A conversation with Dr. William S. Dalton, CEO and Director of the Moffitt Cancer Center
The AACR Cancer Policy Monitor recently had the opportunity to speak with William S. Dalton, Ph.D., M.D., chief executive officer and center director at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Fla., to gain his insight about cancer research policy. Dr. Dalton has been involved in cancer research for more than two decades and his research interests include the areas of drug resistance and new drug discovery. He also serves as the chair of the AACR Science Policy and Legislative Affairs Committee.
CPM: What do you think are some of the most interesting areas in cancer research right now and what is on the horizon that most excites you?
Dalton: We're evolving from studying just single molecules to being able to put a system together. With the sequencing of the human genome and the ability to do gene expression profiling – all the molecular technology we have – is generating so much information that we're beginning to put the whole puzzle together. Understanding the entire puzzle instead of just one piece is going to be phenomenal.
I actually feel that we're at a threshold of very pivotal, major discoveries that will lead to personalized medicine. I think cancer research will lead the way by which personalized medicine is developed.
CPM: You serve as the chair of AACR's science policy committee, what first inspired your interest and involvement in public policy?
Dalton: My first experience was as an assistant professor at University of Arizona. Getting funding for patients without insurance was my first foray into the state legislature and policy making; I was asked to advise policymakers on state Medicare (called AHCCCS in Arizona) guidelines.
Once at Moffitt, I had the fortune of having as my Board chairman, Senator Connie Mack (R-Florida), who was pivotal in doubling the NIH budget in the nineties. I was really blessed to have a true statesman introducing me to legislators and policymakers at that level. To have someone as a chair, colleague and friend who is a former senator with the stature of Connie Mack, that's a once-in-a–lifetime opportunity.
CPM: Would you tell us more about the role of the AACR Science Policy and Legislative Affairs Committee?
Dalton: The AACR Science Policy and Legislative Affairs Committee is a forum for communication, education and creating enhanced awareness of the value of what cancer researchers do. Our cause is not self-evident, and when you have society with a number of priorities, this committee is responsible for educating the public and policy makers and advocating the value of cancer research.
CPM: Weeks after President Obama took office, he announced that, "it is time we once again put science at the top of our agenda and worked to restore America's place as the world leader in science and technology." Do you think the administration and Congress are taking those words seriously and following through on them?
Dalton: I'm very hopeful and encouraged. We are very thankful for the inclusion of $10 billion of direct funding for NIH as part of the American Recovery and Reinvestment Act of 2009 (ARRA). The increase in the FY2010 budget for cancer programs in FY2010 was also encouraging. But I hope the administration and Congress understand that that this funding serves to "prime" the effort and you can't travel very far just on priming. I think we'll know by 2011 if the effort will be sustained; it will require at least a 13.5 percent increase in NIH funding over the FY2010 level. That will be the proof in the pudding.
CPM: Besides adequately funding cancer research, what would you like to see Congress accomplish in 2010?
Dalton: In terms of health care reform, I'd like to see a final bill that covers clinical trials at the federal level.
Comparative effectiveness research (CER) also needs to be continuously advocated for and we need to continue to make sure the policy language is what it should be. If CER evolves in a way that improves quality by personalizing health care, as well as improving affordability and accessibility, then cost containment will be a consequence of that effort rather than a direct goal. Cost containment should never be a direct goal.
Another aspect that is not getting enough attention is health information technology. The backbone of personalized medicine is going to be information. As we develop the means to molecularly profile patients and patient's tumors, how are we going to use that data to make sure that it is helping us determine which therapies are appropriate for which population? The system to create relationships from so many disparate sources does not currently exist. You can't just say you'll discover signatures [patterns of gene activity in cells that signal a genetic predisposition for certain forms of cancer], and that will determine what people need. For it to be useful, it has to be part of a national information technology system for health care.
We have to work with our colleagues and practitioners, not only in academia, but also in the community and educate them about the need to extend health information technology into the realm of cancer research.
With regard to personalized medicine and the use of genetic information to predict cancer risk – all those signature discoveries that are being made by AACR members — the guidelines for how they are used will be largely determined by policymakers and clinicians, but we can't afford to just walk away. We have to say something about the science and how it is to be applied and sometimes explain the limitations of the science.
CPM: What is your advice to researchers?
Dalton: If we just let things happen from a policy standpoint, then we can't complain about how the policies that emerge will affect us. Members of the AACR need to be involved. I think many researchers aren't particularly comfortable advocating their positions. But, in fact, it's not selfish. You're advocating for society, and you have to believe that what you're doing is vitally important for society. Obviously, our members wouldn't be doing what they were doing if they didn't want to have a positive impact on people and society.
Read More from the February 2010 Edition of the AACR Cancer Policy Monitor: