Current NCI Portfolio

The National Cancer Institute works to advance fundamental knowledge about cancer across a seamless and dynamic continuum of discovery, development, and delivery. We provide vision and leadership for NCI-funded researchers across the United States and around the world and strive to ensure that the results of research are used in public health programs and clinical practice to reduce the burden of cancer for all people.

Building on past discoveries and technological advances, we plan, conduct, coordinate, and support cutting-edge research and its application. We support the development of, access to, and use of new technologies by cancer researchers. We encourage creativity and innovation in all of our endeavors. We provide research training and career development opportunities and maintain support mechanisms and collaborative environments to link scientists with their colleagues and with critical technological and information resources. As leader of the National Cancer Program, we provide the public with scientifically sound cancer information using communication methods carefully designed to meet the needs and preferences of cancer patients, their families, and caregivers.

NCI supports a broad range of research to expand our understanding of cancer and develop improvements in prevention and care. Some investigators conduct basic laboratory research on genes that may cause cancer. Others are studying the incidence of cancer in specific populations, such as people of low socioeconomic status and former smokers. Still other scientists focus on translational research such as developing tests to identify patients who carry genes that may make them susceptible to cancer or conducting early clinical trials to determine the readiness of new preventive agents, diagnostic tools, or treatment drugs for full clinical testing.

The paragraphs that follow describe the NCI research portfolio and the multitude of resources that are currently available with NCI funding.

Preempting Cancer at the Earliest Opportunity

Ensuring the Best Outcomes for All

 

Our Research Portfolio

Preempting Cancer at the Earliest Opportunity

Continued discovery in etiology and biology and the subsequent development of interventions in prevention, early detection, diagnosis, and treatment will provide the means by which we can preempt the initiation and progression of cancer at every stage, from precancer through metastasis.

Understanding the Causes and Mechanisms of Cancer
Accelerating Progress in Cancer Prevention
Improving Early Detection and Diagnosis
Developing Effective and Efficient Treatments

Understanding the Causes and Mechanisms of Cancer

NCI's etiology research focuses on identifying and understanding the origins and causes of cancer. Genetic, environmental, and lifestyle factors can all contribute to cancer development. Genetic factors may include inherited genes known to be involved in familial cancer syndromes and spontaneous mutations to genes involved in regulation of cell growth.

Examples of environmental factors that may affect cancer development include exposures to radiation, organic solvents, asbestos, other pollutants, and infectious agents such as viruses or bacteria. Lifestyle factors that put people at risk include smoking, alcohol consumption, parity, sun exposure, diet, level of exercise, and obesity.

NCI's research portfolio includes population studies that identify the cancer risks associated with interactions between susceptibility genes and environmental or lifestyle factors as well as biological studies to elucidate causal pathways. Other studies assess disruptions to normal cellular biology caused by the dynamic interaction of these risk factors. For example, increased production of free radicals and changes in levels of certain hormones and growth factors has been implicated in the development of certain cancers.

NCI's cancer biology portfolio addresses the cellular and molecular mechanisms of cancer initiation, progression, and metastasis as well as normal biological functioning. The portfolio includes studies of abnormal chromosomes or genes, DNA damage or mutation, aberrant gene expression or protein function, epigenetic¹ changes, cancer causing viruses, angiogenesis² and the movement of cells within the body. Approximately 10 percent of the biology portfolio supports research to understand normal biology, especially at the cellular and molecular level. This research includes studies of cellular metabolism and growth, the structure and function of genes and proteins, developmental biology, and cell to cell interactions.

Accelerating Progress in Cancer Prevention

NCI is dedicated to exploring new approaches to prevent the onset of cancer through a broad portfolio of prevention research. Our investigations support the identification of medical and behavioral approaches to cancer prevention that can be translated to public health settings. The majority of the prevention research portfolio addresses strategies for preventing or delaying the onset of cancer, including nutritional approaches, vaccination, and chemoprevention.

• Nutrition related research includes investigation of the role of nutrients and micronutrients on human health, the effects of nutrients or nutritional status on cancer incidence, and techniques for assessing dietary intake.
  
  
• Prevention vaccine research explores strategies to stimulate the immune system to attack infectious cancer-causing agents or tumor-specific antigens and identifies effective vaccine delivery strategies.
  
  
• Chemoprevention research is focused on drugs that can be used to prevent development of a primary or secondary cancer.

Approximately one-quarter of our prevention portfolio supports investigation of behavioral factors that affect cancer risk and strategies to change these behaviors. These projects focus on risk factors such as poor diet, lack of physical activity, sun exposure, and tobacco use. A small proportion of the portfolio addresses complementary and alternative methods for cancer prevention, such as diet, herbs, and other supplements that are not widely used in conventional medicine, as well as biobehavioral techniques such as hypnotherapy, relaxation, meditation, spiritual healing, massage, and biofeedback.

Improving Early Detection and Diagnosis

Much of this research portfolio focuses on the discovery and development of biomarkers and imaging techniques for cancer screening, early detection, diagnosis, and prognosis. Biomarkers are genes, proteins, or other molecules that indicate the presence of cancer based on their patterns or levels of expression.

