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I i I P.O. Box 2370 Reston, Virginia 22090 Telephone 703-620•4646 HAMMER SAYS "EXCITING TIMES" SHOULD CONVINCE ~ PRESIDENT TO INCREASE BUDGET, OK ACT RENEWAL Armand Hammer, after hearing once again details on some remarkable pragreSs in cancer research, repeated his vow to take the case :o Pcesident Re,agan for increased cancer funeaing and for renewal of the National Cancer Act. "Ttiese are exciting ti mes in cancer researehbut theyelsoarc anxious times," Hammersaid Mondayat meetingof the President's Cancer Pune1, which he chairs, at Johns (Continued to page 2) /n Rrirf IONGMIRE REAPPOINTED TO PANEI: NEW ORGAN SYSTEM GROUP FOR BRAIN-CNS TUMORS ASKED 111LLBAM LONGMQtE,distinguished physician at Les Angeles Veterans Administration Hospital and retired head of surgery at UCLA, hes been reappointed by President Reagan to a sccorxi three year term on the President's Cancer Panel. Panel Chairman Armand HammerannouncRd the appoint ment this week at the meeting in Baltimqre, ... PAR"17CiPANTSin last week's meeting on brain tumors agreed on recommending to NCI that a new working group on malignaneies of the brein and central nervous system be established within the Organ Systems Program. The recommendation will go to the Div. of Cancer Prevention b Control's Board of Scientific Counselorsat theBoard'smePtingin. May_;r wni b-- ._tial fi:rtncr; organ site tobe added to the program since the National Pancreatic Cancer Project was established 10 years ago under the old Organ Site Program.... GERALD MURPHY, director of the Organ Systems Coordinetireg Center, has appointed with N CI's concurrence the six members of the OSCC Advisory Boerd.7he Board will meet onnually to evaluate the OSCC and the progress reported by chairmen of the p"rams and to make recom mendations for termination of ongoing pqpams or implementation of new ottes,'Itds Board members are James Cox, Medical College of Wisconsin; Walter Lawrence, Medical College of Virginia; Peter Magee, Fels Research Institute; Bradford Pattem,on,Dana-Fantaer Cancer Institute; Will.iam Shingl¢ton, Duke Comprehensive, Canccr Center; and Willet Whit more, Memorial Sloatt-Kettering Cancer Center..., oDDN'i'REu1$iCT your planning on the basis of the present budget," NCI Directer Vincent I DeYita told center exeeutives at their recent meeting with NCI staff. Ne was referring to the cuts in the core grants budget which has I forced NCIto hold the second cycle of renewals to increases of 5 per cent aver current lev+els. N CI hopesto find enoul:h money to fund them at least at 85 per cent of recom mended budgets. NCI wouid need a little more than $3 million to fund them all at 95 per cent of I reoommended levels, the amounts received by those In the first cycle. P_.' . ' y ~ , Vol. 11 No. 17 April 26, 1985 I I@Copv,.gM 1985 T ne Cance' 4eua• +nc I Subscr,pl,on $1 E,9 yed' No"I, Ameaca $175 vear elsewneie Geography Still An tssue For Centers: Durant Asks Is It "Holy Water" Or Money? ... PageQ Biological Modifiers Journal Objects To NEJ Policy, Says It Will OK Clinical Data Release ... Pap 6 NCAB Committee Stif! Debating How To Encourage Surgical Oncology - . . . Page 7 NCI Advisory Group, Other Cancer Meetings ...Page7

HAMMER SAYS HE'LL ARGUE FOR BUDGET INCREASE, RENEWAL OF CANCER ACT (Continued from page 1) Hapkins Univ.'Iite plan bythe White HouseOffiee of Management h Budget to "forward fund" enough NIH grants with 1985 fiscal year money to hold the number of competing grants to 5,000 hss been determined by the General Account ing Of f ice to be unlawful, Ham mer noted. Congrees had intended for 6,500 competing grants to be funded and appropriated sufficient money to do that. "An equally disturbing problem," Hammer codttinued, "is reauthorization of the National Cancer Act "If the special authorities the Act gave the NC1 director are taken away, it would have a serious, negative impact on cancer research, he said. He commended the American Cancer Society and the new National Coalition for'' - er Research, as well as other organizatL..Is and individual scientists for the efforts they have made in exerting pressures on the Administration and Congress. 'The National Coalition can be especially helpful, as well as individual scientists," Ham mer said. "New diseoveries are co m ing f ro m every side. They are astounding " Ham mer said he is hopeful "we can persuade President Reagan that there should be no d.its in the cancer budget. If anything, the budget should be increased." Citing the evidence of progress presented by Hopkins and Univ. of Maryland investigators at the meeting Monchy; the work of Steven Rosenberg at NCI in treating cancer paiient> wiilr uricricuiuir2; Roland Mertelsmann clinical studies with IL-2 at Memorial Sloan-Kettering, UCLA's recent decision to undertake Ilr2 clinical studies; and a com nient by MSK's Iloyd Old that there have been "more advances in cancer i m munology in the lsst few m on khs t han in the last 25 years," Ha m m er said this "astonishing progress. .. will