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The Cancer Letter      CBS News aired a report Feb. 12 on the Deception at Duke.


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           Cancer Letter.



 

The Cancer Letter is an award-winning weekly newsletter providing the latest on cancer research funding, legislation, policy issues, drug development, and people in the news. Individual subscriptions are $405 per year (46 issues), or $37 a month. Group and Institutional subscriptions are also available. Delivery via online access. 

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Available NowHow We Do Harm, by Otis Brawley with The Cancer Letter's Paul Goldberg, exposes the underbelly of healthcare today—the overtreatment of the rich, the under treatment of the poor, the financial conflicts of interest that determine the care that physicians’ provide, insurance companies that don’t demand the best (or even the least expensive) care, and pharmaceutical companies concerned with selling drugs, regardless of whether they improve health or do harm. Brawley is chief medical officer of the American Cancer Society.
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Recent articles

  The Cancer Letter - May 24, 2013
May 24, 2013
  • Translucent Walls, Modern Classics Create "Corporate Feel" In Office Suite Occupied By Wife of MD Anderson President DePinho
  • Guest Editorial: Guideline Promises to End Twenty-Year War Over Mass Screening for Prostate Cancer
  • UNM Cancer Center Appoints Four Leaders
  • American Cancer Society Awards its Medal of Honor
Read the full free issue of The Cancer Letter here
  The Cancer Letter - Issue 20
May 17, 2013




  CPRIT Likely to Get Funding For Two Years; DePinho Announces Austerity Measures
May 17, 2013

The Cancer Prevention and Research Institute of Texas will likely receive funding for the next two years, provided state legislators are satisfied with plans to overhaul the institute that channels nearly $300 million a year to uses that include research.

Legislators earlier this week said they placed $594 million into CPRIT appropriations for the next two years.

Appropriation appears to be contingent on passage of legislation that would address the problems that came to light during the past year, resulting in multiple firings, resignations and investigations.

The House and Senate bills define and address conflicts and appearances thereof.

>> Read More
  The Cancer Letter - May 10, 2013
May 10, 2013
  • Turmoil in Texas: DePinho Recommended AVEO Stock on CNBC Six Days After FDA Said New Trial Was Needed
  • The Tivozanib Timeline
  • $293 Million NCI Budget Cut To Drop Grant Success Rate
  • Emil Frei, Pioneer of Combination Chemotherapy, Dies at 89
Read the full free issue of The Cancer Letter here
  The Cancer Letter - May 3, 2013
May 3, 2013
  • AVEO's Tivozanib Sunk by Fundamental Flaw: Higher Overall Survival in the Control Arm
  • Turmoil in Texas: AVEO, DePinho Joined at the Hip (Pocket)
  • In Brief: Pollock Named Director of Surgical Oncology At Ohio State Comprehensive Cancer Center
Read the full free issue of The Cancer Letter here
  The Cancer Letter - April 26, 2013
Apr 26, 2013
  • Cuts Claimed to Displace "Millions" of Patients Yet None Seem to Complain. Why Not?
  • NCI Seeks to Maintain Grant Success Rate As Budget Deadlock Deepens on Capitol Hill
  • ASCO Defines Clinically Meaningful Outcomes
Read the full free issue of The Cancer Letter here
  Issue 16 - April 19, 2013
Apr 19, 2013


  Georgetown-Hackensack Consortium Plan Points to Rising Value of NCI Designation
Apr 19, 2013

Georgetown Lombardi Comprehensive Cancer Center and Hackensack University Medical Center John Theurer Cancer Center last week announced plans to affiliate, aiming to create a single consortium.

Located three states apart, the two institutions will start integrating their operations by building a bone marrow transplantation unit at Georgetown, where a BMT program was abandoned years ago.

“What we get out of it is an expanded capacity to conduct high-impact research,” said Louis Weiner, director of Lombardi Cancer Center. “We will have additional colleagues, and we will have a much larger patient base on which to draw for our clinical trials.”
>> Read More
  In Myriad Case, the Supreme Court Hears About Tree Leaves, Baseball and Cookies
Apr 19, 2013

The Supreme Court earlier this week heard oral arguments in a landmark case involving two cancer-related genes.

The case, Association of Molecular Pathology vs. Myriad Genetics Inc., holds huge implications for all parties involved:

Myriad, the biotech company that has exclusive rights to the genes, would lose protection—and millions of dollars—if the court nullifies its patents. Moreover, other companies would be deterred from genetic research, some industry observers warn.

If the court upholds the patents, cancer and genomics researchers nationwide will continue to be barred from using the genes until the Myriad patents expire—for the next two years. And other genes will continue to be patented.
>> Read More
  The Cancer Letter - April 12, 2013
Apr 12, 2013
  • "Start Fighting" Says Former Rep. John Porter To Crowd of 12,000 at AACR Washington Rally
  • Appropriations 2014: Obama Plan Good News for NIH, Bad News For Some Oncologists
  • House Launches Probe of NCI Spending On Cancer Communications, Education
  • In Brief: Dmitrovsky Named Provost at MD Anderson; Paulsen Leaves to Chair Duke Radiology
  • A Video of the Rally for Medical Research in Washington, D.C.
Read the full free issue of The Cancer Letter here
  Issue 14 - April 5, 2013
Apr 5, 2013



  City of Hope CEO Michael Friedman: Cancer Centers Must Adapt; "Not Losing Sleep" Over Sequestration
Apr 5, 2013

Cancer centers will need to show greater ingenuity and flexibility than they have in the past, Michael Friedman, CEO of City of Hope, said to The Cancer Letter.

“For centers that do extraordinary things clinically, I believe they will be able to demonstrate their value and will be strong components of organizations going forward,” said Friedman, who will retire at the end of 2013 after a decade of running City of Hope, an NCI-designated comprehensive cancer center. “But to do this, they are going to have to be very cost-effective—that doesn’t mean cheap—it means cost effective.

“They will have to demonstrate the value of the treatments or the services that they provide, and the idea that these are good academic institutions generating knowledge, that won’t be enough in the future, I fear.”
>> Read More
  Patient Care Emerges as Major Concern Following Sequestration Cuts to Medicare
Apr 5, 2013

Two weeks after Congress voted to keep the government open through the end of the fiscal year, cancer researchers and physicians nationwide are feeling the first palpable impacts of sequestration.

