NCI CAMNews

Spring 2009

Vol.4 - Issue 1

In this issue:

1

Feature

3

A Conversation With

4

News from the Field

7

Funding Opportunities

8

Research Resources

10

Research Highlights

12

CAM Information

13

Meetings

16

Featured Scientific

Meetings

National Cancer Institute

U.S. DEPARTMENT

OF HEALTH AND

HUMAN SERVICES

National Institutes

of Health

The Newsletter of the Office of Cancer Complementary and Alternative Medicine

Rare Plant Compounds from

China Undergo Screening at NCI

KIB’s State Key Laboratory of Phytochemistry and Plant Resources

In July 2008, the United States

government signed a research

agreement with China to foster

collaboration between researchers

studying integrative and Traditional

Chinese Medicine (TCM) in both

countries. One of the first and most

promising of these projects is a

partnership between the Kunming

Institute of Botany (KIB) of China

Academy of Sciences and two groups

at the National Cancer Institute

(NCI).

Xe Office of Cancer

Complementary and Alternative

Medicine (OCCAM) began to

oversee the growing collaboration

after a Memorandum of

Understanding (MOU) was signed

between KIB and NCI in October

2008. KIB will supply rare and

promising specimens, while the

Natural Products Branch (NPB) and

the Developmental Xerapeutics

Program (DTP) will screen them in

NCI’s system of 60 human cancer

cell lines. If any compounds show

promise, more drug analysis and

development would follow, said

Libin Jia, M.D., health scientist

administrator at OCCAM.

KIB’s researchers collect and study

plant specimens indigenous to their

environment, a high-mountain

plateau in southwest China that also

extends into Tibet. Plants that thrive

there could be called

“extremophiles,” said David

Newman, Ph.D., NPB chief.

Temperatures at these altitudes

fluctuate dramatically, with a range

1

continued on next page
in temperatures between the seasons

more extreme than in most areas of

the world. Xe climate requires a

natural hardiness from plants,

because it winnows the supply of

possible nutrients. “Xe ecology is

unique, and also remote,” Dr.

Newman noted. “We relish the

opportunity to study these

compounds and extracts, because we

really have no idea what we may

find.”

Bringing Botanical Compounds

Back

Dr. Jia traveled to KIB last fall and

returned with seventeen plantderived compounds, some from

plants used in TCM. He delivered

the compounds to the DTP labs at

NCI’s Frederick, MD, campus where

the specimens are now undergoing in

vitro screening for anti-cancer

activity.

“TCM has already contributed a few

compounds, like arsenic trioxide and

camptothecin, which are currently

used to treat cancer,” explained Dr.

Jia. “It would be remarkable if we

could find additional ones from the

vast number of medicines China has

been using for centuries.”

In his recent visit to KIB, Dr. Jia was

greeted by KIB Deputy Director

Jikai Liu, Ph.D., who provided a

tour of the scientific organization.

“He showed me their large botanical

seed collection (over 1.2 million

specimens), which is quite unique,”

Dr. Jia recalled. KIB also developed a

world-renowned botanical garden,

where they cultivate many of the

plant species found in the region.

East-West Science and Vice Versa

Xe millennia-long history of TCM

is embodied in the Bencao Gangmu

("Materia Medica”), explained NCI’s

Dr. Newman. It is the most complete

compendium ever written about

TCM, compiled during the Ming

Dynasty in the 16th century. “Xe

descriptions of the plants are

invariably accompanied by the

associated climatic, temporal, and

geographic conditions––information

on where, when, and how to collect

them,” he explained.

“Xe KIB has an extremely talented

group of chemists and plant

biologists,” said Dr. Newman, “who

have been studying these interactions

for years, and who similarly have

developed a large collection of plantassociated microbes that may unlock

a plant’s medicinal potential.”

Two of the compounds that Dr. Jia

brought back from China have

already shown promising anti-cancer

activity in the KIB labs. Xe Chinese

researchers are hoping that NPB will

confirm those findings. But the real

collaboration involves putting the

rest of the specimens through the

rigorous screening process that DTP

established around 1990.

Once anti-cancer activity is detected

in cells, the work may eventually

progress to testing for activity in

animal models of cancer. KIB has

isolated thousands of compounds,

and another batch is on the way to

NPB’s labs.

Xe future of the partnership looks

bright, Dr. Jia commented. OCCAM

is planning a dialogue among experts

on the topic of botanicals in cancer

research this summer. KIB’s Dr. Liu

will provide NCI researchers with

more insight from and details about

KIB’s work and resources at that

meeting.

Discussions about how the results

from some of the projects might

eventually be exported back to China

are also planned. One of KIB’s goals

from the collaboration is to develop a

greater capacity to perform its own

anti-cancer screening. To facilitate

this, Dr. Liu will carry back with him

a functional model of the NCI-60

screening cancer cell lines. One day

KIB may send scientists to train at

NPB and DTP and possibly establish

some of the more advanced drug

screening methods and technologies,

moving science from “west to east.”

❧

from previous page

2

We relish the opportunity to study these

compounds and extracts, because we really

have no idea what we may find.

Dr. David Newman, Chief of Natural Products Branch

“

”

Related stories:

United States and China Sign Research Agreement on Traditional Chinese Medicine

http://www.cancer.gov/cam/newsletter/2008-fall/1.html

From Dust to Discovery

http://www.cancer.gov/cam/newsletter/2007-fall/1.html
A Conversation with:

Isis Mikhail, M.D., M.P.H., Dr.P.H.

Research Development and Support Program Director

Office of Cancer Complementary and Alternative Medicine

Division of Cancer Treatment and Diagnosis

Would you briefly describe

your educational and

professional background?

