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Cancer Policy Monitor: Feb. 13, 2018      

Capitol Corner: AACR Interviews Members of Congress      

Every month, the AACR will be interviewing several members of Congress from both sides of the aisle to get their personal story and views on cancer research. This month, we chatted with Senator Chuck Grassley (R-Iowa), Senator Tammy Baldwin (D-Wisconsin), Representative Brett Guthrie (R-KY) and Representative Suzan DelBene (D-WA).

Jump to the interview with:

  1. Senator Chuck Grassley
  2. Senator Tammy Baldwin
  3. Representative Brett Guthrie
  4. Representative Suzan DelBene

Senator Chuck Grassley (R-Iowa)      

Can you share with our readers, many of whom are cancer survivors, advocates, and researchers, your personal connection to cancer?

My wife Barbara is a breast cancer survivor. Diagnosed 30 years ago, our family was stopped in its tracks when her primary care doctor discovered a lump in each breast during a wellness exam. Just a few years prior to her cancer diagnosis, Barbara had returned to college and the workplace, after taking a hiatus to be at home to raise our five children. She was starting a new chapter in life, and now life was writing an unexpected plot twist. She handled the news with the courage, grit and no-nonsense manner I have cherished for the past 63 years of marriage. As Barbara says, “When life knocks you down, faith and family keep me marching onward and upward.” An incision biopsy revealed a malignant tumor in her left breast.

In April 1987, Barbara had life-saving surgery. Every year since then, she gets an annual mammogram screening and our family gives thanks every day that this resilient woman is a breast cancer survivor. Barbara credits early detection for saving her life and has made advocacy, education and outreach a personal campaign to help save more lives. That plot twist that made our hearts skip a few beats three decades ago opened another chapter for Barbara and myself. We are committed to help raise awareness regarding early detection, wellness and cancer prevention. Barbara and I have served as honorary co-chairs at the John Stoddard Cancer Center booth at the Iowa State Fair. It’s always good to connect with Iowans who take advantage of free cancer and wellness screenings and to share our advocacy for this important public health issue.

According to the Centers for Disease Control and Prevention, one of every four deaths in the United States is due to cancer. More than 500,000 Americans die from cancer every year, the second leading cause of death in our country. We also have enjoyed meeting Iowans and other survivors who participate in wellness walks and other events, especially during Breast Cancer Awareness Month in October. Barbara also serves on the executive committee of congressional families for cancer prevention.

How has the experience of dealing with cancer in your community, both personally and from stories you’ve heard from your constituents, shape your views as a policymaker and a public official?
From a personal perspective, I am a firm believer that healthy habits – getting enough sleep, regular exercise and good nutrition -- are vital to adding years to life and getting the most life out of our years. Barbara’s cancer diagnosis served as a reality check to both of us. It reinforced how important it is to maintain regular wellness checks with a primary care provider, conduct self-exams and not to ignore aches and pains that may flag symptoms of something more serious.

As an elected representative for Iowans, I have made it a mission to keep in touch with my constituents. In fact, I just launched my 38th consecutive year holding meetings in each of Iowa’s 99 counties. Nothing compares to having face-to-face dialogue with my fellow Iowans, no matter the issue, but especially when these conversations involve issues that impact the quality of life and access to affordable health care for a loved one. From that standpoint, I have championed policy measures to keep the delivery of health services accessible to people living in rural and under-served areas of America.

Access to quality health care should not be determined by your zip code. Keeping rural and community clinics and tele-health services open for business is a lifeline to cancer patients who otherwise might have to travel for hours to see a specialist or get lab work done, for example.

What would you say to your colleagues in the legislative branch about the role of federal investment in medical research and cancer research in our nation?
The federal government serves as a check on quality and patient safety through its regulatory responsibilities authorized by Congress. As keepers of the public purse, lawmakers have the authority to channel federal tax dollars towards national priorities and needs, such as medical research. The $6.3 billion 21st Century Cures Act reflects the high priority elected representatives put towards federal investment in innovation, medical science and research studies to accelerate innovative treatments, therapies and cures for the American people diagnosed with chronic conditions and diseases. Specifically, the law authorized nearly $2 billion to accelerate cancer research and improve prevention, earlier detection, survival and ultimately find cures.