The 5.1 percent across-the-board cuts will decrease the NIH budget by $1.553 billion, and NCI’s by as much as $219 million. These cuts must be made in the remaining six months of this fiscal year.

Reports indicate that Medicare patients are among the first to be directly affected by the cuts. Sources say that, at some practices, patients are being turned away because of a 2 percent cut in reimbursement, which is intended to save the government $588 million.
>> Read More
  The Cancer Letter Special Issue - March 29, 2013
Mar 29, 2013
  • MD Anderson Faculty Slam Leadership, Question Moon Shots, Bemoan Workload
  • In Their Own Words: A 64-page Internal Report with over 1,500 Faculty Comments on MD Anderson Morale
  • MD Anderson President Ronald DePinho: "Some of the Feedback was Humbling"
  • Reviews of the Faculty Report by Irwin Krakoff, Robert Cook-Deegan, and Michael Katz
  • 60 Minutes Report "Deception at Duke" Wins Peabody Award
Read this full free issue of The Cancer Letter
  Issue 12 - March 22, 2013
Mar 25, 2013



  House Appropriator Claims NCI, NLM grants Funded Political Activity, Seeks OIG Probe
Mar 25, 2013

Congressional Republicans asked the HHS Office of Inspector General to investigate the appropriateness of funding a prominent scientist whose publications found a link between tobacco companies and the Tea Party conservative movement.

A letter signed by Rep. Jack Kingston (R-Ga.), chairman of the House Appropriations Subcommittee on Labor, HHS and Education, asked HHS Inspector General Daniel Levinson to review three NCI grants to Stanton Glantz, a professor in the Department of Medicine at the University of California San Francisco, as well as a member of the Helen Diller Family Comprehensive Cancer Center and director of the Center for Tobacco Control Research and Education.

The letter also challenges a grant the National Library of Medicine gave to Catherine Gallagher, a Cochrane Collaboration leader and a criminology professor at George Mason University, who studies health problems of young prison inmates as well as gun violence.

“I would appreciate your review of these grants to determine if the lobbying prohibition was in fact violated,” Kingston wrote to Levinson.
>> Read More
  Continuing Resolution Averts Shutdown; Locks in Sequestration Cuts for NIH, NCI
Mar 25, 2013

Congress passed a continuing resolution March 21 to keep the federal government open through the end of September—effectively locking in the 5.1 percent across-the-board sequestration cuts.

The Senate version of the resolution was passed by the House of Representatives with a 318-109 vote. The bill now goes to President Barack Obama, who is expected to sign it when he returns from the Middle East this weekend.
>> Read More
  The Cancer Letter - March 15, 2013
Mar 15, 2013
  • Sequestration Hurts Kids with Cancer
  • COG's Peter Adamson has a Conversation with The Cancer Letter
  • Continuing Resolution Expires March 27; NIH, NCI Hope for Budget Compromise
  • Nature Editorial Criticizes NCI PR Spending
Read the full free issue of The Cancer Letter here
  Issue 10 - March 8, 2013
Mar 8, 2013



  Collins Challenged Over NCI-Funded Research Linking Tea Party With Tobacco Companies
Mar 8, 2013

NIH Director Francis Collins told a House subcommittee that he was “troubled” by a paper in which a prominent tobacco control expert, who is funded by NCI, claims to have found a relationship between tobacco companies and the Tea Party conservative movement.

The paper in question appeared in Tobacco Control, a peer-reviewed journal published by British Medical Journal Group. Drawing on documents dating back to the 1980s and obtained from tobacco companies, the authors point to several instances in which the Tea Party and its predecessor organizations appear to act as proxies for tobacco interests. The paper cites an NCI grant that supports analysis of tobacco industry documents.

The paper’s senior author is Stanton Glantz, professor in the Department of Medicine at the University of California San Francisco, a member of the Helen Diller Family Comprehensive Cancer Center, and director of the Center for Tobacco Control Research and Education.

>> Read More
  Federal Budget Cuts Enacted March 1; HHS Agencies Grapple with Consequences
Mar 8, 2013

The across-the-board 5.1 percent budget cuts that went into effect March 1 slash the NIH budget by $1.553 billion and the NCI budget by $219 million for the remaining fiscal year, officials say.

These deep budget reductions, known as sequestration, affect the entire federal government—with no exemptions for the components of the Department of Health and Human Services.
>> Read More
  Issue 9 - March 1, 2013
Mar 1, 2013

  Guest Editorial: Thoughts on Overusing Radiation in Medicine And Redeeming that Whole Body Scan Coupon
Mar 1, 2013

By Robert Peter Gale, Eric Lax, and F. Owen Hoffman

Wilhelm Röntgen’s discovery of X-rays in 1895 was a transforming event in science and medicine.

Physicians now use various forms of ionizing radiations including light and heavy particles (protons, electrons, alpha particles, etc.), high-energy electromagnetic waves (X- and gamma rays composed of photons of diverse energies) and radionuclides (Iodine-131, Cobalt-60, Technetium-99m, etc.) to screen, diagnose, stage and treat cancers.

>> Read More
  NCI Spent $381.2 Million on PR from 2006-2012, Vastly Outspending Other NIH, FDA Units
Mar 1, 2013

NCI’s spending on public relations dramatically exceeds that of any other NIH institute or center, data obtained by The Cancer Letter under the Freedom of Information Act show.

The cancer institute spent $44.9 million on PR in fiscal 2012, employing 83.5 full-time staff members—FTEs in governmentspeak—to conduct various educational and outreach work at the Office of Communications and Education.

This number of FTEs is more than fourfold the PR workforce of the NIH Office of the Director. Yet, the NCI office also has 77 contract employees, some of them working part-time (The Cancer Letter, Dec. 7, 2012). The next largest PR office at NIH—the NIH The Office of the Director has 19.5 FTEs and no contract employees.

Documents show that, cumulatively, NCI has spent $381.2 million on its PR operations between 2006, the year OCE was formed, and 2012. None of this spending was subjected to peer review.

