A NEW SCRIPT FOR CANCER RESEARCH

Successful experiments are built on a vision of the future and overcome the pitfalls of the past. "Stand Up to Cancer" promises to be such an experiment - ambitious in aim, grand in scale, and smart in design. It is an experiment that will involve not only laboratory scientists and clinicians, but potentially every American.

I admit that I felt considerable skepticism when I first heard months ago about a new national effort to combat cancer. I had studied and written about the "War on Cancer" launched in 1971 by the Nixon administration. The intentions of the physicians, philanthropists and politicians at that time were undoubtedly good, but the initiative failed to fulfill expectations.

The scientists and funders of that effort believed in what was then conventional wisdom, wed to one model of the disease: that most human tumors were caused by viruses. They believed this because some cancers in animals like mice and chickens were found to follow infection with these microbes.

Vast sums of money were directed to this single line of research. The organizers believed so strongly in their idea that they declared that cancer could be conquered in five years, in time for the celebration of the nation's Bicentennial. Researchers with different views about what could cause cancer and how to combat it were given scant resources to pursue their work.

Many years passed until it was finally accepted by all that viruses were not the cause of most human malignancies. Fortunately, important knowledge was gained from this admittedly misconceived effort. That knowledge proved essential in the battle against what, in fact, is a viral disease - AIDS. And the scientists who challenged the prevailing dogma behind the War on Cancer ultimately succeeded; they showed that it is mutations in genes rather than viruses that derange normal cells which then grow and spread in an uncontrolled way - the essence of cancer.

In contrast to the misconceived efforts of the past, the organizers of SU2C have done their homework. They cast a wide net; they elicited opinions and ideas from mainstream scientists and from contrarians working outside the mainstream, from advocates of current paradigms of cancer research and critics of the establishment. They learned what dictated success and what caused failure in ongoing private and governmental initiatives. With this knowledge in hand, they launched this new experiment.

Instead of being wed to one mindset, SU2C seeks creative and novel approaches that span a diversity of ideas. Individual researchers with single projects that could become new clinical treatments within three years will be supported. So will "Dream Teams" that mobilize many laboratories with scores of scientists to translate a platform of biological discoveries into clinical practice.

SU2C avoids the creation of a large and self-perpetuating bureaucracy. It demands milestones and accountability of those who are funded, so that successful work will flourish and projects that flounder will not continue. SU2C is designed to be open, flexible, and forward thinking. It tries to build a different future using the vision of many.

Why many? All researchers have ideas about what is key in the development of a certain type of cancer and how best to treat it. We imagine that our work in the laboratory and in the clinic will fulfill our projections. No one, of course, is always right. Some of our ideas are correct and others are not. Some of our ideas build directly from current knowledge. Others require a leap of thinking that deviates from prevailing concepts.

Some ideas are derived from fields that are most familiar to cancer researchers, like biology and chemistry. Other ideas reach into subjects that may seem less connected to oncology, like physics or engineering, but could enable real progress. The organizers of SU2C draw no boundaries around the origins and the types of thinking. They welcome proposals from all scientific disciplines.

Like smart investors, the organizers of SU2C recognize uncertainty and eschew arrogance, crafting a balanced portfolio rather than placing all the assets on one project or approach. There are safeguards against conflict of interest, so that scientists do not "feed themselves" or their friends. Collaboration and communication underlie each "Dream Team." The predominant culture of failing to share data among researchers will not be tolerated.