How can groups like the AACR and patient advocates best communicate the importance of medical research to the members of Congress? Do you think we have made progress in terms of raising awareness of the importance of National Institutes of Health (NIH) funding to saving lives and helping the American economy?
Patient advocacy groups very definitely make an impact on developing public policy and that bears out in the overwhelming passage of the 21st Century Cures Act in December 2016. The law arguably reflects the best way to gain traction and accelerate legislation to final passage: build broad coalitions. A diverse array of constituencies turned up the volume, from patients and health care providers, to drug and medical device companies, think tanks, medical societies, universities and more.

A sustained and well-orchestrated messaging campaign successfully captured broad bipartisan support on Capitol Hill. Elected representatives have their ears tuned into grassroots advocacy, from constituents attending meetings in their home states or on Capitol Hill, to constituent mail campaigns and social media outreach, patient advocacy groups absolutely bring a big voice to the table. Personal stories also help bring major policy issues down to a human level so hearing from cancer patients, families, and survivors is vital.

The big picture is clear: Americans expect the United States to continue its reputation as a world leader in breakthrough medicine that saves lives, finds cures and improves the quality of life for an aging society. Those expectations require a strategic partnership for medical research among industry, academia and the National Institutes of Health.

Can you tell us more about other efforts—legislation and otherwise—that you have worked on or are currently working on in support of better prevention, detection and treatment of cancer?
From my committee chairmanships of the Senate Aging, Finance and Judiciary Committees, I have conducted robust oversight of public health care programs and federal agencies and advanced legislation to improve the delivery of health care in the United States, particularly to expand access to screening and treatment services for lower-income individuals. My work specific to the prevention, detection and treatment of cancer includes:

In 1997, I helped steer the State Children’s Health Insurance Program S-CHIP program to final passage as a senior member of the Senate Finance Committee. Since its enactment, I have led efforts to reauthorize and expand S-Chip as chairman and ranking member of the Senate Finance Committee. This year Congress extended the program, providing nearly $125 billion to provide coverage through the next six years. This federal-state partnership provides access to health care for children whose families earn too much to qualify for Medicaid. It’s estimated that one-third of children with cancer depend on these two programs for treatment.

Also in 1997, I co-sponsored a resolution adopted by the U.S. Senate calling for accurate, scientific data to determine recommendations for breast cancer screenings, such as a mammography and other emerging technologies, specifically for women ages 40-49.

Since its first issue in July 1998, I have supported many times to extend sales of the USPS breast cancer research postage stamp to help fund breast cancer research. As of Dec. 2017, the stamp has raised more than $87 million for breast cancer research. By federal law, the National Institutes of Health receives 70 percent of the net amount raised and 30 percent is directed to the Medical Research Program at the Department of Defense.

In 2000, I co-sponsored the Breast and Cervical Cancer Prevention and Treatment Act enacted into law on October 24, 2000. It allowed states to make breast and cervical cancer-related treatment and services available to low-income individuals.

In 2007, I co-sponsored the Breast Cancer and Environmental Research Act enacted into law on Dec. 21, 2007. It authorized grants for public and nonprofit entities to conduct research on environmental factors that may be related to breast cancer.

In 2015, I sponsored the Accelerating the End of Breast Cancer Act, securing 53 bipartisan co-sponsors. It would have created a commission to accelerate the end of breast cancer with the goal to end breast cancer by Jan. 1, 2020.

Also in 2015, I co-sponsored the Lymphedema Treatment Act that would provide for Medicare coverage of certain lymphedema compression therapies, a progressive condition that can be caused by cancer treatments, putting survivors at risk of infection, disability and other complications.

In this 115th Congress, I am co-sponsoring the following bills:

The Childhood Cancer Suvivorship, Treatment, Access and Research Act of 2017, the STAR Act to accelerate development of promising childhood cancer treatments.

The ACE Kids Act of 2017 to improve Medicaid program to better coordinate care for children with complex medical conditions, including cancer, that require continuum of care across multiple providers and allowing for flexibility for out-of-state services.

The Reducing Drug Waste Act of 2017; the Preserving Acccess to Affordable Generics Act of 2017; and, the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2017. These efforts aim to increase consumer choice and help reduce the cost of life-saving drugs for patients.

The Cannabidiol Research Expansion Act of 2017 to reduce regulatory barriers and encourage federal research into the potential medical benefits of cannabidiol oil for medical purposes, such as treating side effects of chemotheraphy.

I also serve as a member of the Congressional Caucus on the Deadliest Cancers (103 members), a bipartisan, bicameral coalition to raise awareness about the deadliest forms of cancer, those with a five-year survival rate of below 50 percent.

The AACR is the world’s first and largest organization dedicated to every aspect of high quality cancer research. The AACR has 40,000 members across all states, as well as members in 119 other countries. Do you have anything you would like to say to the AACR and our scientists and physicians who have dedicated their careers to making progress against cancer?

