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Commentary |
a Office of the Director, National Institutes of Health, Bethesda, Maryland, USA b Center for Cancer Research and Department of Biology, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA c Office of the Secretary, Department of Health and Human Services, Washington, D.C., USA d Office of the Director, National Cancer Institute, Bethesda, Maryland, USA
Received November 28, 2006; accepted for publication November 28, 2006.
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EDITOR’S NOTE: |
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 Top Editor's Note: WelcomeKeynote AddressIntroduction of Michael Leavitt,...RemarksSwearing-In RemarksReferences |
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Bruce A. Chabner, M.D.
Editor-in-Chief
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WELCOME |
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TopEditor's Note:WelcomeKeynote AddressIntroduction of Michael Leavitt,...RemarksSwearing-In RemarksReferences |
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Good morning, everybody: Mr. Secretary, Dr. Sharp, NCI staff, Institute and Center directors of the NIH, and distinguished guests. It’s my pleasure to open the ceremony today. I thank you all for being here. I noticed John stopped and saluted Al Rabson and Ruth Kirschstein, two of the jewels of the NIH. They are the institutional memory of the NIH. When I want to know something about the history of the NCI, I go ask Al. Whenever I want to know the history of NIH, I ask Ruth. They remember essentially all of the steps that made NIH such a great institution, and Al remembers the steps that make NCI one of the jewels of the crown.
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For being part of the celebration today of the new director of the NCI, I want to thank you, because we need to recognize the historical importance of the National Cancer Institute whenever we get the opportunity. And I think we also need to recognize that appointing the director of the National Cancer Institute is a significant event for all of us. Today I am pleased to be part of the appointment and swearing-in of Dr. Niederhuber, who has a rich academic background, which includes service at some of our finest research universities, including Johns Hopkins.
Now I’m going to tell you something, and I hope he doesn’t mind... I knew John when I was still an Associate Professor of Radiology, and he came to Johns Hopkins as an oncology surgeon. For those of you who know surgeons—forgive me if you are surgeons—when you meet a surgeon, he has about 30 milliseconds of listening time and an hour of talking time, because they know right away what to do: take action. I was shocked that John was the opposite. I would talk for about three seconds and stop to hear him talk about what to do next, and he would say, "Well, tell me more." He sounded more like a psychiatrist to me. But John was one of the most important colleagues I’ve had in my own career. At Johns Hopkins, he made so many changes that reflected his ability to combine basic science with clinical and translational science, and he understood what it meant in the fight against cancer. He brings to NIH and NCI an ideal set of skills and experiences as an academic mentor. There are so many people, including myself, who have worked with him, who have felt enriched by the association. He’s a terrific surgeon, lab researcher, cancer center director, administrator, and he has been, as you know, attached to the NCI through various roles: chair of the NCAB as well as many scientific advisory councils. But more than that for many of us—and I know the NCI staff knows this about John—he’s a valued colleague and a friend.
I recall an event a few years ago, before I was NIH director. I met John at the Foundation for Cancer Research, and he was there with his wife, Tracey, who was battling cancer at the time, breast cancer. My wife and I and Tracey and John got to know each other, and I’ll tell you there’s no more "human" human being than John. The care he took for Tracey while she was fighting, unfortunately, a losing battle, told me everything I needed to know about John Niederhuber [1]. His caring for and commitment to those suffering from cancer are readily apparent. The same thing happened when he met the Secretary and met all those who had a say in the decision of appointing him as the NCI director.
We are honored to honor him today and to have with us this morning a special guest, who knows Dr. Niederhuber well and is going to help us celebrate the appointment of Dr. Niederhuber. That is Dr. Phillip Sharp. He is Institute Professor of the Center for Cancer Research in the Department of Biology at the Massachusetts Institute of Technology and has been with the Center for Cancer Research since 1974. As you know, his research interests have centered on molecular biology, gene expression of cancer, and RNA splicing. In his landmark work, he shared the 1993 Nobel Prize in Physiology or Medicine. He’s no stranger to us, and last week, we talked about the new Nobel Prize won by Craig Mello and Andrew Fire, and I told him, "Phil, RNA is taking over the world." And he said, "You know, I trained Andrew Fire." So he had a hand in both training the Nobel laureate and, certainly, a hand in making sure that discovery was not unnoticed by the powers that be. He chaired the National Cancer Advisory Board from 2000 to 2002 and was succeeded in that position by none other than John Niederhuber. I think you will agree he is the perfect speaker for this morning, so I give you Dr. Sharp and his speech, "The Science of Cancer Beyond 2006 and John Niederhuber as Director of the NCI."
