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Cancer Bill May Hitch a Ride on Defense Authorization

Supporters of legislation that would bolster research on the deadliest cancers have dodged a Senate hold by attaching their measure to the defense authorization bill.

Oklahoma Republican Tom Coburn had been holding up the legislation (HR 733) because of objections to Congress “micromanaging” the National Institutes of Health and forcing a disease-specific approach to medical research.

But when Senate sponsor Sheldon Whitehouse, D-R.I., brought the language to the floor Thursday as an amendment to the fiscal 2013 defense authorization bill (S 3254), Coburn explained his opposition and then allowed it to move through by voice vote.

“I will be one of the few who vote against this and I’m fine with a voice vote if no other colleagues object. I have no problems with that,” Coburn said. “But in the name of doing good, I would suggest that we’re actually going to limit our ability to achieve at a sooner time the cures that everybody that’s supporting this bill would like to see.”

The next test will be whether the cancer language survives negotiations between the two chambers when the defense authorization bills move to conference committee. The Senate measure is expected to pass in the coming days, while the House endorsed its version (HR 4310) in May.

But a Senate Democratic aide noted in an email that the House already passed the cancer language as a stand-alone measure, “so it’s hard to imagine that they’d want to strip it out of the defense bill.” It won House passage by voice vote on Sept. 19, the same day the Senate Health, Education, Labor and Pensions Committee approved a companion measure by voice vote.

Julie Fleshman, president and CEO of the Pancreatic Cancer Action Network, said Whitehouse had identified the defense authorization measure as a potential vehicle once it became clear that supporters needed to find another path to Senate passage. Her organization has been pushing hard for the bill, which is based on legislation that was originally introduced by Rep. Anna G. Eshoo, D-Calif., in 2008 and focused more narrowly on pancreatic cancer.

Fleshman said in an email that adding the language into the defense authorization makes the group “very hopeful that the legislation will become law before the end of the year.” She praised the progress “during an extraordinarily busy lame-duck session” as a testament to the dedication of the bill’s congressional leaders and pancreatic cancer advocates across the country.

Under the bill, the National Cancer Institute would be required to identify at least two recalcitrant cancers with five-year survival rates of less than 20 percent that are estimated to cause at least 30,000 American deaths each year. The two cancers that meet that definition are pancreatic and lung cancers, according to the Pancreatic Cancer Action Network. The five-year survival rate for pancreatic cancer is 6 percent, while lung cancer’s rate is 16 percent.

The institute would then have to develop a scientific framework to guide research on each of the cancers. At the agency’s discretion, the program could be expanded to other recalcitrant cancers — defined as those cancers with five-year survival rates under 50 percent.

Coburn says that despite the good intentions of supporters, the measure is unnecessary and could end up hurting efforts to combat cancer. In a Sept. 17 letter, he asked NIH Director Francis S. Collins for comment on the legislation and emphasized the interdisciplinary approach of current medical research.

“Every time Congress passes legislation directing NIH in these endeavors, we further restrict the agency’s freedom to respond to groundbreaking discoveries and to allocate resources as the science requires,” Coburn wrote.

In a Nov. 16 response, Collins noted that his agency is not allowed to take a position on the measure, but he made several comments that seemed to back up Coburn’s concerns. Collins said the Health and Human Services Department and the NIH already have the authority to set up working groups and research plans. And Collins maintained that “basic research that may lack any overt connection to specific diseases is the foundation for disease-specific translational and clinical research, and it must be preserved to ensure the discoveries that later drive applied work on individual diseases.”

“In other words, if Congress directs the NIH to study specific diseases without flexibility, it can limit our ability to follow the best leads in science and to pursue discoveries that move an entire research field forward in a way that produces maximum benefit to the public,” Collins said.

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