Imagine the possibilities of a world without cancer. I applaud your dedication and commitment. Know that your vocation and your work makes a difference.

Is there anything we didn’t discuss that you would like to add?

I welcome and value the expertise and advocacy that the American Association for Cancer Research brings to the table. Our republic is made stronger with grassroots engagement and civic participation. That’s one reason I support recognizing May as National Cancer Research Month. All Americans will be impacted by cancer in our lifetimes. Working together we can raise awareness and strengthen resources to continue improving earlier detection and survival rates; advance innovative therapies and treatments; and one day fulfill the hopes and prayers of millions of Americans who are coming to grips with a diagnosis or taking care of a loved one battling this disease by finding cures.

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Senator Tammy Baldwin (D-Wisconsin)      

Can you share with our readers, many of whom are cancer survivors, advocates, and researchers, your personal connection to cancer?

My grandfather was an NIH-funded scientist at the University of Wisconsin-Madison, so from a young age I understood the importance of providing scientists with the resources they need to pursue life-saving research and have long championed strengthening our research enterprise.

And when I was young, I had a childhood illness and was branded with a pre-existing condition, just as any cancer survivor is. I know what it's like to have a diagnosis change your life and your family's life, and to wonder how you will be able to afford the life-saving medication and treatments you need.

This issue is personal to me, and I know it's very personal to so many across Wisconsin who have watched loved ones fight cancer, or have battled cancer themselves.

I have spent my career in public service fighting for affordable health care, and the stories I hear from Wisconsinites inspire me to keep fighting and to do everything I can to ensure that all Americans have access to quality, affordable care.

How has the experience of dealing with cancer in your community, both personally and from stories you've heard from your constituents, shape your views as a policymaker and a public official?

In 2013, I had a particularly powerful meeting with a high school bone cancer survivor from Fond du Lac, Wisconsin, named Ian. Ian told me cancer research helped save his life, which is why he wanted to grow up to be a scientist to help others with his disease. But, he was concerned it wouldn't be possible for him to break in as a new researcher due to NIH funding cuts. 

Ian inspired me to author the Next Generation Researchers Act with my colleague Senator Collins, which has now been signed into law, to fight to improve NIH opportunities for our new and early stage researchers.

Ian recently graduated college, where he was helping a researcher at the University of Minnesota study the genetics of Osteosarcoma and he is now working in a lab with a scientist researching pediatric cancers. I believe that it is important that Congress look for ways to improve the development, availability and safety of cancer treatments, and I'm inspired by the stories of individuals like Ian, who are working to make things better for the patients of the future.

As a member of both the U.S. Senate Appropriations Subcommittee on Labor, Health and Human Services and the Senate HELP Committee, you are a strong champion for medical research on Capitol Hill, and you have supported efforts to provide the National Institutes of Health (NIH) with the largest increases in funding in more than a decade. Why do you believe that robust funding increases for NIH are so important at this time? What would you say to your colleagues in the legislative branch who may not understand as you do how important federal investment in medical research is to our nation?

Right now, NIH rejects nearly nine of eleven grant proposals, one of the highest rejection rates in history and far below the 1/3 success rate called for by agency leaders, because of a lack of resources.  I have long championed strengthening our research enterprise because smart research investments spur innovation, create jobs, grow our economy and bring life-saving medical treatments to Wisconsin families. Cuts to the NIH have negative consequences on our nation's researchers, and jeopardize our country's scientific leadership. Supporting investments in research, science and innovation is about ensuring the best health care for our nation's hard working families.

How can groups like the AACR and patient advocates best communicate the importance of medical research to the members of Congress?

I think the best way to advocate for the importance of medical research is to inform my colleagues of the value of your work. Cancer is the second most common cause of death in the United States and its costs are adding up. Research is vital in the fight against cancer, however, without continued federal support and adequate funding, we are failing the millions of Americans fighting cancer.

Can you tell us more about other efforts—legislation and otherwise—that you have worked on or are currently working on in support of better prevention, detection and treatment of cancer?

I am proud to say that I have worked to improve access to education and preventive screenings to make sure our health care system works for everyone. Early detection is critical in the fight to beat cancer and save lives. That is why I introduced the Invest in Women's Health Act of 2017. This legislation would help women disproportionally affected by breast, ovarian and cervical cancer by increasing access to life-saving cancer screenings at safety net clinics.