For example, prostate specific antigen (PSA) levels are used to screen for prostate cancer. New research focuses on finding additional biomarkers for prostate cancer. Researchers are using proteomic technologies to develop biomarker panels to detect insidious cancers, such as ovarian and pancreatic cancer. Similarly, anatomical and molecular imaging techniques are used to detect tumors, inform prognosis, and identify metastasis.

Promising new biomarkers or imaging technologies undergo preclinical evaluation before advancing to Phase I clinical trials for preliminary safety and efficacy testing. Later stage clinical trials evaluate biomarkers or imaging techniques for clinical specificity, predictive value, quality assurance and quality control, reproducibility, and effectiveness in reducing morbidity and/or mortality. This portfolio also supports research to determine how patients accept and comply with cancer screening methods.

Developing Effective and Efficient Treatments

A large part of NCI's research portfolio focuses on the discovery, development, and evaluation of therapeutic strategies for destroying cancer cells or modulating and controlling metastasis. These include localized, systemic, molecularly targeted, combination, or alternative approaches that do minimal harm to healthy tissue.

• Localized therapies, such as surgery or radiotherapy, directly target the tumor and sometimes neighboring tissue.
  
  
• Systemic therapies are usually administered intravenously or orally and include cytotoxic or hormonal agents, vaccines, antibodies, gene therapy, angiogenesis inhibitors, and differentiating agents.
  
  
• Molecularly targeted therapies are usually administered systemically, but are designed to interact specifically with the tumor and associated tissues.
  
  
• Combination therapies use two or more drugs and/or treatment modalities to increase treatment efficacy.
  

NCI also conducts research on complementary and alternative treatment approaches. New intervention strategies emerging from the treatment research portfolio are first evaluated preclinically and then moved sequentially through Phase I, II, and III clinical testing.

Ensuring the Best Outcomes for All

The successful application of evidence-based interventions for preempting cancer through prevention, detection, diagnosis, and treatment depends on our ability to move effective interventions into practice. NCI works with others to ensure that the results of our research and development efforts are adopted, that they accomplish their intended purpose, and that they adequately address issues in quality of cancer care, survivorship, and health disparities.

Improving the Quality of Cancer Care
Improving the Quality of Life for Cancer Patients, Survivors, and Their Families
Overcoming Cancer Health Disparities

Improving the Quality of Cancer Care

NCI's portfolio includes critical research on the quality of care provided to cancer patients. This portfolio covers the discovery, development, measurement, and dissemination of interventions aimed at improving the quality of cancer care and health-related outcomes across the cancer continuum.

Quality of care research includes refinement of process and outcome measures, including the development of assessment metrics. Research on patterns of care include studies that link key data sources for tracking information on prevention and treatment interventions with NCI's surveillance programs. Other research focuses on understanding behavioral and sociocultural factors that influence the quality of cancer care, developing interventions that target the patient and their families, improving symptom management and palliative care, and training specialized care providers. Our quality of cancer care portfolio also supports use of claims data, design of functional evaluation tools, development of quality indicators for advanced cancer care, and dissemination of end of life resources to Cancer Centers. Researchers also evaluate patient psychosocial distress, the quality of supportive care for advanced cancer patients, and the impact of aging on quality of care.

Improving the Quality of Life for Cancer Patients, Survivors, and Their Families

Survivorship research focuses on the health and life of cancer patients following acute diagnosis and treatment phase and encompasses both the prevention and control aspects of chronic disease epidemiology. NCI's survivorship portfolio includes investigations into the broad spectrum of physiologic, psychosocial, economic, and behavioral effects of cancer and its diagnosis and treatment on survivors and their families with a strong emphasis on long-term and late effects.

NCI supports both descriptive and intervention survivorship research. For example, researchers study the genesis of recurrent cancer and second primary tumors, late effects of cancer treatment, and strategies for the early detection of residual disease in adult cancer survivors. Because breast cancer survivorship is most prevalent, the majority of studies examine the long-term and late effects related to this disease. In addition, pediatric cancer survivorship research is well represented in the research portfolio and a large portion of this research focuses on survivors of childhood acute lymphocytic leukemia.

Overcoming Cancer Health Disparities

It is well known that many population groups across the United States and around the world suffer disproportionately from cancer and its sequelae. Gender, ethnicity, and socioeconomic status are among the major factors that influence disparate rates of cancer incidence, morbidity, and mortality. Areas in which cancer health disparities are particularly evident include reduced access to cancer screening and diagnostic services, treatment disparities, lack of awareness about cancer risk and prevention, lack of access to clinical trials, and differential exposures to cancer causing agents.

NCI efforts focus on improving the status of economic, social, cultural, psychologic, behavioral, and biologic factors that contribute to cancer health disparities. Research in NCI's biology, etiology, prevention, detection, and treatment portfolios addresses many of these issues. Resources and infrastructure necessary for disparities research include informatics, specimen resources, clinical trial groups, statistical methodology, drug and reagent resources, centers, consortia, and education and training of people prepared to work in careers focused on cancer health disparities. NCI's investments are accelerating the development and application of interventions for overcoming disparities across the cancer control continuum and among all underserved populations.