Nearly 80 percent of NCI's budget funds extramural research activities—research taking place at institutions across the country and around the world. The Extramural Research Program supports cancer research in nearly 650 universities, hospitals, Cancer Centers, and other sites throughout the United States and in more than 20 countries. The majority of NCI's extramural funding supports investigator-initiated Research Project Grants (RPGs). For Fiscal Year 2007, NCI invested more than $2.1 billion in support of over 5,200 RPGs. NCI's extramural budget also supports cancer control, investigator training, health disparities research, collaborations with the private sector, and other types of research and development activities.
Program experts within NCI guide and administer the investment in extramural biomedical research. They participate in the decision making process that identifies research goals and objectives, and recommend action for resource allocation.
They also collaborate and maintain effective liaisons with scientists in their program area and monitor technologic, scientific, and policy developments to help identify future research opportunities and priorities. The extramural funding supports areas such as basic research into the workings and mechanism of cancer and its cells; research focused on cancer prevention, early intervention, symptom management, and supportive care; cancer diagnostic and therapeutic cancer interventions research; and research in surveillance, epidemiology, health services, behavioral sciences, and cancer survivorship.
When she arrived at the Clinical Center at the National Institutes of Health, our patient couldn't even make a fist. Her hands, wrists, elbows, hands, and knees could scarcely bend. Her skin was cracking; her face was swollen and disfigured. A once-vibrant woman in her late 20's, she was now severely anemic, wheelchair bound, and wrapped in blankets, to preserve the body heat her skin could no longer retain. Over two years, as she suffered the disabling manifestations of cutaneous T-cell lymphoma, the nights spent in the hospital had come to greatly outnumber those she spent at home. She was in hospice care and lacked the strength to be with her two small children. She came to the Clinical Center virtually out of treatment options—and one there, an initial short list of experimental treatments had all failed.
Having apparently run out of all hope, our patient came into the care of Dr. Martin E. Gutierrez, a staff clinician with the NCI's Medical Oncology Branch. Dr. Gutierrez, who has spent his career working on new therapies for T-cell lymphoma patients, decided to try a new drug being developed through NCI's Rapid Access to Intervention Development (RAID) program. RAID exists to speed the translation of novel anticancer therapies from laboratories to patients. And in this case, the new drug paid off dramatically. Within the first few doses, Dr. Gutierrez began to see improvement. Within seven months, the patient's symptoms were gone. Today, a year after her arrival at the Clinical Center, the patient's tests show no evidence of disease.
Martin E. Gutierrez, M.D.
NCI Staff Clinician
The drug utilized by Dr. Gutierrez was one that was developed, but never marketed, by a pharmaceutical company as a drug to prevent cancer. It was brought to the RAID program by an extramural investigator from Los Angeles, who developed it as a chemotherapeutic drug. Through its RAID program, NCI is able to take another look at agents that may not have fared well in a commercial environment, where the potential for profitability and market share are factors that must be considered. RAID offers the opportunity to further develop promising approaches for prevention, detection, and treatment.