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[Congressional Record Volume 158, Number 127 (Wednesday, September 19, 2012)]
[House]
[Pages H6144-H6147]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

                RECALCITRANT CANCER RESEARCH ACT OF 2012

  Mr. PITTS. Mr. Speaker, I move to suspend the rules and pass the bill 
(H.R. 733) to amend the Public Health Service Act to provide for a 
Pancreatic Cancer Initiative, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 733

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Recalcitrant Cancer Research 
     Act of 2012''.

     SEC. 2. SCIENTIFIC FRAMEWORK FOR RECALCITRANT CANCERS.

       Subpart 1 of part C of title IV of the Public Health 
     Service Act (42 U.S.C. 285 et seq.) is amended by adding at 
     the end the following:

     ``SEC. 417G. SCIENTIFIC FRAMEWORK FOR RECALCITRANT CANCERS.

       ``(a) Development of Scientific Framework.--
       ``(1) In general.--For each recalcitrant cancer identified 
     under subsection (b), the Director of the Institute shall 
     develop (in accordance with subsection (c)) a scientific 
     framework for the conduct or support of research on such 
     cancer.
       ``(2) Contents.--The scientific framework with respect to a 
     recalcitrant cancer shall include the following:
       ``(A) Current status.--
       ``(i) Review of literature.--A summary of findings from the 
     current literature in the areas of--

       ``(I) the prevention, diagnosis, and treatment of such 
     cancer;
       ``(II) the fundamental biologic processes that regulate 
     such cancer (including similarities and differences of such 
     processes from the biological processes that regulate other 
     cancers); and
       ``(III) the epidemiology of such cancer.