>> Read More
  The Cancer Letter - Feb. 22, 2013
Feb 22, 2013
  • Roswell Park Prepares for Sequestration
  • Guest Editorial: As Sequestration Becomes More Likely, Health Groups Must Make Themselves Heard
  • Giaccone Joins Georgetown Lombardi Center
Read the full issue of The Cancer Letter
  Issue 7 - Feb. 15, 2013
Feb 15, 2013


  Deep Budget Cuts Poised to Kick in March 1; Hill Insiders See Little Hope for Deal
Feb 15, 2013

As President Barack Obama delivered the State of the Union address Feb. 12, federal agencies, including NIH, braced for draconian budget cuts scheduled to take effect March 1.

The once unthinkable across-the-board cuts, called “sequestration,” will affect the entire federal government—and medical research, Medicare, FDA and the Department of Defense will not get special exemptions.

“The greatest nation on Earth cannot keep conducting its business by drifting from one manufactured crisis to the next,” Obama said in the speech.

“Let’s agree, right here, right now, to keep the people’s government open, pay our bills on time, and always uphold the full faith and credit of the United States of America,” Obama said. “The American people have worked too hard, for too long, rebuilding from one crisis to see their elected officials cause another.”
>> Read More
  Conversation with The Cancer Letter Swain: “Shattering Impact on Cancer Enterprise”
Feb 15, 2013

The Cancer Letter asked Sandra Swain, president of the American Society of Clinical Oncology, to discuss the impact the sequestration will have on the practice of oncology and cancer research.

Swain, medical director of the Washington Cancer Institute of the Washington Hospital Center and professor of medicine at Georgetown University, spoke with Paul Goldberg, editor of The Cancer Letter.

PG: What’s your thinking about what sequestration is going to do?
SS: I think it’s very clear that sequestration will have a shattering impact on the entire cancer enterprise in the United States.
>> Read More
  Issue No. 6 - Feb. 8, 2013
Feb 7, 2013

  Guest Editorial: Omics Checklist Done, Now Make Business Model for Tests
Feb 7, 2013

NCI’s 30 criteria for development and evaluation of highly predictive
genomic-based diagnostic tests is a consequence of recent unfortunate
experiences utilizing genomic classifiers to assign patients to therapies
in clinical trials.

These are the kinds of tests anticipated by the world of personalized or
precision medicine.

To ensure their accuracy for patients, these tests need to incorporate
measurement of the complex biology underlying such clinical phenomena
as the likelihood of a particular patient benefiting from a particular targeted
therapeutic.

>> Read More
  NCI Unveils Checklist for Omics Studies
Feb 7, 2013

      NCI has published a 30-point checklist it uses to evaluate proposed
clinical studies that rely on genomics and proteomics to determine the patients’
treatment.

     The institute’s standardized, prospective approach is a direct
consequence of three ill-fated Duke University studies that relied on genomic
predictors to determine therapy for breast and lung cancer patients.

     The studies were terminated after this publication reported that a
key investigator at Duke—Anil Potti—had falsified his credentials, claiming,
among other things, to have been a Rhodes scholar (The Cancer Letter,
July 16, 2010).

>> Read More
  The Cancer Letter - Feb. 1, 2013
Feb 1, 2013
  • NCI Ends Brash Foray Into the News Business—Emails Tell the Story of the NCI Cancer Bulletin
  • Letter to the Editor: "We Will Not Be Distracted From Our Mission"
Click Here to read this full free issue of The Cancer Letter
  Issue No. 3 - Jan. 18, 2013
Jan 18, 2013

  Morale, Money Woes Hit MD Anderson
Jan 18, 2013

The staff at MD Anderson Cancer Center expressed dissatisfaction
with the institution’s top management, with 73.4 percent of faculty
members stating that morale at the venerable cancer center has
deteriorated over the past two years.
The results of the survey, which are yet to be released to the MD
Anderson staff, were among internal documents obtained by The
Cancer Letter.
The survey, conducted by the MD Anderson Faculty Senate, points
to dissatisfaction with the institution’s president Ronald DePinho
and his top executives—at a time when the administration is pressing
the faculty to meet aggressive financial targets that critics say are
unrealistic.

>> Read More
  Issue 2 - Jan. 11, 2013
Jan 11, 2013


  Blazing the Pathways: Informatics Platform Provides Foundation for "Center Without Walls"
Jan 11, 2013

               CHARLOTTE, N.C.—The Carolinas Health System was looking for
the next big therapeutic area to develop.

               “We started as every other health system in the country started—
and that was by embracing cardiovascular services,” said Paul Franz, an
executive of the massive organization. “It’s common knowledge that cardiovascular
services are the best market share opportunity, and also happens to be the
most profitable service line.”

               Oncology made sense.

               In 2007, when the system first focused on cancer, its hospitals
were treating about 10,000 new patients a year, a considerable number.
(Now, it’s treating about 14,000.)

               The competition was weak. There were excellent cancer centers
along the system’s boundaries, but not in its core area around Charlotte.
“There was no one who was performing at anywhere close to a national
prominence level,” said Franz, executive vice president of the Physician
Services Group.

               Patients usually saw general oncologists at local practices. If
those patients had more complicated diseases and the money to travel,
they left to get care elsewhere. The opportunity to fill the vacuum was
even more obvious because changes in reimbursement were weakening
physician-owned, office-based practices—potentially making doctors more
willing to join hospitals. Hospitals, on the other hand, remained robust, in
part because they can charge higher rates.

>> Read More
  Issue 1 - Jan. 4, 2013
Jan 4, 2013


  President Obama Signs Recalcitrant Cancers Bill
Jan 4, 2013

President Barack Obama signed a bill Jan. 2 requiring NCI to develop
scientific frameworks for “recalcitrant” cancers.

Formerly known as the Pancreatic Cancer Research & Education Act, the 
bill was attached to the $633-billion 2013 National Defense Authorization Act.

>> Read More
  Sequestration Delayed for Two Months While Congress Debates Debt and Budgets
Jan 4, 2013

Through a series of hurried negotiations and late-night bills, lawmakers
in Washington narrowly avoided the worst punishments of the fiscal cliff—
but set up another crisis by postponing the automatic federal budget cuts
until March 1.

