPECIFIC CANCER
TESTS?
HOW DOES THAT WORK?
>> FIRST OF ALL WE KNOW VERY A
LITTLE.
THERE IT IS INTELLECTUAL
PROPERTY THAT THEY PROTECT.
SO WE DON'T KNOW WHAT THEY ARE
DETECTING AND THERE IS SO LITTLE
DATA -- AND IN CASE OF OVARIAN
WHAT WOULD YOU COMPARE IT TO?
AND COMPARING IT TO PEOPLE WHO
ALREADY HAVE CANCER WHICH WE
KNOW IS NOT THE GOAL HERE.
AND EVEN THE CHALLENGE OF A A
CROSS-SECTIONAL STUDY -- THE
EARLY CANCERS THAT YOU WOULD --
EARLY OVARIAN CANCERS -- ARE
THOSE THE ONE THAT'S KILL
PEOPLE?
PROBABLY NOT AND WHY WERE THEY
FOUND IN THE FIRST PLACE.
USUALLY YOU FIND 3/4.
SO YOU HAVE TO BE VERY CAREFUL
AND YOU HAVE TO BE KNOWLEDGEABLE
-- CONSUMERS ABOUT THIS
TECHNOLOGY BECAUSE THE MARKETING
CAMPAIGN IS EXTREME.
I KNOW I'VE TALKED TO
RESEARCHERS WHO SAY THAT THESE
COMPANIES ARE GOING TO STATE
LEGISLATORS TRYING TO GET THIS
STUFF AND GOING TO CMS AND
TRYING TO PUSH THIS.
BUT HERE IS THE THING.
IT'S NOT A PERFECT ANALOGY BUT A
USEFUL ONE.
IF THIS WAS A DRUG THERE IS NO
WAY YOU WOULD BE GIVING THIS TO
ANYBODY BEFORE YOU DID THE
RANDOMIZED CONTROL TRIAL.
NOW I REALIZE THAT THE TEST IS
NOT -- YOU'RE NOT CONSUMING
SOMETHING BUT THE DOWNSTREAM
EFFECTS ARE INTERNAL.
YOU'RE EITHER IMAGING AND
RADIATION OR BIOPSIES AND
FINANCIAL TOXICITIES FOR LOW
RESOURCED PEOPLE.
ALL OF THESE THINGS.
AND SO IF WE WOULD NOT ACCEPT
THIS FOR A DRUG WHY WOULD WE
ACCEPT IT FOR ANOTHER
INTERVENTION?
DOESN'T MAKE SENSE TO ME.
AND LET ME BE CLEAR.
I'M VERY EXCITED ABOUT THEM THE
TOO BUT AS A PUBLIC HEALTH
OFFICIAL I HAVE TO PUT MY
EXCITEMENT ASIDE AND SAY SHOW ME
THE EVIDENCE.
SHOW ME THE DATA.
BECAUSE IT ISN'T ME GETTING THIS
INTERVENTION.
EVERY ONE OF THOSE PEOPLE MAY
WANT THAT AND IS IT GOOD FOR
THEM AND IS IT -- WHICH TEST
SHOULD IT BE.
SO, ITS VERY COMPLICATED
>> BUT THIS IS ASYMPTOMATIC
GENERAL POPULATION.
>> EXACTLY.
IT COULD BE ASYMPTOMATIC BUT
THEY COULD BE SMOKERS.
SO THEY DON'T HAVE SYMPTOMS
RIGHT NOW BUT IS THERE A TEST
BETTER FOR BRCA RELATED CANCERS.
OVARIAN, BREAST, PANCREATIC.
MAYBE COLON.
BUT YOU GET MY IDEA.
THAT YOU WANT TO TAILOR THEM.
THE OTHER THING -- ANOTHER ARM
IN THE TRIAL.
SEVERAL GROUPS DEVELOPING A
SINGLE CANCER BLOOD TEST AND
THOSE MAY PERFORM BETTER.
SO WHAT IF YOU COMBINE A BUNCH
OF THOSE BECAUSE THEY ARE
FOCUSED ON A PARTICULAR TARGET.
WOULD THAT OUTDO THE
MULTI-CANCER EARLY DETECTION.
IT'S THE SAME SAMPLE.
THE SAME AMOUNT OF BLOOD BUT
TARGETING A SINGLE CANCER MIGHT
BE MORE SENSITIVE PARTICULARLY
FOR EARLY STAGE.
>> THANK YOU SO MUCH.
>> MY PLEASURE.
>> WE'RE UP TO THREE PEOPLE FOR
LUNCH HERE.
FOUR INCLUDING ME.
>> I WOULD LOVE TO JOIN
DR. CASTLE AND WE COULD TALK TO
YOU FOR HOURS.
YOUR PRESENTATION WAS AWESOME.
IT WAS VERY REFRESHING AND
REINFORCING BECAUSE WE'RE
TALKING ABOUT THIS -- THE MCED
TOPIC A LOT.
THE SCIENCE IS NOT THERE YET.
HOW DO WE SUPPORT IT MOVING
FORWARD IS WHERE WE ARE.
TAKE MY BLOOD.
SIGN ME UP NOW.
I WOULD DO IT BUT THAT IS NOT
RIGHT FOR OUR SOCIETY.
BUT MY QUESTION IS A LITTLE
RANDOM.
AND I GUESS SHAME ON ME AGAIN.
I HAD NO IDEA THERE WAS
SELF-COLLECTED HPV TESTS
AVAILABLE.
>> WE'RE TRYING TO GET THEM
AVAILABLE.
>> MY QUESTION TIES INTO THE
REIMBURSE MEANT PIECE.
49 OUT OF 50 WOMEN WOULD NOT GET
CERVICAL CANCER IF WE DID
NOTHING.
WOULD THAT MAKE IT HARD TO GET
OTHER TEASERS APPROVED?
--
>> HE FIRST SAMPLED HIS WIFE
WHICH NEVER WOULD HAPPEN IN
TODAY'S WORLD.
AND THEN THE AMERICAN CANCER
SOCIETY FIRST RECOMMENDED ANNUAL
PAP SMEARS IN 1951.
AND THAT OF COURSE
REVOLUTIONIZED.
WE WOULD NOT BE HERE WITH HPV
RELATED TOOLS HAD THAT NOT
HAPPENED.
SO WE WENT FROM A NOT GREAT TEST
TO A BETTER TEST.
BUT REIMBURSEMENT IS AN
IMPORTANT PART OF THIS.
NOW COMING BACK TO THE 49 AND 50
I ILLUSTRATE THAT.
WE DON'T DO CERVICAL CANCER WORK
TO THE END POINT OF CANCER
BECAUSE WE KNOW WHAT THE
SURROGATES ARE.
SO WE SHOW THAT WE CAN DETECT --
CN2 AND CN3.
SO THE TRIALS GO MUCH QUICKER
AND WE DON'T HAVE TO SHOW AND
THE TREATMENTS ARE FAIRLY BENIGN
AND WE'RE WORKING ON DEVELOPING
BETTER TREATMENTS.
WE CUT THE TISSUE OUT WHICH IS
NOT SO BAD BUT IF WE COULD DO IT
WITHOUT CUTTING EVEN BETTER.
PARTICULARLY IN THE THIRD WORLD
IN THE LOW AND MIDDLE INCOME
COUNTRIES WHICH IS WHERE I WORK.
SO WE DON'T HAVE TO SHOW THAT IT
PREVENT THAT ONE OUT OF 50
CANCERS.
PLUS WE HAVE COMPARISONS.
WE HAVE ALREADY KNOW WHAT TESTS
WORK.
UNLIKE IN THE MCED WHERE WE
DON'T HAVE A TEST THAT WE KNOW
WORKS.
ONCE WE HAVE A TEST THAT WE KNOW
WORKS WE CAN DO THE COMPARISONS
AND IT WILL SPEED IT UP.
HAVING A COME PETTIVE MARKET
BLESS IS GOOD.
IT KEEPS THE PRICE DOWN AND
EVERYONE HONEST.
--
>> AND TO YOUR POINT ABOUT THE
SINGLE ORGAN OR WHATEVER TESTING
-- THERE ARE SOME OTHER --
>> LIKE DEL FINE.
>> I KNOW THAT WE NEED TO CUT
OUR QUESTIONS IN FIVE MINUTES.
SO I KNOW KEVIN YOU HAVE A
QUESTION AND IF YOU HAVE -- IF
YOU CAN TYPE YOUR QUESTIONS IN
THE CHAT AS WELL SO IF WE DON'T
GET TO IT WE CAN AT LEAST TRY TO
GET THOSE ANSWERS FOR YOU AND I
HAVE A QUESTION.
>> ARE YOU GOING TO COLLECT THE
QUESTIONS AND SEND THEM TO ME.
BECAUSE I'M BUSY GETTING LUNCH
DATES AND HAVE NOT BEEN PAYING
ATTENTION.
>> MAYBE WE CAN COLLECT THOSE
FOR YOU.
>> I'LL CLOSE-UP THIS PART OF
OUR AGENDA.