I continue to advocate for increased funding for medical research and supported the 21st Century Cures Act (Public Law 114-255), which authorizes an additional $4.8 billion in increased funding for NIH over the next ten years for specific, innovative NIH research initiatives including cancer research and precision medicine. I am also a proud cosponsor of the National Biomedical Research Act, which would create a Biomedical Innovation Fund designed specifically to provide predictable investments in life-saving biomedical research conducted by leading scientists at the nation's top research institutions. The funding would provide $5 billion annually in supplemental funding for grants for young emerging scientists, and breakthrough research on life-threatening diseases, including cancer.

I have also introduced bipartisan legislation with Senator Capito to improve palliative and hospice care, which vital to so many patients and families. The Palliative Care and Hospice Education and Training Act will grow and sustain our healthcare workforce to improve the quality of care for Americans with illnesses like cancer.

Finally, I recognize that access to affordable medications and prescription drugs is critical for cancer patients. In May, I introduced the Fair Drug Pricing Act with my colleague Senator John McCain. The FAIR Drug Pricing Act would require accountability and transparency for drug corporations who are jacking up the costs of lifesaving treatments. Patients and families have to put their lives on hold when illnesses arise and they shouldn't have to worry about whether they can afford treatment.

Do you have anything you would like to say to the AACR and our scientists and physicians who have dedicated their careers to making progress against cancer?

I want to thank all of you for the hard work you are doing to improve the lives of cancer patients and their families worldwide. I have been inspired by the stories of individuals fighting cancer and fighting for a cure, and I know how important it is for Congress to support efforts to prevent, detect and treat this disease. I will continue to support efforts to improve our nation's investment in medical research.

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Representative Brett Guthrie (R-Kentucky)      

Can you share with our readers, many of whom are cancer survivors, advocates, and researchers, your personal connection to cancer?

Sadly, everyone I know knows someone who has suffered from cancer. I have seen the effects of it in my community and my extended family, and I know how hard it is for families who have to face it head on. That’s why, as vice chairman of the Health Subcommittee, I am committed to finding a cure.

How has the experience of dealing with cancer in your community, both personally and from stories you’ve heard from your constituents, shape your views as a policymaker and a public official?

It has definitely shaped my views. I am sad to say that I have met with Kentuckians whose children have been diagnosed with cancer as well as elderly patients who are suffering from cancer and many people in between. Hearing these stories is inspirational to me as a lawmaker and reinforces the urgency of working to find a cure and to advance precision medicine policies. The stories and experiences also demonstrate how wide-ranging the disease is and the need for a comprehensive approach to finding a cure, focused enough to be effective but broad enough to account for the breadth of affected patients.

As a member of the House Energy and Commerce Committee, and particularly the Vice-Chair of its Health Subcommittee, you have the opportunity to work on issues that are important to both cancer patients and researchers. What would you say to your colleagues in the legislative branch about the role of federal investment in medical research and cancer research in our nation?

Medical research and cancer research in particular is crucial to finding the cure for cancer. Often, this research is not possible without federal investment and funding. As the vice chair of the Health Subcommittee, I believe we must continue to support medical research. I was proud to support the 21st Century Cures Act last Congress, which funded additional medical research and ensured federal policies foster the important development of precision medicines.

How can groups like the AACR and patient advocates best communicate the importance of medical research to the members of Congress?

I believe the best way to advocate for the importance of medical research is to meet with members of Congress and ensure patient advocates’ voices are heard on the federal level. It is important for us to witness firsthand how medical research is helping our constituents. It’s easy to look at NIH reports but not fully understand the significance of the research. Talking to patients about how the research has saved lives is incredibly powerful from a public policy perspective.

Can you tell us more about other efforts—legislation and otherwise—that you have worked on or are currently working on in support of better prevention, detection and treatment of cancer?

I was proud to work on the 21st Century Cures Act, which ensured federal policies foster research, development and innovation, as well as precision medicine. The 21st Century Cures Act included the authorization of $1.8 billion in funding for the Cancer Moonshot over 7 years. This Congress I have co-sponsored the Cancer Drug Parity Act of 2017 (H.R. 1409), the Firefighter Cancer Registry Act of 2017 (H.R. 931), and the Childhood Cancer STAR Act (H.R. 820). I am also a member of the Congressional Caucus of the Deadliest Cancers.

Do you have anything you would like to say to the AACR and our scientists and physicians who have dedicated their careers to making progress against cancer?

Thank you for your hard work to advocate for cancer patients and your work to find a cure. Let’s not get discouraged by the fact that we haven’t found a 100% cure for cancer. As you know, there have been amazing advancements in cancer research in recent years and I personally am very encouraged by this progress. Thanks for your continued efforts to work toward the dream of finding a cure.

