publication date: Dec. 9, 2016

Being an Acting Director, NCI’s Lowy Isn’t Required to Submit Resignation

By Matthew Bin Han Ong

Doug Lowy will continue to lead NCI in his role as acting director in 2017 unless president-elect Donald Trump decides to appoint a different, new director.

As acting director, Lowy is not required to submit a resignation—or at least, that is the presumption, because the permanent position of director is subject to presidential appointment.

Presidential appointees are required to submit their resignations by Dec. 7.

“I am in the situation that I am acting director, and therefore, I am not a presidential appointee,” Lowy said at a joint meeting of the National Cancer Advisory Board and the Board of Scientific Advisors Dec. 6. “It has really been exhilarating for me to be leading the NCI for the last year-and-a-half, and I look forward to continuing to do so as long as the administration allows me to.”

If Trump chooses to appoint a different director in 2017, the process could take between one to two years—or more—to complete. The presidential cabinet positions are always filled first.

For instance, Harold Varmus, the immediate past NCI director, took office 16 months after President Barack Obama was inaugurated. NIH Director Francis Collins was took office after six months.

These positions take a long time to fill, said M.K. Holohan Quattrocchi, director of the NCI Office of Government and Congressional Relations.

“If you look at the past couple of administrations, and just starting with the furthest one back, it took 27 months for Dr. [Bernadine] Healy to take office as the NIH director from the time the president was inaugurated,” Quattrocchi said at the Dec. 6 meeting. “Under President [Bill] Clinton, it took six months for Dr. Varmus to take office as director of NIH, and it took 31 months for Dr. [Richard] Klausner to take over as NCI director. Under George W. Bush, for Dr. [Elias] Zerhouni, [15th NIH director] 14 months.

“The presumption is that, when you have a person in place as an acting, they’re not a political appointee. They do not need to, nor would they ever submit a resignation as an acting [director]. We are very fortunate in that regard that we do not have to face that. It tends to take a very long time for these procedural things to play out. They tend to play out top-down. I think we know it’s going to be rocky, and that’s all we know at this point.”

At the meeting, Lowy summarized NCI’s achievements during his tenure as acting director, citing progress on the Precision Medicine Initiative, health disparities research, an increase in funding for NCI-designated cancer centers, and the institute’s efforts for Vice President Joe Biden’s National Cancer Moonshot Initiative.

An excerpt of Lowy’s remarks at the Dec. 6 meeting follows:

I want to spend a few minutes talking about what’s been going on, as I see it, with some highlights from the last year-and-a-half.

But before I start, you may be aware that presidential appointees—today is Dec. 6—and presidential appointees are supposed to submit their resignations as of Jan. 20, and I guess all of you know that the permanent NCI director is a presidential appointee.

I am in the situation that I am acting director, and therefore, I am not a presidential appointee. It has really been exhilarating for me to be leading the NCI for the last year and a half, and I look forward to continuing to do so as long as the administration allows me to.

So, a few words about the accomplishments. When I started as acting director, I gave a talk a few weeks after that at [the American Association for Cancer Research], and three of the areas that I wanted to emphasize were, first, cancer health disparities, second, Precision Medicine Initiative in oncology, and third, investigator-initiated research.

We have had a number of conferences on cancer health disparities and have started the early onset of cancer—this is a cohort looking particularly at underrepresented minorities where there are cancer disparities, and to try to and essentially do as detailed molecular analysis as possible on these cases to try to get biological insight into similarities and differences with different racial populations. We are thinking about this, as I’ve mentioned previously, in terms of biology, health care access and utilization, and lifestyle factors and with different conditions, there are different factors that play a larger or smaller role.

You’ll be hearing from [Director of the NCI Division of Cancer Treatment and Diagnosis] Jim [Doroshow] about the Precision Medicine Initiative in oncology. It was fully funded exactly a year ago in December of last year, and because of that funding, it has been possible for us to go forward with PMI Oncology, and this is really one aspect of another light motif that has been especially enjoyable for me, which is the strong bipartisan support that NIH has had for biomedical research and, equally important, the strong support for cancer research at the level of the White House last year with PMI Oncology, and this year with the Cancer Moonshot.

I’ll be talking about investigator-initiated research and showing you the latest data from 2016 from the RPG pool in a few minutes. But I now want to turn to the area of the NCI-designated cancer centers. We’ve always recognized how important the cancer centers are, but we have been trying to emphasize their importance in a number of new ways, and also to have them—where it is appropriate—to work more closely together between different cancer centers.

So we increased the funding for the Cancer Center Support Grants; we also have given a number of administrative supplements and really making more use of this than we have in the past.

I have, in the last year and a half, visited 15 different NCI-designated cancer centers, and each time I visit one, I learned something new and important. It’s really been an exhilarating experience for me to see the high quality activity, commitment, and dedication of the people at the different cancer centers.

In 2014, we gave some supplements for promoting HPV vaccination, and at the beginning of this year, all 69 cancer centers banded together to make an announcement, essentially, about the importance of HPV vaccination. This also is in the Blue Ribbon Panel report.

There have already been several meetings between the cancer centers, also involving representatives from the Centers for Disease Control at these meetings. The most recent one, Electra [Paskett, director of the Division of Cancer Prevention and Control in the College of Medicine], was one of the hosts at Ohio State University, and it’s already planned to have another meeting at the [Medical] University of South Carolina.

Another aspect in line with the Blue Ribbon Panel recommendations is for smoking cessation. We are planning to give more emphasis to smoking cessation, especially starting with the cancer centers so that we make smoking cessation much more incorporated, not just that it is standard of cancer, but that it is disseminated. Bob Croyle and his colleagues organized a meeting last month with a number of different people who came together and have made some recommendations. We’re really looking forward to that kind of being the next joint effort for the cancer centers.

The Cancer Moonshot and the Blue Ribbon Panel have really occupied us. I can’t thank all of you enough for your input. Everybody who was involved had a day job that they were supposed to doing something else. They added the Blue Ribbon Panel and the Cancer Moonshot to what they were doing.

I’m especially grateful to Dinah [Singer, acting deputy director of NCI and director of the Division of Cancer Biology], Liz [Jaffee, professor and deputy director for translational research at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University], and to Tyler [Jacks, director of the Koch Institute for Integrative Cancer Research at MIT], for co-chairing the Blue Ribbon Panel.

Copyright (c) 2017 The Cancer Letter Inc.