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KEYNOTE ADDRESS |
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TopEditor's Note:WelcomeKeynote AddressIntroduction of Michael Leavitt,...RemarksSwearing-In RemarksReferences |
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It is indeed an honor to be invited to share a few thoughts on this wonderful occasion, the installation of Dr. John Niederhuber as Director of the National Cancer Institute. In many aspects, this is the most interesting and promising of times for NCI, and Dr. Niederhuber is almost uniquely the right Director for this period. Never before in its history has NCI been more important to the citizens of this country. The confluence of the demographics of the country, the aging of the baby-boomers, the emergence of new treatments for cancer based on specific targets which are more efficacious with fewer side effects, the possibility of treating individual patients based on the genetic constellation of their cancers, and, finally, the continuing advances in the science of cancer, make this the moment of tremendous opportunity and challenge for this new Director. What indication do I have that Dr. Niederhuber is the right person for this challenge? He has had significant experience and shown important leadership at every level of this challenge, from the lab bench to the patient, and from health delivery institutes to the administration of NCI.
Let me first talk about this revolutionary time for the NCI. This country is about to experience an enormous increase in the demand for treatment of adult cancers. A major fraction of our population is passing the age of fifty and we will experience an increased frequency of cancer. It is likely that cancer will displace heart disease as the most common cause of death. This increased disease burden will pressure NCI to focus even harder on research to be able to provide the best quality care to patients across the country. Dr. Niederhuber has stated that one of his priorities at NCI is to bring "science to the patient." It should be noted and celebrated that NCI has already had a big impact on the care of cancer patients; for instance, the rate of age-adjusted deaths due to cancer began to decrease several years ago and everyone expects that the rate of decrease will accelerate in the future. Although we still have a long way to go, it is exciting to realize, for example, that death due to breast cancer has decreased 20%–25% over the past decade, a wonderful indication of the future results in other cancers.
The promise of the establishment of NCI, that it would generate better, more effective and less toxic treatments for cancer, has begun to be fulfilled. The targeted therapies for leukemia, lymphoma, breast cancer, colon cancer, and lung cancer have awakened the country to a new horizon of possibilities. In contrast to the situation a short decade ago, every major pharmaceutical company has greatly expanded its research and development to generate new therapies for the treatment of cancer. The same is true for many biotech companies. The list of candidates in clinical trials is longer and stronger than it has ever been before. NCI has created this eruption in activity and has the challenge of developing new lines of research that ensure that these therapies will be tested and made available to patients in an optimal fashion. This will require close interactions between the NCI, the country’s research community, pharmaceutical and biotech companies, and the FDA. It is highly promising that Dr. Andrew von Eschenbach, NCI’s former Director, has been designated head of the FDA.
The third stream of the confluence that makes this such an interesting time at NCI is the remarkable possibility to advance the science of the disease of cancer and thus future treatments. To many people the words "research on cancer" have the implication of decades of lab work before any results could have an impact on treatment. This is no longer the case; research at the most fundamental level can literally in a few years be translated into the development of new drugs or therapies. The means of translation is manifold, to mention a few: biotech companies, large pharmaceutical companies, NCI-sponsored clinical trials, cancer centers, and other nonprofit organizations. Therefore, most of the fundamental research supported by NCI could, if successful, be translated into therapy in as early as a five-year period. I will briefly cite two examples: In the most recent issue of the journal Cell, two laboratories characterized gene rearrangements and amplifications in mouse models of liver cancer and melanomas and then validated that similar mutations occurred in human cancer and thus identified new targets for therapy in these cancers. This science could, and probably will be, the basis of clinical trials in a few years. In the second example, two weeks ago, we celebrated the Nobel Prize for the 1998 discovery by Andy Fire and Craig Mello of RNA interference (RNAi). In fact, my research group shared a bottle of champagne toasting the research bench on which Andy Fire did his Ph.D. work in my lab. In the eight short years from the fundamental discovery, RNAi is already being tested in animal models for the treatment of cancer and is in clinical trials in man for other indications. In this country, science translates to the patient in a short period of time.
It is informative to list current research topics supported by NCI that could greatly impact the control of cancer in a decade. Among these are: (1) identification of cancer stem cells, (2) elucidation of factors controlling the metastatic spread of cancer, (3) determination of all the mutational changes in cancer stem cells, (4) understanding how tumor cells shape their microenvironment, (5) developing methods to integrate or model the regulatory pathways in tumor cells to predict responses to combinations of therapies, and (6) developing non-invasive imaging methods to detect single cancer cells.