>> THANK YOU PHIL VERY MUCH FOR
WHAT YOU HAVE TO OFFER.
THIS IS A TREMENDOUS VISION THAT
YOU OVERSEE.
AND A TREMENDOUS AMOUNT OF
PROSPECT AND HOPE MOVING
FORWARD.
SO I RELATION THE RESOURCES OF
WHICH YOU'RE ADVOCATING FOR BUT
I'M FASCINATED ALSO BY THE
CANCER PREVENTION FELLOWSHIP
PROGRAM WHICH BRINGS MORE
RESOURCES AND EMPLOYEES AND
DRIVER INTO THIS WHICH IS MORE
THAN JUST A DOLLAR INVESTMENT.
ONE QUICK QUESTION THAT I HAVE.
AND A LITTLE BIT AN OVERVIEW
SITUATION.
YOU TALK ABOUT IDEALLY TO HAVE
NO EVENT AND THAT IS IF CANCER
NEVER OCCURS.
THAT WE'RE ABLE TO BE SO
SUCCESSFUL IN PREVENTING THAT
WHICH IS A GREAT GOAL.
SCIENTIFICALLY WE HAVE TO PROVE
THE THAT AND MY QUESTION IS
UNDER WHAT CONDITIONS OR UNITS
OF MEASURE CAN YOU FIND HOW
SUCCESSFUL YOU ARE IN PREVENTION
UNDER THAT SCENARIO THAT IT DOES
NOT OCCUR?
>> THAT IS A GREAT QUESTION,
CO--KEVIN.
THANK YOU FOR BRINGING THAT.
BECAUSE IT IS SUPER CHALLENGING.
WE DO IT THROUGH CANCER
REGISTRIES.
IF YOU LOOK AT THE -- FOR
CERVICAL CANCER THEY START OFF
HIGH AND THEY COME DOWN AND DOWN
AND THEY'VE LEVELED OFF AND PART
OF THE REASON IS THAT IT'S --
ALL OF THESE THINGS ARE
IMPERFECT AND ALSO BECAUSE WE'RE
NOT REACHING A SEGMENT OF THE
POPULATION THAT -- A SMALL
SEGMENT OF THE POPULATION THE
UNDERSERVED POPULATION THAT 50%
OF THOSE CANCERS OCCUR IN.
SO YOU USE SURVEILLANCE ON A
NATIONAL LEVEL TO LOOK AT
CHANGES.
OR WITHIN A PARTICULAR REGISTRY.
LET'S SAY SOMEBODY INTRODUCED A
MULTI-CANCER EARLY -- DETECTION
YOU COULD SEE DIFFERENCES OVER
TIME OR MAYBE NOT.
AND THAT DOES MAKE IT
CHALLENGING WHICH IS WHY WE'RE
MORE -- WE HAVE TO DO MORE
RANDOMIZED CONTROLLED TRIALS
THAN IN THE TREATMENT SPACE.
IN THE TREATMENT SPACE THEY DO
ONE ARMED TRIALS AND DOES THE
PATIENT SURVIVOR NOT SURVIVE AND
DO THEY KNOW ENOUGH ABOUT THE
HISTORY ABOUT THE HISTORY.
BUT FOR US WE HAVE TO DO
RANDOMIZED CONTROL TRIALS AND IN
THE CASE OF SCREENING TO THE
POINT OF CANCER MORTALITY WITHIN
THE TRIAL TO SHOW THAT IT WORKS.
THAT IS WHY IT'S SO HARD AND
EXPENSIVE.
BUT THE UPSIDE I THINK YOU CAN
APPRECIATE AND YOU SAID IT WELL
-- IS PEOPLE NEVER GET CANCER.
RIGHT AND THAT IS A WIN.
SO IT IS CHALLENGING.
HIGH RISK, HIGH REWARD IN
PREVENTION.
>> THANK YOU SO MUCH, PHIL.
I THINK WE'RE GOING TO NEED A
BIGGER LUNCH TABLE
>> AND MORE TIME.
HOLLY I WANT TO THANK YOU FOR
BEING PATIENT WITH US.
I DO HOPE THAT BASED ON YOUR
PRESENTATION THAT WE CAN
SOCIALIZE SOME OF THE SYMPTOMS
SCIENCE THAT YOU WERE SPEAKING
OF AS IT RELATES TO CLINICAL
TRIAL DESIGN.
I HEAR VERY LITTLE ABOUT SYMPTOM
SCIENCE IN OUR CLING DA -- CLINL
TRIAL DISCUSSIONS.
I WAS THINKING -- I HOPE AS PART
OF YOUR LARGER TRIAL THAT AN
ECONOMIC STUDY IS BEING DONE.
AND THREE, I WAS WONDERING IF
FDA CMS AND OTHERS ARE
COORDINATING TO THINK THROUGH
AND THIS IS A PHIL AND HOLLY
QUESTION BECAUSE I'M IN
COLORECTAL CANCER.
AND I'VE NEVER SEEN A BIGGER
LOBBY BEHIND IT.
BECAUSE WHERE A POLICY AND
RESEARCH GROUP AND I'VE NEVER
SEEN SO MUCH MONEY GO BEHIND
LOBBYING FOR THIS AND OUR
BIGGEST CONCERN IS THAT IT GETS
A HEAD OF THE SCIENCE AND I
SHARE THAT CONCERN WITH YOU BUT
ALSO THAT THE SCIENCE IS NOT
GETTING OUT -- DISSEMINATING
FAST ENOUGH FOR ADVOCACY GROUPS
TO STAND STRONG ROUND THE
SCIENCE BECAUSE I THINK THE
EARLIER QUESTION ABOUT
SENSITIVITY -- SPEAKS SERVE IT
OF DATA * NEEDS TO BE AVAILABLE
ACROSS ALL OF THE DIFFERENT
OPTIONS SO THAT WE'RE NOT
SWAYED.
THOSE ARE THOUGHTS NOT
QUESTIONS.
I HOPE THAT WE CAN HAVE LUNCH
BECAUSE THIS IS ONE OF THE TOPIC
THAT'S ADVOCACY IS SO IMPORTANT
>> I NEED YOU MORE THAN YOU NEED
ME.
SO I REALLY NEED YOU TO GET THE
WORD OUT AND ON ALL THREE OF
THOSE AREAS I WILL ALSO SAY THAT
WE'RE GOING TO HAVE -- I DON'T
WANT TO CALL IT PATIENTS BUT
PEOPLE ADVOCACY GROUPS FOR BOTH
THE DIVISION AND THE
MULTI-CANCER EARLY DETECTION
TRIAL AND I WOULD NEED HELP
POPULATING THOSE.
WE NEED YOUR HELP TO GET THE
WORD OUT AND IT'S UP TO YOU TO
MAKE THE DEMAND TO SAY WE NEED
BETTER PREVENTION.
THAT IS THE WAY OF WE CHANGE IT.
OF COURSE I'M BIASED.
SAYING I WANT MORE RESOURCES BUT
IF YOU SAY I WANT BETTER
PREVENTION THAT IS A STRONGER
MESSAGE.
THANK YOU VERY MUCH AND HOLLY
I'M SORRY I PROBABLY STOLE SOME
OF YOUR TIME.
I'L
>> NO PROBLEM AT ALL.
>> HOLLY.
THANK YOU FOR JOINING US.
YOU'RE A GOOD FRIEND OF THIS
COMMITTEE SO I'M GOING TO TURN
IT OVER TO YOU.
>> I WANTED TO START BY
RECOGNIZING A CHAMPION -- FOR
BIOMEDICAL RESEARCH.
LAWMAKERS PAY TRIBUTE --
CONGRESSMAN PORTER HAD SERVED AS
A CHAIR OF THE HOUSE COMMITTEE
AND LED THE --
[ INDISCERNIBLE ]
AFTER HE RETURNED HE ALSO SERVED
AS CHAIR FOR MANY YEARS
INCLUDING UP TO HIS DEATH.
[ INDISCERNIBLE ]
YOU'LL SEE HERE AT THE FIRST
STEP IS THE RELEASE OF THE
PRESIDENT'S BUDGET PROPOSAL
FOLLOWED BY THE APPROPRIATION.
THAT PROCESS IS STILL UNDERWAY.
THE HOUSE ALSO SLIGHTLY AHEAD OF
THE SENATE.
I ALSO WANT TO MENTION THAT WE
APPRECIATE SEEING CONGRESS'S
INTEREST IN CANCER RESEARCH
ILLUSTRATED HERE WITH IMAGES OF
OUR COLLEAGUES TESTIFYING OVER
THE PAST YEAR OR SO.
>> AND IT'S ENCOURAGING TO SEE
THE CONGRESSIONAL INTEREST.
SO THE TIMING FOR THE FY23
BUDGET PROCESS IS IN A UNIQUE
YEAR.
WE SAW OUR BUDGET ENACTED FAIRLY
LATE WITH THE PRESIDENT'S BUDGET
RELEASED ON MARCH 28.
AND YOU LIKELY HEARD OR READ --
-- REFERENCE THE
ADMINISTRATION'S CONTINUED
COMMITMENT TO BIOMEDICAL
RESEARCH.