Is there anything we didn’t discuss that you would like to add?

I would just like to say thank you again to the AACR for the work that you do, moving us further toward finding a cure for cancer. The research and advocacy that members of the AACR do is invaluable to supporting this fight.

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Representative Suzan DelBene (D-Washington)      

Can you share with our readers, many of whom are cancer survivors, advocates, and researchers, your personal connection to cancer?

It's hard to find someone who hasn't had a friend or family member with cancer. I have. My father died of colon cancer and my father-in-law from lung cancer. Almost 40 percent of us will be diagnosed with some form of cancer in our lives. By investing in life sciences research and promoting innovation, we can make a meaningful difference in the lives of cancer patients and their families. I believe it's a national imperative that our government recognize and help address this.

How has the experience of dealing with cancer in your community, both personally and from stories you've heard from your constituents, shape your views as a policymaker and a public official?

Before Congress, I started my career in biomedical research working in immunology at Oregon Health Sciences University and later in biotech in Seattle. So I know firsthand how important research funding is for enabling medical breakthroughs. I also understand that research isn't a spigot you can just turn on and off. Major scientific discoveries come after years of incremental research. That's why I have spent the last five years in Congress building momentum with my colleagues to increase funding for the National Institutes of Health. Because if we're serious about breaking new ground in preventing and treating cancer, it's imperative we boost investments in medical research and keep that funding stable.

You are a strong and outspoken champion for medical research on Capitol Hill, and you recently lead another bipartisan letter urging the House Appropriations Committee to increase National Institues of Health (NIH) funding by $2 billion. Why do you believe that robust funding increases for NIH are so important at this time? What would you say to your colleagues in the legislative branch who may not understand as you do how important federal investment in medical research is to our nation?

Funding for NIH supports life-saving research to develop breakthrough treatments and improve health outcomes. And it supports more than 300,000 jobs at 2,500 research institutions around the nation. NIH funding helps foster innovations in immunotherapy and precision medicine, which have the potential to eradicate cancer from a patient's body using their own cells. Unfortunately, federal investments in NIH have not kept pace with inflation during the last decade — meaning we are losing the great return we have historically seen. It also makes it harder for new researchers to get started impacting future innovations.

How can groups like the AACR and patient advocates best communicate the importance of medical research to the members of Congress?  Do you think we have made progress in terms of raising awareness of the importance of National Institutes of Health (NIH) funding to saving lives and helping the American economy?

If we're going to succeed in increasing medical research funding and protecting people's access to healthcare, it will be because of the tireless advocacy of volunteers like all of you. It truly makes a difference when constituents share their personal stories with lawmakers. It's one of the most impactful forms of advocacy. Because cancer isn't a partisan issue; it doesn't affect just members of one party. Your voices and stories make a huge difference in this fight. So call your lawmakers, write a letter or request a meeting, and make sure they're hearing about the real-life implications of the policies being debated.

Can you tell us more about other efforts—legislation and otherwise—that you have worked on or are currently working on in support of better prevention, detection and treatment of cancer?

I serve on the House Ways and Means Committee, which has jurisdiction over parts of our healthcare system. Last year, we successfully rebuked efforts to dismantle our healthcare system and the Affordable Care Act, which made tremendous strides in preventative healthcare and protecting people with pre-exisiting conditions, like cancer survivors who I heard from loud and clear. I will continue to protect the progress we've made but also work across the aisle to find ways to increase access to high-quality healthcare and reduce costs.

Do you have anything you would like to say to the AACR and our scientists and physicians who have dedicated their careers to making progress against cancer?

Thank you for your work. You are all leaders in our community. Talk to friends and family and encourage them to join your efforts. Stay engaged and reach out to your representatives to let them know what you think about things happening in our government and how they impact you.

Is there anything we didn't discuss that you would like to add?

I just want to emphasize that we truly are in an exciting time as far research and development of new treatments. Precision medicine was hardly on the minds of patients just a few short years ago and now policy makers like me are looking ahead to figure how things will need to change to provide access to promising treatments that may break from our traditional models of care. Now is not time let up on research funding and advocacy. The next few years have the potential to be transformative and we cannot slow down. 