After graduating from Cairo

University Medical School in Egypt

in 1980, I came to the United States

and completed my clinical boards. I

then received a scholarship from the

University of Alabama at

Birmingham (UAB) and completed

my M.P.H. in epidemiology in 1990.

After graduation, I worked on

epidemiologic studies and clinical

trials in many areas of health:

chronic diseases (heart disease,

diabetes), genetics (Alzheimer’s,

narcolepsy), and rheumatologic

disorders (rheumatoid arthritis,

lupus, fibromyalgia). While working

as director of the WILLOW Project,

an HIV trial funded by the National

Institutes of Health (NIH), I

pursued a doctoral degree in UAB’s

Department of Epidemiology and

International Health. In 2003, I

received my Dr.P.H. and was

honored as the outstanding doctoral

student of the year.

All of these experiences prepared me

for my positions here at NCI. Before

coming to OCCAM, I was a

program director and epidemiologist

at the Clinical and Translational

Epidemiology Branch of the Division

of Cancer Control and Population

Sciences at NCI. In that role, I

focused on stimulating research on

rare cancers and worked on projects

related to chronic diseases and

cancer, cancer risk, outcome, and

prognosis. I served as chair of the

Health Disparities Interest Group

and was a member of the Special

Studies Institutional Review Board.

What does your new role at

OCCAM include?

My main role as director of the

Research and Development Support

Program (RDSP) is to coordinate,

support, and expand OCCAM’s

extramural research activities and

grant portfolio. Xis can be achieved

by developing new initiatives and

collaborative funding opportunities

with other NCI and NIH programs.

Also, communicating with CAM

researchers and attending and

organizing meetings and workshops

will be important for me to build

bridges with this research

community. Such efforts can

promote innovative research and

support new investigators to conduct

rigorous research.

I will also emphasize OCCAM’s new

research priorities, which include the

identification of novel therapeutics

for the pharmacopeia of traditional

medical systems, as defined by the

World Health Organization; the use

of complementary approaches to

improve the therapeutic ratio of

standard and investigational anticancer therapies; and research on

Dr. Isis Mikhail

lifestyle modifications (e.g. diet,

exercise, and mind-body approaches)

for their impact on cancer outcomes

(e.g. response to conventional cancer

therapy and survival).

How did you first become

interested in CAM? How has

that shaped your career?

Having grown up in Egypt, I was

exposed to CAM early on. Xe use of

CAM therapies, such as ancient

Egyptian remedies, for general

sicknesses is a way of life there. Also,

my father owned an export business

where he exported medicinal herbs to

a pharmaceutical company in

Germany. I can still remember hearing

about herbals such as chamomile and

cardamom. I also learned that certain

herbs have potencies based on where

they are planted, when they are

planted, and the soil used.

Contact Information

Office of Cancer Complementary

and Alternative Medicine

6116 Executive Boulevard

Suite 609

Bethesda, Maryland 20892

ncioccam-r@mail.nih.gov

http://cancer.gov/cam

3

continued on next page
During my medical education, I

learned that many commonly used

medicines have herbal origins.

However, conventional medical

education did not include CAM in

its curriculum. My interest in CAM

was revived when I selected the topic

of my doctoral dissertation—CAM

use among HIV-positive women in

association to their clinical disease

indicators. I worked on CAM topics

during my fellowship and am

continuing with it here at OCCAM.

What visions do you have for

the Research Development

and Support Program?

I would like to expand OCCAM’s

extramural research portfolio and see

more robust research in the field of

cancer CAM. Xis can only be

achieved through collaboration—

inter- and trans-disciplinary, within

and outside NIH, and both

nationally and internationally. RDSP

can play an instrumental role in

helping to foster such research

collaborations that can result in

increased recognition of CAM use by

conventional health care

professionals. With more rigorous

and evidence-based research available

in the future, I envision that CAM

will be more recognized and

incorporated as part of conventional

cancer treatments. ❧

Since it was first issued in 2001, the

program announcement (PA) series

“Developmental Projects in

Complementary Approaches to

Cancer Care” has been one of the

most productive mechanisms for

attracting new CAM grants to NCI.

Xe series has included PAR-02-040,

PA-04-053, and the soon to expire

PA-06-400. To replace PA-06-400,

OCCAM has revised this PA, which

has been approved for reissuance and

is expected to be published in May

2009.

Xis new PA will continue to solicit

grant applications that encourage

and support the development of

basic and clinical complementary

cancer research projects (prevention,

therapeutic, and palliative) through

the exploratory/developmental

research grant (R21) award

mechanism. For the first time in the

PA series, the announcement will

also foster innovative research

through two new additions—the

small grant (R03) mechanism and

requests for submissions that focus

on OCCAM’s new cancer CAM

research priority areas.

Xe addition of the small grant

(R03) mechanism allows

investigators the opportunity to

collect preliminary data on CAM

that can provide the basis for future

more extensive research. It also

encourages innovative applications of

CAM approaches and collaborative

research for small research projects as

well as between national and

international studies for comparative

or validation trials. Xese

collaborations are particularly

relevant to CAM practices that have

been identified through the NCI

Best Case Series Program and

warrant NCI-initiated research but

have not ascertained enough data for

a larger project. Examples of such

therapeutic regimens include the

treatment approach of the P. Banerji

Homeopathic Research Foundation,

insulin potentiation therapy, and

macrobiotic lifestyle as per the Kushi

4

from previous page

News from the Field

OCCAM to Reissue Program Announcement but Adds New Priorities

The results of a survey of

CAM practitioners and their

interests and concerns

regarding the care of cancer

patients was published in

the Winter 2009, Volume 7,

Number 1 edition of the

Journal of the Society of

Integrative Oncology. A

similar survey of cancer

researchers regarding CAM

was published last year in

the Winter 2008 edition.