WE'RE ENCOURAGED TO SEE
CONGRESS'S COMMITMENT -.
THE ISSUE AROUND THE BALANCE OF
FUNDING ACROSS NIH AND ARPA-H --
IS A TOPIC FOR DISCUSSION.
SO THE SUBCOMMITTEE PROPOSED AN
OVER-ALL -- OF $2.5 BILLION.
AND THE SUBCOMMITTEE PROPOSED AN
INCREASE --
[ INDISCERNIBLE ]
[ OVERLAPPING SPARE SO, THAT ISE
APPROACH RANGE'S PROCESS STAND.
* THERE ARE MANY PROPOSALS
ENDING AND NOT A LOT OF TIME
LEFT TO REACH AGREEMENTS.
THERE ARE A FEW PIECES OF
LEGISLATION THAT ARE CONSIDERED
MUST PASS AND I'LL TALK BRIEFLY
ABOUT ONE OF THOSE TODAY.
AND THERE ARE OTHER PRIORITIES
THAT ARE POSSIBLE BUT NOT
GUARANTEED.
AND THERE ARE SEVERAL BILLS
INCLUDING ONE THAT CLEARED THE
HOUSE LAST WEEK.
WE STARTED WITH THREE PROPOSALS
AND THAT IS NARROWING DOWN TO
TWO AS REPRESENTATIVES --
CHAMPIONS OF THE 21st
CENTURY CURES ACT -- HAVE REALLY
[ INDISCERNIBLE ]
--
[ INDISCERNIBLE ]
AND CONGRESSWOMAN ASHLEY'S BILL
PASSED -- THE BILL AIMS TO
ESTABLISH ARPA-H -- AND
ADDITIONAL PROVISIONS ADDRESS
THE STRUCTURE AND OPERATIONS OF
THE AGENCY AND THE BILL WAS
AMENDED SPECIFICALLY TO PROVIDE
THAT WHILE THE DIRECTOR WOULD BE
PRESIDENTIALLY APPOINTED THE
APPOINTMENT WOULD NOT REQUIRE
SENATE CONFIRMATION.
THE GEOGRAPHIC LOCATION FOR
ARPA-H IS STILL TO BE
DETERMINED.
BOTH THE HOUSE AND THE SENATE A
YOU AUTHORIZING BILLS SPEAK FEW
THAT IT COULD NOT BE LOCATED ON
ANY NIH CAMPUS.
HOWEVER WE DON'T KNOW WHERE IT
WILL HAND AND SEVERAL STATE
DELEGATIONS ARE WRITING AND
ADVOCATING FOR THEIR STATES AS
POTENTIAL HOMES TO ARPA-H.
I ALSO WANT TO BRIEFLY MENTION
THE FDA USER FEE PROPOSALS.
TWO AREAS THAT I THOUGHT MIGHT
BE OF PARTICULAR INTEREST.
THE HOUSE HAS PASSED ITS
VERSION.
WHICH INCLUDES PROVISIONS
DIRECTOR OFFED THE FDA.
AND IT ALSO INCLUDES PROVISIONS
FROM THE -- GIVE KIDS A CHANCE
ACT.
AND THERE IS MORE INFORMATION
ABOUT EACH OF THESE ADDITIONAL
PROPOSALS INCLUDED IN YOUR
WRITTEN UPDATE.
THE SENATE BILL IS STILL PENDING
A FINAL VOTE.
THE SENATE BILL DOES NOT INCLUDE
THE SAME CLINICAL TRIAL
PROVISIONS.
HOWEVER SENATOR MURRAY DID
MENTION DURING COMMITTEE MARKUP
THAT SHE HAD WORKED WITH SENATOR
RUBIO AND SENATOR BENNETT WHEN
THE BILL COMES UP FOR A FLOOR
VOTE.
THESE ARE A FEW OF THE ISSUES
THAT NEED TO BE RESOLVED.
BEFORE THE HOUSE AND THE SENATE
PASS A FINAL AUTHORIZATION FOR
THE PRESIDENT'S SIGNATURE.
SO I HAVE WORK TO DO.
SWITCHING GEARS I ALSO WANTED TO
HIGHLIGHT TWO RECENT
CONGRESSIONAL BRIEFING.
LAST MONTH DR. -- CHIEF OF NCI
PEDIATRIC AND ONCOLOGY BRANCH
SPOKE AT A HYBRID CONGRESSIONAL
BRIEFING TO HONOR -- AWARENESS
DAY.
ADDITIONALLY DR. AMY LeBLANC
-- SPOKE ABOUT THIS WORK.
SO THIS TWEET IS NOT FROM THE
BRIEFING BUT I COULD NOT RESIST
FROM INCLUDING IT.
YOU CAN FOLLOW THE COMPARATIVE
ONCOLOGY PROGRAM.
[ INDISCERNIBLE ]
PLEASE DON'T HESITATE TO REACH
OUT TO ME OT -- ME AND OUR TEAM.
I OFTEN CLOSE WITH A SNAPSHOT OF
THE CONGRESSIONAL CALENDERS A
REMINDER OF WHERE WE ARE IN THE
PROCESS.
SO HERE WE ARE IN JUNE HEADING
INTO THE JULY 4th RECESS.
AS I MENTIONED IT'S ALSO A
MID-TERM ELECTION YEAR AND IF WE
HAD MORE TIME I WOULD SAY MORE
ABOUT WHAT THAT COULD MEAN.
BUT FOR THE PURPOSE OF THE
CALENDAR IT MEANS THE HOUSE IS
NOT IN SESSION AT ALL IN AUGUST
AND SEPTEMBER AND EARLY OCTOBER.
WE ALSO RECOGNIZE THAT
CONTINUING RESOLUTIONS ARE A
COMMON OCCURRENCE PARTICULARLY
DURING A MID-TERM ELECTION YEAR
SO WE WILL BE WATCHING CLOSELY.
I'M SURE THERE ARE TIMELY
UPDATES.
THE NEXT MEETING IS SCHEDULED
FOR SEPTEMBER 28th.
TWO DAYS BEFORE THE CLOSE OF THE
FISCAL YEAR.
THANK YOU.
AS ALWAYS IF WE HAVE TIME I'M
HAPPY TO TAKE QUESTIONS.
OTHERWISE I THINK I'VE SHARED MY
E-MAIL WITH THE GROUP BEFORE.
I'M HAPPY TO FOLLOW-UP AS WELL
WITH.
THANK YOU.
>> HOLLY.
THANK YOU SO MUCH.
IF WE HAVE ANY QUESTIONS -- WE
CAN PUT THEM IN THE CHAT AND
FOLLOW-UP FOR SURE AND WE CAN
SHARE HOLLY'S INFORMATION IF
THERE IS ANY ADDITIONAL
FOLLOW-UPS.
DUE TO TIME WE'LL MOVE INTO OUR
NEXT PANEL DISCUSSION.
AND JUST AS A REMINDER FOR
EVERYONE HOLLY THANK YOU SO MUCH
FOR YOUR PRESENTATION.
>> THANK YOU, OF COURSE.
>> OUR NEXT PANEL IS FOCUSED OFF
RESEARCH ADVOCACY TRAINING.
REFLECTING ON WHAT IS HAPPENING
IN THE COMMUNITY.
WHAT ARE SOME OPPORTUNITIES THAT
WE'RE SEEING.
OUTREACH PROGRAMS AND ENGAGEMENT
PROGRAMS THAT ARE HELPING TO
SUPPORT RESEARCH ADVOCATES AND
PROVIDING GUIDANCE AND MAKING
SURE THAT THE PATIENT'S VOICE IS
HEARD IN RESEARCH.
WE'RE PLEASED TO HAVE MS. AR --.
WE'RE ALSO JOINED BY DR. ROBIN
VANDER POOL.
I'M GOING TO TURN THIS OVER TO
DR. VANDER POOL TO FRAME THIS
OUT FOR US AND MAKE THE
CONNECTION WITH NCI AND WHAT NCI
IS DOING AND THEN DR. KREBILL
WILL FOLLOW HER
>> THANK YOU FOR THE WELCOME AND
INTRODUCTION ANJEE.
TALKING ABOUT THE COMMUNITY
OUTREACH AND ENGAGER MEANT
OPPORTUNITIES.
AND HOW THAT SUPPORTS THE
PROJECT THAT HOPE IS GOING TO
SPEAK ABOUT IN JUST A FEW
MINUTES.
COMMUNITY OUTREACH AND
ENGAGEMENTS HAS BEEN A
FUNDAMENTAL PART OF THE PROGRAM.
SINCE ITS INCEPTION.
IN THE EARLY 1970s AND IN FACT
YOU WOULD THINK ABOUT THE
COMMUNITY OUTREACH AND
ENGAGEMENT WORK DONE WITH THE
CANCER PREVENTION AND CONTROL OR
THE POPULATION SCIENCE PROGRAMS
AT THE CANCER CENTERS.