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Key Policy Updates from Capitol Hill     

Congress Passes Bipartisan Budget Deal, Paving the Way for Robust NIH Funding Increases in FY 2018 and FY 2019

In December 2017, the AACR delivered a letter to congressional leaders from distinguished AACR current and past presidents and Fellows of the AACR Academy, including 18 Nobel Laureates, calling on leaders in the House and Senate to “move quickly to finalize a multi-year, bipartisan budget agreement that raises the caps on non-defense discretionary spending in FY 2018 imposed by the Budget Control Act.” In all, 95 of the 119 fellows residing in the United States signed the letter, along with the current president of the AACR.

The letter emphasized that innovative cancer treatments, such as molecularly targeted therapeutics and immunotherapies, are now making their way to patients at an ever-increasing pace. These advances, highlighted in the AACR Cancer Progress Report 2017, are the direct result of federal investment in laboratory, translational, and clinical research through the NIH and the National Cancer Institute (NCI). However, with 595,690 estimated cancer deaths this year alone, including children and adults, there is still more work to be done, which is why sustained and robust funding increases for the NIH and NCI remain essential.

Late last week, Congress passed and the President signed the Bipartisan Budget Agreement Act of 2018. The bill includes a two-year budget deal that increases both defense and non-defense discretionary spending caps by nearly $300 billion, split nearly evenly over fiscal years (FY) 2018 and 2019. Specifically, the non-defense increase over two years is $131 billion, which is $63 billion above the cap in FY 2018 and $68 billion above the cap in FY 2019. The bill also included a fifth continuing resolution (CR) to fund the federal government until March 23, in order to allow time for an omnibus appropriations bill to be written that meets the new spending allocations.

With more resources allocated to non-defense discretionary spending, this agreement means the $2 billion increase to the NIH FY 2018 budget approved by the Senate Appropriations Committee last summer can now become a reality. Additionally, the budget agreement paves the way for continued robust increases for the NIH in the coming fiscal year on the order of at least $2 billion. The AACR applauds this development and especially thanks the Fellows of the AACR Academy, who urged Congress in their letter to raise the caps on nondefense, discretionary spending and enable a continued, strong federal investment in the NIH.

Now that the agreement has passed, Congressional appropriators will go to work on crafting a final, FY 2018 omnibus appropriations bill that can be voted on before March 23.

White House Releases FY 2019 Budget Proposal

On February 12, the White House released its fiscal year (FY) 2019 budget proposal to Congress. For the Food and Drug Administration (FDA), the proposal includes an overall increase of more than $400 million to its budget authority above current levels (FY 2017).

The proposal specifically includes $20 million for the Oncology Center of Excellence (OCE), which the Department of Health and Human Services (HHS) budget in brief states “will allow FDA to more robustly help expedite the development of oncology and hematology medical products and support an integrated approach in the clinical evaluation of drugs, biologics, and devices for the treatment of cancer.” The HHS budget in brief specifically cites progress in cancer treatment, stating that “in August 2017, FDA issued a historic action making the first gene therapy available in the United States, ushering in a new approach to the treatment of cancer and other serious and life-threatening diseases.”

For the National Institutes of Health (NIH) budget, the proposal does not provide for the robust, sustained and predictable funding increases that the research community has been advocating for over the past few years. Unlike last year, the FY 2019 budget proposal does not call for draconian cuts to the NIH budget. However, when accounting for medical inflation, the proposed flat level of about $35.5 billion for FY 2019 amounts to a funding cut. Additionally, the proposal cuts the National Cancer Institute (NCI) budget by $24 million compared FY 2017. The proposed budget highlights the Next Generation Research Initiative, noting that it includes $100 million for the Office of the Director to supplement the budgets of institutes and centers for young investigator grants. However, it also seeks to lower the salary cap that can be paid with grant funds.

The proposed budget would in addition move three institutes under the authority of the NIH. These include the Agency for Healthcare Research and quality, which would be renamed under the NIH; the National institute of Occupational Safety and Health, which is currently under the Centers for Disease Control; and the National Institute on Disability, Independent Living, and Rehabilitation Research, which is currently under the Administration for Community Living and formerly under the Department of Education.

Despite the proposal, Congress is expected to continue its trajectory of robust, sustained and predictable funding increases for the NIH. Congressional appropriators are currently working on an FY 2018 omnibus spending bill that is expected to include a $2 billion for the NIH.

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It's Time to Address Cancer Health Disparities      

The below article, written by AACR CEO Margaret Foti, PhD, MD (hc), originally appeared on Research!America's blog.

