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TOBACCO INSTITUTE LIBRARy PRESIDE!;T' S CANCER PA['~EL Room ]!AS~ Buildins 31 Natio~ia! - ~'"~ ..... of Bet~esda, :4arjland Friday, July ~8~ 1972 %~e me'tins ~e, ls convened at-9:50 ~.m~ ~ Mr. Benno Schmidt~ Chairmen ~ presiding,. MR, BENNO SCIE~IDT DR. ROBERT GOOD OTHF~RS: DR..FI~ANK J. EAUSCHER, J~. DR. ROBERT Q. I,L~RSTON ~. CALVI![ B0. BALDWIN~ JR.. DR. BAYARD MORR!SON l,~. J. McSHULSKIS TI55480048

PROCEEDINGS 2 MR. SCH,~4IDT: Mr. Baldwin reported that the 1972 fiscal year app~opr';ation of $378 ,85~ ,000 had been l~lly obligated. This compares with a 1971 obligation of approximately $233 million. The fiscal 1973 appropriation, as it has been resolved in the Joint conference co~m~ittee~ looks like $h~2 million for the National Cancer Institute• However, this &ppropriation b~ll has not yet become law,-and the Institute, for the tim~ being~ is operating under a continuing resolution which'permits obligati6ns at the $378 million level until the new appropriation becomes ]-~V. - Of--course, th~ Ca-nc.e~ appr0pi~'i~t~0_n :is part° o.I" a. !much bigge~ appropriation ~ii!~ i~oOdt .~.~Hich the~'e has been some ,talk Of a _ ~-presidential veto.. Howeyer, I feel sure that On~ ~¢~y-or another,- the Cancer Institute will receive its full ~;~92 .million for the 6urrent fiscal year. This figure is $38 million less than the auihorization ceiling contained in the Cancer Act. Whether this additional ~mount can be obtained in a l~ter supplemental appropriation is not known at this time. I would s~y that it depenSs in part on how urgent the need for this last $38 million hen be demonstrated to be as the fiscal ~ear end approaches. It is too early to know what the outlook for 197h is. There has been some preliminary discussion of a l0 per~entacross-the-board cut for H~ but it seems clear that with the announced purposes of the National Cancer Act and the President's support of those purposes, in the final analysis a budgeta~-E cut would not be expected at this TI55480049

3 point of the ne~- prosr~a, " |4R. BALDWIII: A request was made to, the Office of Management and Budget for 2113 ncw positions in the Cancer Institute for fiscal year 1973. This represented a substm~tial cut at the Director'~ level in the new positions requested by the staff, }{ere the raference to neu positions includes positions at all levels, from clerical to professional, and a majority of the new posit~bns requested were incident to management of the new program and the ~xpendithre of the sddition~l appropriations.. The Office of Management and Budget cut..the requested number back to 144 new positions, thus cutting out 99 of those requested. mn -SO do_i_n 7 tlef~,.Tth.& m~,~ter :ooen :for- ~r~her d-iscusz-iOn, at-_.a :__ ..................... later date;, when; .t!~e .appropriation bill is -si-~n~d by th~ -President ; 1~. soNI,IIDT: i ~m sure ~h~tvhat the O~f~ca of Manag~m~ab and- Budget is ~riving at in reducing the new position ntunbers.is attemptin to' force the Cancer Institute, to the ~im~ extent possible, to use butside personnel and professional'resources, rather than in-house resources for expenditures of the new monies. I believe that %o the greatest extent possible ~hey ~a~% the money t6 be spent through ~rants and co~tracts with the best-qualified scientists rather than by equivalent increases in in-houie activities. They feel that ~e can get excellent %uality and results for the money by getting the maximum ~mount of this work done on the outside of NCI while at thJ same time utilizing NCl's management and planning capabil~ties without dramatic increases in the number of people hired directly by the NCI~ TI55480050

|I Therefore, in order to 6at this position level raised, I think %~e wall have to demonstrate that the positions are needed for efficient administration of the program, and that they are n~t" being ~equested in order to conduct more of the cancer research effort withi~ the Institute. DR. RAUSCHER: The bulk of the new-positions are in the management c~tegory, and they do not represent ~n effort on our par~ to expand greatly our ovn research activities.. MR. SCHMIDT: In connection with these ne~¢ positions and the ~,:hole problem of personnel ceilings, one of our problems is that there are .... orders throughout the GoVernment for every department and every .......... _institute to decrease .its a~r~ge: grade ~evels-e.nd~o:de6rease-it~ " n~i~be~s._Of positions-so that a% the s~me time ~.ze ~re ~trying to--expand our total effort,~i~e~ are Under personnel-directives ~zhich ~-equ~e us to have fewer positions in these v~rious 6fade c~tegories, ~d lower ayerase grade levels each year. One way that ~ze have been able to operate in the C~ncer Institute in spite of these directives is by creating positions called "staff fellows." We h~ve been appointing a certain number of postdoctora~ professionals as staff fellows, ~nd ~mder the NIH rule, those staff fellows can serve for a maxim~a of six years. Then they have to ~o out or -be "convert'~ed". ,, We have also created a rank called "senior staff fellow~ so that during the last portion of that six.year period, if a man performs unusually well, he can be given some increase in compensation TI55480051