>> Read More
  The Raghavan Experiment: With $500 Million to Draw On, An Iconoclast Invents Rational Care for a Gigantic System
Jan 4, 2013

This is the first story in a two-part series exploring an attempt by one 
regional heath care organization to devise a better system for delivery 
of cancer care to 14,000 new patients a year.

By Paul Goldberg

CHARLOTTE, N.C.—The job offer presented to Derek Raghavan 
late in 2010 had the look of a dare.

A vast health system in North and South Carolina was asking him 
to create a better way to practice oncology. 

Raghavan, a medical oncologist who came to the U.S. from Australia 
in 1991, sees this country’s healthcare system with clarity of an outsider. 
His public persona here is shaped largely by years of service on 
the FDA Oncologic Drugs Advisory Committee, where he established 
himself as the sort of guy you don’t want to match wits with.

The job offer had the feel of Raghavan’s own precisely aimed, 
lethal, Australian-accented remarks. 

It boiled down to this: So Derek, you have, on numerous occasions, 
trashed the way America treats cancer. You have cast ridicule and moral 
indignation at the cooperative groups, pharmaceutical companies, the NCI.

Now, create a system that meets your own exacting specifications, old mate.

>> Read More
  Issue 46 - Dec. 14, 2012
Dec 17, 2012
  Turmoil in Texas: Margaret Kripke Comes out of Retirement To Become Chief Scientific Officer at CPRIT
Dec 17, 2012
Margaret Kripke must have a penchant for long odds. 
That’s the only explanation that friends and colleagues can offer for 
the former MD Anderson Cancer Center provost coming out of retirement to 
become the chief scientific officer of the Cancer Prevention and Research 
Institute of Texas.
It’s a challenge to follow in the footsteps of a Nobel laureate who left 
in disgust over violation of principles of peer-reviewed science, taking almost 
the entire peer review structure with him.
If that’s not enough, the Travis County district attorney’s public integrity 
unit opened a criminal investigation of the state agency’s award of an $11 
million grant to a company called Peloton Pharmaceuticals without any peer 
review.  The state attorney general has zeroed in on the same matter, and the 
state auditors have been scouring CPRIT’s books, and are expected to issue an 
audit report in January.

>> Read More
  CPRIT Executive Director Bill Gimson is Out As Scandal Grows, Investigations Begin
Dec 17, 2012
About two weeks elapsed between Margaret Kripke committing to 
take the job as chief scientific officer at the Cancer Prevention and 
Research Institute of Texas and the public announcement that she 
had accepted the job.
During that period, the institute took a brutal pummeling, as 
Texas law enforcement agencies started investigations, legislators asked 
questions and new allegations of impropriety emerged. 
If the allegations stick—which is far from certain—they could move 
the epicenter of CPRIT’s troubles from MD Anderson to UT Southwestern.
  The Cancer Letter - Dec. 14, 2012
Dec 14, 2012
  • Margaret Kripke Comes out of Retirement  To Become Chief Scientific Officer at CPRIT
  • CPRIT Executive Director Bill Gimson is Out As Scandal Grows, Investigations Begin
  • GlaxoSmithKline Partners With MD Anderson, Fred Hutchinson
  • Stand Up To Cancer Launches Immunology "Dream Team"
  The Cancer Letter - Dec. 7, 2012
Dec 7, 2012
  • Is $45 Million Too Much to Spend on PR? NCAB Panel Weighs NCI Communications Budget
  • President Obama Names Six NCAB Members
  • In Brief: Richard Fisher Named Physician-in-Chief, Executive Vice President at Fox Chase Cancer Center
  Issue No. 44 - Nov. 30, 2012
Nov 30, 2012
  NCI Grant Funding: "Zone of Likelihood" Moves From 7th to 9th Percentile
Nov 30, 2012
NCI will extend the “zone of likelihood” of grant funding from 7 percent 
to 9 percent, Institute Director Harold Varmus said to the National Cancer 
Advisory Board Nov. 29.
This change means that next year a larger number of grants will be funded
based on the score they receive from the study section. Grants that fall outside 
this zone are subjected to an additional level of review.
“We are, at least provisionally, extending the zone of likelihood this year 
from the seventh percentile and better to the ninth percentile and better, with the 
supposition that the division will highlight for us a proposal that got a very high 
score that they don’t want to fund, so we can at least have a very brief discussion 
about that,” Varmus said to the board.
  NCCN, McKesson Form Partnership To Build Clinical Support Software
Nov 30, 2012
The National Comprehensive Cancer Network, McKesson Specialty Health 
and the US Oncology Network announced a collaboration to create clinical 
pathways and to produce software that will allow physicians to assess 
treatment options consistent with evidence-based standards.
The pathways and supporting software will also allow providers to consult 
coverage policies mandated by payers.
The system, Value Pathways Powered by NCCN, will be produced in 
collaboration between the NCCN guidelines panel members and the US Oncology 
physicians who develop the company’s Level I Pathways.
  Texas Agency Funded $11 Million Grant Without Peer Review; Official Resigns
Nov 30, 2012
The Cancer Prevention & Research Institute of Texas acknowledged 
that two years ago it gave out an $11 million “commercialization” grant 
without peer review.
The grant was awarded in June 2010 to Peloton Therapeutics Inc. of Dallas.
  Issue No. 43 - Nov. 16, 2012
Nov 19, 2012

