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3 (Tough) Questions on What's Ahead for the NCI—with Douglas Lowy, MD, NCI Acting Director

DiGiulio, Sarah

doi: 10.1097/01.COT.0000467329.26621.37
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Douglas Lowy, MD, became Acting Director of the National Cancer Institute on April 1 after serving as NCI's Deputy Director since July 2010. The NCI's previous Director, Harold Varmus, MD, stepped down from the role to become the Lewis Thomas University Professor of Medicine at Weill Cornell Medical College (OT 4/10/15 issue). Lowy is also a member of the National Academy of Sciences, as well as the Institute of Medicine of the NAS.

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“We are fortunate to have a scientist of such stature stepping into the role of Acting Director of the NCI,” National Institutes of Health Director Francis S. Collins, MD, PhD, said in the news release announcing the change. “Dr. Lowy possesses not only a sharp intellect, deep knowledge of science, and proven leadership experience, but he takes a warm and humane approach to all things. He is superbly positioned to lead the NCI at a time of exceptional progress in cancer research.”

Lowy has more than four decades of experience as a cancer researcher. He received the National Medal of Technology and Innovation from President Obama in 2014 for his work on the biology of papillomavirus and the regulation of normal and neoplastic growth that led to the development of the human papillomavirus vaccine. His laboratory was involved in the initial development, characterization, and clinical testing of the preventive virus-like particle-based HPV vaccines that are now used in the three FDA-approved HPV vaccines.

He is also involved in research that focuses on cancer genes, including investigating the DLC1 tumor suppressor, which encodes a Rho-GAP that is down-regulated in a variety of cancers, leading to the high Rho activity seen in many advanced cancers. His research has identified key scaffold functions for DLC1, including protein-protein interactions and phosphorylations, which contribute to the regulation of its activity and its role as a tumor suppressor.

In a telephone interview, Lowy spoke about the current fiscal climate at the NCI now and what's ahead for the Institute, as well as for his own research.

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1. The NCI has seen a particularly tight fiscal climate in recent years. How does this affect your new job?

“Our budget has been flat or reduced for close to 10 years. And the budget this year is more than $150 million lower than it was five years ago.

“That is a challenge because there are enormous opportunities in cancer research to make progress from the most applied research to the most basic research—and everything in between. So, we run out of money long before we run out of good ideas to test. It is challenging to try to make the strategic decisions [that need to be made] when there are so many competing meritorious opportunities. But that's basically what we need to do.

“One way we are trying to help researchers be able to feel more confident and comfortable with their funding situation is the Outstanding Investigator Award. Instead of being for five years, as are most of our major grants, this award is for seven years and it's for a larger amount of money than most of our research awards. It gives the recipient the opportunity, we hope, to be able to take risks and to test important problems that otherwise might be more difficult for them to do because of the funding situation and continually needing to apply for grants.

“Also, the President's budget for the 2016 fiscal year proposes a 2.9 percent increase for the NCI; and if that proposed budget is passed it will be easier for us to do more.

“And I certainly will advocate for that.”

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2. What are the biggest opportunities for the NCI in terms of areas of research to pursue?

“I see four deep opportunities. One is the Precision Medicine Initiative, which has been proposed for fiscal year 2016 as part of the President's budget proposal. That initiative aims to change the paradigm for more patients to better understand the molecular abnormalities in their cancer and better tailor treatments to those molecular abnormalities. The initiative has several components—adult cancer clinical trials, pediatric cancer clinical trials, an effort to overcome targeted drug resistance, and the building of a knowledge system to support precision medicine.

“Another important area is cancer prevention and screening. Many of the same principles can be applied, in terms of what we understand about the causes of cancer and how cancer comes about, to enable us to be more strategic and more effective in our interventions for cancer prevention and cancer screening.

“And we also have a serious problem with cancer health disparities. It's very important for us to try to understand where these disparities are—we need to understand the biological role, the lifestyle role, and the role of health care access and utilization. And we need to understand how those [factors] come together to lead to imbalances, and what can be done to reduce these imbalances to improve outcomes for all populations.

“And we want to strongly support basic research—because many of the breakthroughs that will help us in the years ahead will come from that basic research.”

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3. You have a very noteworthy research career of your own. Are you able to continue with your own research while taking on these new leadership roles?

“Yes, I was able to continue doing research as Deputy Director, and I anticipate continuing my research activities [in the new role]. My degree of involvement was certainly not what it was when I did not have the responsibilities as Deputy Director, and my degree of involvement now will need to be even less, but that doesn't mean that I won't be involved.

“Research really is integral to what I do, and also to what the NIH does and to what the NCI does. And I think having first-hand experience of doing has benefits.

“Though if you are asking me: Am I going to go to lab meetings when I should otherwise be testifying in front of Congress? I will be testifying in front of Congress.

“I'm very fortunate that the people that I work with in the lab are outstanding and extraordinarily supportive. I expect that I will continue [my research], as long as my site visits reports continue to be positive.”

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
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