Selected results from both

surveys were presented at

the 2nd International

Conference of the Society

for Integrative Oncology in

October 2005.

U P D A T E

Results of CAM

Practitioners

Survey Published

in JSIO
Institute. Using the R03 mechanism,

these approaches and others can be

explored, creating a channel for

potential promising CAM

interventions to be discovered.

Xe addition of OCCAM’s research

priority areas to this announcement

will encourage rigorous research in

these areas that are not currently

represented in the scientific

knowledge:

1. Novel therapeutics in the

pharmacopoeia of traditional

medical systems, as defined by

the World Health

Organization

2. Complementary medicine

approaches to improve the

therapeutic ratio of standard

and investigational anti-cancer

therapies

NCI has recently published its third

annual report on activities relating to

cancer CAM. Xe report, NCI’s

CAM Annual Report: Fiscal Year

2007, led by the efforts of OCCAM,

covers cancer CAM

communications, training, and

research projects sponsored by NCI

between October 1, 2006 and

September 30, 2007. Xe primary

focus of the report is to present

research highlights from NCI’s

comprehensive grant portfolio.

To provide an overall picture of

NCI’s cancer CAM portfolio, the

projects selected for the report

represent a variety of NCI Divisions,

grant mechanisms, research types,

CAM therapies, research institutions,

and types of cancer. Examples of

project summaries featured in the

report include:

■ Fish Oil Studied for Possible

Prevention and Treatment of

Pancreatic Cancer

■ Green Tea Extract and

Erlotinib Explored for

Prevention of Head and Neck

Cancer

■ Dragon Boat Racing May

Help Cancer Survivors Xrive

In addition to research project

summaries, the report provides

information about other NCI CAM

activities from FY 2007 including

meetings, conferences, and

workshops; cancer CAM

communications products;

and a selected list of peerreviewed journal articles,

which published the

results of NCI grant

awards. Unique to this

year’s report is the

description of NCI’s

CAM portfolio

analysis process.

5

3. Research on lifestyle

modifications (e.g. diet, exercise,

and mind-body approaches) for

their impact on cancer outcomes

(e.g. response to conventional

cancer therapy and survival)

Additional information on this PA will

be available upon its release at

http://grants.nih.gov/grants/guide/

pa-files. For extramural research

questions, please contact Research

Development and Support Program

Director Dr. Isis Mikhail at

mikhaili@mail.nih.gov.

NCI’s Third Annual CAM Report Now Available

NCI's CAM Annual Report for fiscal year

2007 is available on the OCCAM Web

site at

www.cancer.gov/cam/attachments/

CAMAnnualReportFY2007.pdf.
NIH highlighted accomplishments

made in 2008 by NIH-supported

scientists in NIH Research Matters.

Xe following dietary supplement

studies were chosen as clinical

breakthroughs in prevention,

diagnosis, and treatment of human

disease. Xis article is re-printed from

the NIH Research Matters Web site:

www.nih.gov/news/research_matters/

december2008/12152008dietsupl_pr

ostate.htm.

Dietary Supplements Fail to

Prevent Prostate Cancer

Two large-scale clinical trials found

that regular intake of vitamin E,

vitamin C or selenium does not

reduce the risk of prostate cancer or

other cancers in older men, as some

previous studies had suggested.

Prostate cancer is the second-leading

cause of cancer death in American

men. It’s expected to kill about

29,000 people nationwide in 2008,

and about 186,000 new cases are

predicted for this year. Over a decade

ago, a couple of clinical studies

found evidence that prostate cancer

risk might be reduced by taking

vitamin E or selenium supplements,

but these older studies weren’t

specifically designed to answer

questions about prostate cancer.

Smaller studies have hinted that

vitamin C might help to prevent

different types of cancer, but earlier

trials haven’t looked at the effects

that vitamin C alone might have on

prostate cancer in men at usual risk

for the disease.

Xe 2 new studies, funded in part by

NIH’s National Cancer Institute

(NCI) and several other NIH

components, were designed to look

specifically at how prostate cancer

and total cancer risk is affected by

different dietary supplements. Xe

results of both trials were published

on December 9, 2008, in the online

edition of the Journal of the American

Medical Association.

Xe larger study—the Selenium and

Vitamin E Cancer Prevention Trial

(SELECT)—recruited more than

35,000 men, age 50 and older, who

had no evidence of prostate cancer.

Participants were randomly assigned

to receive selenium, vitamin E, the 2

in combination or inactive placebo

pills for comparison. Researchers

originally intended to follow each

participant for at least 7 years. But in

October 2008, after an average

follow-up of about 5.5 years, the

participants were asked to stop

taking their pills. Xat’s because an

independent monitoring committee

found that the supplements seemed

to offer no cancer-related benefits. In

fact, preliminary analyses hinted at

some possible harm.

Overall, the researchers reported no

significant differences between the 4

groups in the rates of prostate cancer

or other types of cancer. Xe men

taking vitamin E alone had a slightly

raised prostate cancer risk, and those

taking selenium trended toward a

higher risk of type 2 diabetes. In

both cases, though, the differences

weren’t large enough to prove they

weren’t due to chance. Although the

study participants are no longer

taking their assigned treatments, the

researchers plan to continue

monitoring their health for at least 3

more years to detect any long-term

effects of supplement use.