be brought to the attention of the President. I think therr that Mr. (David) Stockman (OMBdirector)shotild be directed to give his attention to other fields and stay away from cancer research." Albert Owens, director of the Johns Hopkins Oncology Center, said the center had been establishedhecause of stimulation of the National Cancer Act. Owens said ma jor problems the center faces include training of physician scientists, initial support for young faculty members, initial support itor novel research, application of research results to practice, and the potential impact of the prospective payment (DRG) system. "We would like for you to carry the message back that we absolutely support renewal of the National Cancer Act;" Owens told the Panel. "Not to renew would be a most retrogressive and regretful step." Owens said he was "most distressed" by the multiple year funding plan of OD'1B. The Hopkins center would lose 14 grants if thait plan is carried out. "We need generous and stable funding for biomedical research. The NCI bypass budget is reasonable and soundly based. I understand the argument about reducing the national deficit, but the argument for increased support for biomedical research is not entirely self serving. The Constitution gives Congress the power to'provide for the oom mon defense and general welfare: 3We went to be sure that 'general welfare' gets proper attention " NCI Director Vincent DeVita asked Owens if he could predict a time would come when cancer center core grantsare no longer necessary. He also asked what role construction grants played in developing the center. Tt~e core grant, Owens answered, is beco m; ng a progressively smaller part of the center's budget, down from one third at the start to about 12 per cent now. However, "if we lost the core grant, we would lose something vital. It funds young invest i- gators,and provides the operational capability for sltared resources, an increasingly importan t ele m en t in pooling our resources. Also, it provides 10-15 per cent of the salaries for the, major program leaders working in the center " As for construction grants, "the need for matching funds proved a very effect ive way to ope n conversations with a rwmber of people. Havin g t ha t 6 rstt app:avad startcd the p:c.css •clli n6." NCI IJa,puty Director Jane Henney, referring to the problem cited by Owens of training physician investigators, referred to "oversaturation of physicians, even in oncology subspecialtiesd" "'Ihere may be a surfeit of physicians in genera 1, but I don't think we've been overwhelmed by numbers in oncology," Owens said. "We need more of those individuals. it's not just a matter o: supporting them in training. They're concerned abou t what institutions and programs will be there for them when they complete training. They need to see the challenge " Panel member William Longmirc eom mented that although there may be an over supply of surgeons, "not enough of them are interested in cancer research " Stephen Baylin,associate professor of oncology at Hopkins, said "it is inconceivable that we're talking about whether the National Cancer Ac t would be renewed. It is indispensable. The Cancr- Program is thebest money the federal governmer, t spendS" Bert Vogelstein, assoeiate professor of on co lcpy. The Cancer L,et:ter F'age 2 r Aprnl 26, 1985

said "Most of the exciting discoveries in cancer research are in the United States, the bulk of them supported by NCL'Jhat should be a great souree of pride for us all, We need first a, place to'do research and second, the support to Qo it... There must be :nuch greater stabilitvin that support." Stanley Order, professor of oncolop, described tis studies in using radiolabejed anttbodies in the treatment of hepatomas. The process apparentl y has cured some patients in the most advanced stages. One "with the largest tu mor I have ever seen," Order said, weighing 7,200 grams, has had t ne tu m or shrink to 1,700 grams. Others have had upresectable tumors reduel'd to reseetable size. No toxicity has been observed frum the treatment. Order mentioned his majoreoneern about cancer funding. "Each of us in the medical profession has certain commitments. One I have stuck with is radiolabeled antibodies. The other ic in training youngscientists:" He referred to the late Rachel Carson's book "Silent Spring" which warned about potential effects of environmental poisoning. "We face in oncology research another silent spring, which would be the result of cutting off support for research training" George Santos, professor of oncology at Hopkins and a leader in development of bone marrow transhlents in the treatment of some cancers and aplastic anerhia,describea current results. With matched donors, "we should be able to get 70 per cent survival" in aplastic anemia. With allogeneic bone marrow transplant for acute lymphocyticleukemia given during first or second remission, 50 per cent long term survival is being at:iueveti. in aiuvnic myclogenous leukemia, use of cyclosporine to combat