In the 1980s, the National Cancer Institute's director, ., MD, led the "" declared by President Richard Nixon in 1971.
In an exclusive interview with 番茄社区, DeVita discussed the current "" initiative overseen by Vice President Joe Biden, as well as a number of other cancer-related issues from his half-century perspective as a leading cancer researcher, clinician, and administrator.
DeVita's storied career is told in also written for 番茄社区 -- and published late last year by Sarah Crichton Books/FSG.
Now 81 years old, DeVita is currently an Amy and Joseph Perella Professor of Medicine at Yale Cancer Center and Smilow Cancer Hospital at Yale-New Haven, and had formerly served as the cancer center's director.
He was also physician-in-chief at Memorial Sloan Kettering Cancer Center following his tenure as NCI director from 1980-1988. Originally appointed by President Jimmy Carter, he was reappointed by President Ronald Reagan.
DeVita, who is credited with developing combination chemotherapy regimens that led to effective curative treatments for Hodgkin's disease and diffuse large cell lymphomas, has received many honors, including the Albert and Mary Lasker medical research award in 1972, and is one of three principal editors of DeVita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology.
He was also the of the , stepping down in 2013, and is a former president of the American Society of Clinical Oncology.
Several months after The Death of Cancer's debut, DeVita said the public response has been tremendous and very flattering, and he's been trying to keep up with the email.
"The oncology community has been unanimous about liking it and if anyone didn't like it, they haven't let me know," he said.
Moonshot: On Target, or a Misfire?
Asked about the moonshot initiative DeVita said that he doesn't think it has enough structure at the moment, and with the upcoming change in administration "there's no telling what will happen with it, although it is very popular since the American people are still very much concerned about cancer and tend to be supportive."
He thought that the appointment of as executive director of the cancer moonshot task force was a step in the right direction but would be much more effective if he were to become a cancer "czar" with authority over all government cancer funding.
He suggested that the vice president and Simon come up with a plan to modify the current structure and have Congress pass a new Cancer Act before President Obama leaves office so it would be sustainable, noting that if the president only issued an executive order it would probably be rescinded if the Republicans won the election.
DeVita said that venture capitalist . -- who was chairman of the President's Cancer Panel when DeVita was NCI director -- was smart, shrewd, and decisive and understood science and medicine better than any layperson he knew.
"If we had a Benno Schmidt today and put him in Simon's position, I assure you it [moonshot] would run very efficiently."
Be Careful What You Wish For
He also had a cautionary tale for the cancer advocacy community.
In 1998 NIH won a funding increase that led to a doubling of its budget over 5 years -- but unwrapping that funding package turned out to be a very painful process because government funding has to be spent in the year it is allotted and cannot be rolled over.
"It was the most painful thing for biomedical research that ever happened. What you saw was tremendous wasteful spending because people had to fish around to spend money in a hurry and then at the end of 5 years everything fell off the cliff and it ended the careers of many young scientists who got involved because there was money available and [it] destroyed them because it ran out, and then the budget was flat."
He said that government has to be very careful about how it provides funding, and it would be much more meaningful for Congress to provide "no-year funding," adding it might be time to change the organization of how money is spent because it is not very efficient anymore.
Bully Pulpits and Breakthroughs
Recent NCI directors, in DeVita's opinion, haven't seen themselves as a force and haven't used the position as a bully pulpit as he did during his tenure. His advice? Issue from the NCI director, as he did. He said the alerts were very effective, although they were controversial and required the confidence to stand up and be willing to take the heat.
DeVita said that was a paradigm-shifting discovery, and is changing the landscape of cancer therapy.
"I think that and should win the Nobel Prize, either one or both of them. The field has made a major leap forward because we were stymied for decades trying to figure out why we couldn't get the answers before because it made sense it should be helping us."
He said that Allison's discovery of the on , solved this problem and left no question that checkpoint inhibitors work with some very good responses including some complete remissions and extension of life.
"We don't know yet how much it will change things or how useful it will be on a tumor by tumor basis, but we're still finding out, and it's been epic," he said.
What About LOL and TTYL?
When asked about how his tenure as NCI director may have been affected if social media had been around, DeVita laughed and said, "I had social media then, it was ."
He explained that Boyd, the founding editor and publisher of the newsletter, would put everything that DeVita said word for word into the publication.
"At first it annoyed me, and I told Jerry that I wished he wouldn't do that, but he explained that he was a journalist, and I then figured that this was good, I could use it."