“I don’t think any good cancer center director would be worth their weight in salt if they weren’t worried about something at night,” said Mark Evers, director of University of Kentucky Markey Cancer Center.
Speaking on The Cancer Letter Podcast, Evers and Steven Libutti, the William N. Hait Director of Rutgers Cancer Institute, shared overlapping concerns about the latest headlines coming from Washington—particularly the morale of junior faculty and the potential impact of Medicaid cuts.
“In Kentucky, we’ve done, I think, a fantastic job with Medicaid expansion, and that’s allowed many of our patients or many of our population, particularly in Eastern Appalachia and Kentucky, to have insurance and to get their cancer screenings, and I worry about that going forward,” Evers said. “I worry that we’re going to see a drop-off in that.”
Libutti echoed this concern.
I get out of bed every morning thinking, ‘Wow, this is a great field to be in,’ because we’re actually talking about cures for certain cancers, which I thought in my lifetime we would never see.
Mark Evers
“I think if there was one area that keeps me up at night as a state institution at Rutgers, we are reliant on state support for our mission and our program,” Libutti said. “And in New Jersey, the state is very reliant on Medicaid funds that help to support critically important programs that allow for the state to help support our mission.
“And so, I’d say if there was one thing in the uncertainty column right now, it’s how that’s all going to land and play out.”
After decades in cancer research, Evers and Libutti have seen ups and downs in funding. They know when to brace for impact and when to stand back and let the events play out.
“A lot of people are worried about the NCI funding,” Evers said. “I had a really good opportunity to talk to our congressional leaders several weeks ago, and there’s such great bipartisan support that everybody is saying, ‘Don’t worry, we understand and we want to keep the momentum going.’”
Libutti and Evers appeared on the latest episode of The Cancer Letter Podcast, as part of a monthly series called The Directors, which focuses on the problems that keep directors of cancer centers up at night.
This episode is available exclusively on The Cancer Letter Podcast—on Spotify, Apple Podcasts, and YouTube.
Concern over junior faculty and young investigators is warranted, both directors said.
“I do worry about morale and I worry about that next generation of researchers coming up,” Evers said. “Because a lot of our students and postdocs, frankly, the morale is quite low, so I worry about maintaining that going forward, that thrust of momentum.”
However, experience has taught Evers and Libutti to be optimists.
“Whenever there’s a change and whenever there’s any discussions about policy changes or personnel changes or payline changes, there’s often an amplification of what I like to refer to as hand-wringing that occurs in our field,” Libutti said.
There’s so much bipartisan support for the sort of work that we’re doing, especially in the cancer research field, that I think we need to ride out what I’ve heard referred to as a tempest and keep reassuring our faculty that we’re going to get through this together.
Steven Libutti
“And I think it’s incumbent on leadership to take seriously headwinds that may in fact cause a disruption or slow our progress, but also reassure folks that, as Mark said, the Congress actually controls the purse strings and there’s so much bipartisan support for the sort of work that we’re doing, especially in the cancer research field, that I think we need to ride out what I’ve heard referred to as a tempest and keep reassuring our faculty that we’re going to get through this together.”
Are there reasons to be optimistic?
“To see the tremendous improvements in therapy that have come about just literally in the last five to 10 years has made me so optimistic,” Evers said. “I get out of bed every morning thinking, ‘Wow, this is a great field to be in,’ because we’re actually talking about cures for certain cancers, which I thought in my lifetime we would never see.”
Now, imagine what can be accomplished in the near future with the tools we have today.
“I am optimistic that if we continue to make that commitment, what we’re going to see over the next 10 to 20 years is going to be even more impressive,” Libutti said. “And so, I’m very optimistic about the progress we’ve made and the progress that we can potentially make if we all continue to keep our eye on the ball.”
Explore previous episodes of The Directors.
Some highlights:
On maintaining momentum
Said Evers:
It’s almost a paralysis that you see sometimes with young investigators. They just can’t move forward because of thinking about what could happen in the future, and I understand that. I was a junior faculty member at one time as well a long time ago.
