BETHESDA, Md--In an effort to increase participation in clinical
trials, the National Cancer Institute is developing a marketing
campaign aimed at selling patients on the importance of taking part
in experimental treatments. "This effort represents a new and an
important activity by NCI," director Richard D. Klausner told
the National Cancer Advisory Board (NCAB). "The marketing
initiative is aimed at developing approaches to getting the word out
about the value and the opportunities of clinical trials," he said.
A meeting between NCI officials and marketing executives from some
major national corporations will focus "on how to bring the
concept of clinical trials to the publics attention in the same
way that companies market nationally known products," Dr.
Klausner said. "Let me emphasize that this will not be done in
isolation of other NCI clinical trial initiatives or those of other
national oncology groups," he added.
Dr. Klausner announced the NCIs effort to develop the marketing
strategy during a wide-ranging and unusually lengthy
"Directors Report" to the advisory board. His
presentation included discussions of the NCIs extensive and
long-running reorganization, the institutes therapeutic
priorities (see box ), creation of new chemistry-biology centers, the
success of revised cancer center guidelines, and steps to include
consumer advocates on peer review panels.
NCI Does Not Play Favorites
Obviously irked by a recent New York Times article, NCI director
"Let me make it clear, as I thought I had in all my interviews,
"We do not, as an institute, have a favorite gene; we do not
Upon assuming the directorship nearly 3 years ago, Dr. Klausner began
a major restructuring of NCI, guided in part by two detailed reports
critical of its organization and operations. Now that effort is
"By and large, the major structural changes for this
institute--I hope, we all hope--have been completed," he said.
"The new administrative structure that underlies the management
of the Institute has been put in place. Its an administrative
structure that is less hierarchical and more integrated across
Perhaps the most profound change was the separation of the intramural
and extramural research programs. The NCI now has seven operating
divisions: three for intramural programs and four for extramural
operations. Six of the divisions are headed by new recruits to the
NCI and four are headed by women or minority scientists "in
contrast to the long previous history of the Institute," Dr.
Division directors of both programs meet separately every 2 weeks to
discuss ways to coordinate activities. "There is clearly a new
spirit and, importantly, a new set of mechanisms for transdivisional
collaborations," the NCI director said.
The NCI has created a new program of chemistry-biology centers in an
effort to exploit what Dr. Klausner called "a very interesting
and in some ways quite extraordinary development in chemistry, the
area of genetic chemistry or Darwinian chemistry."
The centers will bring together biologists, chemists, and specialists
in developing technology in an effort to devise molecules that can
target very specific points in the extremely complex set of chemical
interactions that transform cells and to help develop these into
chemopre-ventive and chemotherapeutic agents. "One of the goals
of the chemistry-biology centers is to capture some relatively new,
but at this point not well-developed, concepts in chemistry that are
based on the principles of evolutionary biology," Dr. Klausner commented.
Chemists have used these concepts over the last several years to
develop large collections of new molecules. "Now with new ways
of generating in a very short period of time in the laboratory
probably more molecules than have been developed through biological
evolution, the question is: how would one go about relating that to
our developing knowledge about very specific targets," Dr.
Klausner said. "So the goal of these centers is to develop these
technologies in academic settings and to link the development of
these chemical technologies directly to the biology."
Four Chemistry-Biology Centers
The NCI has now funded four such centers: at Harvard University and
the University of Pittsburgh, and at the Scripps Research Institute
and the Torrey Pines Institute for Molecular Studies, both in San
Diego. Dr. Klausner said that the NCI is now seeking applications to
establish additional chemistry-biology centers.
New guidelines are providing more flexible peer review to cancer
centers and have resulted in an increase in the number of centers now
designated as comprehensive cancer centers, Dr. Klausner said.
"The new guidelines have incorporated the evaluation of
comprehensiveness as an integral part of the scientific evaluation of
cancer centers," he said. "The number of comprehensive
cancer centers has risen from 26 to 33 of the 59 US cancer centers."
He said that the NCI had hoped the new guidelines would attract new
institutions and new models of centers to the comprehensive center
program. Ten new applications have been received, and two new centers
will get funds by Sept. 30, the end of the current fiscal year. These
are the University of South Floridas H. Lee Moffitt Cancer
Center, Tampa, and the University of Minnesota Cancer Center, Minneapolis.
The NCI is committed to having consumers involved in all of its peer
review processes, including applications for funding scientific
research, Dr. Klausner said. The recently formed Directors
Consumer Liaison Group, a panel of 15 consumer advocates, is
currently developing initial criteria for selecting consumer
advocates for peer review duties.
The consumer group is also working with Marvin R. Kalt, PhD, director
of the Division of Extramural Activities, to develop a process for
training consumer advocates selected as peer reviewers.