Last week, NCI's senior leadership hosted our semi-annual meeting in Washington, D.C., of the directors of all NCI-designated Cancer Centers. This was the fourth such meeting with NCI, a dialogue I began during my presidency of the Association of American Cancer Institutes. As with the previous meetings, its goal was to encourage frank discussions and gain honest input from the directors on some of the most pressing issues facing NCI - a dialogue never more important than in this period of decreasing NCI budgets. Every aspect of the Center Directors' mission - from core grant support to Center members' R01s - is feeling the pressure of few dollars.

At the meeting, members of a special Cancer Center Directors' Working Group, led by Dr. John Mendelsohn from the University of Texas M.D. Anderson Cancer Center, presented draft reports on their recommendations on how the Centers can help NCI reduce the cancer burden by identifying achievable goals and specific milestones, and by defining the opportunities and potential barriers to achieving our goals. They also presented ideas on ways in which the Centers can extend their research beyond their local communities; provide leadership in the wide dissemination of best practices in cancer care and prevention; and develop innovative ways to work in a collaborative, multidisciplinary way on key opportunities in integrating biology. I am confident that this document will become a vital implementation plan to achieve our promise to our patients.

Their input couldn't have been more timely as NCI faces difficult fiscal decisions. We must all work together with the broad cancer community in making key resource allocation decisions and the Cancer Centers are the cornerstone of our National Cancer Program. They are where the majority of our grantees reside. Institutions with NCI-designated Cancer Centers receive over 60 percent of NCI grant dollars. So the input of the directors as leaders at their institutions is important to us all.

They appreciated the message presented by NIH Director Dr. Elias Zerhouni about the current political and budgetary environment driving the NIH budget process. He told them of the cancer community's unique opportunity to be the first to propose a new vision of how to render cancer care that will resonate with both policy makers and the public. (For more details, please see Dr. Zerhouni's Guest Commentary.)

As Dr. Mendelsohn noted, the Cancer Centers are offering to play expanded leadership and coordination roles in reducing the cancer burden nationwide. This critical consensus regarding our joint responsibilities will complement NCI's mission to focus on supporting cancer research. The Cancer Centers' mission as an extension of NCI into the community encompasses both research and patient care. The Centers are the site of translation. With increased restraints on the federal budget, we need to leverage our current investments to increase research outcomes - and the Cancer Centers are the lynchpin in this process with their strong public-private partnerships and involvement with the philanthropic community.

The Cancer Centers also share NCI's commitment to better manage the nation's cancer research dollars over a longer period of time than is possible with a focus on the yearly federal budget cycle. This means developing 5-year plans using NCI's strategic plan, while keeping the investigator-initiated research pool strong to incorporate new ideas, scientific developments, and technology advances. It also means protecting our future talent pipeline via mechanisms that provide enhanced support for new investigators, such as NIH's new "Pathway To Independence" awards.

The Center Directors' collective experience and unabated commitment to their institutions and the communities they serve, as well as to the highest quality research and patient care, makes their readiness to assume a greater leadership role a dramatic and significant milestone in NCI's mission to lessen the burden of cancer for the American people. I know I speak for the entire NCI senior leadership team when I say we are extremely fortunate to have such a well-established, nationwide program as part of the National Cancer Institute. We all recognize just how much we owe those who came before us - those who had the wisdom and vision to create the national Cancer Centers' Program. They have deeded to all of us a tremendous responsibility to continue to build on their foundation.

Dr. John E. Niederhuber
NCI Deputy Director and Deputy Director for Translational and Clinical Sciences