HOWEVER, NCI AND THE OFFICE OF
CANCER CENTERS DECIDED TO
FORMALIZE THAT ACTIVITY WITH THE
REISSUANCE OF THE CANCER CENTER
SUPPORT GRANT FUNDING
OPPORTUNITY AND GUIDANCE THAT
THEY PUT OUT EVERY SO OFTEN.
SO IN 2016 THEY ACTUALLY
REQUIRED A COMMUNITY OUTREACH
AND ENGAGEMENT COMPONENT AND
NARRATIVE SO A 12 PAGE
NARRATIVE.
SCORE DRIVING PIECE OF THEIR
ACTUAL CANCER CENTER SUPPORT
GRANTS.
WHICH BEHIND THAT 12 PAGE
NARRATIVES IDENTIFYING A
LEADERSHIP STRUCTURE AND ALL OF
THE ACTIVITIES AND INITIATIVES
THAT WOULD GO WITH THE COMMUNITY
OUTREACH ENGAGEMENT CORE AT A
CANCER CENTER.
SO AS THE CANCER CENTERS STARTED
WORKING ON THIS AS A FORMALIZED
COMPONENT?
2019NCI REISSUED THE GUIDANCE
SAYING WE WANT TO YOU WORK NOT
ONLY TRADITIONAL OUTREACH TO
YOUR COMMUNITIES AND YOUR
DEFINED CATCHMENT AREA THE AREA
IN WHICH YOU SERVE YOUR
COMMUNITIES AND YOUR PATIENTS
BUT WE WANT YOU TO ALSO DO WHAT
WE MIGHT CALL IN REACH.
IN THAT YOU NEED TO TAKE THE
COMMUNITY VOICE AND THE
COMMUNITY PERSPECTIVE TO YOUR
BASIC SCIENCE PROGRAMS TO YOUR
CLINICAL SCIENCE PROGRAMS.
THAT YOU ALL NEED TO TAKE YOUR
WORK WITH YOUR BASIC SCIENCE
YOUR CLINICAL SCIENCE AND
TRANSLATIONAL RESEARCH PROGRAMS
AND CONNECT THE COMMUNITY TO
THOSE GROUPS AND REALLY HONING
IN ON WHAT WE'VE BEEN CALLING A
BI-DIRECTIONAL RELATIONSHIP
WHERE THE COMMUNITY NEEDS HELP
DRIVE THE RESEARCH OF THE CANCER
CENTER AND THE RESEARCH IS THEN
RESPONSIVE TO THE COMMUNITY
NEEDS.
AND SO THERE IS ACTUALLY A LINE
IN THE GUIDANCE FROM NCI THAT
SAYS AND I'M GOING TO READ THIS
OUT LOUD THAT THE COON CERTIFY
CENTERS IN WORKING WITH THEIR
COMMUNITIES SHOULD CATALYZE
ACTIVITIES OF SPECIAL RELEVANT
TO THEIR GU -- GEOGRAPHIC AREASD
ENGAGEMENT WITH COMMUNITIES AND
PATIENT ADVOCATES SHOULD INFORM
AND RESULT IN HIGH IMPACT'
SCIENCE.
AND AGAIN THAT IS WHAT YOU'RE
GOING TO HEAR AN EXAMPLE OF THIS
AFTERNOON.
AND I THINK YOU CAN IMAGINE THIS
WAS NOT EASY FOR OUR CANCER
CENTERS AND OUR COMMUNITY
OUTREACH PROGRAMS AND OUR BASIC
SIGN AT THIS I TESTS AND
CLINICAL SCIENTISTS TO TALK TO
EACH OTHER FOR THE FIRST TIME.
OFTEN WE'RE SPEAKING, WE MAY
HAVE THE SAME GOALS OF IMPROVING
THE CANCER EXPERIENCE OR
IMPROVING TREATMENTS OR
IDENTIFYING PREVENTIONS AND
SCREENING TECHNOLOGIES BUT WE'RE
COMING AT IT FROM DIFFERENT
ANGELS AND DIFFERENT VOICES.
SO HOW DO WE GET EVERYBODY ON
THE SAME PAGE?
HOW CAN WE GET BASIC SCIENTISTS
TO UNDERSTAND COMMUNITY CONCEPTS
AND GET COMMUNITY TO UNDERSTAND
WHY STUDYING MOUSE MODELS AND
ZEBRAFISH IS A GOOD IDEA FOR OUR
CANCER RELATED GOALS.
TO BUILD CAPACITY IN THE SPACE
BECAUSE CANCER CENTERS ARE GOOD
AT THE OUTREACH BUT IT'S THAT IN
REACH OUR DIVISION PUT OUT
ADMINISTRATIVE SUPPLEMENT TO
HELP SUPPORT CANCER CENTERS AND
THEIR COMMUNITY OUTREACH
PROGRAMS AND THEIR BASIC SCIENCE
PROGRAMS TO START WORKING
TOGETHER
THEY COULD DESIGN A NEW
COLLABORATION OR BUILD ON AN
EXISTING COLLABORATION.
AND THAT IS WHAT YOU'RE GOING TO
HEAR ABOUT FROM HOPE.
AT THE UNIVERSITY OF KANSAS HOW
THEY WERE ABLE TO LEVERAGE THEIR
PIVOT PROGRAM TO COMPETE FOR ONE
OF THESE SUPPLEMENTS.
TO DEVELOP A TRAINING PROGRAM
ABOUT COMMUNITY OUTREACH AND
ENGAGEMENT.
HOW TO COMMUNICATE WITH PATIENTS
AND COMMUNITIES.
AND HOW TO WORK TOGETHER.
THAT WAS THE TRAINING PROGRAM
THAT THEY CREATED AND WITH THE
GOAL OF DEVELOPING AND AMERICAN
TAKENNING THAT MUTUAL
RELATIONSHIP WHICH MEANS
SCIENTISTS AND COMMUNITY
PATIENTLY RESEARCH PARTERS.
AND WE'VE BEEN REALLY THRILLED
WITH THESE ACTIVITIES.
THE PROJECTS LAUNCHED AT THE END
OF FISCAL YEAR 20 AND HAVE BEEN
WRAPPING UP.
WE HAD ALL OF THE CANCER CENTERS
DEVELOP CASE STUDIES WHICH I'LL
PUT IN THE CHAT FOR YOU TO LOOK
OVER.
SO THAT WE CAN SHARE BEST
PRACTICES INSTEAD OF EVERYBODY
REINVENTING THE WHEEL.
WE'RE THRILLED WITH THE WORK
THAT HAS HAPPENED IN THE SPACE.
I'M NOT GOING TO STEAL ANY OF
HOPE'S THUNDER.
BUT I WANT TO READ YOU ONE QUOTE
-- AND THIS IS FROM ONE OF THEIR
SCIENTISTS.
DESPITE THE TIME I'VE BEEN
RESEARCHING CANCER I HAVE NEVER
MET ANYONE WITH THE DISEASE TYPE
I WAS INVESTIGATING.
THE SUPPLEMENT PROGRAM PROVIDING
ME THE OPPORTUNITY TO MEET AN
ACTUAL PERSON LIVING WITH THE
SPECIFIC TYPE OF CANCER I WAS
RESEARCHING AS WELL AS AN ENTIRE
ADVOCACY ORGANIZATION.
AND THAT IS REALLY ONE SPEAKS
THAT WE HAVE A LOT OF WORK TO DO
BUT ALSO SPEAKS TO THE
OPPORTUNITIES THAT EVEN SMALL
AMOUNTS OF MONEY AND CAPACITY
BUILDING CAN DO AT THESE CANCER
CENTERS IN CONNECTING PATIENTLY
ADVOCATES AND THE SCIENCE
TOGETHER TO MAKE IT MORE
RELEVANT FOR OUR PATIENTS AND
CAREGIVERS AND OUR ENTIRE CANCER
COMMUNITY.
WITH THAT I WOULD BE HAPPY TO
ANSWER QUESTIONS AFTER HOPE'S
PRESENTATION.
>> THANK YOU, ROBIN.
I THINK MY SLIDES WILL BE PULLED
UP IN JUST A MINUTE.
I WANT TO THANK ROBIN FORGIVING
THE INTRODUCTION AS WELL AS
ANJEE AND DR. LOWY FOR INVITING
US.
I REALLY APPRECIATE LISTENING TO
YOUR CONVERSATIONS AND QUESTIONS
TO THE RESEARCHERS AND TO
DR. LOWY.
I'M GOING TO SPEED UP A LITTLE
BIT A PART OF MY PRESENTATION IN
ORDER TO GET US BACK ON TIME.
THE WORK IS THE WORK OF THE
SURVIVORS AND THE COMMUNITY
MEMBERS AND THE FACULTY AND
STAFF.
IN 2016 WE CAME TO THE OFFICE OF
ADVOCACY AT NCI JUST TO SAY WHAT
IS GOING ON?
IT WAS A VIRTUAL PHONE CALL.
TO SEE WHAT WAS GOING ON.
AND I WILL SHARE A BRIEF
OVERVIEW.
FASTEN YOUR SEAT BELTS BECAUSE
I'LL TALK FAST.