graft vs. host disease resulting from bone marrow transplant has improved the prospect for long term survival. In acute nonlymphocytic leukem ia, patients under age 201tave 65 percent disease free subvival after BM T. For those over 20, 30 per cent disease free suavival is being seen "but that should move up to 50 per cent." "Without the National Cancer Act, this would not be happening," Santos said. "N inet y per cent of m y research is funded by NCL" He agreed with Order on training of new investigators. "We need people to take our place " Richard Ross,deanof the Johns Hopkins Medical School, said that at first "the idea of taking peecs out of departments" in sta rt ing the oncology center Wd not meet with'hmiversal enthusiasm. Now, 10 years later, there is no quest ton of :t!. success. It xes a wise decision." The center represents "scp:ore,tUon Nrthout isolation. ..!t ia not tsolutcd fror:. the r„e,r7 ttrra-- of t0jatranulcffort. T1Wt`s wlr-n- u.• wunF: people are." Ross said he was pleased by Ha m mer's reference to Steven Rosenberg, a Hopkins alumnus. "We're very proud of him. He's had a magnifieent career in surgery and research." Ross continued, "If the whole institution operated as well as the oncology center, we would be a better place. The research is first class." He noted that two thirdsof the center's btldget comes from thepeerreviewsystem, with 49of 61 faculty members having ROl or other pri mary suppor t through an independent review mechanism. "I'rn especially dPlighted to see an e mphasis on basic research and clinical research working together. Nowhere is the link between basic research and patient research stronger than in the oncology center." However, "that is a threatened activity because of patient costs and reimbursement policies." Robert Heyssel, president of Johns Hopkins Hospital, told the Panel, "We need your help and some assurances that we b`on't fall back." Refer- ring to inconsistencies and unfair rei rtiburse ment posed bythe prospective payment system, Heyssel mentioned the DRG for anemia. "There is iron deficiency anemia and aplastic anemia." Stephen Schimpff, director of the Univ. of Maryland Cancer Center in Balti more, descri bed t he development of the center from 1981, tvhetz NCI's BaltimorP Canoer Rewsrch Progra m was etjded and the center was established, to the present.'Che staff in 1981 had had no prior extra mural grant experience and the center had no money in peer reviewed grants. Today the center has $1.3 million in grants. Schmimpff said the two centers in Baltimore are "eomplementarv" in evtoveeetic:q snri AlnS!w-y-pMh; they"overlap with breadth" in leukemia research; and "overlap with depth" in pharmacology. Thomas Kelly,professor of molecular biology a geneticsat the Univ. of Maryland Cancer Center, said,"This really is a very exciting time in basic cancer research and basic science in genera l. That isnot an accident. It is the result of support from the federal government. Recent reduct ions and those contemplated will take a toll. It is essential to provide adequate support for new i n vest iga t or•s, not only to train them, but it is essential that we provide support for their projects after training. Our fellows and facultyhave s&nrat deal of anxiety about the stability of support." Julius Pericola, president of Bristol l.abora- tories, described his company's involvement in ouvcr research and development of antieaneer drugr. At the time Bristol-bt yers made the decision for a mapr effort ut cancer, the conventional wisdom in tlre pturrmaceutical industry was that the market potcntUnl was not enough to justify research and tk•vclo{,ment costs, Pericola said."We believed to ttr oont.nrry, and thst proved to be sound judg ment. The Cancer Letter Vol. t t No. 17 / Page 3

Bristol-Myers is now the country's leading maker and marketer of anticancefr drugs" Bristc•1-Mye.rs' progra m of in aking unrestricted grants to selected institutions (now totaling 17) was started at Owens' instigation, Pericola said. 'lt:e blineher in Owens' argument was his statement that "Bristol-Myers support will provide a window on the unexpected," according to Pericola. "1We hoped that other companies would follow sLdt, and some have;" Pericola said. "We are proud of our program. We believe in it, and v+e intend to stick to it. But it has e limit. I still feel (as he said he had when Owens made the suggestion) that it is a dropin the bucket.,i NCI's basic research budget is substantially reduced, will private enterprise pick up the difference? In my opinion, the answer is no. Bristol-Myers couldn't edd, enough.Otu role is nezmwly defined. Our major cornmitment has to be to applied research, which depends on basic research. 