Xe second trial, Physicians’ Health

Study II, looked at how the longterm use of vitamin E or C

supplements affect the risk of

prostate or other cancers. More than

14,000 male doctors, age 50 or older,

were randomly assigned to take

either vitamin E, vitamin C, both

vitamins, or a placebo. After an

average follow-up of about 8 years,

the scientists found that neither

vitamin—alone or in combination—

significantly reduced the risk of

prostate or other cancers compared

to the placebo group. No significant

negative effects were associated with

vitamin use.

Xe results of these studies highlight

the fact that, while dietary

supplements can often seem

beneficial in small observational

studies, large, carefully controlled

trials are needed to test whether they

really live up to their hoped-for

benefits. ❧

6

Related stories:

• SELECT Press Release

http://www.cancer.gov/newscenter/pressreleases/SELECTJAMAresults2008

• Prostate Cancer

http://www.nci.nih.gov/cancerinfo/types/prostate/

• Selenium and Vitamin E Cancer Prevention Trial (SELECT)

http://www.cancer.gov/newscenter/pressreleases/SELECTQandA

• Supplementing Your Diet: Vitamins, Minerals and Beyond

http://newsinhealth.nih.gov/2006/March/docs/01features_01.htm

Dietary Supplement Studies Listed as One of NIH’s 2008 Clinical Breakthroughs
Program Announcement for

Basic and Preclinical CAM

Research Reissued

In October 2008, NCI, NCCAM,

and ODS published the Program

Announcement (PA) PA-09-010,

“Basic and Preclinical Research on

Complementary and Alternative

Medicine (CAM) (R01).” A reissue

of PA-07-007, this announcement’s

purpose is to encourage researchers

to study CAM with an aim of

understanding the mechanisms and

the biomedical scientific basics

behind CAM clinical practices.

Xere are four categories into which

these practices can be grouped:

mind-body medicine, biologically

based practices, manipulative and

body-based practices, and energy

medicine. Xe focus should be on

basic, mechanistic, and preclinical

research. NCI is particularly

interested in interactions between

bioactive dietary components and

CAM modalities.

Researchers are encouraged to

contact the program directors listed

for each participating Institute prior

to submitting their applications. Xe

NCI contact for this PA is

Cindy Davis, Ph.D., of the

Nutritional Science Research Group;

contact Dr. Davis at

davisci@mail.nih.gov. OCCAM

welcomes questions as well; contact

Research Development and Support

Program Director Dr. Isis Mikhail at

mikhaili@mail.nih.gov.

For more information on this PA,

visit

http://grants.nih.gov/grants/guide/

pa-files/PA-09-010.html.

Xe National Cancer Institute

(NCI), the National Center for

Complementary and Alternative

Medicine (NCCAM), and the Office

of Dietary Supplements (ODS) have

released RFA-OD-09-001, titled

“Dietary Supplement Research

Centers: Botanicals (P50).” Xe

purpose of this Request for

Applications (RFA) is to promote

collaborative interdisciplinary study

of botanicals, particularly those used

in dietary supplements. Xis

initiative is intended to advance the

spectrum of botanical research

activities, ranging from plant

identification and characterization to

early phase clinical studies.

Xe NCI Division of Cancer

Prevention is interested in supporting

research focused on the mechanisms

by which botanically derived

bioactive food components might

influence cancer risk and tumor

behavior. Only investigators who

submitted a pre-application in

response to PAR-09-091 and

received notification are eligible to

submit full applications under this

RFA.

Botanicals of particular interest

include traditional herbal medicines

or phytomedicines (e.g., ginkgo,

echinacea, valerian), many of which

are widely available in the U.S. as

dietary supplements. Xis RFA also

supports research on foods of plant

origin (e.g., cranberry, broccoli,

garlic) which by virtue of biologically

active components may provide

health benefits beyond basic

nutrition; these bioactive

constituents are appearing with

increasing frequency as ingredients in

dietary supplements.

For more information, review the

following announcement at

http://grants.nih.gov/grants/guide/

rfa-files/RFA-OD-09-001.html or

contact Dr. Harold Seifried at

seifrieh@mail.nih.gov.

7

Funding Opportunities

Request for Applications on Botanical

Supplements Released

RFA-OD-001 supports research on foods of plant origin such as broccoli.
Pancreatic cancer affects around

37,000 Americans a year. It is

difficult to detect and is considered

largely incurable. Xe American

Cancer Society estimates the oneyear survival rate is 20% and the fiveyear rate is 10%.

NCI and the National Institute on

Alcohol Abuse and Alcoholism

released PA-08-032, “Molecular

Approaches to Diet and Pancreatic

Cancer Prevention (R01),” which is a

re-release of PA-07-257. Xe goal of

this PA is to encourage researchers

who have ideas for “innovative

preclinical and clinical studies to

determine how dietary energy intake

and bioactive food components,

including alcohol, influence

pancreatic cancer development and

prevention.”

Xe agencies releasing the PA hope to

promote collaboration among

“nutritional scientists, cancer

biologists, oncologists and

gastroenterologists to jointly examine

key mechanisms in the pancreatic

cancer process”. Examples of

appropriate research ideas include,

but are not limited to, the following:

■ Nutritional genomic,

epigenomic, proteomic, and

metabolomic approaches to

examining energy metabolism

and/or bioactive food

component activity in relevant

pancreatic cancer models;

■ Relationship between diet,

genetic polymorphisms (e.g.,

enzymes that influence energy

metabolism) and pancreatic

cancer risk.