  Zaltrap Economics 101: The Pricing And Repricing of an Expensive Drug
Nov 19, 2012
Last week, pharmaceutical companies Sanofi and Regeneron 
Pharmaceuticals Inc., the manufacturers of the colorectal cancer drug
Zaltrap (ziv-aflibercept), said they would cut the drug’s “list price” 
by 50 percent, in effect extending discounts to purchasers. 
Soon after Zaltrap’s August launch into the U.S. market, its 
price triggered an unprecedented act of defiance on the part of U.S. 
oncologists: doctors from Memorial Sloan-Kettering Cancer Center 
wrote in a New York Times editorial that they wouldn’t prescribe the 
drug because it costs twice as much as Genentech’s Avastin 
(bevacizumab), a competing drug with similar expected outcomes 
(The Cancer Letter, Nov. 2, Nov. 8).
  Recalcitrant Cancer Bill Heading To Senate May Face Hold in the Lame Duck Session
Nov 19, 2012
The controversial legislation that aims to step up the NCI efforts in
“recalcitrant” cancers is running into opposition in the Senate.
The measure, which has gone through two iterations and has been 
passed by the House, now targets pancreatic and lung cancers. In the 
Senate, it is likely to face a hold from Sen. Tom Coburn (R-Okla.), sources said. 
The original version of the bill—which was an authorization measure—
limited the NCI authority in charting the course on research in pancreatic cancer 
(The Cancer Letter, Aug. 3, Aug. 10, and Sept. 14)
“It would basically have taken away from the NCI the responsibility of 
deciding what grants that address pancreatic cancer would be funded,” NCI Director 
Harold Varmus said to the NCI Board of Scientific Advisors Nov. 5
  The Cancer Letter - Nov. 16, 2012
Nov 16, 2012
  • Zaltrap Economics 101: The Pricing And Repricing of an Expensive Drug
  • Recalcitrant Cancer Bill Heading To Senate May Face Hold in the Lame Duck Session
  • Pres. Bill Clinton to Serve as Honorary Chair Of NBCC's Breast Cancer Deadline 2020
  Breaking News - The Cancer Letter - Nov. 8, 2012
Nov 8, 2012
  • Zaltrap Price Cut In Half Effective Immediately
  • Sanofi Responds to Criticism From Oncologists
  • Revised Price Equivalent to Lower Dose of Avastin
  Issue No. 41 - Nov. 2, 2012
Nov 5, 2012

  Unwanted Distinction: MSKCC Bars Zaltrap From Formulary, Triggering Debate Over Drug Pricing
Nov 5, 2012
The colon cancer drug Zaltrap, jointly marketed by Sanofi and 
Regeneron Pharmaceuticals Inc., is getting the attention no company 
wants.
It has triggered a discussion about the pricing of cancer drugs.
Not the cost—an issue that is explosive enough—but something far 
deeper: the decisions that go into setting the drug’s price. 
The debate was triggered by an editorial in The New York Times,
in which three physicians from Memorial Sloan-Kettering Cancer Center 
explained why their institution decided not to include Zaltrap into its formulary.
“The reasons are simple: The drug, Zaltrap, has proved to be no 
better than a similar medicine we already have for advanced colorectal 
cancer, while its price—at $11,063 on average for a month of treatment—
is more than twice as high,” the MSKCC doctors wrote Oct. 14.
  Conversation with The Cancer Letter - Sanofi: Zaltrap Price Reflects Competing Drugs In Second-Line Metastatic Colon Cancer
Nov 5, 2012
Sanofi officials said that, criticism notwithstanding, their drug Zaltrap 
was priced responsibly and is consistent with other drugs used to treat 
second-line metastatic colorectal cancer.
Recently, officials at Memorial Sloan-Kettering Cancer Center
excluded Zaltrap (ziv-aflibercept) from their formulary because it’s priced 
twice as high as a comparable agent. Genentech’s Avastin (bevacizumab), 
but Sanofi officials disputed this analysis.
Zaltrap’s price is reasonable, if compared with the higher of two doses 
of Avastin, as mentioned on that drug’s label, the drug company’s officials 
said, citing industry studies. 
  The Cancer Letter - Nov. 2, 2012
Nov 2, 2012
  • Unwanted Distinction: MSKCC Bars Zaltrap From Formulary, Triggering Debate Over Drug Pricing
  • Sanofi: Zaltrap Price Reflects Competing Drugs In Second-Line Metastatic Colon Cancer
  • In Brief: Schilsky Named ASCO Chief Medical Officer
  Issue no. 40 - Oct. 26, 2012
Oct 26, 2012
  Komen Under Pressure: Charity Faces Money Woes, Attacks from Right
Oct 26, 2012
This year’s National Breast Cancer Awareness Month didn’t improve 
business at Susan G. Komen for the Cure, as donors continue to appear 
less than enthusiastic and affiliates are reporting significant dollar dips nationwide.
  Conversation with The Cancer Letter: UT System Vice Chancellor Shine Describes Rationale for Granting Waiver to DePinho
Oct 26, 2012
The waiver granted to Ronald DePinho allows him to remain active in 
three biotechnology companies he helped start, but also contains provisions 
that will be “economically disadvantageous” to the MD Anderson Cancer Center 
president, said Kenneth Shine, the University of Texas System executive vice 
chancellor for health affairs.
Shine said he had to weigh the potential pitfalls arising from conflicts of 
interest against potential benefits of hiring a scientist whose interests include 
commercialization to lead MD Anderson.
  Politicians Applaud CPRIT's New Direction; UT Gives Waiver to MD Anderson's DePinho
Oct 26, 2012
Scientists across the U.S. may view recent events at the Cancer 
Prevention and Research Institute of Texas as lamentable: the dissolution 
of a world-class peer review system that helped dispense $300 million a year. 
Top Texas politicians don’t want any part of these blues.
The state’s governor, lieutenant governor and speaker of the House 
earlier this week wrote a letter to CPRIT officials, urging them to move beyond 
funding basic research and broaden the institute’s mandate to commercialization.         
“It is now time for CPRIT to take further steps to fulfill its statutory mission 
and expedite innovation that will deliver new cancer treatments to patients within 
three to five years,” wrote Gov. Rick Perry, Lt. Gov. David Dewhurst and Speaker 
of the House Joe Strauss in a letter dated Oct. 19.
The letter gives CPRIT officials political cover to keep doing what they had 
been doing all year: moving forward with commercialization projects. These efforts 
triggered the resignations of top-tier scientists from CPRIT’s review boards.
  Issue no. 39 - Oct. 19, 2012
Oct 19, 2012
  A Misdirected Email: CPRIT Official Speaks of "New Regime" As Institute Denies Deepening Crisis
Oct 19, 2012
The board chairman of the Texas cancer institute has something to say 
to America’s premier scientists who are resigning from his organization’s peer 
review committees: Good riddance.
“Better to get them all out of the way now,” wrote Jimmy Mansour, 
chairman of the Oversight Committee of the Cancer Prevention and Research 
Institute of Texas. “Gives us the prime opportunity to announce a new regime.”
Mansour, a telecommunications entrepreneur, composed this memo for 
CPRIT executive director Bill Gimson and oversight board chairman Joseph Bailes, 
but had mistakenly hit the Reply All button, sending the nasty epistle to a 
resigning scientist.
The document, which came into public view because of Mansour’s 
sloppiness at the keyboard, belittles scientists and the peer review process, 
and inadvertently provides evidence for the case that troubles in Texas are 
first and foremost about peer-reviewed science. 
  Guest Editorial: Nobel Laureates Offer Simple Formula To Save CPRIT From "Infamy and Irrelevance"
Oct 19, 2012
The citizens of Texas were wise to contribute $3 billion to the fight 
against cancer.
Legislation and an amendment to the state Constitution created 
the Cancer Prevention and Research Institute of Texas (CPRIT), enabling 
a 10-year program in cancer research and community-based prevention 
activities. 
  Issue 38 - Oct. 12, 2012
Oct 15, 2012