1b assume that privatP enterprise can niake up for substantial cuts in basic research is unrealistic " Comments from members of the audience included: Jerome Cardin, representing an organization called the Basic Cancer Research Foundation-"We believe basic research is our best hope, and the Johns Hopkins Oncology Cent'er is one of the best. Government should provide irdqreased support for basic research. (Recent actions by the government) have sent a confusing message. On one hand, the Administration is encouraging private support; on the other hand, it is withdrawing funds already aFpropriated by Congress. I hope you can convince the President that he can't encourage private support by withdrawing federal commitments." David Ettinger, on the DItG issue-"Clinical cancer research equates with the best cancer treat- ment. It is sometimes costly. (HHS Secretary) Margaret Heckler'sstatement that DRGs will have no impact on clinical research has no basis in fact." Linda Arenth, director of nursing at Hopkin9-" W e are concerned about prospective payment. Variations in cancer treatment are not fully reflected in DR G rates.'Itiey must recognize severity of illness and variations in treatment." Norman Rockwell, private citizen--"I'm overwhelmed by the progress which appears to have been made in the last 35 years. But from the point of view of the dying patient, it is too little, too late." Ne described the facility at Hopkinq for dying patients and family members. "The only intelligent course for this country is to carry out research with all possible resources." Bart Fisher, chairman of the Aplastie Anemia Foundation .4dvisory Com missic+rr"Fifty one billion dollars appropriated for defense has not t+een obligated:' He recom mended a freeze on the defense budget which he contended would nat cut actual defense spending due to the unobligated funds left over from prior years. Failing that,'"the medical com munity will have to lobby our fellow ci tizens for more taxes to pay for biomedical research:' GEOG~RAPHY REMAINS AN ISSUE FOR CANCER CENTERS; NCI "HOLY WATER" OR MONEY? =ince the early days following enactment of the National Cancer Act of 1971, NCI has had to contend with pressures frc:n a varietyof sources, not the least of which is Congress, to make available to all regions of the country the best and latest in the dagnosis and treat ment of cancer.'IT>st was stmngly implied in the section of the Act which authorizes NClsupport for'new centers for basic and clinical research into, training in, and demortistration of, advanced diagnostic, prevention and treatment methods for cancer." The goal in those days was to encourage develop- ment of either comprehensive cancer centers or clinical centers with advanced capabilities so geographically distributed that no patient would have to drive more than half a day to reach one. That goal evolved into the various community prc~grams initiated andsupported by NCI, including regional cooperative groups, the Cooperative Group Outreach Program and Com munity Clinical Oncology Progra m. The issue of geographic distribution of NCi aupported cancer centers remains alive, however, and the pressures are still there. Jerome Yates, who heads the Centers & Com- munity Oncology Program in the Div. of Cancer Prevention & Control, presented a discussion paper on the issue at the recent meeting of cancer center executives at NCI: "NCI cancer centers are often portrayed as oiganizetions where excellence in the diagnosis and maregement of cancer as well as concentrated cancer training and research occurs. Research, pat ient ca re and training are present to a varying extent in all of the NCI cancer centers. Basic science research is coordinated in some centers without clinical components and some clinical research is conducted inlocations without laboratory reseerch or onsite training activities. The NCI centers progra m has developed and maintained excellence through the peer review system. "NCI has not stipulated that every center have programs in training, basic research, clinical research, cancer control research, or outreach activities. Indeed, NCI formally recognizes and funds flourishing laboratory and cancer control centers without clir.ical care components. These specialiaed centersand omsortial centers are foci The Cancer Letter Page 4 / April 26, 11 985

of resemdi without direct cancer pat ient management responsibilities. They are largely located in envirormentsproviding a critical mass of research expertise-most often at universities or in free standing institutes. "One major intent of the National Cancer Act of 1971 was to provide patients wit h access to opt i m al patient care through replication of, NCI centers in the U.