Sharpless, 55, said in an interview that he had “hugely mixed feelings” about enjoying his positions at the NCI and FDA. But he said his time as chief federal health official has been “pretty tumultuous,” largely because of the enjoyable but stressful work brought on by the coronavirus pandemic, including NCI’s role in evaluating coronavirus tests.
“My time in government,” Sharpless said, “should be measured in dog years.”
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A longtime researcher studying the relationship between cancer and aging, Sharpless was director of the Lineberger Comprehensive Cancer Center at the University of North Carolina before joining NCI in October 2017.
He said he wants to return to Chapel Hill to spend more time with his wife, an endocrinologist, and other family members, including his 89-year-old mother. He said he’s not going to another job but expects to return to academia at some point.
As the nation’s leading cancer doctor, Sharpless was optimistic about progress in controlling the disease and praised President Biden’s revamped anti-cancer “moonshot,” which aims to halve the nation’s cancer death rate in 25 years.
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“Making cancer less deadly and a more manageable disease, that’s doable,” he said, adding he believes deaths could be significantly reduced, particularly among young and otherwise healthy people. But to make such progress, he said, the nation needs sweeping improvements in clinical trials, increased aggregation and sharing of data, and increased prevention and screening.
Sharpless has repeatedly warned of the damaging effects of the pandemic, noting that millions of people have missed routine cancer screenings or delayed treatment. NCI modeling suggests another 5,000 to 10,000 people could die from breast cancer over the next decade due to pandemic-related delayed diagnoses and poorer prognosis, he said, urging adults to resume screening.
Cancer death rates have declined significantly since the 1990s, in large part due to a sharp decline in smoking, but also due to new treatments, including immunotherapies, which help the immune system “see” and fight cancer. Still, about 1.9 million new cancer cases and more than 609,000 cancer deaths are expected in the United States this year, according to the American Cancer Society.
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This enduring toll has led some critics to argue that the nation needs new strategies to fight cancer that focus less on seeking breakthroughs and more on improving prevention, improving quality of care, and reducing the toxic effects of cancer focus on treatments. Cary P. Gross, professor of medicine at the Yale School of Medicine, wrote in the Hill newspaper that governments should take more steps to reduce smoking and encourage vaccination against the human papillomavirus, which causes cervical and other cancers raise.
The NCI director’s departure comes as the Biden administration grapples with a highly uncertain future dominated by a pandemic that may be abating — or in a temporary doldrums. Efforts have been complicated by a series of recent personnel changes.
In December, Francis Collins resigned after 12 years as director of the National Institutes of Health. In February, Eric Lander, Biden’s top science adviser whose office is taking the lead in the Cancer Moonshot restart, resigned after admitting he had treated subordinates “disrespectfully and demeaningly.” Collins recently took up a temp position as Biden’s senior science adviser.
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White House coronavirus response coordinator Jeff Zients is leaving his job this month and will be replaced by epidemiologist Ashish Jha, dean of Brown University School of Public Health.
In another development on cancer research, Congress recently funded a new Advanced Research Projects Agency for Health, a priority for Biden. The new agency will seek to accelerate progress on serious diseases, including cancer, Alzheimer’s and heart disease.
Among cancer specialists and patients, the new agency generates mixed views. Some fear that ARPA-H, as it is known, will siphon off the Cancer Institute’s funds, while others say it will be more nimble than NCI at tackling high-risk research. Biden’s budget proposal for the next fiscal year called for a small cut in NCI funding and billions for the new agency.
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Sharpless said the moves around the new agency did not affect his decision to leave the company and he believes ARPA-H could be useful if there were flexibility in contracting, staffing and other rules that sometimes slow down government bureaucracy, and if coordinated with the Cancer Institute.
After leading the Cancer Institute for a year and a half, Sharpless joined the FDA in April 2019 as acting director after Scott Gottlieb resigned as commissioner. After the Trump administration appointed MD Anderson Cancer Center official Stephen Hahn as FDA commissioner, Sharpless returned to the NCI board of directors.
“Ned had a profound impact on two agencies during a period when cancer treatment was making great strides and we were facing a multi-generational pandemic,” Gottlieb said. He credited Sharpless with NCI’s role in helping validate diagnostic tests for the coronavirus and designing them how researchers “embraced the new field of immunotherapies”.
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Sharpless said he’s most proud of his pediatric cancer efforts, including raising an additional $50 million a year for a decade to increase research.
“My thinking here has evolved,” he said.
“I’m an adult oncologist and thought this was a condition where American progress was satisfactory,” he said, referring to childhood cancer.
But his views changed and now he believes better treatments are badly needed. While childhood cancer is rare, patients often develop medical problems, including second cancers, later in life because of the toxic treatments, he noted.
NCI’s Pediatric Cancer Initiative is focused on sharing data between children’s hospitals, clinics and networks to try to accelerate ways to improve children’s care.
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Sharpless also pushed to increase grants for investigators, which have faced intense competition over the past decade. He said increasing the percentage of applications NCI can fund is a slow but ongoing process. Sharpless also created NCI’s Equity and Inclusion Program to develop a more diverse cancer workforce and reduce health disparities.
Xavier Becerra, Secretary of State for Health and Human Services, praised Sharpless’ work in responding to the pandemic and its efforts to “minimise the negative impact of the pandemic on people living with cancer” in a statement.
Sharpless’ final day as NCI director is April 29th. Douglas R. Lowy, Executive Vice President at NCI, will serve as Acting Director.
“I think he was a great director, a serious scientist,” who understood the needs of patients and the responsibilities of being an NCI director, said Ellen V. Sigal, founder and chair of Friends of Cancer Research, a nonprofit advocacy group.