  Blistering Resignation Letters Declare CPRIT Outside Mainstream of Science
Oct 15, 2012
Sometimes people follow through on their warnings. 
Scientists who review proposals for the Cancer Prevention and Research 
Institute of Texas said last spring that they would follow their chief scientific 
officer, Alfred Gilman, out the door.
And they did.
Seven of the eight members of the CPRIT scientific review council said 
they would leave, and the eighth is expected to quit as well, ending their 
association with the Texas state agency that dispenses $300 million a year 
for cancer research and commercialization.
  MD Anderson's Balance Sheet is Issue No. 1 For DePinho's "Moon Shots Program"
Oct 15, 2012
MD Anderson President Ronald DePinho acknowledged “missteps” and 
“communications snafus that let misunderstandings gain traction” during his 
45-minute State of the Institution address Oct. 9.
For the first time, DePinho focused on the money needed to finance his 
risky, multi-billion-dollar Moon Shots Program while living on the limited 
budget of the cancer center that costs $9 million a day to operate.
While the UT Board of Regents has shown tolerance, if not disregard, 
for DePinho’s propensity to cause controversy, no one doubts that the regents 
are intensely following MD Anderson’s bottom line. 
DePinho’s remarks make it clear that his moon shots will require continued 
belt-tightening and, more importantly, finding new sources of revenue.
  The Cancer Letter - Oct. 12, 2012
Oct 12, 2012
  • MD Anderson's Balance Sheet is Issue No. 1 For DePinho's "Moon Shots Program"
  • Blistering Resignation Letters Declare CPRIT Outside Mainstream of Science
  • George Sledge Jr. Named Oncology Chief at Stanford University
  Issue no. 37 - Oct. 5, 2012
Oct 9, 2012

  A Conversation with the new NCCN CEO, Robert Carlson
Oct 9, 2012
PG: I think we met at the first NCCN meeting.

RC: That very well may be.

PG: And that was quite a meeting, because there was a nice fight 
between the evidence-based people and the transplanters, who 
wanted to make [high-dose chemotherapy with autologous bone 
marrow transplantation] the standard of care for breast cancer. I’m 
sure I recall this correctly, you basically said, “No way, only clinical 
trials.” That’s my memory. What did that episode teach you?

RC: Well, I think that, in retrospect, I wouldn’t characterize it as a 
fight—I would characterize it as a difference in perspective and 
approach to a very significant and substantial clinical problem. 
One of the things that experience taught me was that, no matter 
how convincing lower-level evidence is, you always need to be skeptical 
of evidence until it becomes high-level evidence and, hopefully, is 
replicated multiple times. 
  News Analysis: Industry's Accelerated Recovery Initiative May Push Manufacturers Toward Collusion
Oct 9, 2012
By Rena M. Conti
The Federal Trade Commission recently issued an advisory opinion to 
the Generic Pharmaceutical Association, approving the trade group’s effort to 
help alleviate drug shortages. 
The generic manufacturers are launching an Accelerated Recovery 
Initiative, which seeks to engage generic drug manufacturers and FDA in a 
coordinated program. 
If all goes well, the initiative will increase the transparency of the 
production process and expand the existing capacity to manufacture small-
molecule and biologic-based cancer drugs. 
  NCCN's First Physician CEO: Carlson Pledges Broader Research, Policy Agendas
Oct 9, 2012
An argument can be made that writing guidelines is one of the most 
daring exploits in medicine.
Stanford oncologist Robert Carlson found this when he volunteered to
chair a committee that put together a synopsis of breast cancer treatment 
for the National Comprehensive Cancer Network.
The year was 1996, and some of his colleagues in breast cancer 
passionately believed that high-dose chemotherapy with bone marrow 
transplantation was the right way to treat breast cancer. The approach 
seemed to stand to reason, and if its superiority wasn’t shown yet, it would 
be soon enough, they argued.
For the transplanters, the stakes were high. 
Had NCCN included transplantation in the guidelines, it would have 
made it easier to get insurance coverage for the expensive, toxic procedure.
Carlson dug in his heels.  
  Issue 36 - Sept. 28, 2012
Oct 1, 2012