& Multiple models for geographic distribution have been dt:veloped over the past 15 years. All have addressed patient access to centers. However, the lack of clinical research capability and laboratory and training programs persists in some areas of the country, and this is unlikely to change. The shiftingof oncologists traiiied in clinical research from largeurbe.n center. to moderately sized cities without medical schools has gradually increased the level of interest and ability of medium sized corn munities to participate in clinical research. Siccessful NCI com m unit yclinical research prog- tams sur, ~~ as the ~operative Group Outreach Pnogra m and the Community Clinical Oncology Program demonstrate new abilities of community elinieal investigators. They also serve as regional leaders for consultation in diagnosis ehd management of cancer in a selection of geographic areas presently devoid of cancer centers. "We are considering an in depth analysis of the eommunity clinical trials efforts as data become avaaable from our community program evalua- tior..'Iherelationshipof these com m unity clinical research efforts to their research bases (clinical trials groups and cancer cettters) and the regional networks formed by some, for example, the Northern Cali.fomia Oncology Group, North Central Cancer Tieaimeni Group, Piedmont Oncology t3 oup, and tne Illinois Cancer Council represent different models which have been able to extend their interests beyond treat ment research to regional cancer control research. "''l7ie cancer center cdnsortial concept was developed to encourage this type of interaction, but most com munity physiciahs involved in clinical research will still interact primarily with the national clinical trials groups ." 71hepaper offered these questions to consider: 1. What are the advantages and disadvantages for destpwating com munity cancer centers without readily accessible NCI (prototype) cancer cimters in their regions? 2. What are the appropriate criteria for their designation, their location, and their research participation? 3. What should the relationship of the com- munity cancer centers be with other regional cancer interests, clinical trials groups, and the formally designated NCI cancer centers in regions where this may occur? 4. Should cancer control act ivities be a require- ment to the primary activit y of such a center? lf so, to what extent should financial and mrganiza- tional stability be assured? Is such assurance realistic in our present environment2. 5.Ce.nt:rsservingconcentrated minorAty popu- lations pro%:de benefits for their communities by increasing awareness and facilitating aceess to state of the art care for cancer-might an NCI designation foster iRproved patient manogement? 6. What is the role of all types of cancer eenters in the N Cl goals for decreased mortali t y and morbidity for the Year 2000? Yates offered these options to consider: 1. Geoggraphic distribution of centers should be allowed to develop spontaneously within the e~d st ing center and consortial guidelines (the draft of guidelines for the new consortia). cancer center grant were'disctssed by the center executives who suggestedsbme changes and will be presented to the DCPC Boai d of Scientific Counselors in 1Nay-71te Cancer l.etter, April 19). 2. Free standing clinical cancer centers with peer reviewed approved participation in clinical research should be considered. 3.Onlyc^ommuniitycancer centers with clinical research links to existing cancer centers in or close to their regions should be considered. 4. Requite 2 or 3 above but also demonstrate that multidisciplinary cancer management planning is the norm. 5. Need for different types of centers to provide access topetients from underserved areas (minority or geographic) to state of the art screening, prevention, diagnosis and treatment. Yatesopened the discussion with the qiuestion, "Where should we go in supporting com munity centers where no prospect exists for basic research?" He said he plans to bring together persons representing community centers, rooperative groups, traditional cancer centers, DCPC and the Div. of Cancer 7reetment to discuss the issue. However, "'I'he bottom line is where will t he m oney come from? We've invested a fair amount of money in community programs. We ought to use informntion coming out of them in logical planning to determine if we should issue new RFAs for CCOP or its successor." "Are you about to get into an accreditation process?" asked John Durant,Fox Chase Cancer Center.'7s It a matter of money, or is it holy water, holy waterbeing accreditation? Why do you have to tie money to holy water?" "You eould say that the core grant acts as an The Cancer Letter Vol. 11 No. 17 / Page 5

aect+editationsystem," Yates replied. He added that erticism from Congress has included charges that rural physicians who participate in clinical researchsometinpes "feel theyare being treated as second class citizens." "What business are we in?" asked Ross M cIntyre, Norris Cotton Cancer Center. "Is it coping with the most difficult tiiological problem man has ever addressed? Or are we in the business of satisfying political expediency?" The resounding answer, from Yates and others in the room, was "Both!" Franco Muggia, New York L'niv., asked if "there is any thought of tieing in com munity activities with the consortium centers?" "'ftt's a good point," Yates answered. "Maybe through that sort of thing (other mechanisms to improve geographic distribution) will not be necessary." BIOLOGICAL MODIFIERS JOURNAL SAYS IT WILL OK RELEASE OF CLINICAL DATA At least one professional journal in the cancer research field