Word that Letai might be the next NCI director spread rapidly through the cancer research community. Cancer scientists who spoke with STAT expressed relief that Letai, who they described as both kind and an excellent, highly qualified scientist and physician, would likely lead the nation’s most important cancer research office.
“It’s an excellent choice, especially considering everything right now,” said Diana Azzam, a cancer researcher at Florida International University and a board member of the Society for Functional Precision Medicine where Letai serves as president. “He’s a great scientist,” she said of Letai, “a great person, and very open and upfront. He’s very direct and open about his position and where he stands. I think that’s an important quality we need in a leader at NCI.”
As president of that society, Letai has advanced the cancer treatment approach called functional precision oncology. The theory behind functional precision oncology is to take tumor samples from patients and use the living samples to screen many, sometimes hundreds, of drugs for efficacy.
Or, as Letai said in an interview last year, “expose that tumor to a whole bunch of drugs and see which ones will work. This straightforward, commonsensical procedure is something we do every day in microbiology when treating infectious diseases.”
The approach was controversial when it began decades ago, Azzam noted, but Letai’s leadership allowed the field to progress and gain traction.
“He was able to navigate our way through it, and he really drove collaboration. Now we have a society,” she said. “He’s always thinking about what impacts patients. If he continues to do that, he can bring the same vision to NCI, that’s great.”
Along with being an advocate for the functional precision oncology approach, Letai has extensively published other scientific work investigating cell death and cancer biology. One particular achievement is that Letai’s lab discovered certain leukemias rely on an anti-cell death protein called BCL-2 for survival.
That played a key role in the development of Venclexta, a BCL-2 drug developed by AbbVie, for certain leukemia patients. Venclexta is now a backbone of treatment for many adult leukemia patients and generates $2.6 billion in annual sales.
There hasn’t been an NCI director since Kimryn Rathmell resigned from the office on Jan. 20. Since President Trump’s inauguration, the NIH and the NCI have gone through significant upheaval, including the cancellation of key grant programs like the NCI Outstanding Investigator Award, mass employee terminations, and the introduction of lists of words that trigger internal review on agency documents.
Throughout, cancer researchers and advocates have told STAT that they have felt particularly vulnerable without an NCI director to stand up for the community.
“During all this, that they don’t have someone who has a voice, whatever that voice would look like, is discouraging,” Julie Fleshman, the president and CEO of the pancreatic cancer nonprofit PanCAN, said in May.
Earlier this year, UNC Lineberger Comprehensive Cancer Center director Robert Ferris put the lack of NCI leadership more bluntly: “We’re barreling down the tracks. We need a train conductor.”
While it’s not yet clear how Letai would navigate serving in the Trump administration, cancer researchers and leaders were optimistic about his nomination. Still, skepticism remained about how much Letai as NCI director would be able to swing the direction of national cancer research policy and funding one way or another.
Calling the choice of Letai “great news,” Wafik El-Deiry, director of the Legorreta Cancer Center at Brown University, said: “There are challenges as the Trump administration will have to come to terms with wanting to be the best in the world with a good plan to get there. Both the NIH director and the incoming NCI director are limited financially in executing an innovative vision and plan for America First that hopefully will be addressed by the U.S. government.”