  Nobel Laureate Gilman Prepares to Leave The Texas Cancer Agency—Can it Survive?
Oct 1, 2012
On Oct. 12, Alfred Gilman will leave the $3 billion Texas agency where 
he oversaw cancer research.
The parting is anything but amicable, and it doesn’t look like it will be 
over quickly. 
The Nobel laureate, who spent the past three years as the chief scientific 
officer of the Cancer Prevention and Research Institute of Texas, says the 
principles of funding good science at the state agency have been supplanted 
by political manipulation and greed.
“I built something I am proud of, and now it’s being taken apart,” Gilman 
said to The Cancer Letter. “I can’t work for people who are pushing their own interests 
at the expense of the interests of cancer patients.”
The institution Gilman built relied on top-level scientists from outside the 
state to distribute funds, rising above politics of all flavors: academic, parochial, 
and Texan. Gilman’s departure raises an important question: can CPRIT 
exist as a credible scientific agency without Gilman?
Or, more precisely, can it survive being publicly slammed by Gilman?
As the CPRIT drama plays out, there is little doubt that the state legislature 
could easily find an alternative use for the $300 million a year it appropriates to 
the cancer venture.
Changes at MD Anderson Cancer Center play a central role in this battle. 
CPRIT’s decision to award $18 million to a biotechnology incubator run by Lynda 
Chin, the wife of that cancer center’s president, Ronald DePinho, was a principal 
cause of Gilman’s departure.
  The Cancer Letter - Sept. 28, 2012
Sep 28, 2012
  • Nobel Laureate Gilman Prepares to Leave The Texas Cancer Agency—Can it Survive?
  • House Passes Cancer Bill With Mandates for NCI
  • Carlson Named NCCN Chief Executive
  Issue 35 - Sept. 21, 2012
Sep 21, 2012
  White House Estimates 8.2 Percent Cut To NIH, NCI and FDA Budgets
Sep 21, 2012
The White House Office of Management and Budget released a report 
detailing the full effect of automatic budget cuts planned for the federal 
government, scheduled for January 2013.
The report, released Sept. 14, estimates an 8.2 percent cut across the 
budgets of NIH, NCI and FDA.
NIH would lose $2.5 billion, lowering its budget to $28.3 million. The 
FDA’s discretionary budget would drop $318 million. NCI’s budget would 
decrease by an estimate of $400 million.

>> Read More
  As MD Anderson Targets Eight Cancers, Detailed War Plan Remains Under Wraps
Sep 21, 2012
MD Anderson President Ronald DePinho rolled out his long awaited 
Moon Shots Program at a ceremony Sept. 21.
DePinho, who in the past had vowed to “kick cancer’s butt,” was more 
measured as he introduced projects targeting eight specific cancers. 
The cure for cancer wasn’t promised during the hour-long conference, 
which was pegged to the 50th anniversary of President John F. Kennedy’s 
speech that began the American effort to send a manned spacecraft to the 
moon.
MD Anderson materials described the moon shots as efforts “to 
dramatically accelerate the pace of converting scientific discoveries into clinical 
advances that reduce cancer deaths.”
  DePinho Seeks Broad Waiver From COI Policy To Cover Financial Ties With 12 Entities
Sep 21, 2012
As MD Anderson President Ronald DePinho announces what he calls 
the “Moon Shots Program” to eventually cure cancer, his efforts to send 
science soaring to unexplored heights continue to be plagued by the 
terrestrial challenges of managing conflicts of interest with a dozen different 
entities.
Days before the announcement, MD Anderson’s hometown newspaper, 
the Houston Chronicle, reported that DePinho was seeking a broad waiver 
DePinho had said in an interview with The Cancer Letter that he is 
seeking a broad waiver covering many entities (The Cancer Letter, Sept. 7).
  Issue 34 - Sept. 14, 2012
Sep 18, 2012

  Suit Against Craig Thompson Settled As Company He Co-Founded Licenses "Newly Identified" Discoveries From UPenn
Sep 18, 2012
The University of Pennsylvania and its former cancer center director, 
Craig Thompson, settled the lawsuits that claimed that Thompson had 
formed a company around discoveries he made while working at Penn.
However, two brief press statements—signed by Thompson, the 
university and the companies involved—provide little insight into events 
that led to the litigation and the details of the settlement.
The dispute pitted the Leonard and Madlyn Abramson Family Cancer 
Research Institute and the university against Thompson, who has moved 
on to become CEO of Memorial Sloan-Kettering Cancer Center.
  Earmarks for Research: "Recalcitrant" Cancers? Committee Rewrite Of Pancreatic Bill Raises New Questions
Sep 18, 2012
A House committee has completely overhauled a controversial bill that 
would have directed NCI to focus more of its attention on pancreatic cancer.
The bill, proposed by the Pancreatic Cancer Action Network, has collected 
the co-sponsorships of 290 House members and 58 Senate members. The new 
House version of the bill no longer contains features that cancer researchers 
found least acceptable.
Gone is the earmarked authorization of $887.8 million in NCI funds to be 
used for pancreatic cancer research.
Gone is the 13-member advisory panel which would chart the direction of 
this research.
Gone is the threat of bypassing the NCI peer review system.
  Issue No. 33 - Sept. 7, 2012
Sep 7, 2012

  DePinho Bets MD Anderson Credibility On His Cancer “Moon Shot” Program
Sep 7, 2012
Later this month, at MD Anderson Cancer Center, Ronald DePinho will 
announce the details of something he unabashedly calls the “moon shot,” 
a plan for dramatic reduction of mortality for at least five cancers.
The date of the announcement—Sept. 21—wasn’t arrived at by chance.
It comes five decades and nine days after President John F. Kennedy’s 
“we choose to go to the moon” speech, delivered at Rice University, also in Houston.
MD Anderson President DePinho is by no means the first cancer politician-scientist 
to risk angering the gods and nature by promising a giant leap toward the cure. 
Vows of this sort were a prominent part of political buildup that produced the 
National Cancer Act of 1971 and have resurfaced regularly since. 
  A Year in Houston: DePinho Reflects on Plans, Conflicts, Controversies—and Lessons Learned
Sep 7, 2012
The Cancer Letter invited MD Anderson President Ronald DePinho to 
reflect on his first year as head of the cancer center.
The interview offered new perspective on his approach to managing 
conflicts stemming from relationships with industry, the role of his scientist-wife 
Lynda Chin plays at MD Anderson, his plans for what he calls “the Moon 
Shot Program.”
DePinho also provided his perspective on the controversies that 
arose during his first year at MD Anderson, particularly stemming from 
Chin’s biotechnology “incubator,” which received $20 million in Texas 
state funds, but was ultimately withdrawn, to be resubmitted at a later 
date.
The interview was conducted by Paul Goldberg, editor and publisher 
of The Cancer Letter. 
PG: In your job interviews, originally with the UT System 
chancellor and the regents, you were asked, I’m sure, to describe 
your vision for MD Anderson. In a nutshell, what were the plans you 
described for them?
RD: The interview process was a very essential and lengthy one, 
during which I was asked to describe my vision for MD Anderson and for 
cancer care in the future, which, I’m sure, was asked of all the candidates.
  Issue No. 31 - Aug. 3, 2012
Aug 3, 2012
This issue has been made free and available to the public.
  • An Earmark for Pancreatic Cancer
  • Advocacy Group Amasses Support For Bill That Threatens Integrity of NCI Peer Review
  • Conversation with The Cancer Letter: PanCAN CEO Denies Bill Would Undermine NCI's Role in Directing and Funding Research
  Issue No. 30 - July 27, 2012
Jul 30, 2012

