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139th National Cancer Advisory Board

questions. Years 2 and 3 would be used for implementation of the more expanded model and evaluation of the metrics and research questions around the pilot program. In regard to funding, Dr. Niederhuber explained that it is the intent to support multiple sites through the NCI’s prime contract with SAIC-F, at a level of $9 M for the 3-year period. Supplemental funding models would be considered in support of goals as they evolve. Guidelines for allocation of resources would be 40 percent for health care disparities and 20 percent each for information technology, the biospecimen initiative, and clinical trials. Next steps are a Development Committee review of comments obtained from the RFI issued in mid- August, drafting of the Request for Proposal (RFP), and a strong communication effort to educate stakeholders in the cancer community regarding this proposal and elicit feedback. The proposed timeline for this initiative includes closing the RFI period in September, RFP release in mid-October, pre-proposal conference in mid-November if needed, RFP response deadline in mid-December, RFP response evaluation in mid-January, and pilot selections completed early in 2007.

Questions and Answers

Dr. Diana Lopez, Professor, Department of Microbiology and Immunology, University of Miami Miller School of Medicine, suggested that the recommendations of a Project Review Group (PRG) commissioned by the former Secretary, DHHS, could be used in formulating guidelines for the NCCCP inasmuch as community-based health care delivery was a major focus of the report. Dr. Niederhuber replied that many issues and ideas generated by the PRG were brought to the discussions of the NCCCP Development Committee, as well as research in the various NCI Divisions. He suggested that the community site can be viewed as a laboratory that provides an opportunity to implement many different programs at one site for the improvement of health care delivery. As a result, it will be possible to evaluate whether conducting activities in an integrative fashion is a more effective approach than doing them in isolation. Ms. Ryan commented that the NCCCP is comprehensive and ambitious, and she asked whether the NCI had conducted a national snapshot of the landscape to determine what programs may exist in the areas of interest to the program, such as access to health care. She also commented that, from a research perspective, there may be a question of feasibility, for example, the time needed for a community center to operate effectively. Dr. Niederhuber gave assurance that options and resources that could play into the program were extensively researched during the program development phase. Dr. Moon Chen, Professor, Public Health Sciences, and Associate Director, Cancer Disparities and Research, University of California, expressed enthusiasm for the NCI vision of linking together a nationwide cohort to address health care issues.

Dr. Everson applauded the NCI for the vision embodied in the NCCCP, and he noted that it is a vision that his institution’s network of more than 1,000 practicing oncologists try to emulate. He volunteered to help in any way and share his experience base. Dr. Chabner recounted his institution’s experience in attempting to develop a similar program in a largely Portuguese and Hispanic hospital system, and he described unexpected challenges that were encountered, including the need for a very strong program for translation to put patients on complex protocols such as the current Phase I protocols. Another challenge was encountered in trying to find the right trial for the right person. He expressed the view that much thought must be given to the feasibility of matching the trial to the local expertise and patient population on a larger scale. Ms. Ryan agreed that feasibility questions are valid, but she cited the challenges facing the COG in getting aphaeresis done in institutions nationwide for its massive Phase III trials in neuroblastoma, and she commented that success in achieving that was a valuable learning experience.


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