■ Mechanistic studies on the

impact of oxidative stress,

dietary antioxidants in

pancreatic cancer (e.g.,

apoptosis, IGF-1 signaling);

■ Understanding synergistic

relationships between

bioactive food components in

signaling pathways relevant to

pancreatic cancer;

■ Development of relevant

animal models for pancreatic

cancer and application of such

models to studies on dietary

prevention of pancreatic

cancer; and

■ Understanding the molecular

mechanisms by which dietary

fat, oxidative stress,

acetaldehyde, cytokines, and

other factors contribute to the

pathogenesis of chronic

alcoholic pancreatitis.

For more information on this PA,

contact NCI’s Division of Cancer

Prevention Program Director

Dr. Sharon Ross at

rossha@mail.nih.gov and visit

http://grants.nih.gov/grants/guide/

pa-files/PA-08-032.html. ❧

8

Xe National Institutes of Health

(NIH) has a world-renown peer

review system designed to enable

NIH to assess the merit of each grant

application in a consistent and nonbiased way. After a year of

assessment, NIH identified four

priority areas of change needed for

the current peer review system:

engaging the best reviewers;

improving the quality and

transparency of review; ensuring

balanced and fair reviews across

scientific fields and career stages,

while reducing administrative

burden; and continuing to review the

system of peer review. Enhancements

to the NIH peer review system based

on the priority areas are now

underway.

NIH’s Center for Scientific Review

has been setting the stage for these

changes with both NIH staff and the

broader scientific research

community through

communications such as policy notices

in the Guide for Grants and Contracts,

briefings to NIH Councils, training for

NIH staff, press releases, newsletter

articles, and listserv communications.

In addition to providing these

resources, the Enhancing Peer Review

Web site is continually updated with

new content, such as a video

presentation that was posted in March

2009. Scientific Review Officers have

been communicating with reviewers

and preparing them for the training

Research Resources

Pancreatic Cancer Prevention Supported 9rough Program Announcement

What’s New with NIH Peer Review?
continued on next page

9

they will receive as the spring review

meetings commence.

For an overview of the timetable for

implementing the changes to the

peer review system, see NOT-OD09-023

(http://grants.nih.gov/grants/guide/no

tice-files/NOT-OD-09-023.html).

For more information, please visit

the Enhancing Peer Review Web site

at http://enhancing-peerreview.

nih.gov.

Learn More About NCI

Funded Research Projects

Each year, NCI supports

approximately 450 cancer CAM

research projects. If you are

interested in learning more about

these NCI projects or other CAM

research projects funded by other

Institutes at NIH, you will find

multiple federal Web sites and

databases designed to help in your

search. Xree public resources that

are available to help you to locate

this type of information are the

Research Portfolio Online Reporting

Tool (RePORT)

(http://report.nih.gov/index.aspx),

Computer Retrieval of Information

on Scientific Projects (CRISP)

(http://report.nih.gov/crisp/

index.aspx), and the NCI Funded

Research Portfolio

(http://fundedresearch.cancer.gov/).

RePORT

RePORT is an NIH Web site that

provides access to reports, data, and

analyses related to the comprehensive

NIH research portfolio. Launched in

February 2008, RePORT includes

the NIH biennial report, strategic

plans for the individual NIH

Institutes and Centers, budget and

spending information, success rates,

funded investigators, and extramural

institution data. It also showcases the

NIH’s new, consistent and

transparent process for categorizing

and reporting research projects called

the Research, Condition, and Disease

Categorization (RCDC). RCDC uses

215 categories to describe research

projects, one of which is

Complementary and Alternative

Medicine.

By selecting Categorical Spending

from the RePORT home page, you

can find the RCDC table, which

displays fiscal year funding amounts

for grants, contracts, and other

funding mechanisms. By clicking on

the FY 2008 Actual link in the

category Complementary and

Alternative Medicine, the system will

populate a list of all of the NIHfunded CAM projects. You will find

the name of the primary funding

NIH Institute, project number,

project title, principle investigator’s

name, institution, state, and funding

amount available for each project.

CRISP

RePORT now also hosts the CRISP

database. CRISP contains

information on federally funded

research projects and programs

supported by agencies within the

Department of Health and Human

Services (DHHS). Xese research

projects are primarily extramural and

are conducted by universities,

hospitals, and other research

institutions. In addition to

information on extramural projects,

grants, contracts, and cooperative

agreements, you will also find

information on intramural programs

of the NIH and U.S. Food and Drug

Administration.

Xe best way to search CRISP for

cancer CAM projects funded by NCI

is to choose NCI from the Institutes

and Centers list and use the Search

Terms box to search for specific

topics within CAM. Watch over the

next year for new features in CRISP,

as the database is updated to include

budget information and links to

publications and patents that are a

result of the NIH-funded research.

NCI Funded Research Portfolio

If you are only interested in locating

information about NCI research

projects, use the NCI Funded

Research Portfolio, which was

introduced last summer as a

replacement for the Cancer Research

Portfolio. Xe search functions and

overall navigation make this database

a user-friendly way to access

information about NCI-funded

research grants, contract awards, and

intramural research projects.

To find grants investigating a specific

CAM therapy, for example

acupuncture, use the keyword search

on the home page. Xe Portfolio’s

Advanced Search page allows you to

search more specifically with options

including: fiscal year, research topic,

project type, cancer type, funding

mechanism, NCI Division, project

number, principal investigator, and

research institution.