  FDA to Move Away From Central Radiology To Investigator Review In PFS Endpoint Trials
Jul 30, 2012
FDA is moving away from uniformly demanding central radiological 
review of scans in studies measuring delay in progression.
At a meeting July 24, the agency’s clinical advisory panel was 
generally supportive of the change that will likely lead FDA to rely more 
on assessments of progression-free survival made at the study sites.
Interpretation of radiographic evidence—and who gets to interpret 
it—is a fundamentally important question in the development of cancer 
drugs that rely on PFS as the primary endpoint. 
The pharmaceutical industry estimates that central radiology review can 
add $4,500 to $7,500 per patient to the cost of a trial. Overall, central 
radiology can cost between $1 million and $3 million. 

>> Read More
  Conversation with The Cancer Letter: Statistician Lori Dodd Saw Research Question In the Midst of 2007 ODAC Debate Over Avastin
Jul 30, 2012
While watching the FDA Oncologic Drugs Advisory Committee debate 
the breast cancer indication of the Genentech drug Avastin (bevacizumab) 
on Dec. 5, 2007, NCI biostatistician Lori Dodd discerned the contours of a 
great research question: 
Why do evaluations of cancer progression vary depending on whether 
they are made by investigators at research sites or by central review 
committees? At what point does this discordance start to matter? 
  Issue No. 29 - July 20, 2012
Jul 24, 2012

  House Measure Would Eliminate AHRQ, Rescind PCORI, Cut Outcomes Research, And Halt NIH's Title 42 Hiring Program
Jul 24, 2012
A spending bill that cleared a House subcommittee eliminates the 
Agency for Healthcare Research and Quality, and moves the U.S. Preventive 
Services Task Force to the office of the Health and Human Services Assistant 
Secretary for Health.
The legislation—which passed through the Appropriations subcommittee 
on Labor, HHS, Education and Related Agencies July 18—is intended to halt the 
implementation of the Affordable Care Act, by rescinding previously allocated 
funds and prohibiting the use of any additional money to implement the law.

>> Read More
  Fallout Over PSA Guidance Continues— Specialty Groups Dissent, Congress Attacks
Jul 24, 2012
The American Society of Clinical Oncology earlier this week issued a 
“provisional clinical opinion” that recommends physicians discuss prostate-
specific antigen testing with asymptomatic patients whose life expectancy 
is ten years or longer.
The guidance contradicts the recommendations by the U.S. Preventive 
Services Task Force, which gave routine PSA testing of asymptomatic men 
the grade “D,” which means that the task force has concluded that there is 
at least moderate certainty that the harms of doing the intervention equal 
or outweigh the benefits in the target population.
  Conversation with The Cancer Letter: How ASCO's Guideline Differs—And Why
Jul 24, 2012
The American Society of Clinical Oncology’s recommendation on 
screening for prostate cancer with prostate-specific antigen is slightly 
more positive about the test than the guideline written by the U.S. 
Preventive Services Task Force.
Nonetheless, the ASCO “provisional clinical opinion” blasts a hole 
in the established practice of including the PSA test in routine chemistry 
panels used by primary care physicians.
  Issue 28 - July 13, 2012
Jul 16, 2012
  Needed Enhancement or Unfunded Mandate? New NCI Program to Merge CCOP, NCCCP
Jul 16, 2012
NCI is combining the programs it uses to engage community oncologists 
and hospitals. 
The institute is merging the NCI Community Cancer Centers Program, the
Community Clinical Oncology Program, and the Minority CCOP. 
The new entity, which will be called the NCI Community Oncology Research 
Program, or N-CORP, is expected to be in operation in 2014. It will be housed in 
the Division of Cancer Prevention, institute officials say.
If all goes well, the consolidation could enable a community oncologist to 
enroll patients in clinical trials, collaborate with tumor registries at a cancer center 
a thousand miles away, and participate in health services research.
If things go badly, the new system will create unfunded mandates, driving 
away doctors by asking them to do more at a time when they are facing significant 
economic pressures on many fronts. 

>> Read More
  Issue 27 - July 6,2012
Jul 9, 2012

  Help Wanted: Varmus Irked by Having to Fill Jobs With Salaries NCI Can't Afford to Pay
Jul 9, 2012
The National Cancer Advisory Board and the Board of Scientific 
Advisors jointly adopted a resolution to allow the institute to continue 
its use of the controversial Title 42 program to recruit and retain staff 
members. 
The two boards met and sat at the same table June 25, for the 
first time in NCI’s history.
This largely symbolic joint action of the two boards comes at a 
time when critics in Congress have once again begun to eye the program 
used by NIH to pay some staff members more than the federal GS pay 
scale allows. 
NIH institute directors, including NCI’s Harold Varmus, are Title 42 
employees. This makes them, technically, consultants, critics have said. 
The program was established in 1944 to enable NIH to hire special consultants, 
usually part-time or full time on a temporary basis. It became widely used as 
a pay system five decades later.

>> Read More
  Book Review: In Memoir Written to Avoid Doing Time, Disgraced Exec Reflects on BMS Heyday
Jul 9, 2012
Andrew Bodnar had a compelling reason to write a memoir.
In fact, he was compelled to write it. A federal judge ordered the former 
senior vice president of Bristol-Myers Squibb to produce an unusual 75,000-word 
manuscript reflecting on his “criminal behavior in this case so that others similarly 
situated may be guided in avoiding such behavior.”
 
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