There could equally well be many other topics on this list. However, its obvious richness means that there will continue to be better and more effective treatments for cancer in the future.
So, Dr. Niederhuber assumes the leadership of NCI at its most promising and challenging period. NCI is challenged to do everything possible to facilitate the transfer of the benefits of its past research for the betterment of patients. NCI is also challenged to work with every sector of society to coordinate and promote their future involvement in developing new drugs and therapies for cancer. Finally, NCI is also challenged to continue to support research that will ensure that a decade from now there will be new possibilities to better control cancer. I am sure that Dr. Niederhuber has the ability and commitment to weave all of these expectations into a rich tapestry, which will accelerate the rate of decrease in death due to cancer. Just to add another challenge to this list, Dr. Niederhuber will probably have to accomplish all this in the shadow of a restrictive Federal Budget.
In spite of all of these challenges, I am optimistic about the future of NCI and I am sure Dr. Niederhuber is as well. It is obvious that his range of past experiences and accomplishments is ideal for this post. As you know, he has been Deputy Director of NCI for the past year and was Chair of the NCAB, Director of the Wisconsin Cancer Center, and Chair of the Department of Surgery at Stanford University, after rising through the academic and clinical ranks at the University of Michigan and Johns Hopkins. This is a remarkable record of service. At a more detailed level, Dr. Niederhuber is credited for making major contributions to an amazing range of research topics, spanning from understanding how the B-lymphocyte tyrosine kinase (BLK) functions in intracellular signaling, a subject of great interest to my past research, to developing implantable drug delivery systems for chemotherapy. I cannot think of another person with this range of experience; he can relate to every level of the challenges facing NCI. Further, I know him as a person of great integrity, passion, and commitment.
In closing, I wish for him that the evening sun lights his path and warms his back as he leads the NCI to an even greater height of accomplishments in the control and treatment of cancer.
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INTRODUCTION OF MICHAEL LEAVITT, SECRETARY OF HEALTH AND HUMAN SERVICES |
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TopEditor's Note:WelcomeKeynote AddressIntroduction of Michael Leavitt,...RemarksSwearing-In RemarksReferences |
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It is now my pleasure to introduce our Secretary, my boss, Secretary Michael Leavitt (Fig. 1
). As I’ve worked with the Secretary, I have to tell you that, at no time, have I seen a leader confronted with so many crises in rapid succession. His analytical approach about the priorities that need to be set in a complex organization such as the Department of Health and Human Services, was the most impressive to me. He has a sense of time, and tells us a story about the clock that goes tick and sometimes doesn’t go tock, about how he had to fix this, and about how he has a sense of tick-tock between now and the end of his term. He wants to make a real difference. You should have seen how he managed the Medicare Modernization Act implementation and how he responded to Katrina and pandemic flu.
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I have the pleasure of seeing Andy von Eschenbach here, who is now the acting commissioner of the FDA, and Sam Broder, who was the previous director of the NCI in the late 80’s, both of whom have contributed enormously to NCI and NIH.
The secretary is now going to administer the oath of office to John Niederhuber (Fig. 2). Mr. Secretary, welcome.
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REMARKS |
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TopEditor's Note:WelcomeKeynote AddressIntroduction of Michael Leavitt,...RemarksSwearing-In RemarksReferences |
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Dr. Zerhouni, thank you very much.
May I acknowledge that I never enter the gates of this great institution without a flood of appreciation for the fact that it exists, and that I have the privilege of being associated with it.
It is my privilege to be here, not only as Secretary of Health and Human Services, but also to play a very important role: I am here today to represent the President of the United States. And the President, having been elected by the vote of the people, means I am here today to represent the people of the United States: I am here to implement a decision of who should lead this great institution in a chosen and distinguished position on behalf of the people of the United States. The people have a compelling interest, because there is no family that has not been touched by this disease.
We selected a devoted researcher and a dedicated public servant. Dr. Niederhuber is a board-certified physician and oncologist, as all of you know — qualifications that have been expressed by those who know him well.
As we have become better acquainted over the course of time, it’s become evident to me what he has in his head. More importantly, I’ve come to understand what he has in his heart.
I was here just a couple of weeks ago at dinner with a number of his colleagues here at NIH. We talked in a very personal way about the way cancer has affected his family. It was evident to me that he will bring to this position something far beyond his distinguished academic past and his insightful intellectual capacity. He brings a heart that will represent the people of this country in a very important and noble way.
I read a comment that Dr. Niederhuber made recently at the American Association for Cancer Research. I’d like to read it to you, because I think it so clearly indicates what is in his head and in his heart.