       ``(ii) Scientific advances.--The identification of relevant 
     emerging scientific areas and promising scientific advances 
     in basic, translational, and clinical science relating to the 
     areas described in subclauses (I) and (II) of clause (i).
       ``(iii) Researchers.--A description of the availability of 
     qualified individuals to conduct scientific research in the 
     areas described in clause (i).
       ``(iv) Coordinated research initiatives.--The 
     identification of the types of initiatives and partnerships 
     for the coordination of intramural and extramural research of 
     the Institute in the areas described in clause (i) with 
     research of the relevant national research institutes, 
     Federal agencies, and non-Federal public and private entities 
     in such areas.
       ``(v) Research resources.--The identification of public and 
     private resources, such as patient registries and tissue 
     banks, that are available to facilitate research relating to 
     each of the areas described in clause (i).
       ``(B) Identification of research questions.--The 
     identification of research questions relating to basic, 
     translational, and clinical science in the areas described in 
     subclauses (I) and (II) of subparagraph (A)(i) that have not 
     been adequately addressed with respect to such recalcitrant 
     cancer.
       ``(C) Recommendations.--Recommendations for appropriate 
     actions that should be taken to advance research in the areas 
     described in subparagraph (A)(i) and to address the research 
     questions identified in subparagraph (B), as well as for 
     appropriate benchmarks to measure progress on achieving such 
     actions, including the following:
       ``(i) Researchers.--Ensuring adequate availability of 
     qualified individuals described in subparagraph (A)(iii).
       ``(ii) Coordinated research initiatives.--Promoting and 
     developing initiatives and partnerships described in 
     subparagraph (A)(iv).
       ``(iii) Research resources.--Developing additional public 
     and private resources described in subparagraph (A)(v) and 
     strengthening existing resources.
       ``(3) Timing.--
       ``(A) Initial development and subsequent update.--For each 
     recalcitrant cancer identified under subsection (b)(1), the 
     Director of the Institute shall--
       ``(i) develop a scientific framework under this subsection 
     not later than 18 months after the date of the enactment of 
     this section; and
       ``(ii) review and update the scientific framework not later 
     than 5 years after its initial development.
       ``(B) Other updates.--The Director of the Institute may 
     review and update each scientific framework developed under 
     this subsection as necessary.
       ``(4) Public notice.--With respect to each scientific 
     framework developed under subsection (a), not later than 30 
     days after the date of completion of the framework, the 
     Director of the Institute shall--
       ``(A) submit such framework to the Committee on Energy and 
     Commerce and Committee on Appropriations of the House of 
     Representatives, and the Committee on Health, Education, 
     Labor, and Pensions and Committee on Appropriations of the 
     Senate; and
       ``(B) make such framework publically available on the 
     Internet website of the Department of Health and Human 
     Services.
       ``(b) Identification of Recalcitrant Cancer.--
       ``(1) In general.--Not later than 6 months after the date 
     of the enactment of this section, the Director of the 
     Institute shall identify two or more recalcitrant cancers 
     that each--
       ``(A) have a 5-year relative survival rate of less than 20 
     percent; and
       ``(B) are estimated to cause the death of at least 30,000 
     individuals in the United States per year.
       ``(2) Additional cancers.--The Director of the Institute 
     may, at any time, identify other recalcitrant cancers for 
     purposes of this section. In identifying a recalcitrant 
     cancer pursuant to the previous sentence, the Director may 
     consider additional metrics of progress (such as incidence 
     and mortality rates) against such type of cancer.
       ``(c) Working Groups.--For each recalcitrant cancer 
     identified under subsection (b), the Director of the 
     Institute shall convene a working group comprised of 
     representatives of appropriate Federal agencies and other 
     non-Federal entities to provide expertise on, and assist in 
     developing, a scientific framework under subsection (a). The 
     Director of the Institute (or the Director's designee) shall 
     participate in the meetings of each such working group.
       ``(d) Reporting.--
       ``(1) Biennial reports.--The Director of NIH shall ensure 
     that each biennial report under section 403 includes 
     information on actions undertaken to carry out each 
     scientific framework developed under subsection (a) with 
     respect to a recalcitrant cancer, including the following:
       ``(A) Information on research grants awarded by the 
     National Institutes of Health for research relating to such 
     cancer.
       ``(B) An assessment of the progress made in improving 
     outcomes (including relative survival rates) for individuals 
     diagnosed with such cancer.
       ``(C) An update on activities pertaining to such cancer 
     under the authority of section 413(b)(7).
       ``(2) Additional one-time report for certain frameworks.--
     For each recalcitrant cancer identified under subsection 
     (b)(1), the Director of the Institute shall, not later than 6 
     years after the initial development of a scientific framework 
     under subsection (a), submit a report to the Congress on the 
     effectiveness of the framework (including the update required 
     by subsection (a)(3)(A)(ii)) in improving the prevention, 
     detection, diagnosis, and treatment of such cancer.
       ``(e) Recommendations for Exception Funding.--The Director 
     of the Institute shall

[[Page H6145]]

     consider each relevant scientific framework developed under 
     subsection (a) when making recommendations for exception 
     funding for grant applications.
       ``(f) Definition.--In this section, the term `recalcitrant 
     cancer' means a cancer for which the five-year relative 
     survival rate is below 50 percent.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Pennsylvania (Mr. Pitts) and the gentlewoman from California (Ms. 
Eshoo) each will control 20 minutes.
  The Chair recognizes the gentleman from Pennsylvania.

                             General Leave

  Mr. PITTS. Mr. Speaker, I ask unanimous consent that all Members have 
5 legislative days within which to revise and extend their remarks and 
insert extraneous materials in the Record on H.R. 733.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Pennsylvania?
  There was no objection.
  Mr. PITTS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today to support H.R. 733, the Recalcitrant 
Cancer Research Act of 2012.
  This act will bring new hope to patients with cancers.
  It is never easy to lose someone to cancer, but it is especially 
difficult when you are not even given a fighting chance.
  Cancers with low survival rates and poor outcomes have baffled 
researchers for more than 40 years. These are recalcitrant cancers.
  While survival rates for many cancers have climbed from 50 percent to 
67 percent, there are still cancers that have yet to reach the 50 
percent benchmark.
  While there are various types of cancers that fall under this 
definition, nearly half of the 577,190 cancer deaths expected in 2012 
will be caused by eight deadly cancers, including pancreatic and 
ovarian cancer.

