NCAB Has Concerns About Future of Clinical Research

BETHESDA, Md--The National Cancer Advisory Board (NCAB) will seriouslyconsider the suggestion of one of its members to send a strongmessage to Congress regarding cancer research.

Philip S. Schein, MD, chairman and CEO, U.S. Bioscience, Inc.,told the Board, "We need to let Congress and the Administrationknow that the war on cancer is not over, and that to cut fundingwould be a serious mistake. Despite the recognized advances thathave been made in the management of specific tumors, current statisticssuggest that 50% of newly diagnosed patients will die of theirdisease. The status quo is clearly unacceptable."

He then recommended that the Board prepare and transmit a resolutionabout the importance of continuing cancer research. Members ofthe NCAB agreed and asked Dr. Schein to draft a message.

Fear of the consequences of a proposed 27% cut in NIH fundingby the year 2000 dominated the NCAB meeting. Edward J. Sondik,MD, acting director of the NCI, exhorted committee members tothink about how their own institutions, as well as the NCI, willadapt to the reduction in funding. "It means that there willhave to be changes in the way we do business," he said. "Allprograms will be affected." [See "Scientists Must Adaptto Reduced NIH Funds" for Dr. W. Maxwell Cowan's view onhow funding cuts may affect research.]

NCI core grants, while not the biggest revenue source for cancercenters, are one of the most important. "They provide leveragefor other revenue, and they lend a nurturing aspect to the sciencedone at an institution," said Robert Young, MD, president,Fox Chase Cancer Center.

Dr. Young and two other cancer center directors present at themeeting also cited health-care reform as a major threat to cancercenters. They fear that changes in the health-care system currentlytaking place across the country may limit patients' access tocenters of excellence; seriously jeopardize payment for the patientcare component of clinical trials; threaten the amount of researchfunds that academic health-care centers can raise from the privatesector; limit patients' access to oncologists; and imperil innovationbecause clinical trials, as currently done, cost more than ordinarycare.

Comprehensive cancer centers are the best places for doing translationalresearch, and translational research is a major hope for the conquestof cancer, said Martin D. Abeloff, director, Johns Hopkins OncologyCenter.

He said that his Center has expanded from singular to multidepartmentalfunction, with focus on cancer prevention, genetics, early detectionand diagnosis, and innovative therapies.

"We require flexibility in the way we use our limited fundsso that we can achieve the highest possible productivity, andcan take risks and be innovative," Dr. Abeloff said. As health-carereform proceeds, he said, cancer centers may be in danger of becomingan anachronism.