by being made a senior staff fellow. ~ut at the pr~sen} time, there is no place you caflput him on ~ tenured basis or on a permanent.basis, no matter how good he i's, once his six-year period expires. So this means that the best of these fellows start looking for. Jobs as they begin to approach the Qnd of that period, and some of them before they begin to approach it. I.have a~leSter here from Senat6r Javlts ~hlch raises this ~uestion in connection ~ith a pa~'ticular St~ff fellow, Dr. Rubin, who has brought the matter to the attention of Senator Javits' oTfice_, Aud I would appreciate it, Dr. Rauscher~ if you ~:ould ~. give m~ a memor=~dum off thi~ over~l-1 situ4tfon~ end--also a~draf~Z -reply _to~Senator Savits, ?ofthst I c~n respond to. this letter.._ ~dyou ~ight: aiso~ include any recon~endations.-you haye -as~ to what ~rther action we can take to try to ~freeze this situatibn at the O~[B or at the departmental .level, or %'herever the ~ction ~eeds to be taken. This is a matter that has been before the Panel previously, and I have written the ~.%ite House staff on this s.~bject, but so far ~e have not received any relief from these general directives that hold a very tight rein on us as far as creation of ne~" positions, promotions, and all the things that _are necessary to keep good people and a good organization going. The C~ucer Bill did give us some slight relief in that it provided for those 50 positions that the Director can fill as consultants or TI55480052

experts. compensation as Government Jobs go for those positions. can be fflled for a period of up to two years only. are exempt positions and permit fairly high-level But they DR. CLARK: That is full-time? DR. RAUSCIIER: Part-time or full-time, either way. DR, RAUSCHER: We have not filied any of the consultant spots yet, but I~ have gi.ven~_pe_rmission for recruitments, and I have certain recruit~.~ents underway in my o~m office~ which, when constummated, would result in the use of a total of about ~5 of.those consultant positions. ~ ~ - . i : ......DR~RAUSCHER:~- I hav_e made ~Dr~ Will.Jam Tenry .... l~u~o~og~~ Branch ~d propose -to appgint him to ~th~ po~it~on Associ a~e~ s~ient~.f~c- Di~ect6r for !r~unolo~~ ~- a -ne~.zly ~d program. I sm~ continuing the recruitment of a Deputy Director who will b~ a real Deputy Director, to whom all other program chie~fs and others in NCI report, ~-ud who is capable of r~mning the NCI operation when I am required to testify, go abroad, go to the ~ite House, or do the myriad of other things that take me a~ray from direct day-to-day supervision of the NCI program. I have a top man in mind, and I think there is a good chance of ~etting him. are ~Iso r$cruitln6 a Scientific Director for Etiology~ an Associate Director for Public Affairs, and a Chief of the Cmncer Control Program. I am also very pleased to have been able to recruit Dr. John Bailar, TI55480053

7 who ~ill join us in September, Dr. Bailar is a dlstiu.guished M.D. biosts.tisticiau ~ith great talents in the field of demogr~uhy~ and ~ill.be a fine addition to our organization. He ~lill be a big help to whomever we get to run the Control Program; or could very ~ell run it himself as Chief. DR. GOOD: I ~ould just like to say I ~ very please that immunology ~zill be identified as a'se~arate are,a~ and I think that there are m~my directions that we can go in that field. Bill Terry is a veil-trained man and will be an excellent addition to the staff in this capacity. ~ ,DR. PJ~USCHER: Several months ago we comniled a documentation whfchlwa~s submf, thdd £o NIH.~ and through t~[ to ~he Secgetary~'s ~ Office ~ justi-~in~ the ~le~atioh of~Zhe National--cancer Institute to B~eau status. ~is w~s epo~oved last we~k by t~e:Secretary,~ ~d was told this morning that it appea~ed in t~e Federal Register N@sterday. So this is now ~ reality,~" MR. SC~4IDT: I have brought to th@ attention of the Panel a letter ~hich I have received from Senator Javits, dated June 30, copies of which have been sent ~o ~r. Rausche~ and others, This letter dealt with an application by Dr. John H, Heller of the New England Institute, for support in purchasing Enz.yme Q-10 for testing as an immu~otherapeutic agent in p~tients with cancer of the breast. Dr. Rausch~r and Dr. Morrison gave the Panel a full briefing of the background of this matter, and it appwared that Dr. Heller T155480054

