Yesterday marked the second annual retreat of National Cancer Institute-designated Cancer Center directors. The retreat provides a forum for NCI leaders to brief the directors on important NCI initiatives, and for an open and honest dialogue on the national cancer program.

Just like the inaugural retreat last spring, this year's retreat was gratifying and educational. It allowed NCI leaders to better understand the complexity of the challenges facing Cancer Centers, as well as the breadth of the opportunities before us.

As the recent special issue of the Cancer Bulletin described, NCI-designated Cancer Centers have evolved into the core of the national cancer program. The majority of individual R01 and P01 awards, for example, go to researchers at NCI-designated Cancer Centers, as do the majority of funds for training grants and Specialized Programs of Research Excellence.

Given their many strengths, I believe it's vitally important to expand Cancer Centers' sphere of influence. To achieve that end, we are following a two-pronged strategy: continuing to provide opportunities for Cancer Centers to excel as individual institutions serving large, diverse communities, while also working to integrate the work of these state-of-the-art institutions so that the whole of the Cancer Centers Program is greater than the sum of its parts.

Evidence of the latter can be seen in the technology initiatives such as the cancer Biomedical Informatics Grid, molecular imaging, and nanotechnology, all of which take advantage of Cancer Centers' acumen in research and forming partnerships and, consequently, are enhancing the capacity of technologies to speed us toward the molecular oncology era.

Our goal is to integrate Cancer Centers into all of NCI's strategic initiatives. Cancer Centers provide remarkable infrastructures and are often centers of technological and scientific excellence. As a result, they offer, for example, ideal backdrops for the initiatives between the Food and Drug Administration and NCI aimed at improving the development process for new cancer drugs and diagnostics.

As we anticipate the official release in June of recommendations from the Clinical Trials Working Group - a group that included a number of Cancer Center representatives - center directors voiced optimism about the role their institutions will play in reshaping the clinical trials process to accelerate progress in prevention, diagnosis, and treatment.

An area in which I believe Cancer Centers can have a dramatic impact involves disparities in cancer care and outcomes. As many center directors stressed during the retreat, addressing these disparities is absolutely critical if we are to achieve the 2015 goal, and many Cancer Centers have the expertise and established community networks needed for this line of research.

Cancer Centers' involvement is not relegated to domestic initiatives. They are providing important training to international researchers and clinicians, often through programs run by the NCI Office of International Affairs. In many instances, this involves hospital-based training on the latest cancer treatment techniques, allowing oncologists from around the world to improve cancer care in their countries.

Cancer Centers are leaders in the effort to eliminate the suffering and death due to cancer. They have the power to influence and transform cancer research and care at every level. In fact, I see the Cancer Centers Program as a model for creating change across the health care system - a model that NCI can nurture and guide, not via a cancer-centric approach, but rather a cancer-led approach that delivers on the promise of the cancer community's expertise, strength, and commitment to life and good health.

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