What I’ve been trying to do is to have everybody focus on the mission, what we’re doing. We’re doing such important work in the state. We’re starting to see tangible benefits from that from our Kentucky population, which has some of the worst cancer rates in the country, and just trying to get everybody to recognize that we have a mission here at the Markey Cancer Center, and that mission is our population and our patients.
And again, just wanting to make sure that folks recognize how far we’ve come, and that this paralysis is going to hinder us, our momentum in the future. It seems to work a little bit, but I know people still get in their quagmire of worry and concern.
Whatever the paylines, grant applications must go in, Libutti said:
The mission is what has to drive us, and we can’t control the things we can’t control, but we can control our commitment and doing good work and still submitting grants.
The reality is a payline of 9%, versus a payline of 7%, is still a tough hill to climb or a hurdle to get over. That still means that 91% or 93% of applications aren’t getting funded.
And so, it’s a game where you’ve got to be in it to win it, so to speak, and so I know that when these first concerns began in February and March about what was going to happen with the funding and grants, study sections were being delayed and board meetings were being canceled, my message to my investigators, young and more senior was now’s the time to write grants and get them in.
On Medicaid cuts
It’s too early to predict how Medicaid cuts will play out in each state.
Said Libutti:
It’s going to be very different state to state in terms of what this impact looks like, because much of what’s in that bill as it relates to Medicaid is about who’s getting Medicaid resources and what are the requirements for them to get those Medicaid resources, and how that’s going to land in each individual state is yet to be fully realized.
Our health system is very much engaged in trying to understand this in conversations with the state. I know the state Department of Health and other entities are very focused on how this is going to impact in New Jersey, but I don’t think anyone has a definitive understanding of what the magnitude of this will be.
And that’s why I think we have to, while being acutely aware of the negative impact it can have, really understand it better before we start to make plans for how we’re going to address it.
On NCI budget cuts
Libutti and Evers said they believe that Congress is unlikely to allow the 40% cut to NIH proposed by the Trump administration to be enacted.
“There’s a tremendous amount of uncertainty and that’s pretty much what we’re navigating right now,” Libutti said. “But if I’m going to say there are two things I am certain of, I am certain that the NCI budget won’t be cut by 40%.
“And the second thing that I can guarantee is that indirect rates will not be 12%.”
Said Evers:
I’m the eternal optimist, so I have to say I don’t have a plan B or C if that should happen, but in speaking to our congressional leaders privately, they say there’s no way that you’re going to see a 40% cut in NCI.
I feel confident in that, and if you look at how the proposed reorganization and amalgamating different institutes, the NCI is the only institute that is not being amalgamated with other institutes.
Again, I get the sense both in the state and as well at the national level, at least from our Kentucky representative senators, etc, is that this is bipartisan. We want to support, we understand the momentum that is having in our state, and don’t worry.
Listen to the full episode on Spotify, Apple Podcasts, or YouTube.
A transcript of the podcast is available below:
Katie Goldberg: Welcome back to The Directors, a special segment of The Cancer Letter Podcast. This series is sponsored by ASCO—the American Society of Clinical Oncology.
This time, B. Mark Evers, director of Markey Cancer Center in Kentucky, and Steven K. Libutti, the William N. Hait Director of Rutgers Cancer Institute in New Jersey, talk about maintaining optimism and the momentum of research while the field prepares for Medicaid and funding cuts.
Evers is also physician in chief of the oncology service and vice-chair for research in the Department of Surgery at Markey, and Libutti is also vice chancellor for cancer programs, distinguished professor of surgery, and affiliated distinguished professor in genetics at Rutgers—as well as senior vice president of oncology services at RWJBarnabas Health.
And with that, let’s get started.
Paul Goldberg: Dr. Evers, Dr. Libutti, thank you for agreeing to be a part of The Directors. We started this podcast early this year in order to keep track of how cancer centers are doing and to check in monthly with two directors at a time, and to see how events in Washington and Bethesda are trickling out into the real world outside the Beltway. So, thank you. And my first question is always the same: What’s keeping you up at night, gentlemen?
Mark Evers: Well, I can start off. I don’t think any good cancer center director would be worth their weight in salt if they weren’t worried about something at night.