To locate information on CAM

using the Advanced Search page,

select one of the following

complementary and alternative

approaches drop-downs under

Research Type (Common Scientific

Outline [CSO]):

■ Complementary and

Alternative Prevention

Approaches
■ Complementary and

Alternative Treatment

Approaches

■ Complementary and

Alternative Approaches for

Supportive Care of Patients

and Survivors

Xe above list does not include all of

NCI’s CAM projects, so also try

searching other Research Types

including:

■ Behavior Related to Cancer

Control

■ Interventions to Prevent

Cancer: Personal Behaviors

that Affect Cancer Risk

■ Nutritional Sciences

■ Patient Care & Survivorship

Issues

Before you begin, determine whether

you want to search for NCI-funded

projects or projects funded by other

Institutes at NIH. Xese three

resources will provide helpful

instructions and answers to

frequently asked questions to guide

you as you search. ❧

Vitamin C is commonly known to

be essential to human health.

However, specifically as it relates to

cancer treatment, the value of

vitamin C is debated and often

considered a topic of scientific

controversy. Cancer researchers have

investigated various ways of

administering high-dose vitamin C,

including both orally and

intravenously. Researchers have also

examined different forms of vitamin

C—ascorbic acid (AA) and

dehydroascorbic acid (DHA)—

which may well be a comparison of

apples and oranges.

Research Highlights

10

In 1952, William J. McCormick, M.D.

speculated that vitamin C could be

useful as an anti-cancer agent by

strengthening collagen and thereby

preventing the spread of metastases.

Xe idea was revisited in the early

1970s by Ewan Cameron, M.D. and

his Scottish colleagues. Xey

administered high dose AA to patients

with advanced cancer. Linus Pauling,

Ph.D., winner of two Nobel prizes,

and Cameron coauthored two

retrospective case series that

suggested high doses of vitamin C as

a treatment agent substantially

prolonged life and improved well

being in some patients with

advanced cancer. However, two

from previous page

Vitamin C as a Potential Anti-Cancer Agent: Progress and Controversies

Researchers Debate the Role of IV Vitamin C as a Cancer Treatment

double-blind, placebo-controlled

clinical trials performed in the late

1970s and early 1980s at the Mayo

clinic showed no anti-cancer effects

from high-dose vitamin C, and

interest in the field waned.

More recent research shed light on

why the Mayo clinic trials were not

History of Vitamin C Research
comparable to the earlier case series

of Cameron and Pauling. Cameron

administered AA both orally and

intravenously, but the Mayo clinic

investigators used only oral AA.

Research over the past decade has

shown that vitamin C concentrations

in humans are carefully regulated, in

part by diminished absorption in the

intestine as doses increase.

Intravenous administration produces

concentrations that can be more than

100 fold higher than concentrations

produced by maximal oral doses.

Xus, most of the 10 gram oral dose

administered in the Mayo clinic

trials—approximately 100 times the

Recommended Dietary Allowance—

would have been directly excreted,

unable to reach the targeted cancer

cells.

Current Research

Recently, researchers at NIH have

revisited the potential of vitamin C

as an anti-cancer agent. To

circumvent the absorption problem

seen with oral dosing, researchers

from the NIH’s National Institute of

Diabetes and Digestive and Kidney

Diseases (NIDDK), led by Mark

Levine, M.D., tested intravenous or

intraperitoneal injections of highdose AA in mouse models of ovarian

cancer, pancreatic cancer, and

glioblastoma.

In all three tumor types, the

injections reduced tumor growth by

approximately half compared with

untreated mice. In addition,

metastases were found in about 30

percent of untreated mice, but in

none of the mice injected with AA.

Xe study was published in the

August 12, 2008 Proceedings of the

National Academy of Science.

In additional work, investigators at

the University of Kansas Medical

Center led by Jeanne Drisko, M.D.,

were able to achieve similar

concentrations of AA as those

achieved in the mice by using

intravenous injections in human

subjects with ovarian cancer. Xis

work has since been confirmed in a

phase I clinical trial led by L. John

Hoffer, M.D., Ph.D.

“Xe way that the body handles oral

and intravenous vitamin C

differently raises the question of

whether or not the clinical trials that

were done with only the oral

formulation were adequate to help us

understand the role, if any, vitamin

C has in cancer treatment,” said Dr.

Jeffrey D. White, director of

OCCAM.

More questions were recently raised

by a study from the Memorial SloanKettering Cancer Center about using

vitamin C in combination with

traditional chemotherapeutic drugs.

In that study led by Mark Heaney

M.D., Ph.D., published in the

October 1, 2008 issue of Cancer

Research, investigators injected

tumor-bearing mice with a

combination of DHA, the oxidized

form of vitamin C, and the

chemotherapy drug doxorubicin.

Xey found that mice receiving the

combination had tumors four times

larger than the tumors in mice

treated with doxorubicin alone.

Corresponding studies in cell lines

suggested that the DHA may have

protected the cancer cells’

mitochondria from doxorubicininduced damage.

Incomparable Results

In assessing the value of vitamin C as

a cancer treatment, comparisons of

the NIDDK and Memorial SloanKettering studies have been made.

However, there are some problems

with making these comparisons. Two

different forms of vitamin C, AA and

DHA, were used in the studies. Xe

studies had different aims. One

looked at AA’s anti-cancer effects as a

stand-alone therapy, while the other

looked at the effects of DHA when

used with certain chemotherapy

agents. In addition, different dose

ranges were examined, which would

be similar to comparing

pharmaceutical concentrations of

vitamin C levels to that of an oral

supplement.

Dr. Levine’s laboratory is planning

further preclinical studies to measure

the effects of AA injections in

combination with chemotherapy

agents and to understand the

mechanisms behind why high-dose

AA affects some cancer cells but not

normal cells. He hopes to use that

information “to figure out which

types of cancer may be sensitive to

ascorbate [AA] and which wouldn’t

be,” he explained. In addition, in the

near future, “We think this work

needs to go forward to targeted

clinical trials, and we’re looking for

clinical partners to help us do that,”

said Dr. Levine.

