Dr. von Eschenbach Gives His Views on the Future of NIH and Its Research Thrust

BETHESDA, Maryland—The new director of the National Cancer Institute intends to advance NCI’s role in the discovery and application of specific targets for diagnosing and treating cancer, and to increase its interaction with other organizations to more fully integrate and coordinate cancer research and care.

"Our emerging understanding of cancer at the genetic, molecular, and cellular levels opens up enormous opportunities to alter disease processes at each level," said Andrew C. von Eschenbach, MD. "The paradigm that I grew up with as an oncologist was to find cancer and kill it. Now we can look forward not only to eradicating cancer but also to targeting and controlling it by modulating and altering the behavior of cancer."

Forging Partnerships

Dr. von Eschenbach said the Institute would continue to forge partnerships with federal, state, and local governments, industry, and nonprofit groups participating in the battle against cancer. "The NCI can’t provide for everything that is required for a successful national cancer agenda, but it must play a key leadership role in making sure the agenda is fulfilled," he said. "Cooperation, collaboration, and integration are very important."

Dr. von Eschenbach assumed his post in January as NCI’s 12th director. He made his comments regarding his goals in an interview conducted and released by the NCI office of communications.

The new NCI chief trained as a urological surgeon and joined the faculty at the University of Texas M. D. Anderson Cancer Center in 1977, where he focused much of his research on prostate cancer. At the time of his appointment as NCI director by President Bush, he was professor of urologic oncology at M. D. Anderson and served as the director of its Genitourinary Cancer Center and its Prostate Cancer Center.

Unlike many past NCI directors, its newest leader has never worked at the Institute. Nonetheless, he said his many years at M. D. Anderson have provided him an understanding of how a governmental system functions, and its rules, regulations, and processes.

He noted that when he began his oncology career, the emphasis in research was on site-specific cancers, with the NCI at the forefront of promoting this work.

"Due to progress since then, we are beginning to understand cancer at a more fundamental level—at a genetic and molecular level," he said. "We will be applying and combining agents for detection, treatment, and prevention that are directed to unique targets in the malignant process. From a pharmaceutical or biotechnology perspective, the development of a drug will be based on a target and that target may be present on a subset of tumors from a variety of organ sites."

Dr. von Eschenbach said he found the mix of research funded by NCI to be well balanced and he would continue to develop it after careful deliberation and consultation with experts.

The NCI director also described urologic oncology as a model system for addressing many of the fundamental problems of cancer. He specifically cited the disease he researched at M. D. Anderson. "Prostate cancer is the most prevalent malignant transformation that occurs in men. For most, it remains a relatively innocuous disease throughout life, but for a subset of men, it’s a vicious disease," he said.

This represents a major research challenge, he said, "to understand not only the origin of cancer but also the basis for its virulence. Research is now revealing that organ-specific, cell-to-cell interactions, such as those between prostate cancer cells and bone, are critical to the metastatic cascade. Thus, prostate cancer is an important model for metastasis."