I TALK WHY WE ENINVOLVE PATIENT
ADVOCATES THE AND GIVE AN
EXAMPLE -- * AND SHARE LESSONS
LEARNED AND OUTCOMES.
THE UNIVERSITY OF KANSAS IS
LOCATED ON THE STATE LINE.
THE STATE OF KANSAS AS WELL AS
18 COUNTIES IN MISSOURI.
4.5 MILLION PEOPLE.
THE BLUE AREAS REPRESENT RURAL
AREAS AND SOME OF THE COUNTIES
HAVE LESS THAN SIX PEOPLE PER
SQUARE MILE.
AND WE HAD TO THINK HOW ARE WE
GOING TO DO COMMUNITY OUTREACH
AND ENGAGEMENT WITH SUCH A LARGE
LAND MASS.
TWICE THE SIZE OF MANY STATES.
SO WE NEEDED TO FIRST IDENTIFY
AND MONITOR AND UNDERSTAND THE
DATA.
WHAT IS HAPPENING IN OUR CANCER
COMMUNITY IN OUR CATCHMENT AREA.
WE KNEW THAT WAS NOT ENOUGH.
WHAT ARE THE STRENGTHS OF THE
COMMUNITY.
HOW DO WE STIMULATE THAT
INFORMATION INTO IMPORTANT
RESEARCH.
THAT IS WHERE PIVOT COMES IN
PLAY.
WE NEED TO HEAR FROM THE
ADVOCATES AND THEN HOW DO WE GET
THE SCIENCE INTO MAKING AND
DOING GOOD.
DRIVE AND DISSEMINATE AND
IMPLEMENT ACTIVITIES AND WE DO
THAT THROUGH THE ALLIANCE.
WE EXTEND CLINICAL TRIALS
INCLUDING AND CORE TRIALS INTO
COMMUNITY CANCER CENTERS ACROSS
THE STATE OF KANSAS AS WELL AS
PROVIDE OUTREACH AND PARTNER ON
EVIDENCE BASED INTERVENTION --
AND ALSO TRAIN PROFESSIONALS
ACROSS THE STATE.
NEXT SLIDE PLEASE.
SO WE HAD A BOARD AS I MENTIONED
BEFORE AND THEY ARE 18
INDIVIDUALS THAT MEET FOUR TIMES
A YEAR -- WHY DO WE HAVE THIS
BOARD?
DO WE NEED TO DO SOMETHING
DIFFERENT.
PARTNERED WITH CHERYL JOURN
BEGAN -- PROBABLY MANY OF YOU
KNOW HER.
THEY CAME TO OUR DIRECTOR AND
SAID HEY WE THINK KU NEEDS ITS
OWN PATIENT RESEARCH ADVOCACY
PROGRAM AND THEY PULLED THEM
TOGETHER AND WE WERE ALL
ON-BOARD.
THIS IS A GREAT IDEA.
AVENUE DR. JENSON INVESTED HIS
TIME AND TREASURES SO WE COULD
DEVELOP THIS PROGRAM.
SO THE COMMUNITY ADVISORY BOARD
IS DIFFERENT AND WE HAD TO THINK
ABOUT IT.
WHAT IS THE ROLE?
THE COMMUNITY ADVISORY BOARD IS
AROUND OVER ARCHING -- WHILE OUR
PATIENT PARTNERS SPEND TIME ON
THE RESEARCH PROCESS AND
PARTICIPATING IN GRANT REVIEWS
AND PARTICIPATING IN THE
DEVELOPMENT OF PROTOCOLS -- HELP
WITH REPORTING THE RESULTS.
AND WE WANT TO BE CLEAR THAT FOR
US FOR KU CANCER CENTER WE'RE
TALKING ABOUT PATIENT RESEARCH
ADVOCACY.
WE'RE NOT TALKING ABOUT THE
OTHER PARTS OF ADVOCACY THAT ARE
IMPORTANT AND WE'LL HAVE TO
CONTINUALLY ENGAGE WITH -- AND
FOR THIS PART FOR PIVOT WE'RE
TRYING TO MAKE SCIENCE BETTER.
AND WE DECIDED THAT OUR RESEARCH
ADVOCATES NEEDED TO BE -- --
SURVIVORS OR CO-SURVIVORS.
AND THEY NEED TO BE LIKE YOU
COMMITTED TO REPRESENTING THE
COLLECTIVE PATIENT EXPERIENCE.
THEY NEEDED TO BE TIED TO
THINKING ABOUT HOW'S SCIENCE
COULD CHANGE IF THEY SHARED THAT
COLLECTIVE EXPERIENCE SO THEY
NEEDED TO MAINTAIN THEIR
RELATIONSHIPS WITH OTHER PEOPLE
WHO HAVE EXPERIENCED CANCER.
SO WHY DOES KU CANCER CENTER
WANT TO DO THIS?
WE THINK IT ENSURES PATIENT
FOCUS AND RELEVANCE.
ADD A HUMAN FACE.
PROVIDE REAL LIFE AND DIVERSE
EXPERTISE.
AND SPUR INNOVATION BASED ON THE
EXPERTISE.
AND THIS IS WHAT THE ATTRIBUTES
OF A GREAT ADVOCATE -- I TOLD
YOU HAVE -- TO FASTEN YOUR SAME
BELTS.
-- SEATBELTS.
* WE WANTED TO WALK THE WORK.
-- WE HAVE WANTED TO WALK THE
WALK.
WE WANTED TO LISTEN.
WE LAUNCHED OUR FIRST MEETING --
WE WERE HYBRID FROM THE
BEGINNING AND THAT WAS ZOOM BY
THE WAY AND BEFORE COVID.
AND WE MADE SURE THAT THE SEATS
AT THE TABLE WERE GOING TO BE
AVAILABLE TO A DIVERSE
EXPERIENCE.
SO BY AGE, RACE, ETHNICITY,
CANCER EXPERIENCE.
CANCER DIAGNOSIS.
REALLY WANTED TO MAKE SURE THAT
WE THOUGHT ABOUT INSURANCE, NO
INSURANCE.
ECONOMICS.
SO WE HAD TO LEAVE OUR SEATS
OPEN AND THERE WERE TIMES WHEN I
WOULD HAVE PEOPLE THAT I LOVED
AND CARED ABOUT SAYING I HAVE
THIS WOMAN WHO WOULD BE GREAT
FOR YOUR BOARD -- AND WE HAD A
LOT OF WHITE WOMEN WITH BREAST
CANCER THAT WAND TO
PARTICIPATED.
WE WANT TO INTENTIONALLY LEAVE
THE SEAT OPEN.
>> SO IT WAS PATIENT DRIVEN.
THE ADVOCATES ACTUALLY CREATED
THE VISION.
WE LAUNCHED INTO A 12 PATIENT
LELEADER TEAM.
THAT IS FROM A OUR FIRST
TRAINING WHERE WE HAD ABOUT 40
ADVOCATES AND THEY WERE NOT
ADVOCATES YET.
THEY WERE SAYING MAYBE I WANT TO
DO THIS.
I'M NOT SURE.
AND WE ASKED EVERYONE HOW WOULD
THEY DESCRIBE RESEARCH?
AND THE WORDS THAT CAME OUT THE
BIGGER WORDS CAME OUT MORE
FREQUENTLY.
CONVENIENT FOR ME TO HAVE MY
NAME ON THE SLIDE.
HOPE, LIFE, FAMILY.
TIME.
AND SO I THINK THEY HAD SOME
REAL LIFE EXPERIENCES AND YOU
CAN SEE THE PICTURES OF A
VARIETY OF ADVOCATES THAT
PARTICIPATE.
IF YOU LOOK CLOSELY YOU'LL SEE
ON THE T-SHIRT IT SAYS MY VOICE
IS MY SUPER POWER AND THAT IS
WHAT WE WANTED TO CREATE THROUGH
PATIENT RESEARCH AND
PARTNERSHIPS.
AND THE T-SHIRT WAS CREATED BY
THE COMMUNICATION TEAM THAT IS
RUN BY PATIENTLY ADVOCATES.
SO NOW WE HAVE OVER 130 MEMBERS.
HARD TO BELIEF.
AND IF YOU CAN SEE THEY HAVE
NUMBERS IN THEM.
WE'RE STILL WORKING TO GET
FURTHER OUT WEST.
EASIER TO RECRUIT PEOPLE THAT
ARE CLOSE US TO.
BUT WE'RE STILL RECRUITING.
VARIED EXPERIENCES OF CANCER
TYPES, AGE, GENDER.
WE'VE HAD PEOPLE JOIN -- THAT
ARE OUTSIDE OF OUR CATCH MAN
AREA.
WE LIMIT OUR PARTNERSHIPS TO
THOSE WITHIN OUR CATCHMENT AREA.
THIS GIVES YOU AN IDEA.
WE'RE HOSTING ANOTHER TRAINING
AGAIN IN PERSON.
SO THE PATIENT ADVOCATE TRAINING
HAS BEEN CREATED BY OUR TASK
FORCE.
IT IS LED BYE-BYE THE PATIENT
RESEARCH ADVOCATES.