World Cancer Day, which took place earlier this month, aims to "get as many people as possible around the globe to talk about cancer." This year, the American Association for Cancer Research (AACR) hopes that, in addition to talking about cancer broadly, people around the world will also discuss the disproportionate impact that cancer has on disadvantaged and minority groups. We must continue to talk about the problem of cancer health disparities and address this pressing issue comprehensively and with passion and commitment. 

According to the National Cancer Institute (NCI), cancer health disparities are “adverse differences in cancer incidence (new cases), cancer prevalence (all existing cases), cancer death (mortality), cancer survivorship, and burden of cancer or related health conditions that exist among specific population groups.” From issues affecting access to and use of health care, to clinical trial participation, cultural beliefs and genetics, many complex and interrelated factors contribute to disparities in cancer health outcomes both in the United States and around the world. Other factors contributing to these disparities include age, disability, education, ethnicity, gender, geographic location, income and race.

While the global cancer research community has been making unprecedented strides toward finding cures for various types of cancer and improving and extending the lives of cancer patients everywhere, we still face a long road ahead when it comes to addressing the disproportionate impact that cancer has on disadvantaged and minority groups. Today, black men still face double the rate of death from prostate cancer than men of any other racial or ethnic group, while Hispanic children remain 24% more likely to develop leukemia than non-Hispanic children. Poor women with early-stage ovarian cancer are still 50 percent less likely to receive recommended care than women of higher socioeconomic status. These are just a few of the disparities that we highlighted in the AACR Cancer Progress Report 2017, but many more exist.

The AACR has made addressing cancer health disparities one of its top priorities, and this important area has been a focus of AACR President Michael A. Caligiuri, M.D., during his term in office. The AACR Annual Meeting 2018 in April will feature exciting new sessions on cancer health disparities, thanks to Dr. Caligiuri’s Presidential initiative. This year also marks the 11thtime that the AACR will be organizing the AACR Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved. Over the next few months, we will continue to increase our commitment to addressing this critical issue, with several groundbreaking disparities-related initiatives in the works.

For over 110 years, the AACR has been and continues to be committed to preventing and curing all cancers.  This work is carried out by fostering research, education, communication, collaboration, advocacy and funding for the top cancer science and medicine in the world. This World Cancer Day, we called for a global commitment to putting an end to cancer health disparities, wherever they may exist. Our 40,000 members across 120 countries, among them being researchers, physician-scientists, other health care professionals, cancer prevention specialists, and patient advocates, stand ready to deliver on that commitment. 

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FDA-AACR-ASTRO Workshop: Clinical Development of Drug-radiotherapy Combinations    

Date: Feb. 22-23, 2018. Location: Hyatt Regency Bethesda Hotel, One Bethesda Metro Center, 7400 Wisconsin Ave, Bethesda, MD 20814

Register for in-person or webcast participation. See the Workshop Agenda.

The below article by workshop co-chair Amanda Walker, MD, first appeared on the blog of our workshop partner, the American Society for Radiation Oncology (ASTRO). Dr. Walker is associate director (acting), Oncology Center of Excellence and medical officer, Division of Oncology Products 1, Office of Hematology and Oncology (OHOP), Center for Drug Evaluation and Research (CDER) at the FDA.

The field of medical oncology is undergoing a remarkable transformation. Cancers that were once considered death sentences, such as multiple myeloma and metastatic melanoma, are turning into chronic diseases due to the use of novel targeted systemic therapies. Immunotherapy, heralded as a “game changer” in oncology, is altering the natural history of certain malignancies, checkpoint inhibitors are making their way into front-line management and CAR-T cell therapy has demonstrated durable responses in patients with refractory hematologic malignancies.  
 
The field of radiation oncology is also undergoing a remarkable transformation. Improved radiation delivery techniques allow radiation oncologists to more precisely target the tumor and spare normal tissue. Treatment times are shortening due to the delivery of higher doses per fraction, and radiation fields are shrinking. A number of clinical trials are investigating the role of stereotactic body radiation therapy (SBRT) in patients with oligometastatic disease, and novel image guidance techniques allow adaptive radiation treatment planning in real time, providing yet another tool to optimize the therapeutic index of radiation therapy. 
 
While both medical oncology and radiation oncology have made great strides independently of one another, very little has changed in terms of the systemic therapies that we use in combination with radiation. Over the past 10 years, the Office of Hematology and Oncology Products at the U.S. Food and Drug Administration (FDA) has approved more than 200 new drug and biologic licensing applications, but none of these approvals were for use in combination with radiation therapy. The reasons for this discrepancy are complex and multifactorial, including limited regulatory precedent and perceived challenges in trial design and data collection with radiation.
 