He said, "My friends, you and I are tasked with answering the call of every patient, every survivor, every caregiver, every friend, and every loved one. We are privileged to be their beacons of honesty, support, and hope."
May I say, doctor, that is your call. It is the call for all of us. And I have every confidence today, as I administer the oath of office on behalf of the people of the United States, that you will lead this great national enterprise in a way that will ennoble its ongoing mission and touch the hearts, lives, and minds of every American.
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SWEARING-IN REMARKS |
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TopEditor's Note:WelcomeKeynote AddressIntroduction of Michael Leavitt,...RemarksSwearing-In RemarksReferences |
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Mr. Secretary, Dr. Zerhouni, fellow directors of the Institutes and Centers of the National Institutes of Health, honored guests, NCI colleagues, and my many friends: I am deeply indebted to all of you for being here today, and for sharing with me this very special occasion in my life.
I want to express my gratitude to President Bush and to Secretary Leavitt for the privilege and distinct honor of serving as the Director of the National Cancer Institute. I am profoundly humbled by your confidence in me and by the fact that you are willing to entrust me with the leadership and the distinguished history of this proud institution.
Never, in all the years of sitting on the edge of my patients’ beds during late-evening rounds; of making the walk from the operating room to the family waiting area; of working in the lab with my students and fellows (some of whom are here today) or coming to Washington all those times to serve on committees for Vince, Sam, Rick, and, most recently, Andy — never did I picture myself standing at this podium at this time to accept the directorship of the National Cancer Institute.
And while I have been doing this job now for a year, I think it has only been in the past couple of weeks, since my official appointment, that the enormity of the responsibility of this position — the responsibility to our patients suffering with cancer — has really struck home.
On the day he formally proposed the National Cancer Act of 1971, President Nixon said: "The time has now come for us to put our money where our hopes are." But he also made it eminently clear that dollars weren’t enough. "Money," Mr. Nixon continued, "can help set the stage for faster progress, but in the end it is our brainpower alone which can lead us to our goals."
President Nixon’s words are even more fitting today. The momentum of our progress against cancer, and of biomedical research as a whole for all diseases, is occurring at a pace none of us could have predicted. For the very first time in more than seventy years that our country has kept statistics on cancer incidence and mortality, we have seen an actual, real decline in cancer deaths.
For every one of us here today, that is the hope — the promise — we have so desperately needed. This progress, this pace of discovery, and our Nation’s leadership position in biomedical research must not be taken for granted.
Today, even more so than in 1971, we face very real challenges, which test our ability to persuade the very brightest, the most visionary of our young people, to see the opportunities and the rewards of a career in biomedical research and patient care.
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Our success — the ability to achieve our goals — depends on college students who see and who value the tremendous opportunities of a life immersed in scientific discovery: a life of service, of caring for those less fortunate. These young citizens need to have confidence that this great country will continue its investment in science. They need to be confident that productive careers await them.
The National Institutes of Health has long been the mechanism through which this great Nation supports the world’s premier biomedical research engine. Through its outstanding intramural laboratories and the support of an unmatched cadre of extramural scientists, we have been blessed with success after success.
There is no other NIH. There is no other place like NCI anywhere in the world. It is imperative that we tell our story, and that we work with the leaders of our country to ensure that the United States continues to lead the world, that we continue to serve the world.
Elias, my friend, I could not be more proud, nor can I think of any greater honor, than to be asked to join my colleagues on the NIH team. To my fellow Institute and Center directors, I extend a hand of friendship, of collegiality, and — perhaps most important — of collaboration.
While we at NCI are dedicated to lessening the burden of cancer, we also recognize that cancer has been, and will continue to be, a research model for many diseases. An article in the Journal of the National Cancer Institute [2] provides a timely reminder of our importance as a community of scientists. "Progress," the author wrote, "has been most rapid in scientific research when imaginative, talented, technically curious, and, above all, sincerely interested investigators are encouraged to search for new facts, beyond the curtains that limit our knowledge and to pool their specialized resources and skills on a basis of mutual interest and respect."
That’s a message we can — and do — embrace. But it is even more profound when you consider that the quote I just read comes from an article written nearly half a century ago, in 1957, by G. Burroughs Mider, the NCI’s Associate Director in charge of research. His words remind us that the need for scientific collaboration across disciplines is not a new idea.
It is my great hope that through my leadership at NCI and through the talented NCI scientific community, we can continue, and even fortify, the tradition Dr. Mider so eloquently described.
To the staff of NCI: I am honored and proud to work in your service. Institutions — university or government, private or public — that do great work and make a true difference in this world are always infused with people of enormous talent, commitment, and drive.