VOTED ON BY THE PATIENT RESEARCH
ADVOCATES.
I DON'T HAVE A VOTE WHICH I
THINK IS RIGHT BECAUSE THIS
NEEDS TO BE PATIENT DRIVEN.
THE EDUCATION COMMITTEE HAS
PULLED TOGETHER DIVERSE
PRESENTATIONS THAT ARE AVAILABLE
BY ZOOM.
IN PERSON, HYBRID.
AND THE TOPICS INCLUDE CANCER
RESEARCH 101.
BUT ALSO HOW TO CREATE A
BIOSKETCH.
IT'S NOT SET UP FOR ADVOCATE TO
SUBMIT.
BUT IT'S NEEDED IF THEY ARE ON A
RESEARCH PROPOSAL.
THEY WANTED TO UNDERSTAND ABOUT
THE TRANSLATIONAL RESEARCH TIME
LINE AND AS YOU KNOW THAT IS WAY
TOO LONG.
SO THEY WERE DISAPPOINTED IN
THAT.
AS WELL AS HOW TO REVIEW GRANTS.
AND NOW -- THEY GET INVITED TO
WEBINAR AND CONFERENCES SO THEY
ARE AN INTEGRAL PART AND PART OF
OUR DNA.
BUT TRAINING IS NOT ENOUGH.
WE FELT LIKE WE NEEDED TO
SURPRISE TOOLS AS WELL SO SUSAN
G KOMEN WAS NICE ENOUGH TO ALLOW
US TO ADAPT THEIR TOOLKIT.
WE HAVE A RAPID REACTOR TOOLKIT.
WE HAVE PIVOT YouTube SO WE
ARCHIVE TRAININGS AND OUR
ADVOCATES PARTICIPATE ON BENCH
TO BEDSIDE FACEBOOK LIVE.
WE SHARE NEWSLETTERS AND INVITE
THE ADVOCATES TO THE CANCER
CENTER SYMPOSIUM AND ONE OF THE
FAVORITE WALKS IS THE POSTER
WALK.
THE RESEARCHERS LOVE IT.
THEY HAVE TIME FOR THEMSELVES.
WE HAVE A PRIVATE FACEBOOK AS
WELL AS A HAU -- A HANGOUT TIME.
THE QUESTION WAS -- IF YOU BUILD
IT WILL THEY COME?
WE WERE NOT SURE THEY WOULD AND
IN FACT -- THEY DIDN'T AT FIRST.
IT WAS STILL JUST A HANDFUL.
SOME OF THE CLINICIANS DID.
SO WE DECIDED WE NEEDED TO
CREATE SOMETHING INNOVATIVE TO
ALLOW THE RESEARCHERS TO DIP
THEIR TOE NIECE PATIENT RESEARCH
ADVOCACY.
WE CREATED RAPID REACTOR TEAMS
AND YOU CAN SEE THE FLYER.
AND WE MODELED IT AFTER THE
VANDERBILT DESIGN STUDIOS.
WE NEED TO GET MORE RESEARCHERS
INVOLVED.
AND THE RAPID REACTOR TEAMS ARE
SET UP.
60 MINUTES.
WE ASKED TO PROVIDE A BLURB OF
WHAT THEY WERE GOING TO SAY.
WE ASKED THE RESEARCHER TO
CREATE A POWER POINT THAT SHARES
THEIR SCIENCE WITH FIVE SLIDES
AND WE GIVE THEM THE TEMPLATE
AND WE GIVE THEM FEEDBACK.
USUALLY A COUPLE OF TIMES.
STILL TOO COMPLICATED.
YOU HAD SOME GREAT EXAMPLES OF
GOOD SLIDES HERE TODAY BUT WE
DID NEED -- WE NEED TO
CONTINUALLY WORK WITH THE
RESEARCHERS ON HOW TO PRESENT.
WE HAVE ALLOW THE RESEARCHERS TO
TALK FOR 10-15 MINUTES AND THEN
FACILITATE A CONVERSATION WITH
THE AD -- ADDS VACATES.
-- ADVOCATES.
SO WE FACILITATE THAT
CONVERSATION SO THAT THEY BOTH
GET SOMETHING OUT OF THE
PRESENTATIONS AND IT DOES HELP
THE RESEARCHERS PRIORITIZE
TOPICS, HONE THEIR RESEARCH
STRATEGY.
THINK ABOUT ELIGIBILITY
CRITERIA, THE BURDEN OF THE
PARTICIPATING.
CAN I GET THAT BLOOD DRAWN
LOCALLY VERSUS DRIVING IN AND
STRENGTHEN RECRUITMENT AND
RETENTION.
AND THE RESEARCHERS ARE
EVALUATING THEIR EXPERIENCES.
WE HAVE THE ADVOCATES THAT
EVALUATE AFTERWARDS AND THE
RESEARCHERS HAVE SAID THAT IT
HELPS THEM TO UNDERSTAND THE
PATIENT VOICE.
AS YOU CAN SEE 14% INCREASED
SENSITIVITY.
28% FEEDBACK ON FEASIBILITY.
THESE ARE REALLY IMPORTANT
PROJECT APPROPRIATENESS.
THEY COME BACK RAVING ABOUT THE
OPPORTUNITY.
BUT THEN IT WAS BASIC
SCIENTISTS.
DR. LEWIS WANTED TO SPEAK US TO.
I DON'T KNOW HOW THEY WILL
INTERACT.
BUT SHE PROVIDED A PRESENTATION
ON HER SCIENCE THAT WAS SPECIFIC
TO -- TRIPLE NEGATIVE BREAST
CANCER AND TALKED ABOUT
INFLAMMATION AND THEN STARTED
ASKING QUESTIONS ABOUT WHAT DOES
THAT MEAN FOR AFRICAN-AMERICAN
WOMEN AND AN OPPORTUNITY TO
ADDRESS THIS I'M F ---I'M FLAT S
AND THEN WAS FUNDED FOR IT.
* MY PERFECT SPENCE IS HIGHLY
INFLUENCED BY RESEARCH.
-- AND WE'RE HOPING FROM THAT
RAPID REACTOR TEAMS WE CAN HONE
AND CREATE PATIENT PARTNERSHIPS
BEYOND THESE ONE TIME TOUCHES
BUT WE HAD NOT GOTTEN TO THAT
LEVEL YET.
SO AND PARTLY BECAUSE
RESEARCHERS WERE NOT QUITE SURE
HOW TO INTERACT WITH THE
ADVOCATES SO WE CREATED -- WE
SHARED THE TOOLKIT WITH THEM.
WE HAVE THEM PRESENT ON THE
WEBINAR AND WE HELP THEM
COMMUNICATE BEFORE THE WEBINAR.
WE PROVIDE ONE-ON-ONE COACHING.
FACILITATE A DISCUSSION AND HELP
THEM WITH THEIR SUMMARY.
BUT WE STILL WERE NOT GETTING
THE SAME LEVEL OF INTERACTION
WITH THE BASIC SCIENTISTS.
SO WE WERE THRILLED WHEN THE
OFFICE -- RELEASESSED THAT CALL
FOR THE BASIC SCIENTIST PROGRAM.
*.
WE WERE AT THE POINT WHERE WE
COULD LAUNCH OFF AND CREATE
SOMETHING EXCITING.
AND WE WERE LUCKY TO RECEIVE ONE
OF THE SUPPLEMENTS.
WE CREATED A NINE MONTH
TRAINING.
IT WAS SELECTIVE PROCESS.
NOT EVERYBODY WHO WANTED TO
PARTICIPATE WAS ALLOWED TO AND
THAT GAINED SOME EXCITEMENT THEN
SO OTHERS NOW WANT TO
PARTICIPATE.
WE STARTED OUT WITH PRINCIPLES
OF COMMUNITY ENGAGEMENT AND
PRINCIPLES OF RESEARCH PATIENT
ENGAGEMENT.
THOSE LOOK DIFFERENT AND THEN ON
TO SHARED COMMUNICATION SKILLS.
WE CONTRACTED OUT WITH THE
CENTER FOR COMMUNICATING
SCIENCE.
AND THEN DID SOME -- TEAM
BUILDING -- HAVING INDIVIDUAL
MEETINGS.
WE HAD THEM NEGOTIATE HOW TO BE
PARTNERS.
AND THEN WE SAID OKAY NOW YOU'RE
GOING TO MEET ONCE A MONTH WITH
US AND WE'LL TEACH YOU SKILLS
AND YOU WILL GO OUT ONCE A MONTH
VIRTUALLY OR OTHERWISE AND
ENGAGE EACH OTHER ON THE
RESEARCH.
AND WE KNEW -- AND WE WANT YOU
TO END WITH PRESENTING AT THE
SYMPOSIUM.
AND WE KNEW WE WERE SUCCESSFUL
WHEN ADVOCATES HAD TO PRESENT
THEIR SCIENCE PARTNER THEIR
RESEARCH PARTNER AND THEY DID AN
AMAZING JOB SO THAT MEANT THEY
WERE TRULY COMMUNICATING.