So, a lot of people are worried about the NCI funding. I had a really good opportunity to talk to our congressional leaders several weeks ago, and there’s such great bipartisan support that everybody is saying, “Don’t worry, we understand and we want to keep the momentum going.”
But a couple of things do worry me.
One is the morale of our junior faculty. Steve and I have been around long enough to see fluctuations and doom and gloom being proclaimed, but many of them have not, and I do worry about morale and I worry about that next generation of researchers coming up, because a lot of our students and postdocs, frankly, the morale is quite low, so I worry about maintaining that going forward, that thrust of momentum.
And the other thing I worry about, I have to say, is the Medicaid situation. In Kentucky, we’ve done, I think, a fantastic job with Medicaid expansion, and that’s allowed many of our patients or many of our population, particularly in Eastern Appalachia and Kentucky, to have insurance and to get their cancer screenings, and I worry about that going forward.
I worry that we’re going to see a drop-off in that.
Steven Libutti: I would just echo what Mark said.
My concerns also are focused on young investigators and our junior faculty, and always, whenever there’s a change and whenever there’s any discussions about policy changes or personnel changes or payline changes, there’s often an amplification of what I like to refer to as hand-wringing that occurs in our field, and this often leads to even greater anxiety, especially among junior faculty that, as Mark said, haven’t seen the ebbs and flows over the decades.
I began my journey at the NCI 30 years ago, and so I’ve been through a number of different changes of administration where various levels of panic set in, both in the intramural and extramural world.
And I think it’s incumbent on leadership to take seriously headwinds that may in fact cause a disruption or slow our progress, but also reassure folks that, as Mark said, the Congress actually controls the purse strings and there’s so much bipartisan support for the sort of work that we’re doing, especially in the cancer research field, that I think we need to ride out what I’ve heard referred to as a tempest and keep reassuring our faculty that we’re going to get through this together.
I also share Mark’s concern about Medicaid. I think if there was one area that keeps me up at night as a state institution at Rutgers, we are reliant on state support for our mission and our program, and in New Jersey, the state is very reliant on Medicaid funds that help to support critically important programs that allow for the state to help support our mission.
And so, I’d say if there was one thing in the uncertainty column right now, it’s how that’s all going to land and play out.
Paul Goldberg: I see a lot of common threads, so I’m just going to pull on them one by one. I guess the first one is junior faculty. What do you do about this? How do you talk to people who are just starting in their careers? How do you keep their morale up? Is there anything you can say or do? Are there best practices out there?
Mark Evers: For me, and Steve’s exactly right, it’s almost a paralysis that you see sometimes with young investigators. They just can’t move forward because of thinking about what could happen in the future, and I understand that. I was a junior faculty member at one time as well a long time ago.
What I’ve been trying to do is to have everybody focus on the mission, what we’re doing. We’re doing such important work in the state. We’re starting to see tangible benefits from that from our Kentucky population, which has some of the worst cancer rates in the country, and just trying to get everybody to recognize that we have a mission here at the Markey Cancer Center, and that mission is our population and our patients.
And again, just wanting to make sure that folks recognize how far we’ve come, and that this paralysis is going to hinder us, our momentum in the future. It seems to work a little bit, but I know people still get in their quagmire of worry and concern.
Steven Libutti: And I agree with Mark, the mission is what has to drive us, and we can’t control the things we can’t control, but we can control our commitment and doing good work and still submitting grants.
The reality is a payline of 9%, versus a payline of 7%, is still a tough hill to climb or a hurdle to get over. That still means that 91% or 93% of applications aren’t getting funded.
And so, it’s a game where you’ve got to be in it to win it, so to speak, and so I know that when these first concerns began in February and March about what was going to happen with the funding and grants, study sections were being delayed and board meetings were being canceled, my message to my investigators, young and more senior was now’s the time to write grants and get them in.
Because there’s a fiscal year, this fiscal year, where there is money that has to be spent by the feds, and just get grants in, and we’ve seen one of our more successful grant years this year in numbers of applications submitted and grants awarded.
And so, I think all we can do is continue to drive the mission forward, advocate for the importance of funding for our mission to our constituencies so they continue to message that to their elected representatives, and control the things that we can control.
