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- 18' - Drug Research Reports Voli. 14, No. 45 NCIEMBARKS ON A'FIRST;' CONGREGATES MOST ADMINISTRATORS, RESEARCHER'S IN FRONT RANKS OF ONE DISEASE AREA TO CREATE COORDINATED NATL. STUDY The interest of scientists creating Phase 2 of the Natl. Cancer Plan is so intense that they have requested a second, previously unscheduled meeting of their group before turning their work over to Phase 3 planners. They met first at Airlie House in Warrenton, Va. on Sunday, Oct. 31 and stayed in session throughi Wednesday. The seven Phase 2 cmtes. were each expected to produce a broad approach to their subject areas -- identification of external carcinogens, modification of host functions, prevention of cell transformation, research on preventing post-trans- formation tumors, ranking of risk groups in the populbtion, assay of proposedtreat- ments, and exploration of rehabilitation or "compensation" for patient deficits ("The Blue Sheet" Sept. 29, p. 17). The crnte. chairmen are well on their way to drawing up their seven reports, but have told the Natl. Cancer Institute (NCI) that they want to meet again on Nov. 19, after first comparing each other' s report with their own to make sure no important matters "fell into the cracks" between reports. They want to turn over to Phase 3 planners a unified, all- encompassing natl. research and treatment pl'an deserving the attention focused on their project by President Nixon's support for a new "initiative" against cancer. RuscK Heads Meeting To Remove "Establishment" Stigma; Marston, Baker Leave Early The keenness of the scientists' interest in the Natl. Cancer Plan was demonstrated when a matter of import to the life-long work of one of the planners arose the Sunday night the meetings convened~. Reached by a reporter, the scientist said he'd heard of the important development, was extremely interested~ in it, but couldn't talk about it because his rnind was on the next day's planning sessions. The 40 scientists at the meetings each were given a microphone hooked to a central recording, system. In addition; a vicinity microphone was placed in each room as a double check. The seven cmte. chairman were invited to bring rapporteurs to monitor the meetings as well. Most brought scientists from their own institutes. Wis. U. McCardle Clinic Director Harold Rasch was at the helm during the Phase 2' opening meeting. Rusch has publicly favored the Senate Cancer Consultants' Panel that recommended a natl. cancer authority located inside NIH but' administratively able to bypass NIH to get its money and orders from the White House. His appointment represents an attempt to take the "establishment" stigma off the meetings. NIH Director Marston and NCI Director Carl Baker opened the meetings, but then departed with the express purpose of leaving the scientists to reach their conclusions without direct influence from N'IH topside. NCI allowed a couple of its informationofficers to attend some of the sessions. The entire Nat1. Cancer Plan, production is being staged by NCI somewhat on an Q arm's-length basis via a $900,000 contract to Auerbach Associates. The firm, located in Q suburban DC will reduce the output of the many days of meetinas to document form. R% M Some at the meeting went away with the impression that the govt. is committed to 05 what comes out of the months-long process, but such is not the case. NCI Chief of Systems Operations & Planning, John, McShulskis told "'The Blue Sheet" that whatever comes out will go through the "usuall review procedures."' He said he was not referring to N'IH study sections, etc. but to the review any govt. project of this scope would get. The plan is expected' to cost $1 bil./yr. by 1976. 0

- ~ ~ . November 10, 1971 Drug Research Reports - 19 - H'e and NCI Associate Director for Program~ Planning & Analysis Louis Carrese said HEW's topside -- Richardson, DuVal -- are getting prog,ress reports on the planning and the Office of Management & Budget will eventually review it. Some weeks ago, NCI Director Baker said that NCI had selected seven objectives as Phase 1 of the Natl. Cancer P1ani. The general approaches to these objectives are being developed in Phase 2, to be completed Nov., 19th. Originalily, the entire month of November was set aside for Phase 3 seriatum cmte. meetings by 240 scientists engaged in spelling out the particulars for accomplishing the approaches developed in Phase 2., The original! schedule called for completion of the plan iniDecember. . An, NCI spokesrnan now says the meetings, presumably into Phase 3, will continue to January and the end date is not yet lmown. It is possible, though NCI has not said as much, FORTY MIMEC TO AIRLO~ HOUSE SESS9Q3N CN NATiL. CACNICER PLA:a 'AC T MI PRCCRaMS VViLL RESU LT FIRCPv1 RECw~;iP~EINATWINS. N1CI SAYS 0 Identification of external, agents, carcinogens; focusing on preventing the agents from reaching the body or blocking them after ingestion - HAROLD RUSCH, McArdle Lab, Wis. U~., chairman., JAMES MlLLER, McArdle Lab. NORTON NELSON, NYU. PAUL KOTI11% Temple. ERNEST WYNDER, American Health Founda- tion. JOSEPH MELNICK, Baylor. Q Modiflication of the individual; alteration of host functions, possibly by vaccines - ARTHUR UPTON, SUNY (Stony Brook), chairman. MAURICE HILLEMAN, Merck Institute. HARRIS BUSCH, Baylor. ALBERT SABIN, Weizmann Institute. VICTOR M'cKUSICK, Hbpkins. C-) Prevention of cell transformation from normal to malignant; search for cause - SO L SPI EGE LMA N, P&S, chairman. THEODORE HAUSCHKA, Roswell Park. HARRY EAGLE, Einstein. DONALD PARSONS, Roswell Park. DAVID BALTIMORE, MIT. D. BERNARD AMOS, Duke. 0 Search for possibility of'. preventing tumors after cell transformation from normal to malignant- HILARY KOPROWSKI, Wistar Institute, chairman. RENATO BASERGA, Temple. WILLIAM McDERMOTT, Boston City Hospital. BERNAR',D FISHER, Pitt. RICHARD SMITH, Fla. U'. 