AND WHEN WE ASKED THE SCIENTISTS
AND THE ADVOCATES TO ASSESS THE
COMMUNICATION SKILLS WE FOUND
THAT THE ADVOCATES FELT AND THE
SCIENTISTS AGREED THAT THE
RESEARCHER HAD IMPROVED THEIR
COMMUNICATION SKILLS.
THEY TALKED ABOUT HOW THEY
INCORPORATED ADVOCATES AND
FUNDED PROPOSALS.
THEY WANT TO CONTINUE TO PARTNER
WITH THESE ADDS VACATES AND
TONYA IS THERE WITH HER RESEARCH
PARTNER.
DR. GUNN IS AN MD-PhD.
AND THEY ALSO SAID THEY WANT
OTHER SCIENTISTS TO PARTICIPATE
IN THE PIVOT PROGRAM.
AND OVER-ALL OUR PIVOT OUTCOMES
HAVE TO ENGAGED MORE THAN 80
RESEARCHERS NOW.
SO WE ARE STARTING TO ENGAGE
RESEARCHERS.
WE'VE SUPPORTED OVER 65
PROPOSALS.
AND WE'VE HAD SUCCESSFUL FUNDED
PROPOSALS THAT ARE PILOT GRANTS.
DEPARTMENT OF DEFENSE GRANTS.
ONE OF THE BIGGEST WINS WAS --
THEY RECEIVED COMMENTS BACK
ABOUT HOW OBVIOUS IT WAS THAT
THE PATIENT RESEARCH ADVOCATE
WAS PART OF THEIR DEVELOPMENT OF
THEIR PROJECT AND WE POSTED OVER
47 SESSIONS.
THE LESSONS LEARNED IS THAT
PARTNERSHIPS REQUIRE INTENTIONAL
INTERACTIONS AND THEY DO TAKE
TIME BUT THEY SPEED UP THE
SCIENCE SO THE TIMES WELL WORTH
IT IF IT'S SPEEDING UP THE
SCIENCE BUT WE HAVE TO REMIND
THE RESEARCHER WHEN THEIR HEADS
ARE DOWN TO LOOK UP AND REACH
OUT TO THEIR PATIENT PARTNERS.
WE ALSO KNOW THAT TOPICS CAN BE
TRAUMATIZING.
CANCERRING CHALLENGING.
OR HEARING ABOUT -- IT WAS
CHALLENGING SO WE DECIDED TO
INCLUDE -- WE HAVE A LICENSED
CLINICAL SOCIAL WORKER ON OUR
TEAM AND WE DID A WEBINAR ON HOW
TO CREATE SPACE AND SUPPORT
YOURSELF AND OTHERS AND CONTINUE
TO CHECK-IN WITH THE ADVOCATES
IN THE AREA AND THEN RESEARCH
CAREERS ARE FLUID AND THEY
INVOLVE CHANGING INSTITUTIONS.
WE'RE ASKING TO MATCH PEOPLE
THAT MAYBE ARE NOT A GOOD MATCH
SO WE NEED TO CONTINUALLY WORK
WITH BOTH THE ADVOCATE AND THE
RESEARCHER TO MAKE SURE THEIR
NEEDS ARE BEING MET.
COMMUNICATE RESPECTFULLY.
AND IF THEY ARE GOING TO SHARE
THAT AND COMMUNICATE THAT -- --
WE'LL MATCH WITH ANOTHER
ADVOCATE.
THOSE ARE SOME OF THE LESSONS
LEARNED.
THERE IS A TON OF PATIENT
RESEARCH ADVOCATES THAT CAN GIVE
A COLLECTIVE VOICE TO SCIENCE
AND IT WILL MAKE A DIFFERENCE.
SO AGAIN I STARTED AND I WANTED
TO END -- THIS IS NOT MY WORK.
AND WE HAD THE LEADERSHIP OF THE
CANCER CENTER WITH THE
RESEARCHERS AND THE DIRECTORS
AND THE COMMUNITY ADVISORY BOARD
AND THE STAFF AND KU CANCER
CENTER FACULTY.
I WANT TO ACKNOWLEDGE THEIR
WORK.
AND FEEL BLESSED TO BE PART OF
THIS MISSION.
AND THAT IS BASICALLY IT.
REACHING MORE PEOPLE AND SAVING
MORE LIVES.
YOU HAVE TO HAVE AT LEAST ONE OF
THEM.
SORRY I WENT SO FAST BUT I
WANTED TO MAKE SURE I GAVE YOU
TIME TO ASK QUESTIONS.
>> EXCELLENT PRESENTATION.
REALLY APPRECIATE THAT AND
YOU'VE DONE SOME AMAZING WORK IN
KANSAS.
SO WHAT QUESTIONS?
ANNIE, YOU WANT TO GO FIRST?
>> SURE.
THANK YOU SO MUCH, AN AMAZING
PRESENTATION ABOUT THE WORK
YOU'VE DONE AND IS IT TONYA.
THANK YOU FOR BEING HERE AND
YOUR WORK.
I WOULD LIKE TO HEAR ABOUT YOUR
IMPRESSIONS AND CONTRIBUTIONS
AND WHAT YOU'RE MOST PROUD OF.
MY QUESTION IS -- AND AGAIN
AMAZING WORK.
DID YOUR PATIENTLY RESEARCH
PARTNERS NEED TO BE PROCESSED BY
THE CANCER CENTER AS VOLUNTEERS?
WAS THERE AN INTAKE SYSTEM AND
DID THAT CREATE A BARRIER TO
PARTICIPATE INCOME PIVOT?
HOW DID YOU GET AROUND THAT?
AND HOW DO YOU HANDLE MULTIPLE
REQUEST FOR THE SAME CANISTER
TYPE?
-- CANCER -- TYPE
>> THE ADVOCATES DO NOT HAVE TO
GO THROUGH A SPECIFIC PROCESS OF
ON-BOARDING THEM.
THEY COME DIRECTLY THROUGH
PIVOT.
WE DO NOT PAY THEM AS STAFF
MEMBERS.
THEY ARE NOT PART OF THE CANCER
CENTER AND WE THOUGHT THAT WAS
AN IMPORTANT ASPECT.
WE PROVIDE CONSULTATION FEES TO
THE ADVOCATES.
WE FEEL IT'S IMPORTANT TO PAY
THE ADVOCATES FOR THEIR TIME.
AT THIS POINT IT HAS NOT BEEN A
BARRIER WITH OUR CANCER CENTER.
WE GET LOTS OF SPECIFIC CANCER
REQUESTS.
WE'VE DECIDED AND WE DON'T WANT
TO BE A VENDING MACHINE SO WE'RE
TRYING TO WORK -- HOW DO WE
REALLY HELP THOSE RESEARCHERS
THINK ABOUT WHO WOULD BE A GOOD
PARTNER AND WE CANNOT ALWAYS
MATCH THE SPECIFIC CANCER TO THE
RESEARCHER.
BUT OFTEN THE ADVOCATES HAVE AN
OVER ARCHING EXPERIENCE AND THEN
WE WORK WITH THE RESEARCHERS
SAYING IF THIS IS YOUR AREA OF
RESEARCH LET'S FIND CLINICIANS
DOING THAT AND HELP YOU HAVE
FIND THAT INFORMATION.
WITH 130 ADVOCATES AND NOT ALL
OF THEM PARTNER.
SOME JUST WANT EDUCATION BUT
THERE IS A LARGE NUMBER THAT
WANT TO PARTNER.
SO WE'RE PRETTY LUCKY IN THAT
PART
>> THANK YOU AND I'M HOPEFUL
SOME DAY ONE OF YOUR PIVOT
RESEARCH PARTNERS WILL BE A
MEMBER OF OUR NCRA.
>> WE WOULD LOVE THAT.
>> I DIDN'T KNOW IF TONYA WANTED
TO SHARE ANYTHING BEFORE I
SPOKE.
>> SO FOR THE PATIENT ADVOCATED
TO PARTNER WITH THE RESEARCHER
PARTICULARLY THROUGH THE RAPID
REACTOR IT'S A WAY THAT THE -- I
THINK YOU INITIALLY FOR THE
ADVOCATE WHEN THE SCIENTIST THE
RESEARCH SCIENTISTS SAID THIS IS
WHAT I NEED WORK WITH AND THEN
PRESENTED WITH THE SLIDES AND SO
THEY HAVE A SMALL AMOUNT OF TIME
TO TALK ABOUT THAT AND THEN THE
DISCUSSION REALLY IS LED BY THE
ADVOCATES BY ASKING THE
QUESTIONS THAT THE RESEARCHER
HAS NOT EVEN THOUGHT ABOUT IT.
I WANTED TO SAY THE RESEARCHER
DOES NOT REALLY WORK IN A CLINIC
MOST OF THE TIME.
THEY WORK IN A LAB.
SO THIS IS AN COMMUNITY FOR THEM
TO ENGAGE WITH A HUMAN, A REAL
PERSON.
TO HAVE THAT HUMAN TOUCH AND
HUMAN RELATIONSHIP WITH THE WORK
THAT THEY ARE DOING.