8 and his colleagues had failed to m~[e ~ grsmt application as they had been requested to do. A grant application. ~.~as requested in order to get the matter into appropriate form for proper peer review, However; since all Dr, Heller ~ranted ~as for NCI .,. pay for the materials, he had submitted only unsolicited contra~t proposals. T~e NCI had felt that it couldnot provide support without having the fuil program ~ubmitted for scrutiny and peer review. Secondly, the NCI professional.staff.who reviewed the matter did not feel that the s~limal experiments conducted by the applicant had been sufficient to Justify 'contract support, ~nd they further i~e~orted that~ n01~ciiniCal. d~t~ ~adT_~44n s~mi~ted ~;,i~h- res~ec-t to %lie ~imited clinical testing which had occurred, Un~e~ ~hese dircumsts~uce they had- fel-t a g-rapt was impossible; bega~s~ ~t had not- been requested in a form which would permit the r~quisite peer review, and contract support was not given because the animal and clinical data submitted did not warrant such support. Notwithstanding these factors, in view of the interest expressed by Senator Javits and the current interest in the field of immunotherapy, the Director recommended to the Psauel, and the P.anel agrged, that a special committee of singularly well-qualified scientists and doctors in the field of i~nunolo~y, chemotherapy, and breast cancer have a look at all th~ research data arid ~he proposed program and determine whether it is a program that NCI should support. I{ it is determined that the ~,nimal experimentation is inadequate, TI55480055

the precise nature of the inadequacy ~rill be pointed out, If the experimentation is adequate and the program deserves support, a determination ,~ill be made as to the form such support should take. I% ~ras suggested that Dr. Frank Dixon, Dr. Lloyd Old~. Dr. Chandler Stetson, Dr. Gordon Zubrod, and Dr. Michael Brennan, be asked to serve as a special peer review group for resolving this matter. (Whereupon, at ].2:30 p.m. ,..~ working luncheon was t~_ken until 1:15 ~.m. ) .AFTERNOON SESSION RL:JS~_~ERI. Sauce continues-to be one o~the~ mos~ serious. concerns-0f~t-~e NO-i staff .as b~ing~a possible de_~err_e_nt ii2~ g£t~:[n~ on~ ~.;ith the-];a.ti0ne.1 Coa~ez' Progr[un. -The :~on~essC£as ~auth~,iz4d, with OB~ concurrence, a number of new positions 9or the National Cancer In.stltute, These positions will be used l~÷gely in terms of managing the program, including secretaries, contract specialists, top-level scientific managers, ete: We ~ere, however, s.uecessfu'l during the ~'ast week in getting ~n additional floor in Building 33. ~hrough Dr. Marston's concurrence and support. ~is will help the space problem this year, but if additional needed ~ositions ~re forthcoming as-~e have requested~ from the C~ngress for the management aspects of t~e program, we will need to seek additional space somewhere, hopefully on the NIl[ c&mpus, or in adJoinin~ space in Bethesda. TI55480056

lO Another major problem regarding space is ~at concerned with renovation of existin~ s~ace, At the present time all renovations on the c~mpus are a~ministered by a central NIH engineering staff, BeCause of the severe position cutbacks over the past t~ree years, there are inadequate numbers of people sod ioadequate skilled personnel to perform renovations on a timely basis. At tl~e present time, even a small renovation job in a single laboratory room may take ma~y months to complete, Accordingly, I have requested pcrmiss.i0n ~from NIH to use what we interpret as existing authority to co~tract with outside firms to perform renovation for" the NCI on a much ~.~or¢: timely basis. We L~have ~not~yet r~celved -a-reply ~o~this ~request ~. ~ ~,_ SCHMIDT:~ In connection With your space res~irements did get anothe~ fioo~ i~ this ~bui].dinG; right? DR, RAUSCHER: That is correct; and again I wish to thank Bob Mnrston for his suppo~-t. ' MR. SCHM!DT: Dr. Rauscher has re%iewed with me a pr.eliminary 'chart showing the various report~ that are due from the Director, the Nationa~ Cancer Advisory Board, ~nd the National Cancer Pm~el. As soon as these charts are in final form copies will be sent to ~embers of the Panel. This will provide us, ~1ong other things, ~ith a schedule as'~othe~timing and responsibility for ~he prepara- tion of the report vhich the Panel is required to make to the President at the end of each calendar year. What about the National C~cer Progrs~m Plan? TI55480057