                              {time}  2130

  This bill will direct the National Cancer Institute to establish a 
scientific framework for the study of recalcitrant cancers. Working 
groups will be appointed to prepare the framework that will include a 
review of current research and identification of key research questions 
and a summary of promising discoveries. The NIH would then be required 
to issue a report to Congress with recommendations on the effectiveness 
of the scientific framework model so that we can ensure that progress 
is being made and determine whether this type of model should be 
expanded to other types of diseases and conditions.
  I urge my colleagues to vote in support of the legislation, and I 
reserve the balance of my time.
  Ms. ESHOO. Mr. Speaker, I rise in support of my legislation, H.R. 
733, which was originally named the Pancreatic Cancer Research and 
Education Act, which has now been renamed to be the Recalcitrant Cancer 
Research Act of 2012.
  I first introduced this bill in the 110th Congress in honor of a very 
dear friend, Ambassador Richard Sklar, who was a victim of this 
devastating disease.
  Pancreatic cancer is a disease from which very few people survive. 
It's essentially a death sentence. It's because of the families, their 
friends, neighbors, doctors, and coworkers who have advocated for much 
better research and treatments that we've made it to the finish line 
legislatively and that we are here this evening.
  Sadly, the outcomes for those with pancreatic cancer have remained 
relatively unchanged since the passage of the National Cancer Act 
nearly 40 years ago. Only 6 percent of people diagnosed with the 
disease live longer than 5 years. Let me say that again. Only 6 percent 
of people diagnosed with pancreatic cancer live longer than 5 years; 75 
percent die within a year of diagnosis. Pancreatic cancer remains one 
of the most lethal types of cancers, even as survival rates for other 
cancers have increased.
  The Pancreatic Cancer Research and Education Act, which I introduced 
with my wonderful colleague, a real gentleman of the House, 
Representative Leonard Lance, directs the National Cancer Institute, 
the NCI, to develop a long-term strategic plan for addressing the 
disease, bringing together the finest minds in our country with the 
best expertise in this area. The plan will be used by the agency as a 
roadmap for navigating the best way forward in research for early 
detection, for new diagnostic tools, treatment therapies, and even 
cures.
  While pancreatic cancer is one of the most devastating of all 
recalcitrant cancers, or those with a high mortality rate and few 
treatments, it's certainly not the only cancer that needs increased 
attention. That's why I've worked closely with my colleagues on both 
sides of the aisle to expand our legislation to include all 
recalcitrant cancers so that we can make progress in other areas, too.
  I'm exceedingly proud to say that this bill enjoys the bipartisan 
cosponsorship of 293 Members of the United States House of 
Representatives. I want to thank Chairman Upton, Fred Upton, whom I 
cajoled, whom I pestered, whom I pleaded with, whom I constantly kept 
after. He reminded me that I needed patience. I kept reminding him that 
I've been at it for 6 years. But he listened, and I appreciate that and 
I salute him for it.
  To the ranking member of the full committee, Mr. Waxman, to the 
staffs of the majority, both the Health Subcommittee, the full 
committee majority staff and the minority staff, I want to thank them 
as well, because without them we really cannot get our work done.
  I also want to say how proud I am and grateful I am for the efforts 
of the pancreatic cancer advocates who had the courage to share their 
painful stories with their Representatives and educate them about the 
importance of this legislation. I would also like to make mention of 
Senator Sheldon Whitehouse, who is the author in the other body and has 
been a marvelous advocate and carrier of this legislation. And last but 
not least, I'd like to pay tribute to Erin Katzelnick-Wise of my staff, 
who, for all of this time--over three Congresses--has worked diligently 
and vigorously and loyally on this bill.
  I look forward to seeing H.R. 733 signed into law by the President so 
that we can begin the important work of finding a cure for pancreatic 
cancer, as well as the other cancers that take the lives of our fellow 
Americans every day. I think with the passage of this and the signature 
of it, the American people will say, at last, at last the Congress has 
acted on a bipartisan basis on something that is of utmost importance 
and urgency to the American people.
  With that, Mr. Speaker, I reserve the balance of my time.
  Mr. PITTS. Mr. Speaker, at this time I would like to yield 3 minutes 
to the chair of the full committee, the gentleman from Michigan (Mr. 
Upton).
  Mr. UPTON. Mr. Speaker, this legislation, H.R. 733, the Recalcitrant 
Cancer Research Act of 2012, will indeed take important steps to 
improve outcomes for cancer patients.
  For the many Americans who have been diagnosed with a hard-to-treat 
cancer, hope is not easy to come by. These patients have heard all 
about the advances in cancer treatments and cures but are left to 
wonder why there isn't some help for them. Unfortunately, their cancers 
do not respond to traditional treatments and, as a result, have had 
very few improvements in prevention, diagnosis, and treatment in 
decades.
  Take, for example, pancreatic cancer. According to the NIH, it is 
estimated that 44,000 men and women will be diagnosed with this cancer 
this year, of which 35,000 will die. The 5-year survival rate is less 
than 6 percent, compared to other cancers with survival rates of over 
90 percent.
  This bill will guide efforts at the National Cancer Institute in 
identifying the scientific framework that will outline those unanswered 
medical and scientific questions that will help to focus research 
efforts for those deadly cancers. Ensuring the availability of 
qualified researchers and important resources, such as patient 
registries, will also move the process forward.
  Tonight we work to provide patients and their families a little more 
hope. This bipartisan legislation is an important step as we continue 
to see breakthrough advances in cancer research, particularly for those 
cancers whose survival rates remain low and treatment options are 
limited.