SO THEY ARE VERY APPRECIATIVE OF
THOSE PIECES AS WELL.
SO THERE ARE WINS ON BOTH SIDES.
>> THANK YOU SO MUCH.
>> YES.
THANKS.
I JUST WANTED TO THANK YOU HOPE.
THAT WAS A GREAT PRESENTATION.
WE'RE EXCITED FOR YOU TO SPEAK
AT OUR ANNUAL MEETING IN OCTOBER
ON PATIENT ENGAGEMENT.
THIS IS A GREAT EXAMPLE OF THE
PIVOT PROGRAM.
AND AS DR. VANDER POOL
HIGHLIGHTED THESE CASE STUDIES
WE ACTUALLY AT AACI HEARD FROM
OUR CANCER CENTERS WHEN THESE
NEW GUIDELINES CAME OUT THAT
THEY WANTED TO HAVE A LISTSERVE
AND FORUM WHERE THEY COULD
COMMUNICATE WITH ONE OTHER.
I WILL CREDIT AMY BECAUSE SHE
ASKED IF AACI COULD PUT TOGETHER
A LIST OF WHERE THE CANCER
CENTERS COULD SHARA AMONG EACH
OTHER.
WE'VE ROUND 200 INDIVIDUALS --
THAT COLLABORATE.
AND WILL POINT OUT ALSO
DR. CHRIS LEE -- WILL BE
PRESENTING AT OUR ANNUAL MEETING
AS WELL.
HE IS GOING TO TALK ABOUT FRED
HUTCHINSON CANCER CENTER'S PLAN
TO ENHANCE EFFORT AND WILLING TO
SHARE THE DEI AND THE
DEVELOPMENT OF THE DEI PROGRAMS
AND METRICS.
SO I THINK IT'S REALLY IMPORTANT
WHAT THE CANCER CENTERS ARE
DOING AND HAPPY THAT THE NCI HAS
PRIORITIZED THIS AND WE'RE HAPPY
TO COLLABORATE.
WE LOVE SHARING ANYTHING THAT
YOU WANT TO PROVIDE WITH OUR
LISTSERVE.
OUR CENTERS ARE ALWAYS EXCITED
TO EAT THAT UP.
I LOVED HEARING ABOUT THE PIVOT
PROGRAM.
IT IS JUST ONE EXAMPLE OF ALL OF
THE GREAT WORK THAT THE CANCER
CENTERS ARE DOING.
>> THANK YOU.
AND I WOULD HAVE TO SAY THAT ALL
THAT I KNOW I'VE LEARNED FROM MY
COLLEAGUES AND FROM THE
COMMUNITY.
I'VE BEEN PART TAFT COMMUNITY
SINCE 2003.
I MAY HAVE MET DR. VANDER POOL
AT THAT POINT.
*
THEY'VE BEEN SHARING AND WE
SHARE BARK.
IT'S COMMUNITY OUTREACH AND
ENGAGEMENT.
WE LOVE INTERACTING WITH PEOPLE
SO WE TRY TO BUILD AND GROW AND
BUILD EACH OTHER UP BECAUSE THAT
IS THE ONLY WAY WE CAN IMPACT
THE CANCERS AND CHANGE THE
TRAJECTORY OF THE DISEASE.
>> AND I AGREE.
THANK YOU.
>> DO WE HAVE ANY MORE
QUESTIONS?
EXCELLENT.
THIS IS A GREAT PRESENTATION.
IT'S ALWAYS NICE TO BE ABLE TO
HIGHLIGHT TRAINING PROGRAMS THAT
ARE HAPPENING IN THE COMMUNITY.
IT REMINDS US OF VARIOUS ASPECTS
THAT WE CAN DO AND SUPPORT AND
IF WE HAVE ADVOCATES THAT WE
KNOW WHO ARE IN KANSAS WE KNOW
WHO TO SEND THEM TO.
THIS WAS A GREAT PRESENTATION.
THANK YOU SO MUCH FOR JOINING US
AND SHARING WHAT IS HAPPENING AS
IT RELATES TO DEVELOPING LOCAL
CANCER CENTERS RESEARCH
APPLICANTS
>> THANK YOU FOR ALL THAT YOU
ARE DOING.
IT IS MAKING A DIFFERENCE AND
KEEP THOSE VOICES LOUD.
IT WAS GREAT TO HEAR THEM TODAY.
>> I LOVE THOSE T-SHIRTS.
>> WE ALL NEED A SUPER POWER
T-SHIRT.
>> I'LL SEND ONE TO YOU.
>> IN CLOSING -- AMY I THINK
WE'RE WRAPPING UP OUR MEETING AT
THIS POINT.
IS THAT CORRECT?
>> YES.
SO WE CAN MOVE TO THE FINAL SORT
OF PORTION WHICH IS WRAP UP AND
THE ADMINISTRATIVE ITEM OF
VOTING ON THE MEETING MINUTES.
>> EXCELLENT.
>> LET'S -- LET ME PROPOSE WE
VOTE TO APPROVE THE MEETING
MINUTES FOR THE 85th NCRA
MEETING.
BOTH WERE INCLUDED IN OUR
MATERIALS SO I'LL JUST CALL FOR
A MOTION TO APPROVE.
>> SO MOVED.
>> WILL SOMEONE SECOND?
>> JENNIFER IS SECONDING.
>> WE CAN APPROVE THOSE MINUTES
AND FINALIZE THE MINUTES FOR THE
85th NCRA MEETING.
>> I THINK WE NEED TO VOTE
>> WHO NEEDS TO VOTE.
EVERYBODY JUST RAISE YOUR HAND
AND VOTE.
EXCELLENT.
OKAY.
NOW THEY ARE OFFICIALLY
APPROVED.
>> I'LL TURN IT OVER TO ANJEE TO
CLOSE US OUT BUT I DO WANT TO
THANK ALL OF YOU FOR YOUR TIME
TODAY.
THIS WAS A GREAT MEETING.
WE COVERED A TREMENDOUS AMOUNT
IN ONLY A COUPLE OF HOURS AND
THE DISCUSSION WAS AWESOME.
A GREAT INTERSECTION OF SCIENCE
AND PATIENT INPUT.
AND I CANNOT THANK YOU ENOUGH.
WE'VE BEEN DOING NCRA FOR A
NUMBER OF YEARS NOW IT'S REALLY
HELPFUL AND AWESOME TO SEE HOW
THE BOARD HAS EVOLVED AND
PARTICIPATE IN THE MEETINGS
THREE TIMES A YEAR BECAUSE IT IS
SO VALUABLE US TO.
AND I WANT TO THANK ANJEE FOR
HER TIME OVER THE PAST COUPLE OF
YEARS.
SHE HAS BEEN SO HELPFUL AND HAS
REPRESENTED SO MANY PATIENTS AND
SO MANY ADVOCATES AS SHE HAS
HELPED US SHAPE THE MEETINGS AND
FOCUS ON THE SWEET SPOTS.
I SAY THIS AT THE TOP OF EACH
MEETING BUT I CANNOT REITERATE
ENOUGH.
I KNOW YOU ARE DOING SO MANY
DIFFERENT THINGS.
WE REALLY APPRECIATE IT.
BECAUSE YOU WERE PULLED IN SO
MANY DIRECTIONS AND LITTLE SO
HELPFUL TO US.
I WANT WANTED TO THAT CAN -- --E
STAFF.
THEY ARE WORKING ON THIS MEETING
AND ON A VARIETY OF OTHER
ADVOCATE ENGAGEMENT ACTIVITIES.
SO I WANT TO MAKE SURE THEY
UNDERSTAND HOW MUCH THEY ARE
APPRECIATED BOTH WITHIN N
CONTRADICTION AND OUTSIDE.
THANK YOU FOR YOUR TIME.
ANJEE, IF YOU WANT TO CLOSE US
OUT THAT WOULD BE GREAT.
OUR NEXT MEETING IS IN
SEPTEMBER.
* THAT WILL BE THE NEXT TIME WE
COME TOGETHER.
>> IT WAS A GREAT MEETING TODAY.
IT WAS A SPOT ON BEING ABLE TO
HEAR FROM DR. LOWY AND
DR. CASTLE AND A RESEARCH
ADVOCACY PROGRAM ALL IN THE SAME
MEETING.
IT HAS BEEN A PLEASURE TO CHAIR
THIS GROUP AND I PASS THE TORCH
ON TO ANNIE.
CONGRATULATIONS.
YOU'RE GOING TO BE GREAT.
I HOPE TO MEET EVERYONE IN
PERSON.
SINCE WE ALL PLANNED A LUNCH
DATE.
--
>> DO YOU KNOW IF SEPTEMBER WILL
WE BE IN PERSON?
>> I DON'T KNOW YES.
STAY TUNED.
WE'LL LET US KNOW WELL IN
ADVANCE.
MOST OF OUR BOARD MEMBERS HAVE
REMAINED VIRTUAL.
OKAY.
HAVE A GREAT DAY.
THANK YOU ALL SO MUCH.
THANK YOU, ANJEE.