Unconventional Innovations Program

To spur development of daring technologic improvements in cancer treatment and detection in the 21st century, the National Cancer Institute (NCI) recently created an Unconventional Innovations Program. The five-year, $48 million program seeks to stimulate development of radically new technologies in cancer care that can transform what is now impossible into the realm of the possible for detecting, diagnosing, and intervening in cancer at its earliest stages of development.

Envisioned are futuristic technologies that may sound like Star Wars medicine, but which are grounded in scientists' rapidly-evolving grasp of how alterations in the molecules within our cells may lead to cancer. These technologies would enable physicians to scan the human body for molecular changes that foreshadow disease and, then once detected, to intervene with minimally invasive procedures, including some that may seem like science fiction such as injectable miniature robotic devices (nanorobots) capable of killing tumors or "smart" polymers that both detect cancer and deliver drugs.

This past summer, NCI began to plant the seeds for the development of these forward-thinking approaches by reaching out to scientists outside the cancer research community to learn about technologies developed for other purposes, such as interplanetary probes and global communications technology, that might prove useful for the highly specific molecular recognition and signaling capability needed for a new generation of diagnostic and treatment tools. Once this information is acquired and sifted, NCI will solicit proposals for the first investments in these new technologies, with the earliest contracts expected to be awarded in 1999.

The vision of the Unconventional Innovations Program is to couple detection and diagnostic technologies based on remote sensing to far less invasive treatments than those employed today surgery, chemotherapy, and radiotherapy which, though often effective, can be uncomfortable and painful. The ultimate goal of the program is to provide medical care for cancer patients that detects early cellular changes typical of cancer and includes treatments that target molecular alterations from occurring in an individual patient's cells.

Cancer is not one but many diseases arising from changes in our genes and how these genes work within our cells. As scientists learn more about the patterns of gene changes typical in specific cancers, they are conceiving new ways to apply that knowledge to cancer medicine, including prevention.

How would the new cancer medicine work? At least several scenarios are possible. During an annual checkup, a patient is given a cocktail of synthetic molecules that together can spotlight hundreds of genetic changes specific to cancer. A whole body scan detects a small focus of abnormal cells in the liver, which are then pinpointed and treated by a laser burst, leaving normal cells intact. Afterwards, the patient is allowed to return to work with the recommendation that he or she return in six months for another checkup.

Or, a patient undergoing a yearly medical examination, provides urine, blood, sputum, and saliva samples, which are tested by a handheld device for hundreds of cellular changes associated with cancer. The device subsequently detects at low levels the presence of alterations indicating that the patient's bladder harbors cells that may turn cancerous. The doctor immediately administers fluids that home in on the bladder, washing it with molecules carrying a drug and a marker for the cancer cells, so that the drugs only enter the cancer cells. A week later, the doctor sends the patient a kit of indicator sticks to test weekly for any reappearance of the altered cells.

For more information about cancer visit NCI's Web site for patients, public and the mass media at http://rex.nci.nih.gov or NCI's main web site at http://www.nci.nih.gov.