National Cancer Institute

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The National Cancer Institute (NCI) is part of the United States Federal government's National Institutes of Health. The NCI is a federally funded research and development center, one of eight agencies that compose the Public Health Service in the United States Department of Health and Human Services. The NCI coordinates the National Cancer Program.

The National Cancer Institute has large intramural research programs in Bethesda, Maryland and NCI-Frederick at Fort Detrick, in Frederick, Maryland. In addition, the NCI funds cancer researchers around the United States.

Legislative history

Congress established the NCI by the National Cancer Institute Act, August 5, 1937, as an independent research institute. Congress then made the NCI an operating division of the National Institutes of Health by the Public Health Service Act, July 1, 1944. Congress amended the Public Health Service Act with the National Cancer Act of 1971 to broaden the scope and responsibilities of the NCI "in order more effectively to carry out the national effort against cancer." Over the years, legislative amendments have maintained the NCI authorities and responsibilities and added new information dissemination mandates as well as a requirement to assess the incorporation of state-of-the-art cancer treatments into clinical practice.

Anti-cancer drug investigations

The NCI played an early role in the development of anti-cancer drugs in the U.S. According to a 1996 NCI analysis of drugs approved by the FDA, two-thirds of the anti-cancer drugs approved as of the end of 1995 were NCI-sponsored Investigational New Drugs:

Alkylating agents

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Cyclophosphamide.

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Chlorambucil (Leukeran) (1957)
Cyclophosphamide (Cytoxan) (1959)
Thiotepa (1959)
Melphalan (Alkeran) (1959) (IV in 1993)
Streptozotocin (Zanosar) (1982)
Ifosfamide (Ifex) (1988)

Antimetabolites

Plant alkaloids and antibiotics

Synthetic drugs

Hydroxyurea (Hydrea) (1967)
Procarbazine (Matulane) (1969)
O, P'-DDD (Lysodren, Mitotane) (1970)
Dacarbazine (DTIC) (1975)
CCNU (Lomustine) (1976)
BCNU (Carmustine) (1977)
Cis-diamminedichloroplatinum (Cisplatin) (1978)
Mitoxantrone (Novantrone) (1988)
Carboplatin (Paraplatin) (1989)
Levamisole (Ergamisol) (1990)
Hexamethylmelamine (Hexalen) (1990)
All-trans retinoid acid (Vesanoid) (1995)
Porfimer sodium (Photofrin) (1995)

Hormones and steroids

Biologicals

Alpha interferon (Intron A, Roferon-A) (1986)
BCG (TheraCys, TICE) (1990)
G-CSF (1991)
GM-CSF (1991)
Interleukin 2 (Proleukin) (1992)

In addition, scientists in the NCI played an important role in the discovery and development of important AIDS drugs including zidovudine (AZT), didanosine (ddI), and zalcitabine (ddC).

Controversy

The previous Director of the Institute is Dr. Andrew von Eschenbach, who has been tapped by the administration to head the FDA replacing Lester Crawford. The NCI, in partnership with pharmaceutical companies, funds research into new drugs. These drugs may appear before the FDA for approval, and some anticipate that the FDA cannot be impartial if its head has an interest in seeing the drug approved because of another relationship.

According to the Center for American Progress, shortly after Dr. Eschenbach was appointed Director in 2002, he changed an informational fact sheet on breast cancer on the NCI site which for years had stated that there was no causal link between abortion and breast cancer. The new text said that "tests disproving the abortion - breast cancer link are inconclusive." One hundred NCI scientists signed a statement taking issue with that change, citing many studies, none of which found any such causal link. Dr. Eschenbach eventually relented and the original text in the fact sheet was restored.

Quality Assurance

The NCI provides funding for numerous cancer research endeavors. Two of its largest known grants include the Radiological Physics Center (RPC) in Houston, Texas and the Quality Assurance Review Center (QARC) in Providence, Rhode Island. The RPC assures the NCI of proper participation in the physics-related aspects of its studies and QARC provides radiotherapy quality assurance and diagnostic imaging data management to all of the NCI sponsored cooperative groups. The RPC essentially guides all participating institutions as to how radiation is to be applied in a radiotherapy protocol. QARC on the other hand performs thousands of radiotherapy reviews per year and receives radiotherapy data from around one-thousand hospitals in both the United States and abroad. In all, over thirty-thousand cases have been reviewed at QARC since its inception in 1977. QARC also maintains a strategic affiliation with the University of Massachusetts Medical School in Worcester, Massachusetts. The RPC has been consistently funded by the NCI since 1968 and QARC has received support from the NCI since 1980.