objects to the policy of the "New England Journal of Medicine" relating to release of information prior to publication. In an editorial in the "Journal of Biological Response Modifiers,"Editor Robert Oldham called NEJ's policy "indefensible" when clinical studies are involved and set forth his journal's policy of makingavailable to inquiry im mediately data from any study accepted for publication. nli4wmkPditorialacknowled¢ed that scientists have proprietary rights to the products of their studies which they may consider "as their personal intellectual property." However, "while such feelings are natural and probably occur in all of us, it is importar,t to examine the effect of such ieelings anct their resulting actions on others. For research a:tivities in the laboratory, where the resultsdorot have immediate clinical application, the question of timingand privacy are probably not of major importance. . . "Clinical research activities should be viewed differently. As is illustrated by the recent caitroversysurroimdingthe publication of research results from the National Surgical Ad juvan t Breast Program, it is clear that this issue has major implications for patients. In the press analysis of this controversy, it was reported that Dr. Bernard Fisher (NSABP chairman) was unwilling to share the results of a clinical study involving the use of radical vs. le:;s radical surgery in patients with breast cancer. This study was to be publ:shed in the "New England Journal of Medicine." Their policy of not releasing information prior to pubiication was the basis for Dr. Fisher's unwillingness to share ti:ese data in advance of publication. Such a pra_.^:.~ has been defended by the Journal's editor, Dr, :.:ziold Relman,on the grounds that his journal pun-shes rapidly anr) contains 'newsworthy' sc:e',tific articles. -?s the editor of this journal and as a clinician sc:entist, this position seems indefensible. 'Pi.-er r°ss and newsworthiness may mean one thing to a joa:.-nal editor or to a clinical investigator, but it tas auite another meaning to the patient. For the patient, timeliness is today and newsworthiness relates to facts which might be important to the treatment of the disease. It can be easily envisioned that several hundred to sever i1 thousand woa:en may have been affected in this controversy. The study.. addressed an i m portant issue for each woman developing breast cancer.. Aver the span of a few weeks, hundreds of patientsacross the United States and around the world will have to make the decision to have or not have a more or less radical surgical excision of their breast cancers. This personal decision must be made on a'real time' basis and if data have already accrued which might influence this decision, it should be available to those patients im mediately. "It is indefensible to withhold such data from patients who are making this decision because of joiumal policy, newsworthiness, privacy of data or any of these kinds of issues. In particular, this study, being supported by public funds (govern ment grants) is at risk for criticism when the informa- tion from it is not freely available at any point in time during the conduct of the study. Statisticians have many arguments as to when data must be analyzed, and there has been much written on the dangers of a preliminary analysis of an ongoing triaL However, onee the data have been analyzed and submitted for publication, the timing of statistical analysis, the acceptance of the article and the timingof thepublication become moot issues.The date have been analyzed and the study, for the purpose of that publication, is complete. Informa- tion from surhstudiesshould be freely available to patients when these studies might immediately influence patient decisions and clinical care. While no system exists for the rapid or instantaneous dissemination of such clinical information to patients or to their physicians and while it is unclear that the initiation of such a system of rapid communication (in preference to standard publication of medical journals) would be useful or cost effective, it is ciear that data which are available and accepted for publication should not be restricted when investigators are spevifically asked questions on results of their studies. "It is our policy to make available to any inquiry clinical data from any study accepted for The Canceer Let-ter Page 6/ April 26. 1985