We’ve hit rough seas in the past and we’ve navigated them, and I’m confident we’ll do the same now.
Paul Goldberg: Do you have town hall meetings for young investigators or do you meet with them one on one and say, “Hey, take it easy”? And actually, can you say, “Take it easy,” because the numbers are pretty devastating because of the accounting? The changes in how the money is going to be spent really pushes it down to 2%-to-3% now.
Mark Evers: Well, I don’t think you ever want to minimize their concerns, so it’s hard just to say, “Take it easy. Everything’s going to be all right,” because they can definitely read the news and they obviously have concerns.
But again, I think it’s reassuring them that, again, us old timers, we have seen these coming cycles. And you ask about meeting with the investigators, I think communication at these times is extremely important, and sometimes that means just saying, “I don’t have an update.”
Because sometimes if people haven’t heard anything, then they obviously become more concerned. And you just play it by each person as well. I have regular meetings, leadership meetings, as well as larger town hall meetings, but if I see somebody that’s really paralyzed or really down, then I do schedule individual meetings with those investigators.
Paul Goldberg: You’re doing the same, Steven?
Steven Libutti: Yes. We do have town halls. We also try to make certain there’s communications coming from our associate directors and program leaders and others.
I would say, though, there’s still a tremendous amount of uncertainty, and that’s part of what the message has to be. The budget for FY2026 has not even come out yet, and so, we really don’t know where it’s going to land at this point.
For example, a lot of the grants and a lot of cases are winding their way through courts in terms of decision-making. Just this morning, we received an update from the university that all of the currently terminated awards have been reinstated, and they’re working on sorting through all of that based on a federal judge’s decision.
Now, obviously, appeals can happen, et cetera, but we really don’t know where this is going to land at this point.
And so, I think I’m not minimizing the risk, but I think it’s also important not to allow it to distract us from our mission. Our mission is not politics and determining how these arguments are going to land themselves.
Yes, we can be advocates, yes, we can be subject matter experts, but at the end of the day, we have to reassure folks that our mission is a critically important one.
Cancer doesn’t select based on political affiliation. I think everyone knows that, and at the end of the day, we don’t want to get so paralyzed by our fear of what we’re reading in the media or what various advocacy groups are getting super buzzed up about.
We need to continue to do the good work that we have to do, and to encourage them.
There’s ways we can help to bridge or support our junior faculty through resources from the state or resources through other sources of philanthropy, and that’s I think an important thing for us to recognize as well in terms of this mission, is I think we’ve been very much dependent on one major source of funding for driving cancer research in this country, and I think it’s a bit of a wake-up call that you must be diversified in terms of how you’re going to support this kind of work, and I think it’s important for us as a field to look at how we’re going to adapt moving forward so we’re not so dependent on one source of funding.
Paul Goldberg: I guess another thread that I’m going to pull on is Medicaid. How do you plan for what’s coming down? Because this is a done deal, that there will be cuts to Medicaid.
Trump signed the bill, the One Big Beautiful Bill. What kind of impact is it going to have? How much can you see right now?
Mark Evers: I can’t see a lot, to tell you the truth. I don’t know what necessarily the changes, where they will land. Obviously there’s concern on my part, but I’m just not adept enough to totally understand the bill and what cuts there are and how that will affect us.
Paul Goldberg: And not for lack of trying, because it’s not visible yet where you’re looking.
Mark Evers: Right. It’s just hard to understand when you try to read the legislation and that sort of thing. So, I don’t know if anybody totally understands how that will impact us and our state yet, so I think more to be determined.
Steven Libutti: And that’s the key point that Mark makes, is it’s going to be very different state to state in terms of what this impact looks like, because much of what’s in that bill as it relates to Medicaid is about who’s getting Medicaid resources and what are the requirements for them to get those Medicaid resources, and how that’s going to land in each individual state is yet to be fully realized.
Our health system is very much engaged in trying to understand this in conversations with the state. I know the state Department of Health and other entities are very focused on how this is going to impact in New Jersey, but I don’t think anyone has a definitive understanding of what the magnitude of this will be.
