Cancer researchers were nervous early this year about who President Donald Trump would choose to replace Harold Varmus as director of the National Cancer Institute (NCI). But in June their fears of an unconventional candidate proved unfounded when he tapped Norman “Ned” Sharpless. Sharpless, 51, who was then director of the Lineberger Comprehensive Cancer Center at the University of North Carolina (UNC) in Chapel Hill, checked all the right boxes for the community: He is a physician-scientist who treats patients, he has started two biotech companies, and he runs a basic research lab focused on p16—a protein important to cell division and aging.
Sharpless, who started work in October, takes over for Doug Lowy, the acting director since Varmus left in March 2015. Sharpless has spent the last 2 months absorbing information about the $5.7 billion institute. He has talked to all six former living NCI directors, for example, as well as NCI grantees and intramural staff.
Talking this week with ScienceInsider, Sharpless declined to lay out specific plans. But he mentioned three areas that are important to him: big data, basic research, and translating discoveries into devices and treatments. He’s also been thinking of ways to bolster the careers of young investigators, a perennial issue for NCI’s parent agency, the National Institutes of Health (NIH).
Q: Why do you want to be NCI director?
A: My old boss Ron DePinho [Sharpless’s postdoctoral adviser, now at MD Anderson Cancer Center in Houston, Texas], who nominated me for the job, actually called to convince me why I should consider doing it. And I sort of stopped him in midsentence and said, “Wait, Ron, you had me at ‘NCI director.’”
I really believe it’s a special time in cancer research. We have this basic biological understanding and the notion that cancer is thousands of different diseases, and that has really allowed us to speed progress. We’re going to remember the cancer researchers of the day the way we talk about [Louis] Pasteur and [Robert] Koch and antibiotics. The opportunity to be involved at this time was just too much to pass on.
Wait, Ron, you had me at ‘NCI director.’
Q: IBM’s effort to use the Watson supercomputer to guide cancer treatments has been controversial. What are your thoughts about big data?
A: I am 100% convinced that the area of artificial intelligence and machine learning will have a huge impact on cancer research and cancer care. [At UNC], we used Watson to organize the literature related to novel therapeutics for [our] molecular tumor board that was trying to decide what drug to give a patient based on [their tumor] mutation. The STAT article to which I think you’re alluding called that a paralegal function. [It noted that Watson was compiling knowledge generated by others.] The point is it’s like a million paralegals that are really, really fast and that’s superuseful. When you start doing a thousand patients a year, the allocation of therapy decisions gets very hard.
Q: Aren’t there already a lot of efforts to compile cancer patient data, like the American Association for Cancer Research’s Genomics, Evidence, Neoplasia, Information, Exchange?
A: The clinical data are the hard part. Genomic data are black-and-white compared to the clinical data in electronic health records. Having med students reading charts and abstracting them is just too slow, and so these tools that use natural language processing to extract the records are very useful. That’s going to get us a million patients that are clinically annotated and aggregated with genomic data sets. That will allow us to do the kinds of things that we really need to do.
Q: Where should NCI be going with immunotherapy?
A: Around 6 years ago, one of the senior leaders of the immunotherapy movement was complaining to me about how NCI’s portfolio for immunotherapy research was small and didn’t have enough basic science or clinical trials. I don’t think anyone could make that statement about the NCI portfolio today. Importantly, it includes a really strong commitment to basic science. We just don’t understand cell biology well enough to make full therapeutic use of immunotherapies.
I’m a little worried that young investigators are becoming demoralized. It’s a very tough funding environment.
Q: Are you worried about the drastic cuts to the 2018 NIH budget that the Trump administration has proposed?
A: I am obligated to support the president’s budget. I will say that the congressional commitment to [NIH] has been good. The budget has gone up significantly in the last 2 years, and the [preliminary congressional] budget for 2018 looks promising as well. I think the budgetary challenges are real. Because if you consider the burden of cancer or what it costs society, even $5.7 billion is not really enough.
But I would argue an even harder challenge for the NCI director is just the scale and scope of this place. [It’s] difficult particularly for an extramural scientist like me to come in and lead it. Which is why I’m so pleased to have the help of [NCI Deputy Director] Doug Lowy, who was the acting director for 2 years and was also Harold Varmus’s deputy director.
Q: What are your thoughts on NIH’s efforts to help young researchers?
A: One idea we’ve been kicking around is to give some subset of new, young investigators an extended period of R01-like [research grant] funding. So instead of stopping the grant at 5 years, they would submit a slightly more significant package than a standard noncompeting renewal. And if that’s approved they would get 2 years extra funding. That approval process would be more or less just to make sure they’re still making progress.
We realize there are intense pressures on young faculty to get data together before they can get their second grant and get tenure. I’m a little worried that young investigators are becoming demoralized. It’s a very tough funding environment. I want to send the message that we are very receptive to proposals from young investigators and we are committed to their success.
Q: Are you planning to have a lab at NIH?
A: Most of the people who worked for me at [UNC] have now gotten their own jobs. But I have some knock-in mice that I produced in my lab that I’m trying to import to the NCI so that I can start a lab effort here. It’s very important to me. It’s just nice to think about science. It’s nice to understand the problems of a working scientist.