publication'an the 'Journal of Biological Response Modifiers.' The time frame from acceptance to publication may be only one to two months or may be as long as three or four months. in either case, it would be unreasonable to withhold data from clinical studies which mi,,ht be relevant to 'real time' deeision making by patients and their physician. I would urge other editors of medical journals to take a similar stance on this issue." NCAEt COMMITTEE STILL DEBATING ISSUE, HOW TO ENCOURAGE SURGICAL ONCOLOGY The National Cancer AdvisoryBoard's Committee on Innovations in Surgical Oncology continues to debate the seemingly never ending issue of how surgical oncology can be encouraged and developed. The com mittee, chaired by Ed Calhoan, is scheduled to meet again during the May session of the NCAB. "We have made a giant stepforward in competing for ytxmgsurgeons through NCI's surgical oncology training programs," committee member Robert Hickey said at the last meeting. "One of the paramount functions of this committee might be to talk with our colleagues, persons interested in surgical oncology, and ask them their views of NCI programs," committee member Victor Braren com mented. "1 still think N Cl has a tolerant view of surgical oncology. N Cl would like to have mare surgeons involved in the CAmcer Program but doesa't know, how to get them. There are too manyshrdy sections with no surgeons, with no one looking at grants from a surgeon's viewpoint." Iris Sdneider, NCldirector of staff operations, objected to the word "tolerant" and suggested instead, "puzzlement," which Braren agreed was appropriate. "Surgeons do not think NCI ig-interested in auge=; Braren continued. "There needs to be a basic change in approach by NCL" eeds to be a "We have to change the entire atmosphere," committee member Geza Jako said. "Since this committee was formed, Dlr. (Bruce) Chabner (director of the Div. of Cancer Treatment) and the NCl atmosphere have changed." "I know surgeons," said Calhoon, one himself. "There are five in my family. At AMA, they're difficult to deal with. Who gets the press? SLcgeons. They'll have to be spoon fed on grants•- manship. Thit is something NCI will have todo " "Jatathan Rhoeds (first chairman of the NCAB) was a practicing surgeon; NCI assistant director Elliot Stonehill said. "1There has always been more than tolerance for surgeons on the NCAB.'1'he lack of interest has been on the part of surgeons, not N CI. We have to stimulate them to develop good research ideas. It is not an issue of tolerance. The issue is lack of raw material." NCI ADVISORY GROUP, OTHER CANCER MEETINGS FOR MAY, JUNE, FUTURE Society of Head and Neck Surgeons Fifth Anmual joint Meetrng--May 5-8, Cerromar Bea ch, Pue rto Rico. Contact Drr, James Helsper, SHNSSecretary, 635 E. Union St., Pasadena, Calif. 91101. Cliaical Cytopathclogy for Pathologists-->`t a y 6-17, Johns Hopkins. Contact John Frost, M.D., 604 Patholagy Bldg, Johns Hopkins Hospital, Baltiadore 21205. Biometry dt Epidemiology Contract Review Committee--May 6-7, NIH Bldg 31 Rm 8, open May 6 8:30-9 a.m. Fitst hterbational Conference on S7cin Melanema -May 6-9v Vatice. Contact Conference Secretariet, lstitutoIQazionale Tumori, Via Venesian 1, 20133, Mil an, Italy. NationalTumor Registrars Assn; -May 7-10, Hotel QQxen Mary, Long Beach, Calif. 1985 annual meeting. Contact Cynthia Creech, Cancer Program Manager, Huntington Memorial Hospital,100 CongressSt„ Pasadena, Calif. 91105, phone 818-440-5186. Div. of Cancer Etiology Board of Scientific Comselotip-May 9-10, NIH Bldg 31 Rm 10, open 1 p.m,-adjummcnt May 9, 9 a.m: adjoumment May, 10. Div. of C,ancer Prevention a Control Board of Scientific Comaeloet-May 9-10, NIH Bldg 1 Wilson Hall . Open May 9 8:30 a.mr3 p.m., May 10 8:30 a.m,-adjournment. DCPC Board of Scientific Counselors Prevention Committeb-Map 9, NIH Bldg 1 Wilson Hall, open 5-7 p.m., closed 7 p.m: adournment, 1ldrances in Cancer 1reatmena-May 9, Roswell Park continuing education in oncology. Cancer Cbtmotberapy Update:1985-May 9-10, Alientown, Pa. Contact Richard Attilio, Allentown Hoseital, 17th a Chew Sta., Allentown 18102. Society for Clinical Trials Sixth Annhtal Meeting~-May 12-15,NcwOrleana. Contact Dr. Curt Futberg, 600 Wpndhurat Ave., Baltimore 21Z10. t~}-one 301-435-4200. CimOenEe of Local7bmor Control and Its Impact on9unival'-Mat 12-17, Rome.Third Rome Intcr- nationalSympas-um, Contact Assoeia:ione Italiana la Promizione dello Studio deUe Mallattie Wcologiscbe,Via Ple diMarmo, 18,Rome,Italy. National Cancer Advisory Board Committee on 0qan9ptedan Plaogtams-May 12, AiIH Bldg 31 Rm 8,7 m., open. a' Cbncer Advisory Board-May 13-15, NIH Bldg 31 R m 6, open M ay 13 8 15, 8; 3 0 a,m.-adjourn- ment, clobed May 14. NCAB Committee an Caaatrecrion-May 13, 5 p.m., elosed. NCAB Committee on Year 2000 GaaL-May 14, NIH Bldg 31 Rm 2, 5 p.w., open, NCAIi Cmdnitta mliorn,ataotrMay 14, NIH Bldg 31 Rm 6, 7:30 p.m., open. NCAB Cowatittee on Sapeal OrwoZogy-May 14, NIH Bldg 31 R m 4, 8 p.m., open. AQHToclnoiogT Aseessnoenr Mceting an Registries for Booc Mars+r Traneplant atioo--M ay 13-15, Masur Auditotatm,ddD-i,Bethesda, Md_ Contact Peter Murphy, Prospect AAsoeiatea,Suite 401, 2115 E. jefftrson The Cencer Letter Vol. 11 No.17 /Page7