And that’s why I think we have to, while being acutely aware of the negative impact it can have, really understand it better before we start to make plans for how we’re going to address it.
Paul Goldberg: Well, that’s very clear. And actually, it matters a lot because Kentucky has the highest cancer burden in the US and New Jersey is, correct me if I’m wrong, is number five; right?
Steven Libutti: We’re actually somewhere… That’s not totally off. I believe we’re probably seventh in incidence right now and maybe a little bit higher in mortality, depending on the cancer that you look at, but still top 10. Both Kentucky and New Jersey are top ten states in terms of impact of cancer on its population.
Mark Evers: And that’s a top-ten list you don’t want to be on.
Steven Libutti: That’s right.
Mark Evers: For our basketball team, that’s okay, but not for us.
Paul Goldberg: Well, Medicaid would certainly impact your ability to make things better, to get off that top-ten list, so yes. Another part of it that’s been worrying me a lot is the CDC cuts, proposed CDC cuts, which would get rid of the cancer registries, or funding for state cancer registries. Have you been affected by that? Is that happening?
Mark Evers: So, Paul, it’s not getting rid of them. Certainly, there have been cuts to our SEER registry, but we receive generous funding through the state as well so I think that’s going to mitigate some of those cuts.
It’s something that we’re dealing with and we’re planning for the future, because I don’t see those cuts coming back anytime soon if at all, so how can we be leaner and meaner with our registries and move forward?
But I would say that that’s not the only source of funding for our registry, which is good.
Steven Libutti: That’s true for us as well. In fact, our state this coming fiscal year, FY ’26, increased its investment and support for our cancer registry, and so, I think we’ll be fine, at least over the next year, in terms of continuing the good work that our cancer registry does.
And remember, there are cancer registries across the country. I think just about every state has a cancer registry program, but the number of SEER-funded cancer registries is much fewer, and so this is work that has to get done state by state.
We very much appreciate the federal investment in this, and I certainly believe that should continue in terms of supporting these registries, but we’re going to keep this kind of work going through any sort of rough patch that we may find with respect to federal funds.
Paul Goldberg: Can you do COE without that kind of support? So, you’re really seeing this as a priority? You’re staying with this kind of population science approach?
Steven Libutti: Oh, absolutely. Our COE work continues.
Paul Goldberg: What about another thread to pull: the appropriations and the president’s budget request, which would cut NCI by nearly 40% and, of course. cut the indirect costs, cap them at 15%. Are you getting a sense in Congress that that may not be happening, or are you planning for this somehow?
Mark Evers: I’m the eternal optimist, so I have to say I don’t have a plan B or C if that should happen, but in speaking to our congressional leaders privately, they say there’s no way that you’re going to see a 40% cut in NCI.
I feel confident in that, and if you look at how the proposed reorganization and amalgamating different institutes, the NCI is the only institute that is not being amalgamated with other institutes.
Again, I get the sense both in the state and as well at the national level, at least from our Kentucky representative senators, etc, is that this is bipartisan. We want to support, we understand the momentum that is having in our state, and don’t worry.
Steven Libutti: And what I would say is there’s a tremendous amount of uncertainty and that’s pretty much what we’re navigating right now, but if I’m going to say there are two things I am certain of, I am certain that the NCI budget won’t be cut by 40%.
I think that that’s, again, another thing that promotes hand-wringing and fear among faculty, both junior and senior. But there have been many attempts or proposals from the executive branch over my thirty-year career that proposed or threatened major cuts, and I’ve never seen that occur once Congress weighs in, and, again, Congress controls the purse strings and does the appropriating.
And the second thing that I can guarantee is that indirect rates will not be 12%.
Now, will indirect rates be adjusted, and do we have to look at a world where some institutions that get over 100% indirect reimbursement, that that’s probably going to go away.
I think, absolutely, that’s going to be looked at, and I think there will be an adjustment or a relook at the formula that’s used for calculating indirect rates. But I think these draconian proposals to cut indirects down to that level aren’t going to happen, because it would gut the entire university-based research enterprise, not just for cancer, but for everything else.
