The Head of National Institute of Health addresses the 101st AACR Meeting

Francis Collins, President of the National Institute of Health, made his address to AACR, on Monday April 19th. It turned out to be much more scientific than expected, and in a positive way.

Indeed, I was expecting to hear something about NIH resource allocation, scarcity of funding and challenges for the future of cancer research. While this was present, it was intermingled with some good info about science projects, and a detailed description of the Cancer Genome Atlas (TCGA).

Collins started off by describing NIH's double mission: to research on fundamental questions in nature, and to apply that knowledge to improve health. He then described the NIH funding budget for 2010: $31 Billion, 84 % of which will be devoted to extramural programs, more than 50 % to research projects for individually driven grants (and here the NIH director made a point to reassure scientists that, although he supports high-throughput technologies, he still thinks that science is individually driven).

Thanks to the 2010 Recovery Act, signed into law by President Obama on February 17 (http://recovery.nih.gov/), NIH funding has been increased by $10 billion and researchers can finally breath a sigh relief after years of low budget under the Bush administration.

Then Collins described five broad areas of research that in his opinion represent great opportunities for investments (Collins F, Science 1 January 2010). The first one is the application of genomics and other high-throughput technologies to fundamental biological questions. In Collins' words, questions which have the word 'all' in them, for example; 'What are all the genes of our genome/all the microbes/all the proteins?'.

He then focused on the one example of such applications which is dearest to him, the Cancer Genome Atlas (TGCA), as he was instrumental in its setup. TGCA (http://cancergenome.nih.gov/ ) aims at identifying genetic mutations and epigenetic changes that drive cancer. The initial pilot project focused on glioblastoma, squamous cell lung carcinoma and serous cystadenocarcinoma (carcinoma of the ovary). TGCA policy is to make data publicly available to the whole of the research community, even before publication. An exciting trio of publications on TGCA and glioblastoma was recently published (Nature September 2008; Plos One February 2010, Cancer Cell, 2010) and identifies four subtypes with show very different response to therapies and different prognosis. As the pilot phase is now concluded, the funds allocated by the Recovery Act allow an exciting expansion to about other 20 cancer types. Among the potential tumours to be mapped are adenocarcinoma of the lung, colon, uterus, carcinoma of the kidney, acute myeloid leukaemia and invasive ductal carcinoma of the breast.

The rest of the world has similar projects aiming at a collaborative effort, such as the International Cancer Genome Consortium (ICGC, http://www.icgc.org/).

But, as Collins rightly emphasized, the discoveries of the TGCA and the ICGC will really benefit cancer research only if the entire cancer community jumps on the data and finds smart ways to use it. Of course there are challenges in terms of keeping track of the huge amount of data and in interpreting it, but as Francis put it: "What a great problem to have!".

As for the second opportunity to invest funds, it's 'translational research': filling gaps between basic science and the clinics to find new treatments. NIH is really working on this, by empowering academic researchers to play a bigger role in building these bridges. For those not in the know about one of the most interesting NIH initiatives, the NIH Molecular Library, in Dr Collins's words "it's about time you looked it up" (http://mli.nih.gov/mli/).

Dr Collins was also glad to share the news of a new joint leadership council between NIH and FDA (http://www.fda.gov/ScienceResearch/SpecialTopics/RegulatoryScience/ucm201654.htm ), which aims to improve translational research and make the clinical trials scene "regulatory review ready". Scientists out there will already know hiw much thats needed!

The third project is to put science to work for the benefit of health care reform! That should sound sweet to the ears of those working in the field of health policy, health economics, pharmacoeconomics, and similar related fields.

And fourth; encouraging a greater focus on global health issues. Collins, being a US citizen, thinks that US, and NIH in particular, have a responsibility towards the rest of the world in terms of global health issues. However, he was keen to underline the soft approach that they should take in applying this mandate, an approach that should be radically different from the one chosen by the US in the past few years towards the rest of world. One example of this mandate is the 'OLACPD' collaboration between the NCI and the Fogarty Center (http://www.fic.nih.gov/ ) for advancing cancer research in Latin America (http://www.cancer.gov/aboutnci/olacpd).

Last but not least; 'reinvigorating and empowering the biomedical research community'. Even if NIH received an injection of funds with the Recovery Act, that's only a temporary relief (2-years funding), and NIH researchers need to be creative in the way they're investing their funds and in developing ways to raise more for the future. 'Pioneer Awards' have also been designed for especially innovative researchers (http://nihroadmap.nih.gov/pioneer/ ).

Summing up, Collins urged scientists to "make the case for research".

"We -as scientists - have the responsibility to spread awareness about the exciting things we are doing, and need to pass on our enthusiasm to the public. Cancer research will only benefit from it."

I can only agree!