How did your NCI board appointment come about?
I received email stating that I had been nominated by NCI leadership. I honestly don’t know for sure how it came about, but my guess is that the NCI director [W. Kimryn Rathmell, MD, PhD], whom I know, looked at the list of board members and noted that Colorado was not represented. She may have questioned why a large portion of the country was not represented. If you look at a map of the 57 NCI-designated comprehensive cancer centers around the country, we are a lone dot on that map with a lot of space around us.
What are some ways your role on this board will be valuable to the CU Cancer Center and the CU School of Medicine?
I remember back when I was a fellow, someone said to me about the cancer research enterprise, “Either you’re in or you’re out.” In other words, either you hear about things ahead of time, and you know what’s going on, or you just wait for things to be published and announced. You’re already behind people who have advance notice about the overall direction of the NCI.
This advisory committee is one of many ways our CU Cancer Center members and School of Medicine faculty can stay ahead of developments at the NCI and NIH. As we learn the priorities of the NCI, we can match them to our program development, our recruiting efforts, and some of our scientific priorities. Having some advance knowledge of what’s going on with the NCI budget can be very helpful, too – things they’ll be spending on and things where they might be cutting back.
It’s also a chance to take the things that are most important to our agenda in Colorado and the Rocky Mountain west and bring them to D.C. to ensure that the leaders there know what’s important to us.
What are some Colorado priorities that you hope to bring to the NCI’s attention?
There are things that are unique to Colorado that someone at the NCI might not think of. This place has needs and priorities that are distinct.
I grew up on the East Coast, where you have several cancer centers that are practically next door to each other and there isn’t much of a rural population. Here, we serve a large area far from another comprehensive cancer center, and much of it is rural. In addition to Colorado, we see a lot of patients from Wyoming, Nebraska, New Mexico, and Kansas who are far from any other comprehensive cancer center, so we don’t have the luxury of being good at some things and not others because there’s another center down the street to fill the gap. On a clinical level, we have to be able to take care of any hematology/oncology problem.
In the next hour, one Coloradan will die of cancer on average, and the most common causes of those deaths are lung, colon, pancreas, breast, and prostate cancer. Those are common cancers that cause the majority of the more than 8,400 deaths a year in our state. We need to ensure that we have good science and clinical trial opportunities here so patients have access to that, and for that we need NCI support. I want to ensure that Colorado patients don’t have to get into an airplane to get access to the most promising treatments.
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What will your duties be on the NCI board?
We’ll usually meet four times a year, and one of the meetings is virtual. My first meeting was in December. We get an update from the NCI on everything from scientific priorities to policy priorities to budgetary concerns.
There was a discussion about priorities for the next few years in terms of science trials. For instance, we talked about NCI’s Experimental Therapeutics Clinical Trials Network (ETCTN), which is a national phase 1 trials group that we’re a member of and we’ll be re-competing for funding, so it was helpful to hear where that program is headed. I happen to serve as the principal investigator for Colorado on that grant.
And we also heard about more specific proposals. For instance, there was a proposal to develop a grant mechanism to develop better technology to create tumors in a dish for laboratory experiments. Should that be a grant request for proposals from the NCI, or should we let industry do that? These are examples of topics that are discussed.
Are these discussions public?
As with most governmental functions, discussions are public but there are certain topics that are confidential. I am prohibited from participating in any discussion where there’s even a whiff of potential conflict of interest for me personally. But for the most part, they’re meant to be public. And I’m able to come back to Colorado and touch base with various investigators and our CU Cancer Center leadership and let them know that, pending final decisions by the NCI director, there are some of the priorities we discussed that may or may not be aligned with what we’re doing.
We’ll soon have a new presidential administration, and there’s been a lot of talk about possible changes in federal health policy. Does that make it even more valuable for you to be in a position to keep abreast of policy changes?
The short answer is, yes. Overall, cancer tends to be a bipartisan issue, so I don’t think the NCI is anticipating a drastic increase or decrease in funding. In terms of how cancer research is supported, there are vigorous cancer centers in red states and blue states, so it does not favor one party or another.
In a larger sense, the NCI is consulted on policy questions that might affect us. For example, our clinical partner, UCHealth, is the number one Medicaid care provider in Colorado, Any changes in Medicaid funding would affect our patients, so we’re paying close attention to that. Also, we’re at the epicenter in training the future workforce in cancer – from physicians, nurses and advanced practice providers to scientists, research coordinators and people who work in the commercialization space – so things that affect education are important to us.
In Colorado, we’re always thinking about rural patients and the barriers they face, and how changes to Medicaid and other programs could have a major impact in the state. Those are some policy matters we talked about that are important to Colorado.
We’re there to talk about science and policy priorities. We’re not there to talk about politics or candidates. And that’s smart, because cancer is an apolitical problem. It affects everyone.
