Building on Opportunities in Cancer Research

Melinda Merchant, M.D., Ph.D., of the NCI Pediatric Oncology Branch, and Ewen Raballand navigate the hallways of the NIH Clinical Center, where Ewen participated in a clinical trial testing natural killer cells to treat his osteosarcoma.

Some of the NCI’s budget supports the research of scientists who work at the NIH Clinical Center and in offices and laboratories located in Bethesda, Rockville, and Frederick, Maryland. These intramural investigators conduct basic, clinical, and population-based research, including the study of rare cancers, and are encouraged to explore the translation of relevant findings from the laboratory to the clinic.

At the NIH Clinical Center, the largest clinical research hospital in the world, intramural researchers are able to quickly test new approaches to cancer prevention and treatment. Clinical studies can be developed in close collaboration with researchers from extramural institutions and the findings extended by extramural investigators. The ability of the NIH Clinical Center to treat patients from all over the world facilitates expeditious clinical research on rare cancers, which may help patients with these diseases and produce insights relevant to more common cancers.

For example, the use of immunotoxins that target a protein expressed in mesotheliomas has produced long-term responses in patients with this relatively uncommon cancer and is leading to clinical trials of this approach in patients with more common tumors.

In another, recent advance, adult patients with a type of cancer known as Burkitt lymphoma had excellent long-term survival rates—upwards of 90 percent—following treatment with low-intensity chemotherapy regimens. Standard treatment for Burkitt lymphoma involves high-dose chemotherapy, which is highly toxic and, historically, cures only 60 percent of adult patients.

The NIH Clinical Center does not come without expense. The NCI and the other NIH institutes and centers support, financially and professionally, the operations of the clinical center, with the NCI covering more of the costs than any other institute.

Chanelle Case Borden, Ph.D. - Spotlight on Scientists

Chanelle Case Borden, Ph.D., a National Institutes of Health postdoctoral fellow, discusses overcoming challenges and the rewarding field of molecular oncology.

The intramural program also conducts population and multidisciplinary research to discover geneticand environmental determinants of cancer and new approaches to cancer prevention. Over the years, research by this group of epidemiologists, geneticists, and biostatisticians has influenced public health policy in the United States and around the world.

NCI researchers, together with colleagues at the National Institute for Occupational Safety and Health, recently completed the first study to show that heavy exposure to diesel exhaust among miners was associated with an increased risk of developing and dying from lung cancer, even after adjusting for other lung cancer risk factors, such as cigarette smoking. The findings, which took years to develop, played a pivotal role in the recent classification of diesel engine exhaust as carcinogenic to humans (a group 1 carcinogen) by the International Agency for Research on Cancer. The conclusions have implications not just for miners but also for the 12 million American workers and tens of millions more worldwide who are exposed to diesel exhaust in the workplace and for people who live in cities with high levels of diesel exhaust.

The activities of the NCI intramural research program complement those of other aspects of the National Cancer Program. With both academic and private sector partners, intramural researchers can undertake longer-term projects that may be difficult, if not impossible, through traditional funding mechanisms. For example, NCI researchers studied immunotherapy during long periods when it was not in vogue.

However, the findings from this long-term research made important contributions to the current widespread efforts to develop immunotherapy as a standard of care for a range of cancers. In addition, some public health issues, as exemplified by the diesel exhaust study, take many years and would be very difficult to conduct without government support.

View the recommended budget increase for NCI’s intramural research program

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