And I have to believe that, since Congress is the only body that can reassess and readjust those indirect rates, that there’ll be a debate, likely a rigorous one, and then we’ll see something come out of that, but I don’t think we’re going to see the cuts as proposed.
Paul Goldberg: But the world where indirect costs were just something you never talked about and people just avoid that, it’s not something you talked about in polite company—that’s over.
Now, it’s make it more transparent, which actually is a great thing, I would argue.
What about your clinical trials? Are you able to keep them going? Is anything falling off the screen? Is anything being cut right now?
Mark Evers: So, at least for Markey, our clinical trials are going gangbusters, and so we’ve not cut anything on that—and won’t. Really, we have not… Again, we’re watching this closely, but we have not been impacted in a negative sense, as of yet.
Steven Libutti: Yes, and I would have to also say that we’re not cutting back at all on our clinical trials activity.
We’re on track for a high watermark this year in terms of clinical trial accruals. We haven’t closed therapeutic clinical trials… And this year, our non-competitive renewal, our grant was funded at the rate we were awarded before any of this had taken place.
We’ve seen some grants held by our members terminated or adjusted based on some of the grant readjustments that were made, but as I mentioned already, this morning, we were informed that many of those terminated grants have been reinstated.
And so, as I look at where we stand today in terms of funding from the feds, we have not yet seen a major negative impact. I’m not saying that we’re not concerned about what the future holds. A lot of uncertainty, not saying I can predict all things in a crystal ball, but at the moment we are steadfast in our pursuit and focus on our mission.
Paul Goldberg: Can you envision a world where cancer centers can operate with less of NCI involvement, with more of the internal leadership that is here right now? I’m asking this because right now, there is no NCI director who’s a permanent director, and maybe between now and the time this is broadcast, there will be one.
Can you imagine a world where NCI is secondary or tertiary? It’s always been primary to you.
Mark Evers: Yes, I can’t imagine. I think NCI still takes front and center, and to your point, poor Doug Lowy has been interim director now, this is about his third stint.
So, we’ve seen this before, so that doesn’t bother me in terms of we don’t have an NCI director at this point. But I think also to Steve’s point earlier, we’ve been steadfast and it’s always we go for federal funding or NCI funding with our grants, but we’re looking at other options, other foundations, industry, etc.
I think it’s a good exercise, actually, because it’s really forcing us to look at other funding options that are out there, really increasing our message with our donors as well to increase philanthropy, so it’s a healthy process.
Steven Libutti: Yes, it also forces you to look at what are you deploying your resources to support and what are the expenses that you’re bearing, and how can you do a better job of being more efficient and more effective.
In answer to your question about the NCI, no, I can’t and I don’t want to imagine a future where the NCI is not a major player in directing our overall vision and mission of cancer research and important areas of cancer priority across the country, and the NCI designated centers are really the NCI’s soldiers in the field that help to implement and to give feedback on those strategies that we develop together, but I’m also not concerned with respect to the appointment of a permanent director yet.
I have absolute confidence in Doug Lowy’s ability to lead. He’s done this on many occasions, and Doug has never given me the impression that he’s just there to keep the ship going the way it’s going.
Doug doesn’t look at that interim title as being just keeping things the same. I’m certain he will lead and will look for opportunities to better what we’re all striving to accomplish. And so, I think time will tell in terms of when and who will be the next director of the NCI, but for now, I’m confident in the leadership that’s there.
Paul Goldberg: We have not heard patients tell the world how it’s affecting them, this uncertainty. Are you feeling that uncertainty from your patients?
Mark Evers: I think one of the good things that we’ve done, I’m sure Steve has done it, and other cancer center directors as well, is to have open discussions with our community advisory board.
I actually did an op-ed for our paper here as well to really get the word out and tell the public, because I think that they don’t necessarily always understand in terms of what may be coming down the pike.
Just emphasizing the importance of cancer research funding, how much this is, what momentum that we have is really at danger if we were to see major, major cuts.
Sometimes I think it’s better for us to be talking to our patients and patient advocates, because then they speak to their legislative folks, and sometimes that means more than if I or Steve spoke to our legislative group.
Steven Libutti: Yes, totally agree.