[[Page H6146]]

  I want to thank Chairman Waxman and his staff, as well as Chairman 
Harkin and Ranking Member Enzi of the Senate committee, which passed 
the Senate version of this bill today in committee, for enabling us to 
be on the verge of really getting this legislation into law, which is 
one of the reasons why we bypassed the full committee.
  We were delighted to pass this legislation last week in subcommittee, 
and I singled out particularly my friends, Anna Eshoo and Leonard 
Lance, for their stalwart work on moving this legislation. And I've got 
to tell you, the many times we met and chatted about this legislation, 
I was given an update on the number of bipartisan cosponsors from 233 
to 240, and now 290-something that are there. It is, indeed, a 
bipartisan piece of legislation.
  One of the reasons why we bypassed the full committee this week in 
markup--which began, actually, this afternoon and we'll finish 
tomorrow--is we wanted to get this bill to the floor right away so that 
we don't even have to wait for a lame duck session to get it signed 
into law. So I would hope that my Senate colleagues move this quickly.
  But I just really want to thank my friends, Anna Eshoo and Leonard 
Lance, for their great work. The staff that put this together--I'll 
tell you, in sitting down with the NIH folks 2 weeks ago, we've really 
expanded. We've broadened this to include more than just pancreatic, 
how this started.

                              {time}  2140

  We have the stakeholders now on board that are excited about this 
legislation and what it will hold. The private sector out there--and, 
man, we've sure heard from them over the last year or so--but I know, 
too, that they are very happy with the passage of this tonight. It's a 
dream that's come true thanks to you.
  Ms. ESHOO. Mr. Speaker, I would just like to add to the comments that 
I made earlier that this is really highly unusual that a bill would 
enjoy such high co-sponsorship.
  So, to the advocates that may be tuned in tonight, I, again, want to 
pay homage to them for their advocacy, for their tenacity, for their 
turning their real pain and loss into something that is worthy of those 
that were lost. Almost 1,000 bills were referred to the Energy and 
Commerce Committee during this, the 112th Congress. There was no other 
bill that enjoyed the high number, 293 bipartisan cosponsors.
  This Congress has been really torn a part by so much disagreement, a 
high amount of nonpartisanship, people all over the country really 
scratching their heads and saying, can anyone ever come together in 
Congress to get something done for the American people. And while I 
wish there were so much more, I think that this stands tall and is an 
eloquent statement about my colleagues that signed on to this as 
cosponsors.
  And I thank, again, the leadership on both sides of the aisle, the 
staff that is so wonderfully responsible for the beautiful work that's 
done and, again, close my comments by paying tribute to the Republican 
leader on this legislation, Representative Leonard Lance, who is a 
genuine gentleman, an outstanding legislator, a good friend, and a man 
of real integrity.
  I say bravo to all of the advocates. God bless you all.
  I yield back the balance of my time, Mr. Speaker.
  Mr. PITTS. Mr. Speaker, at this time I would like to yield 4 minutes 
to the gentleman from New Jersey, (Mr. Lance), a member of the Health 
Subcommittee.
  Mr. LANCE. Mr. Speaker, I rise tonight in strong support of this 
legislation that I have had the honor of cosponsoring with my friend 
and colleague, Congresswoman Anna Eshoo of California. The legislation 
improves the prevention, the diagnosis, and the treatment of cancers 
with high mortality rates, including pancreatic cancer.
  Since President Nixon declared the war on cancer 40 years ago, the 
overall 5-year survival rate for all a cancers has climbed from 
approximately 50 percent to 67 percent. There are, however, cancers 
such as pancreatic cancer that still have high mortality rates and have 
not seen substantial progress in diagnoses or treatment of the disease. 
These so-called ``recalcitrant cancers'' are among the deadliest 
diseases and are the very types of cancers that this bill seeks to 
address.
  This legislation will direct the National Cancer Institute to 