0 Ranking of population, groups according to their vulnerabilityto the disease; identification of risk; more accurate diagnosis. " ABRAHAM LILIENFELD, Hopkins, chair- man. MJCHAEL SHIMKINi, Calif. U. (La Jolla). JOHN FROST, Hopkins. ALEXANDER MARGULIS, Calif. U: ('.S-F). ROBERT SCHWARTZ, Tufts. ~ Pursuit of new and old Ieads on treatment; ex- ploitation of fast-developing, ideas in immunology and other fields - JA,ti1ES HOLLAND, Roswell Park, chairman. ANTHONY CURRERd!, Wis. U. LOREN HUMPHREY, Kan. U. HOWARD SKIPPER, Southern Research Institute. HENRY KAPLAN,, Stanford. CL) Exploration in depth on rehabilitation, cos- metic, prosthetic, other compensation for patient deficits; easing lot of the uncured - Ji. HERBERT DIETZ, NYU', chairman. JOHN HEALEY Jr., M.D. Anderson. KENNETH ARTISS, Bethesda, Md. ROBERT STEWART, VA. DAVID KAPLAN, Stanford. ARTHUR HOLLEB, American Cancer Society. CHARLOTTE TAN, Slban-Kettering Institute. LOUIS WASSERMAN, Mt. Sinai.

4; - 20 - Drug Research Reports Vol. 14, No. 45 i that the President wi11~ air the final plan. Nixon called a press conference in the White House 4 when he first announced the then-titled "Cancer Cure Program," now the Conquest of Cancer. An early spring announcement of the plan would create a hopeful note in Nixon's re-election campaign, by that time getting into second' gear. At the same time, it would not be so soon that the lay public would be looking for results by November. EDITORS' NOTE: Three of the nation's foremost politicians, the President, Sen. Kennedy (D-Mass.) and'Rep. Rogers (D-Fla.) have personal!, vested interests in the outcome of current cancer research legislation. Top ranking NIH and Assn. of American Medical Colleges execs have opposed" the powerful Mary Lasker biomedical research lobby in a struggle which could irreversibly alter the structure of NIH. See story omp. 11 for latest developments. While politicians battle over cancer research, technicians are struggling with the fundamental issue of how basic biomedical research can move forward most swiftly. Carrese, coming to NIH from the ranks of systems specialists who revolutionized the Defense Dept. under MacNamara, and McShulskis both see the current planning as a part of a continuing' process. Whatever Natl. Cancer Plan is announced early in 1972', Carrese told "The Blue Sheet", modifications and additions will, quickly be added. Carrese Approach Would Put All Top~ Cancer Researchers Into One Planning Effort These will come out of the new insights gained by the administrators as they struggle to put into practice the studies outlined~ by the 280' planners involved. The rnodifica- tions will also grow out of new lab data. Carrese centers his attention, not on~ a static, 1972' Natl. Cancer Plan, but on the creation, of a process sensitively matching current operations to current perceptions of scientific opportunities. Just as sensitively the plan, he hopes, will feed back corrections,. or stop-ord'ers. The Carrese approach does something never before attempted in biomedical research, congregating the nation's entire front rank of cancer researchers and research admin- istrators in one vast, rational planning effort. The first approximation of a Natl . Cancer Plan will brook no factionalism. Presumably all major differences in ap- proach wi I I be accommodated. If scientists take strong, contradictory positions, the process will emphasize first the areas of agreement while setting up side mechanisms to explore the contradictory ap- proaches until one is proved or disproved. Former NIH Direct'or James Shannon before he retired sought a way to combine the best in intuitive, exploratory research with the best in modern, targeted research. The Carrese approach translates that effort into a modern, self-correcting data flow system providing. a panoramic view of what's going on, focusing, sharply on decision points, promptly slapping on the desk of top administrators the decisional data they need'. Whether it works or not, NIH has moved into a new era. If scientists are satisfied the plan is fair, productive, and good for the rapid building, of knowledge, the plan will be a worldwide prototype for biomedical research. The public can be expected' to keep up the pressure for discovery of cures for cancer. The massive, coordinated plan sure to result wouU seem to leave no room for the contributions of the rebel, the anti-establishment'arian, but the liegislative history of the Cancer Conquest program is studded with promises that some money will be reserved for intuitive, invest'igator-initiated research, plan or no plan. l