Integrating Cancer Science
Cancer is a complex disease arising from a myriad of genetic and environmental events that elude and exploit normal cellular processes. The disease process is further confounded by its diversity and its progressive nature. Cancer science is currently at a crossroad where input and approaches from a breadth of disciplines are necessary to understand and appreciate its complexities. Scientists are recognizing the need for study designs with the power to uncover the environmental, lifestyle, genetic, and molecular determinants and pathways involved in cancer initiation, promotion, and progression.
Cancer research of the future will be energized as people from the various disciplines combine forces. New paradigms of collaboration will mean new ways of thinking about how we do science. This new culture will require the creation of an environment conducive to change, the merging of old disciplines, and the development of new ones. New funding mechanisms will accelerate development of infrastructures for cutting-edge interdisciplinary research at the intersection of basic, clinical, and population sciences. Integrated review of grant applications will take into account the melding of various disciplines, support large-scale team-based consortia to foster the inclusion of genomics and other emerging technologies into epidemiologic study designs, and use other less formal ways to encourage interdisciplinary teams to evolve in both directed and serendipitous ways.
Investments in integrative science will uncover the many factors influencing cancer initiation, promotion, and progression and thereby hasten the development of cancer prevention, detection, and treatment interventions. Epidemiologists, geneticists, behavioral scientists, and biologists will be working alongside statisticians, engineers, physicists, bioinformaticians and computer scientists, sociologists, psychologists, communication specialists, and educators to improve the quality of cancer care, and health outcomes for diverse populations. Large-scale consortial efforts involving population cohorts will systematically evaluate and identify molecular and biochemical biomarkers of susceptibility, gene-environment interactions, causal pathways and intermediate outcomes, and early-stage lesions amenable to early detection and treatment. Disparate perspectives and approaches will build the kind of synergy required to facilitate the easy flow of information from basic research to application.
Proposed New Investments
NCI will support a broad set of interactions and efforts, both within NCI and across the scientific community, to develop an integrative approach to cancer research. We will use novel funding approaches, promote new paradigms, and encourage multicenter partnerships that will capitalize on efforts across the entire biomedical research community for the benefit of cancer patients and those who care for them. We will develop training initiatives to introduce new and established investigators to the integrative science paradigm. NCI will use new investments in Fiscal Year 2007 to foster integration in four critical areas.
- Systems Approach
NCI will use a systems biology approach to build on the totality of information available about cancer processes. The studies will examine the interrelationships among the immune system, the tumor microenvironment, tumor stem cells and self-renewal genes, cellular response to DNA damage, exogenous and endogenous chemicals, epigenetics, inflammation, and mechanisms of cancer susceptibility and resistance. We will support development of computational models to facilitate the generation of hypotheses and to predict or explain the complex, multilevel interactions that lead to cancer initiation and progression. - Integration of the Biological with the Population and Public Health Sciences
Equally important to the successful understanding of cancer and the development of interventions to benefit all people will be an integrative epidemiologic framework to address NCI strategic research initiatives in cancer prevention and detection, health disparities, and other areas of biological, clinical, sociological, and public health importance. We will support research that extends beyond molecular epidemiology to consider the roles of behavioral, sociocultural and psychosocial factors in cancer susceptibility, utilization of recommended screening, and treatment outcomes. - Advanced Technologies to Facilitate Integration
NCI will support the development and availability of advanced technologies for use in integrative cancer research. We will work to ensure that research teams have access to advanced technologies, including informatics and computational resources, to enable the generation, integration, and analysis of vast amounts of biomedical information. - Translation into Practice
We will use integrative approaches to translate interventions to public health and medical practice. NCI will assess and implement recommendations from the National Cancer Advisory Board Translational Research Working Group which will analyze existing research efforts and identify opportunities for accelerating the delivery of validated interventions to the people who can benefit. We will complete the loop of integrative science by developing approaches to inform basic researchers about lessons learned from the application of emerging interventions in clinical and public health settings.
Implementing new pursuits to promote program integration and interdisciplinary team science will require new funding structures and environments conducive to team science and effective collaboration. We estimate the need for a budget increase of $190 million for new investments in this area.