establish a scientific framework that will guide research efforts on 
recalcitrant cancers by identifying unanswered medical and scientific 
questions. This framework seeks to bring together the brightest minds 
from Federal health agencies, from academia, and from private research 
fields with the hope of yielding new treatments and cures for 
recalcitrant cancers.
  I thank Chairman Pitts and Ranking Member Pallone of the Health 
Subcommittee for their steadfast support of the bill; and I thank the 
chairman of the full committee, Mr. Upton, and the ranking member, Mr. 
Waxman, for their essential help.
  At a time when so many Americans are concerned about the lack of 
bipartisanship in Congress, this legislation is an example where 
members of the House Energy and Commerce Committee work together, as we 
so often do, on critical health care issues. This legislation will 
reach the President's desk. This is the way Congress should work.
  I give special recognition to Congresswoman Eshoo for her tireless 
efforts, not only in support of this legislation, her legislation, but 
for her advocacy throughout her public life in support of cancer 
research and education.
  I also thank Senator Whitehouse for his work on this issue. And I 
thank Jeff Last, of my staff, for all that he has done on this 
important legislation.
  Also, Mr. Speaker, I thank Lisa Swayze for her advocacy in support of 
the pancreatic cancer issue, advocacy in memory of her husband, the 
great actor and dancer, Patrick Swayze.
  On a personal note, when my twin brother, Jim, and I were 12 years 
old, we lost our mother to cancer after a valiant 3-year battle. I 
dedicate whatever modest work I have done on this issue in her memory.
  I urge my colleagues to support the Recalcitrant Cancer Research Act.
  Mr. PITTS. Mr. Speaker, in conclusion, I want to commend the advocacy 
of Mr. Lance and Ms. Eshoo, the leadership, Mr. Upton, the ranking 
member of the full committee and the subcommittee, and thank the staffs 
of both the subcommittee and the full committee for their tireless work 
in putting together this bipartisan compromise, an excellent bill. And 
I urge support from the Members for H.R. 733, the Recalcitrant Cancer 
Research Act of 2012.
  I yield back the balance of my time.
  Mr. WAXMAN. Mr. Speaker, this bill is an example of Congress 
functioning at its best. As introduced, Congresswoman Eshoo and 
Congressman Lance's legislation addresses a policy goal that resonates 
with many of us--making progress in our fight against pancreatic 
cancer. In fact, nearly 300 Members of the House--Democrats and 
Republicans alike--are co-sponsors of this legislation.
  Through the Committee process, Members and staff worked on a 
bipartisan basis to respond to input from the National Institutes of 
Health and National Cancer Institute (NCI), pancreatic cancer 
advocates, and cancer researchers. I believe the end result--the bill 
before us today--represents a fair and balanced approach.
  H.R. 733 now focuses on a broader category of cancers, the so-called 
recalcitrant or deadliest cancers. The legislation directs the NCI to 
develop scientific frameworks to guide research efforts on recalcitrant 
cancers--defined as those cancers with 5-year relative survival rates 
below 50 percent. The bill requires the Director of the NCI to complete 
frameworks for at least 2 recalcitrant cancers that meet additional 
criteria set forth in the bill--having a 5-year survival rate of less 
than 20 percent and causing at least 30,000 estimated deaths--within 18 
months of enactment. It is my expectation that NCI will begin first 
with pancreatic and lung cancer. But in doing so, I also expect NCI to 
consider applying the scientific framework model to other recalcitrant 
cancers.
  Importantly, the bill ensures there will be an opportunity for 
outside experts to offer their perspective as the Director of NCI works 
to complete each scientific framework. H.R. 733 also calls on NCI to 
submit each completed framework to Congress and post it on the 
Department of Health and Human Services' website.
  No doubt, many Members like myself have met with constituents and 
heard the heart-wrenching stories of those families who have been 
impacted by pancreatic cancer. The unfortunate reality is that we 
rarely hear from