St., Rockville, Md. 20852 phone 301-468-6555. Stm~eam Aaa4, for Caneet kesearch-•-May 13-15, Brat~slava, Czechoalovakia. Eighth meeting. Contact Dr. Marta Grofova,Seaetary General, 8th Meeting BACR, Cancer Research Institute,ulul armady 21,812 32 Bratislava. Clnealogy Iiuvi gSocisty 106 CAMess-May 15-18, Houston. Contact Nancy Berkocenta, ONS, 3111 BanJcaville Rd„ Stirite 200, Pittsburgh 15216, phone 412-344-3899. International Meeting on Advances in Yxrology-- M5-18, Cats,nia, ltaly. Contact Angclo Castro krstitute of Microbiology,Uv.iv, of Catania, -Fa ndrone, 81, 95124 Catanta. Canca ReseacchMaapowet ltevietq Comtnittee-- May 16-17, Bethesda Holiday Inn, open May 16 8: 3 0-9 a.m. Nattions,l Assn.of Oncology Social Workers-May 16-18, Houston. Contact Office of Conference Services, Box 131, M.D. Anderson Hospital, 6723 Bertner Ave., Houston 77030. Wozehless Cmceti'Iirestmenta-May 17-19, Victoria, B.C. CG act Blue Mountain Oncology Program, PO Box 327, Walla Walls, Wash. 99362, phone 509-525-1290. AmericanSodetyof Clitoical0ncalogy--M,ay 19-22, Houston. 21st annual meeting. Contact ASCOE:ecir tive Director, 435 N. Michigan Ave., Suite 1717, Chicago 60611, phone 312-644-0828. Societyof 8argicslClncology-May 19-22, Houston. An•stal meeting. Contact Charlene Terranova, SSO, 13 Elm St., Manchester Mass. 01944. Effect of Ti.n on Mahgnant Cell Growt}r-May 19-22, Scranton, Pa. Second international symposium. Contact Dr. Larry Sherman, Chemistry Dept., Univ.of Scranton,Scranton 18510, phone 717-961-7705. American Aaaa.for Cancer Reseaach-May 22-25, ttOUSOOn, 7tRh acrlial meetIDg. lAntact ApAl.i, T emple Univ. School of Medicine, West Blvd, Rm 301, Philadelphia 19140. American Aaro. for the Advaacecserrt of Scienee- May 26-31,Los Angel,ts. Contact AAAS Meetings OE6ce,1101 Vermont Ave.NW, Washington D.C. 20005. Div. of Cancer Biology R Diagnosis Board of Scientific Counselors-M ay 29, NIH Bldg 31 R m 9, open 9-11 a.m. Cancer RestArca t Repoat-ies Contrsct Review Committee--May 31, NIH Bldg 31 Rm 9, open 9-9:30 a.m. President's Cancer Pancl-June 3, Memorial Sloan-Kettering Cancer Center, New York, 9 a,m,, open. Div. of Cancer Treatment Board of Scientific Couasellors--June 10-11, NIH Bldg 31 Rm 10. AdvaotoiaH~abgy- une 10-14, London. Contact Mrs. E. Backer, School O1fic.e, Royal Postgraduate Medical School, Du Cane R aad, London W 120HS, England. Advances in the Care of the Chald with Cancer--June 12-14, HiYton Hotel, Los Angeles. Cont act A m e rie an Cancer Society, 777 Third Ave., N ew Yoirk 10 017, phone 212-371-2900. Breast Preaer.atidn: Worlahop on the Technique of Coasaratiot Strrgery and Radiotherapy for Early BoaR Csmxt•-June 14-15, Memorial Sloan-Kettering Cancer Censer,Nehv York. Contact CME Conference Planning Office, C-180, MSKCC, 1275 York Ave., New York 10021, phone 212-794-6754. Asm,of American Ca:aeet Iastitutes-3une 16-18, Washington Hilton Hotel, Washington D.C. dmiealOnoobgyeod Cancet Ntmting-june 16-20, Stockholm. Contact Mrs. Ira Thilen, Stockholm Convention Bureau, Jakobs Torg 3, S-111 52 Stockholm, Sweden. 8dembcanaa7lsmbr Growtir-june 17-20, Catholic Univ., Rome. Contact Scientific Secretariat, Istituto Patologia Qeneaale University' Catrolic, S. Cuore, Largo F, Vita, 1-00168, Roma, Italy. 7taricologyUpdate'85-June 17-19 Johns Hopkins School of Hygicnte lR Public Heaith, Baltimore. Contact Program Coordinator, Toxicology Updatc '85, 'Ilrtner Rm 22,720 Rutland Ave., Baltimore 21205. Cistieal Care aad Medical Management of the Cancer Patient-Jtme 20, Roswell Park continuing education in oncology. Hrra3Bary Gyneonknie a Breast Caneer-Juae 23-25, Redl.ionIrm,Omaha. Contact Hereditary Cancer Institute, Creighton Univ., Omaha, Neb. 68178. Fourth Intermtiooal Comfercnce on Environmental lAutageaa-June 24-28, Stockholm, Sarellite sym- Qpsia are scheduled ntr genetic tozicology of the diet in Copenhagen June 19-22; risk assessment in relation to mutagens and carcinogens in Oslo June 20-22;and monitoring of occupationaletposure to genotosicanta in Helsinki June 30-July 2. Contact Congress Office,ICEM-85, Stockholm Convention Burcau, Ho= 1617, ."i-1iioo, SQoe.'sitoim, FUTURE MEETIIBGS X11th International Symposium on Comparative ResearchonLeakemia and ReLted Diseases-July 7-12, Hambuzg, Germany. Contact Dr. David Yohn, Secretary General, Suite 302, 410 W, 12th Ave., Columbus, Ohio 43210, phone 614-422-5602. 'Popia is GaatroenRerolog ar liver Disease--Oc t, 3-5, Turner Bldg, Johns Hopkins Medical Institutions, Baltimore. Contact Jeanne Ryan, Program Coordinatot,Offace of Continuing Education Johns H••pldnsUniv,Sehoolof Medicine,720 RutlanJ Ave., Baltimorc 21205. Immttnobiology of Cancer and Allied lmmtme Dysftmetions--Nav. 4-7, Copenhagen, Includes presentations on human cancer immunobiology, markers, emgenously induced immunodefieieneies, clinical management, AIDS, new approaches to immunomodulation, and immunobrology of metastases. Contact M, Rodler & Co., Freyung 6, Poatfach 155, A-1014 Vienna, Austria. TheCancer Lefler _Editor Jerry D. Boyd Pudt.tn(b +p•,v.e,ar•t fi-es a\^a• hs I 'e Ca•-ce~ lrae' lnc - P O. 60~ .J'Q Fes.cn y.•1)-a:: ng;l n so p.h•,shN J+ tne Ci.n.[al Cln:e' l.•itl r Au ••4M$'rf••(10. 11c^A ot !re :'nhtcM J( :^-c pur'.cJt rn •q,•y be n.) •e_ Pva' $v)1(_ or tlantm,ltOd m anv IPn Ck'•m,ys~on u1 t~'reJr~•yhP• rr r( J•,( meJ~~ •Pe:r^n( ~,rrna~"'dl p1•C•.`(t`D..r.C 'r(:?d ^U W e:I ,e.,.•ctwqhOVi llle p,.C• .y- \ n,latc•S I ..k , n`a: re^t':•f'S Jn0 S'•~' (y`P da°\+CM-