We’ve done the same. We’ve had open communication with our Cancer Community Action Board and brought them up to speed. We speak to our Director’s Leadership Council. I have a meeting actually with them later today.
That’s a group of folks in our broader community that helped to advise the director on avenues of importance in addition to our Community Action Board. And so, keeping those lines of communication open, really demonstrating and showing examples to those folks of what federal funding has achieved in terms of not only new approaches to therapy, but ways to better diagnose and detect cancers at their earliest stages, and how devastating major cuts to that support will be, not just in the immediate period but into the future.
We’ve made so much progress over the last 30 years in early detection, cancer screening, lowering mortality for cancer, and we don’t want to see us lose ground on that momentum, and certainly if devastating cuts were to happen from the federal government, that could be an outcome.
And we’ve always had such a great partnership between academia, industry and the federal government in terms of science and health in general, but certainly cancer specifically, that we have to keep explaining why that’s so important.
Patients are really focused on what they’re dealing with and often are unaware of the complexities of how this all is funded, and I think us telling the story and explaining it.
AACR recently was involved, or at least members of AACR were recently involved in an interview that brought some patients into the conversation, brought in investigators from a couple of different cancer centers into the conversation.
So, I think there are efforts, and we’re certainly doing it as Mark is as well through our community action boards.
Paul Goldberg: You’re both surgeons and both of you are immunologists as well. Is there any aspect of this where immunology is being affected, the promise of immunology being compromised by these cuts?
Mark Evers: I haven’t seen it myself, Paul. Obviously, that’s a concern for not only immunology, but just the whole cellular therapy field, which has just really exploded in a good fashion, but I truly haven’t seen it yet.
Steven Libutti: Yes, it’s a concern. Just like other research programs, we don’t know what the full impact will be and what the final budget will look like, and certainly that has the potential to impact the momentum that we’ve gained, especially in research related to cell therapy and adoptive cell transfer.
One of the challenges, I think, we have in that field, which is incredibly promising, our own Cell Therapy Program at Rutgers led by Christian Hinrichs has been making some tremendous gains in its application of solid tumors.
The processing and the fact that this is really truly individualized therapy, that you’re creating a new product for each patient, has levels of complexity and therefore expense that we have to address and find ways to make it more cost-effective so we can get it out to more patients.
And I think the partner for making that kind of progress is not only funding agencies like the NCI, but regulatory agencies like FDA, where we have to work together with FDA to come up with newer ways of evaluating and approving those sorts of therapies to try to mitigate some of the costs associated with them.
But I haven’t yet seen anything that has caused us to pull back on the reins on our efforts in that area, but obviously we’re keeping a close eye on the support that we’ll need to continue to make progress.
Paul Goldberg: What are you most optimistic about now?
Mark Evers: What am I most optimistic? Well, I tell people a lot that I’ve been in this business, and I know Steve has as well, for probably 30-plus years, and 30 years ago, it was quite depressing at times because we had a few drugs to treat cancer patients.
Most of those were basically poisons, they had terrible side effects. But to see the tremendous improvements in therapy that have come about just literally in the last five to 10 years has made me so optimistic.
I get out of bed every morning thinking, “Wow, this is a great field to be in,” because we’re actually talking about cures for certain cancers, which I thought in my lifetime we would never see.
Steven Libutti: Yes, I have to agree. That’s what still gets me excited about having chosen this as a career, is just in my lifetime, watching the impact that science has made on changing the outcome of a cancer diagnosis for patients is just incredibly awe-inspiring, and it’s why it’s so important that the federal government continue to partner with academia and industry to drive this forward and why the investment of the federal government in this kind of research is so incredibly important.
I am optimistic that if we continue to make that commitment, what we’re going to see over the next 10 to 20 years is going to be even more impressive. And so, I’m very optimistic about the progress we’ve made and the progress that we can potentially make if we all continue to keep our eye on the ball.
Paul Goldberg: Well, thank you very much, and thank you for your leadership.
Steven Libutti: Thank you, Paul.
Mark Evers: Thank you, Paul. We appreciate the opportunity to speak to you.
Paul Goldberg: Thank you.