[[Page H6147]]

survivors of pancreatic cancer themselves since they are so few. In 
California alone, nearly 4,000 people will lose their lives to 
pancreatic cancer this year. An additional 12,000 Californians will die 
from lung cancer. Their families--and many others--have asked for our 
support in improving the diagnosis and treatment of pancreatic, lung, 
and other recalcitrant cancers.
  There's no disputing that great progress has been made in our fight 
against cancer over the past 40 years. Consider for example the 
improvement we've seen in the overall five-year relative survival rate 
for all cancers, and the important discoveries that NCI has made 
through its Cancer Genome Atlas program in understanding what makes one 
cancer different from another. Nonetheless, there are certain cancers 
where we haven't seen as many gains. That's precisely why I support the 
approach taken in H.R. 733.
  I'm very proud of the work of Chairman Upton, Chairman Pitts, Ranking 
Member Pallone, Congresswoman Eshoo, and Congressman Lance--as well as 
all of our staff--on this issue. I urge my colleagues to support 
passage of this bill.
  Mr. FATTAH. Mr. Speaker, I proudly cast a ``yea'' vote in support of 
H.R. 733, the Pancreatic Cancer Research and Education Act, with the 
memory of Elmer Chenault in mind. This important legislation will 
address the high mortality rate associated with Pancreatic Cancer. Mr. 
Chenault, my father-in-law, was a senior management officer and federal 
compliance official of the Environmental Protection Agency, Army 
veteran of the Korean War and a devoted family man. Elmer spent his 
working career in the scientific and environmental fields and was one 
of the first officials of the EPA, joining it shortly after it was 
founded in 1970 under President Richard M. Nixon. He grew up in 
Wyoming, Ohio, a suburb of Cincinnati. Joining the EPA in the early 
'70s, Elmer became a tireless advocate for environmental justice for 
communities of color and the economically disadvantaged.
  His passing was a trying time for my family, an experience too many 
know too well when confronting this terrible disease, and his loss 
continues to be felt by many in Philadelphia. I thank my colleague from 
California for her stalwart support for this legislation and look 
forward to a time when no family must face the scourge of Pancreatic 
Cancer.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Pennsylvania (Mr. Pitts) that the House suspend the 
rules and pass the bill, H.R. 733, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  The title was amended so as to read: ``A bill to provide for 
scientific frameworks with respect to recalcitrant cancers.''.
  A motion to reconsider was laid on the table.

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