As I revisit all that has happened over the past year in cancer research, I reach an inescapable conclusion: We are not only expanding our foundation of knowledge and tools with which rapid advances can be made in understanding the mechanisms of cancer, we are also exponentially increasing the opportunities to manage this lethal disease.

The Clinical Proteomics Technologies Initiative launched this year, for instance, will improve the technologies used in proteomics research - a field that is offering new avenues for early detection and diagnosis. There also is The Cancer Genome Atlas Pilot Project, which will yield information about genetic determinants of susceptibility to cancer while laying the groundwork for a full-scale understanding of the genetic etiology of cancer. And the establishment of the NCI Alliance for Nanotechnology in Cancer, including Centers of Excellence and new training programs, will explore new worlds of diagnosis and treatment.

Technology will undoubtedly accelerate progress, but it is just one piece of our robust National Cancer Program.

Within the other parts of our portfolio, an important project completed this year was the work of the Clinical Trials Working Group, which produced 22 recommendations for reworking the NCI clinical trials program to make it more effective and efficient. In May, NCI also made an unprecedented commitment to addressing disparities in cancer care with the launch of the Community Networks Program (CNP). The $95 million CNP will help to implement community-based projects aimed at reducing disparities in underserved populations.

Large-scale clinical trials in 2005 yielded results that will have profound effects in preventing and treating many cancers. For example, three different clinical trials showed that adding trastuzumab to chemotherapy significantly reduced the risk of recurrence in women with early-stage, HER-2 positive breast cancer. Results from the Lung Health Study showed that intensive smoking-cessation programs not only can help people stop smoking, but, for those who do quit, can significantly improve long-term survival. Stunning results were seen in an HPV vaccine trial, demonstrating that most cases of cervical cancer can be prevented, which will have important implications in underdeveloped countries. And in September, results from the DMIST trial demonstrated that a subset of women can significantly benefit from digital mammography.

In the laboratory, there were numerous studies that yielded noteworthy results, often using ingenious techniques or novel approaches. Researchers from NCI and the University of Minnesota, for example, published a study demonstrating how employing "jumping DNA" called transposons in mouse models may enable us to identify new cancer genes. In addition, researchers from the University of Michigan studying prostate cancer identified for the first time, the presence of a commonly fused gene in a solid tumor. The researchers believe other solid tumors may also harbor common translocations, which could serve as biomarkers of disease.

These are just samples of the outstanding work being done every day by cancer researchers. Eliminating the suffering and death due to cancer by 2015 is a bold and ambitious goal, but this past year has demonstrated progress that gives us hope.

Certainly there are significant hurdles to overcome, from tough budgetary decisions to the physical limitations of available research tools. But our progress is consistently accelerating and there is ample proof of the principle that the mechanisms of cancer are vulnerable. In 2006, as cancer yields to our determined attack, lives will be saved.

Dr. Andrew C. von Eschenbach
Director, National Cancer Institute