Whether these DHA results in mice

will translate to intravenous AA

injections in people remains to be

determined, said Dr. Heaney. “I

think vitamin C could turn out to be

something of a double-edged sword.

DHA may protect tumor cells, and

depending on how you’re giving AA,

there are times when it may have

some therapeutic properties.” ❧

11
CAM Information

For the past decade, OCCAM has

successfully worked to stimulate

cancer CAM research by focusing

much of its communication efforts

on cancer researchers and CAM

practitioners. For the next ten years,

OCCAM has made a commitment

to continue its progress in research

while expanding its efforts in the area

of patient outreach and

communication. Xe goals outlined

to address this commitment include

positioning NCI as the authoritative

and unbiased voice on the topic of

cancer CAM. To meet this goal,

OCCAM will produce additional

resources for cancer patients that will

fill in the existing information gaps

and address cancer patients’

information needs.

In order to develop resources that

will best serve the needs of patients,

OCCAM will conduct a qualitative

needs assessment to identify the

CAM issues and topics most

important to cancer patients. “We

recognize the need for improved

patient communication and

information on cancer and CAM.

Xe information collected in our

assessment will help shape a dialogue

about cancer patients’ needs related

to CAM. It will also help us

determine high priority areas for new

patient-focused publications and

resources.” said Dr. Jeffrey D. White,

director of OCCAM.

To prepare for the needs assessment,

OCCAM reviewed the following:

■ existing information resources

that NCI and other agencies

offer on cancer CAM

■ data from focus groups that

addressed cancer patients and

caregivers cancer CAM

information needs

■ literature published in peerreviewed journals on cancer

patients’ information-seeking

behaviors

OCCAM’s qualitative needs

assessment will target groups who

work closely with patients including

cancer patient educators, oncology

social workers, nurses, and patient

advocates. After analyzing the results,

OCCAM hopes to work with

representatives from these and other

groups to produce resources that will

meet the needs identified. ❧

Ten-Year Mark Brings New Commitment to Patients’ CAM Information Needs

Sign-up for OCCAM’s Listserv

Stay up-to-date on the latest cancer CAM news at NCI with OCCAM’s

listserv, OCCAM Announcements. As a listserv subscriber, you will

receive a monthly email about upcoming workshops and lectures, new

funding opportunities, publications, and other resources. To subscribe,

simply visit OCCAM’s Web site:

http://cancer.gov/cam/news/occam-announcements.html

12
Meetings

Libin Jia, M.D., health scientist

administrator in the Office of the

Director at OCCAM, attended two

conferences in China during October

2008. Xe first was sponsored by the

Cancer Foundation of China, titled

“Xe Progress and Prospect of

Traditional Chinese Medicine

(TCM) Cancer Xerapy and

Prevention.” Xe conference was held

from October 22-24, in Zhangjiajie,

Hunan Province. Dr. Jia was invited

to the conference by the Foundation

to share the projects on CAM and

cancer that NCI is currently

supporting, particularly on TCM

related to cancer therapy or

prevention. Xe attendees, who were

primarily doctors trained in

conventional medicine, were

interested in learning about

OCCAM’s projects and updated

Web site. During this meeting, Dr.

Jia also learned about current TCM

cancer research in China.

Xe second conference was the “2nd

International Congress of TCM and

Integrated TCM-Western Medicine

(WM) Oncology”, held in Beijing on

October 24-26. Dr Jia was invited by

the World Federation of Chinese

Medicine Society to be a plenary

session speaker and a chairperson. In

his talk, Dr. Jia again gave an

overview of current NCI investments

in CAM and cancer. He discussed

specific projects, which highlight the

importance of scientific research on

TCM drug mechanisms. For

example, he talked about the

successful cooperative study on

Sheng Qi Formula taking place

between NCI and Guang An Men, a

hospital in Beijing. Xis

collaboration has led to some new

findings on the regulatory function

of this TCM drug on the immune

system.

During his travels, Dr. Jia also had

the opportunity to meet with Dr.

Hongsheng Lin, chairman of the

Beijing meeting and the chief of the

Oncology Department at the Guang

An Men hospital of the China

Academy of Chinese Medical

Sciences. Xey discussed the

continuation of cooperative research

between NCI and Guang An Men

hospital, future TCM-related

projects, postdoctoral training

offered by NCI, and information

exchange between two institutions.

Meetings Fruitful for NCI Collaborations with China

For the past five years, NCI has

provided grant support for the

international conference of the

Society of Integrative Oncology

(SIO). Xe 2008 conference was held

in Atlanta, Georgia in November and

was supported, in part, by an R13

conference grant from OCCAM.

Xis 2-day meeting drew almost 225

attendees and included presentations

and discussions on recent advances in

the field covering topics such as

botanicals, Traditional Chinese

Medicine (TCM), CAM therapies

for symptom management, and

integrative survivorship.

Isis Mikhail, M.D., M.P.H., Dr.P.H.,

director of OCCAM’s Research

Development and Support Program,

commented about her experience as a

first time attendee, “I was working

previously at OCCAM when SIO

was in the early stages of being

established. I was glad to see the

organization fully operational and

witness the number of attendees

interested in cancer CAM research.”

Opening day topics on integrative

oncology included research

challenges, communication issues,

addressing the whole person, and

practical implications. Dr. Mikhail

commented on the conference

program, “Several of the session

topics corresponded to OCCAM’s

research priority areas, specifically the

ones on botanicals and TCM.”

Two of NCI’s staff members were

part of the conference program.