Recent studies have shown that radiation therapy can work synergistically with immunotherapy agents to induce potent antitumor immune responses. A number of mechanisms have been postulated including increased expression of negative immune regulators, increased antigen presentation and other modifications of the adaptive immune response with radiation. Other targeted molecular therapeutics, such as inhibitors of DNA repair enzymes and growth factors, have a strong preclinical rationale for use in combination with radiation therapy based on their mechanism of action, yet very few agents have successfully moved from the lab into clinic.
 
Given the enormous potential for drug-radiotherapy combinations to improve meaningful clinical outcomes, the American Association for Cancer Research (AACR), ASTRO and the FDA are co-sponsoring the Clinical Development of Drug-Radiotherapy Combinations Workshop to address the lack of development in this area. The workshop takes place on February 22–23 at the Hyatt Regency Hotel in Bethesda, Maryland, and will bring together key stakeholders from around the world, including industry, regulatory agencies, patient advocates and academic oncologists. The goal is to engage in robust discussions with a focus on the most practical aspects of drug development.
 
Radiation will remain a fundamental pillar of cancer treatment for the foreseeable future, but until every cancer patient treated with radiation therapy is cured, there is still work to do. We are reaching the limits of our siloed approach to advancing the field. Now is the time to break down the silos and join forces with our colleagues to improve the lives of our patients. Join us at the workshop next month so we can start this important work.

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Sign Up Today: AACR Early-career National Day of Action 2018      

In conjunction with the AACR Early-career Hill Day on March 7, we invite early-career scientists anywhere in the U.S. to participate in the National Day of Action by contacting members of Congress to urge their support for robust, sustained and predictable funding increases for the National Institutes of Health. It only takes a few minutes to send an email and/or call your congressional representative and senators, and your voice can greatly help advance our message to Congress!

You can sign up today to receive an alert on March 7 with easy instructions on how to contact your members of Congress. By signing up today, your information will already be pre-filled when you return on March 7, which makes taking action a simple one minute process. Sign up here, and make sure to select the "Early Career scientist," as well as the "Remember Me" and "Email Opt-in" boxes, so that we can send you the alert on March 7.

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Save the Date: Rally for Medical Research 2018    

The sixth annual Rally for Medical Research will be held Sept. 12-13, 2018 in Washington, D.C. For those who cannot participate in person, the online Rally National Day of Action will take place Sept. 13.

Stay up-to-date on registration information by visiting the Rally website, Facebook, and Twitter pages.

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Join the AACR Cancer Action Alliance    

Launched in January 2012, the alliance leverages the strength of AACR members and interested nonmembers to build nationwide public and congressional support for cancer research and scientific progress. Alliance members are kept regularly informed about the news and events that affect cancer research and are alerted to opportunities to contact Congress or participate in other forms of outreach. Alliance members receive action alerts, timely legislative updates and other resources to facilitate their efforts.

With the Trump administration proposing deep cuts to the NIH budget, it is imperative that everyone who cares about defeating cancer speak out now and urge lawmakers not to turn their backs on the incredible scientific opportunities that are before us. Senators and representatives need to hear directly from residents in their district and/or state to understand what is at stake for their constituency, in terms of economics, health and competitiveness, if cancer research is not made a priority.

It is free and simple to join and your contact information will be used only to contact you about the AACR’s advocacy efforts and opportunities to take action.

Sign up here to receive action alerts and learn about opportunities to join other scientists, patients, survivors, and concerned citizens in calling on Congress to provide critical funding increases for the lifesaving cancer and biomedical research supported by NIH and NCI.

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Share Your Cancer Research or Advocacy Story    

We’re looking for inspiring stories from researchers and advocates about why they became interested in cancer research or advocacy and how they work in their own way on behalf of cancer patients and survivors. You can submit your story starting today for a chance to be featured on our Take Action website and future editions of the Cancer Policy Monitor.

You can be as creative as you like. Write your story in your own words, make an online mini-site, create a video, or submit a digital collage. Any way you think would best tell your story is acceptable. There is no deadline to submit your story. We will be accepting stories throughout the year. Submit your story and/or links​.

Ken Dutton-Regester, a melanoma researcher who serves as the chairperson of the AACR Associate Member Council, the leadership body of the associate members of the AACR, shared the story of his work. Ivy Elkins, a lung cancer advocate in the AACR Scientist↔Survivor Program, shared the story of how she became a lung cancer advocate. Kerie Berkowitz shared the story of how she survived ovarian cancer and became an advocate for survivorship issues.

Read more stories​ and submit yours today!

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