The importance of what we do at NCI, on behalf of every man, woman, or child who knows or fears cancer, cannot be underestimated. And, as a cancer research community, we are certainly not exempt from the disease we dedicate our careers to fight. Indeed, for a great many of our colleagues at the National Cancer Institute, cancer is a personal, as well as a professional, issue, because they — or perhaps I should say we — are survivors, patients, caregivers, or loved ones of cancer patients.
Sometimes, in the course of our lives, we talk about being in the right place at the right time. Sometimes we may speak of destiny or fate or direction. However we choose to interpret them, I believe that these important crossroads in life are about recognizing and grasping opportunities, and making all you can of them.
As I said earlier, the rapidity with which we are gaining new knowledge, coupled with the emergence of constantly advancing technologies, is creating greater opportunity to accelerate progress against cancer than any of us dared to dream at the time I began my career. Cancer, we know today, is a disease of alterations in genes, which accumulate over a lifetime. Each day, it seems, our insights grow deeper. We come to a greater understanding of the genetic changes that render a cell malignant. We learn more about the complex interactions of the cancer cell with its microenvironment and host. We learn more about the drivers of metastasis.
In today’s post-genomic scientific environment, we are rapidly entering an entirely new era of risk determination, disease prevention, diagnosis, and highly targeted therapies. It is the era of genomically and proteomically characterized disease. As we move into this new era of personalized medicine, ideas, tactics, and techniques are coming from many sectors of science. The physical sciences and engineering are being applied to optimize the discovery, development, and, ultimately, the delivery of interventions to the patient. The once-futuristic tool of nanotechnology is being used to perform molecular classification of tumors, to enable high-throughput screening, and to predict therapeutic efficacy. Imaging is becoming a tool to ascertain just how much of a small molecule is reaching a targeted receptor and whether the therapeutic molecule changes cellular function. Computational biology — systems biology, if you will — is addressing issues such as information scale, modeling, simulations, and data interpretation.
For certain, new technologies will continue to blossom and multiply.
I know that our time together at NCI will hold moments of great success. I look forward to every exciting advance and discovery.
I also know our time together will bring many challenges. We are in a fiscal period in which management of the National Cancer Institute will involve the careful stewardship of finite resources.
I will do my best to provide you with an open door and a listening ear, with strong leadership skills honed in the operating room and the laboratory, to captain this team in difficult times. It will be up to the leaders of NCI to find and allocate the resources necessary to maintain our scientific momentum.
To this end, NCI will need to consider new partnerships, in order to leverage resources and knowledge. We will need to carefully consider each new research program and scientific proposal. We will need to examine all existing programs, to search for ways to be leaner, but at the same time even better, in achieving our mission. Our responsibility is to continue conducting quality research, offering solutions to our challenges. As Albert Einstein said: "In the middle of every difficulty lies opportunity."
It is critical in these times that we communicate effectively across our various constituencies. As a cancer community, we must strive to speak with a more unified voice, in order to call others to action on behalf of cancer research.
I believe we must work to find the best ways to bring the latest science to patients in the communities where they live — through our NCI-supported cancer centers, which are always referred to as the "crown jewels" of NCI — and by the building of a new rim of community-based cancer care.
We must make our science, our medical advances, available to all of our citizens, especially those who may lack the financial means, the language capacity, the education, or simply the physical strength to seek out the best care. We must bring our science — our technology — to the patients where they live.
I share the view of my friend and colleague John Seffrin, chief executive officer of the American Cancer Society, who so effectively states his belief that, in the next decade, patient access to our accomplishments — our science — will become a greater determinant of cancer mortality than any currently recognized cause.
In one of the most-quoted lines of American politics, the late Vice President Hubert Humphrey said the moral test of government is how it treats "those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy and the handicapped."
It is, after all, our responsibility to continually earn, and always merit, the public’s trust. We maintain that bond by being good financial stewards; by letting the best science be our guide; by clearly and plainly communicating what we learn about cancer; and by honestly saying what we have yet to learn. We should convey hope, but always be grounded in facts.
And so it is with an unshakable commitment — to every cancer patient, every survivor, advocate, friend, father, mother, son, daughter, and caregiver — that I sincerely thank you for the opportunity to serve this great institution and this great country, and solemnly pledge to do my very best. May God bless America and give us the knowledge and wisdom to serve our patients.
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REFERENCES |
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TopEditor's Note:WelcomeKeynote AddressIntroduction of Michael Leavitt,...RemarksSwearing-In RemarksReferences |
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