John Milner, Ph.D., chief of the

Nutritional Science Research Group,

gave a presentation titled “Nutrition

for the Cancer Survivor.” Joseph

Kelaghan, M.D., M.P.H., of the

Community Oncology and

Prevention Trials Research Group,

gave an update on NCI’s

Community Clinical Oncology

Program.

Xe program, abstracts, and selected

videos from the 2008 conference are

available on the SIO Web site at

www.integrativeonc.org/events.html.

SIO’s 6th International Conference

will take a place in New York City on

November 12-13, 2009.

Five Years of NCI Funding Support for SIO’s International Conference

13
On February 25-27, 2009, the

Institute of Medicine (IOM), in

partnership with Xe Bravewell

Collaborative, held a summit to

examine the role that integrative

medicine (IM), a marriage between

conventional medicine and CAM

therapies, can play in the nation’s

health agenda. Xe three-day summit

gathered participants from academia,

clinical centers, advocacy

organizations, government agencies,

health insurance providers, as well as

patients. Xe main purpose of the

summit was to bring the different

parties together to share knowledge

and work toward U.S. health reform

that includes IM.

Dr. Harvey V. Fineberg, president of

the IOM, opened the summit by

reflecting on the current state of IM

and providing the many different

dimensions of IM. As Dr. Fineberg

described it, IM:

■ Fulfills the World Health

Organization (WHO)

definition of health: “A state of

complete physical, mental, and

social well-being, and not

merely the absence of disease”

■ Extends across the whole

spectrum of medicine,

caregivers, and institutions

■ Focuses on the individual to

create patient-centered care

■ Conveys openness to multiple

modalities of care

Xe summit’s keynote addresses and

panel discussions covered topics such

as innovative health care models, the

science of IM, current and future

health care workforce and education

needs, and the economic state of the

U.S. health care system. Speakers

included Senator Tom Harkin (DIA), Dean Ornish, M.D., and

Mehmet Oz, M.D. Over the course

of three days, the summit addressed

the definition of IM, how to

incorporate IM into conventional

medicine, and how to use the

concept of IM to advance health

reform in the U.S. A review of all of

the panel discussions and a

commitment to produce a thorough

meeting summary ended the

summit. Xe agenda, presentation

slides, white papers, and videocast of

the summit are available on IOM’s

Web site:

www.iom.edu/CMS/28312/

52555.aspx.

During the same week as the

summit, the Senate Committee on

Health, Education, Labor and

Pensions held two hearings to discuss

IM. Xe hearings were chaired on

Monday, February 23 by Senator

Barbara Mikulski (D-MD) and on

Xursday, February 26 by Senator

Michael B. Enzi (R-WY), the

ranking member of the Committee;

Senator Harkin; and Senator

Mikulski. Each hearing had a panel

with four IM experts, who gave

opening statements and then

answered questions posed by the

attending Senators. Several of the

panelists were also speakers at the

IOM summit, including Dr. Oz and

Dr. Ornish. Panelists commented on

the need for a special office in the

White House to oversee health

reform and the importance of health

coaches to insure a continuum of

care for patients. ❧

IOM and U.S. Senate Hold Events on Integrative Medicine

14

New NCI Factsheet!

Calcium and Cancer

Prevention:

Strengths and Limits of the

Evidence

Xis factsheet discusses whether a

relationship exists between higher

calcium intakes and reduced risks of

certain types of cancer.

www.cancer.gov/cancertopics/factsheet/prevention/calcium
15

OCCAM’s Monthly Lecture Series

>e OCCAM Monthly Lecture Series will be held

from 1:00 – 2:00 pm ET

on the second Wednesday of each month at

6130 Executive Plaza

1st Floor, Conference Room H

Bethesda, MD 20892

Date

May 13, 2009

June 10, 2009

July 8, 2009

August 12, 2009

September 9, 2009

Speaker

Dr. Ming You

Department of Surgery,

Washington State University

Dr. Mian Ying

Department of Pathology,

University of Illinois College of

Medicine

Dr. Wei Jia

Department of Nutrition,

University of North Carolina at

Greensboro

Dr. Constantinos Koumenis

Department of Radiation

Oncology, University of

Pennsylvania

Dr. Susan Zunino

United States Department of

Agriculture, California

Topic

Anti-tumor B and Lung Cancer

Breast Cancer Prevention and

Treatment With Noni Juice

To Be Determined

Phenolic Antioxidants as Tumor

Radio/Chemosensitizers

Evaluation of Resveratrol and

Curcumin as Xerapeutics

Against High Risk Leukemia

Upcoming Lectures
To obtain a copy of this newsletter or for inquiries on

cancer and CAM, please contact

1-800-4-CANCER (1-800-422-6237).

NIH Publication No. 09-5854

April 2009

16

Date Meeting Location OCCAM Staff

Attending

April 6-9, 2009

April 18-22, 2009

May 12-15, 2009

May 29-June 2, 2009

September 8-11, 2009

November 12-13,

2009

8th Annual Oxford International

Conference on the Science of

Botanicals*

American Association for

Cancer Research Annual

Meeting*

North American Research

Conference on Complementary

and Integrative Medicine*

American Society for Clinical

Oncology Annual Meeting

NIH Mind-Body Week

Society for Integrative

Oncology*

Oxford, MS

Denver, CO

Minneapolis, MN

Orlando, FL

Bethesda, MD

New York City, NY

Shea Buckman

Dr. Isis Mikhail

Dr. Libin Jia

Dr. Isis Mikhail

Shea Buckman

Dr. Farah Zia

Lauren Rice

Shea Buckman

Dr. Isis Mikhail

*Indicates that an OCCAM staff member will be at the NCI or OCCAM exhibit booth.

Featured Scientific Meetings