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used to fully develop the program and expand the number of supplements available nationwide.

As was mentioned, the PHS National Conference will bring together experts from across the education community, Federal Government, and private industry to help develop strategies and a long range plan for PHS involvement in science education. The National Institutes of Health, which is providing a large portion of the funding for the conference, will devote any additional available funds to implementing these recommendations.

NATIONAL CANCER INSTITUTE

STATEMENT OF DR. SAMUEL BRODER, DIRECTOR, NATIONAL CANCER

INSTITUTE

BUDGET REQUEST Senator HARKIN. We will call up all the individual directors here, Dr. Broder at the National Cancer Institute; Dr. Lenfant, Heart, Lung, and Blood; Dr. Tony Fauci with Allergy and Infectious Diseases; and Dr. Harald Löe, National Institute of Dental Research. It is my intent to just simply start in the order in which I have it here.

I will start with Dr. Broder, National Cancer Institute. Dr. Broder, the committee has your budget request for $1.8 billion, which is about 5 percent more than last year. I note that more than one-half of your proposed growth for 1992 is for research project grants, while your request for centers and training is essentially flat with a loss of two of your basic research centers. So, Dr. Broder, could you please give us a brief statement in support of your request, as well as any scientific highlights that you would care to make?

OPENING REMARKS

Dr. BRODER. Thank you very much. Sir, it is my great honor to be here.

This year has been marked by high scientific achievement for the National Cancer Program. The National Cancer Institute (NCI) has pioneered methods of rapid communication about advances in clinical research and continues to disseminate state-of-the-art information in the United States and throughout the world. New cancer drugs have been developed and new prevention strategies using vitamin derivatives have proven effective.

Scientists from NCI and the National Heart, Lung, and Blood Institute have pioneered gene treatment studies. Last year, studies successfully traced the activity of new genes in reinfused cells into patients, and a related study introduced gene therapy for an extremely unusual but important inherited immune system disorder caused by the absence of the enzyme adenosine deaminase, called ADA. Preliminary results in the first patient, a 4-year-old girl, suggested her immune function has, in fact, improved and, therefore, we would declare this the first successful, or at least experimentally successful, application of genetic engineering in the form of gene transfer therapy. The results are still preliminary and they cannot be taken to be a final answer, but we do believe that this is an important advance.

Most recently two patients with melanoma, a form of skin cancer that is quite virulent and often lethal, were treated with special tumor infiltrating lymphocytes armed with a gene that produces a potent antitumor agent, tumor necrosis factor, and this again is a result of the gene transfer technology that we were discussing.

Major progress has been made in reducing deaths from childhood cancers and in preventing or treating many common cancers in adults as well. However, there has been less progress in reducing the death rate from common solid tumors in patients age 65 and over. Many Americans, the poor, the underserved and members of some minority groups do not have access to state-of-the-art prevention, early diagnosis and treatment, and have disproportionately high cancer incidence and mortality rates. We must increase our efforts in cancer prevention and control.

Research on cancers that affect women is a high priority for the National Cancer Institute as cancer is the second leading cause of death among women in the United States with more than 150,000 women expected to die in 1991 of cancers of the lung, breast, colon, and reproductive tract.

NCI supported scientists are unraveling the genetic mysteries of the cancer cell and important new theories of how cancer evolves from the normal cell are emerging with increasing information about oncogenes and suppressor genes.

The NCI cancer centers program provides interdisciplinary cancer research and state-of-the-art diagnosis, treatment and rehabilitation, prevention, and cancer control, as well as community outreach and research on a number of cancers, including AIDS-related cancers, throughout the Nation.

Additionally, NCI's ability to transfer technology effectively rests on community programs such as the clinical cooperative groups and the community clinical oncology program which we refer to as our CCOP program. The latter are especially important in getting state-of-the-art treatment to rural areas, and we now have active participation in NCI funded clinical trials in many small towns throughout the country, some with wonderful names like Spirit Lake, Royal, and Rembrandt.

Among other new cancer drugs, there is a great interest in taxol as it can kill various cancer cells. This is an important drug. It is derived from the bark of yew trees and is in very short supply, but NCI is undertaking taxol development from alternative renewable resources. This is an important and, in fact, an emergency priority of the Institute.

Prevention is the most effective way to eliminate a disease, and NCI is studying smoking cessation, diet, chemoprevention, cancer vaccines, and the use of special hormones to prevent tumors.

The NCI has assisted in evaluating potential environmental issues such as those related to nuclear powerplant facilities.

The NCI also has an important mission in AIDS research, and works closely with other Federal agencies. While not the lead agency at the National Institutes of Health, the NCI is proud of its supporting role. NCI scientists have made vital contributions in areas such as basic biomedical research on the pathogenesis and natural history of the Human Immunodeficiency Virus (HIV). We have drug development programs and vaccine development programs. The NCI intramural program is a leader in developing new therapies for children with AIDS and pediatric research in AIDS is an important priority of the institute. As people with AIDS are surviving longer, the incidence of AIDS related cancers is increasing, and NCI is working to meet this challenge.

PREPARED STATEMENT One measure of the success of the National Cancer Act is that there are over 6 million survivors in the United States, people who have had cancer and who have survived. We have accrued a new understanding of the basic biology of cancer which in turn is pointing to effective prevention, diagnosis, and treatment. We must continue our progress, and the NCI stands to fulfill that goal.

Mr. Chairman, the 1992 budget request for the Institute totals $1,810,230,000.

I would be very pleased to answer any questions. [The statement follows:)

STATEMENT OF DR. SAMUEL BRODER

This year, the twentieth since the National Cancer Act, was passed, has

been marked by high scientific achievement for the National Cancer Program.

Research on gene therapies is progressing, resulting in new ways of

intervening against cancer.

Studies assessing the cancér risk posed by

nuclear facilities have been conducted. New drugs to treat cancer patients have been developed and new prevention strategies using vitamin derivatives have proven effective. A high level of sophistication in recombinant DNA technology has been achieved and much of the biotechnology industry in the United States has emerged from basic science Investigations in these areas.

One measure of the success of the National Cancer Act is that there are over

six million cancer survivors in the United States today. Despite these and

many other successes, the priority placed on cancer research by the National

Cancer Act is as needed today as it was in 1971 when the National Cancer

Program was founded.

There will be over a million new cases of cancer and a

half million people will dle of cancer in the United States this year. Many Americans who could benefit from the findings of this research do not currently have access to state-of-the-art prevention, early diagnosis and

treatment.

The National Cancer Institute also has an important role in AIDS research and works closely with the National Institute of Allergy and Infectious

Diseases and other Federal agencies.

NCI scientists have made vital

contributions using basic biomedical research to study the pathogenesis and

natural history of Human Immunodeficiency Virus (HIV) Infection, AIDS drug development, and vaccine development. The NCI Intramural program is one of

the most important centers in the world for developing new therapies for

children with AIDS.

A new challenge is now on the horizon:

as people with

AIDS are surviving longer, the incidence of AIDS-related cancers is

increasing, and NCI is working to meet this challenge.

Cancer is the second leading cause of death among women in the United

States, with more than 150,000 women expected to die of lung, breast, and colon cancers and cancers of the reproductive tract in 1991. Women

participate in every phase of NCI research and NCI strives for proportional

representation of women in all clinical trials.

Research on cancers that

affect the survival of women is an exceedingly high NCI priority.

Major progress has been made in reducing deaths from childhood cancers..a

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