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>> I'm glad to be back
in the Natcher Center.
I'm Harold Varmus
and as you-- thank you.
[ Applause ]
>> There is no better time
in my view of working
in cancer research
for the last 40 years
to lead the nation's cancer
research efforts.
The idea of being
on a campus that's dedicated
to both supporting science
across the country and indeed
around the world
and doing great science
of its own here on campus,
training a lot of people,
is a remarkable pull for me.
The National Cancer Institute
does a lot of things,
doesn't just do basic science
and clinical science,
but it does public
communication, it does training,
it does policy formulation
and that is in everything
that we do and everything
that we say will be based
on evidence.
We have to remember
that the great achievements
in science that I'm aware
of have almost always begun
with an individual scientist,
the lone explorer having an
unexpected idea.
And this is an essential precept
to remain faithful
to if we're going
to retain the stature
of the NCI, the NIH
and American Science.
I always emphasize
that scientific thought usually
begins with individual
scientists but it also depends,
depends strongly
on the community of scientists
who share, who validate,
and who expand ideas.
This is very important moment
for us to try
to get the clinical trial system
into a much better shape
because all of us
who are paying attention
to how clinical--
how therapeutics have developed
for cancer know
that we have a tremendous
opportunity before us
to use genetic information,
to think about how therapies are
chosen and used.
We have opportunities
for finding biological markers
to follow disease
and its response to therapy
in new ways,
and we're gonna need to think
about how clinical trials are
redesigned to take advantage
of these new
scientific opportunities.
The second big issue has to do
with the utilization
of the Mark O. Hatfield Clinical
Research Center.
That should be full of patients
from all around the country.
It should be doing the most
adventurous clinical research
in the world and we need
to figure out how to pay
for that and get people
everywhere in the country
excited about using it,
and I'll be giving a lot
of attention to that.
The third issue has to do
with cancer drug approval
and regulation.
The methods that are currently
in use need to be readjusted
to a modern era
in which there is genetically
based selection of therapies
and new ways
to monitor the effectiveness
of therapies and new ways
to approve therapies.
Despite a few significant--
in some cases even
dramatic advances we have
had clinically,
it still has to be acknowledged
that we have not succeeded
in controlling cancer
as a human disease to the extent
that I believe is possible,
either through prevention
or treatment.
We need to ask ourselves
honestly why have we not
succeeded at the level
that we aspire to and what needs
to be done.
How do we for example get the
genetic test
that are now available
for analyzing the underlying
lesions in a tumor
into the hands of physicians
who are trained 20, 30,
40 years ago.
Well, I'd like to go
to a deeper issue and that has
to do with how we think
about the scientific problems
that we as an institute are
trying to solve.
This means doing a kind
of question formulation process
that is not as simple as saying,
how do I cure cancers.
Getting to a level
of specificity is based
on new developments
in our science
and it's getting a set
of questions that are not pie
in the sky but actually offer
the prospect
for substantial degrees
of answerability, if you will,
in the foreseeable future.
Over the next year,
I'm going to stage a series
of meetings inviting people
from across a range
of disciplines, people who work
in a variety of fields
across the country and try
to define-- to establish a list,
defined list
of provocative answerable
questions that will help our
scientists think
about what the next steps ought
to be and help us make stronger
advances against cancer.
We need, as an institution,
to be building infrastructure,
but I am concerned a little bit
about simply saying we're gonna
go out and pay
for infrastructure
because it's always tempting
to provide more infrastructure
thinking that will help science
and we have to be very careful
about calibrating our interest
in infrastructure
against scientific needs.
But I also think that we need
to expand the range
of what we do in certain ways.
I don't know all the ways yet
but here are some ideas.
We have to think
about how far we should go
in the pipeline and development
of therapeutics and we need
to think about how developments
in health information technology
can be utilized
to do comparative
effectiveness research.
It's clear the world is
or can be transformed
by information technology,
but I don't think we've given
full attention to the question
of how we can make use
of that information
in pursuing efforts
to control cancer.
I've been concerned that--
that cancer is not
on the global health agenda even
though as populations abroad
age, cancer has become an
increasing source of burden
of disease.
It means actually developing
some programs that are suitable
for improving health
in poor countries,
tobacco control,
vaccination
against oncogenic viruses,
there's a long list of things
that we could think about doing
in a more organized way.
The National Cancer Institute is
a very strong place
but it's clearly not self
sufficient to do all the things
it needs to do.
The NCI needs
to be not just NCI,
proud and alone
and fighting its own wars,
but working
with the other institutes
and centers, virtually all
of which do cancer research
or something that's closely
aligned to it or informative
about cancer.
I've already reached
out to people at the FDA
and the CDC to think
about how the NCI can be
partnering with those agencies
which have profound impacts
on what we do.
And then there are lots
of other folks
in the public domain,
non-governmental organizations
and advocacy groups
and scientific societies
who have a great deal
to offer us.
I think we have to recognize
that we cannot succeed
in controlling cancer
without strong connections
with industry.
And I am aware
and you're all aware
that as a government
organization,
these are dicey issues.
I am a strong proponent
of the idea
that we should manage conflicts,
not forbid them
and I'll be doing quite a bit
to try to make sure
that we don't violate the strong
underlying precepts
of ethical conduct in science,
that we have a healthy
relationship with industry.
I know and you all know
that cancer is a serious matter.
We, seeing cancer
in our families, in our friends,
we're worried about ourselves.
But the seriousness
of cancer doesn't mean
that we can't enjoy what we do.
I look forward to working
with all of you here
over the next several years.
Thank you.
[ Applause ]
[ Silence ]