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[Volume 14, Issue 4](/cancerdiscovery/issue/14/4)

1 April 2024

[![Issue Cover](https://aacr.silverchair-cdn.com/aacr/content_public/journal/cancerdiscovery/issue/14/4/12/m_candisc_14_4_cover.png?Expires=1729104520&Signature=sY7-L~CF7daDpyWi5GDpjeefkD6Edzf7GmJT3U5UtpHT~NGDlYgkrxvwPMj89ASUcBuB0jTLsl4TKeWEDs~bWlu2sqgXTJ7s01MJiSaLlzVU-O42W9NA5RgLjmFM~-m0FogXfXMDG9HnT1IgLUk5udq-hGi04zr35EgwQIrvw2bQdIAJ8qa2OYugfVw8uR~iolxoq-6GUUIF--Vi~jt8HX0nMITQ9lL-TbT0Mh9yyS-QXwMqo57e6d1Ozmi6qHTLmClMWW~ggvTVQ7rAnOw29zt6Lzec1z6Ns47qbYwEcX1wMqVD0ASnjmY2hJw~PNUbOu1lDAI51Sri5zApGYG7zw__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA)](/cancerdiscovery/issue/14/4)

- [SELF-COLLECTION FOR HPV TESTING TO IMPROVE CERVICAL CANCER PREVENTION (SHIP) TRIAL NETWORK](#15623741)

- [CHILDHOOD CANCER DATA INITIATIVE](#15623743)

- [TUMOR-INFILTRATING LYMPHOCYTES FOR ADVANCED MELANOMA](#15623745)

- [Authors’ Disclosures](#15623752)

- [References](#15623754)


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Science in Society\|April 04 2024

# Using the National Cancer Plan to Drive Innovation in Cancer Research

[W. Kimryn Rathmell](javascript:;)

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W. Kimryn Rathmell
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1NCI, NIH, Bethesda, Maryland.

\* **Corresponding Author:** W. Kimryn Rathmell, NCI, NIH, 31 Center Drive, Building 31, Bethesda, MD 20814. E-mail: [Kimryn.rathmell@nih.gov](mailto:Kimryn.rathmell@nih.gov)

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\* **Corresponding Author:** W. Kimryn Rathmell, NCI, NIH, 31 Center Drive, Building 31, Bethesda, MD 20814. E-mail: [Kimryn.rathmell@nih.gov](mailto:Kimryn.rathmell@nih.gov)

Cancer Discov 2024;14:555–8

Online ISSN: 2159-8290

Print ISSN: 2159-8274

©2024 American Association for Cancer Research

2024

American Association for Cancer Research

_Cancer Discov_ (2024) 14 (4): 555–558.

[https://doi.org/10.1158/2159-8290.CD-24-0223](https://doi.org/10.1158/2159-8290.CD-24-0223)

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W. Kimryn Rathmell; Using the National Cancer Plan to Drive Innovation in Cancer Research. _Cancer Discov_ 1 April 2024; 14 (4): 555–558. [https://doi.org/10.1158/2159-8290.CD-24-0223](https://doi.org/10.1158/2159-8290.CD-24-0223)

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Summary:

The NCI director presents her vision of the National Cancer Plan as an integrated framework that can help drive innovation in cancer research to speed progress toward ending cancer as we know it.

Since the signing of the National Cancer Act of 1971 ( [1](javascript:;)) that empowered the NCI to take broad and bold steps to carry out the national effort against cancer through the creation of a National Cancer Program ( [2](javascript:;)), we have seen a tremendous rise in the innovative approaches with which we treat cancer and the depth of knowledge we have about cancer. We have amassed an astonishing array of tools to help us achieve earlier diagnoses, less toxic treatments, better quality of life in survivorship, and more equitable distribution of benefits of research. Importantly, this progress has led to meaningful improvements in the outcomes faced by many people diagnosed with cancer; cancer mortality has declined by a third in just the past three decades ( [3](javascript:;)). This trend must continue and accelerate ( [4](javascript:;)) if the cancer community is going to collectively achieve the goals of the President and First Lady's Cancer Moonshot, ( [5](javascript:;)) – reduce the cancer mortality rate by 50% by 2047 in the United States and improve the experience of those living with cancer. We are also at a critical inflection point in this effort – we can reach more patients, apply technologies to a broader array of cancers, and achieve both scientific and cultural shifts needed to accomplish the sea change we so urgently need. Yet, cancer remains a top fear of many, and virtually everyone can easily name a loved one or friend who lost their life to cancer. To change what it means to face a cancer diagnosis, we have more work to do as a community.

It is against this backdrop that I joined the NCI as director in December 2023. During the first few weeks of my new role, one thing quickly became clear: the NCI and the cancer research ecosystem are larger and more complex than I even anticipated. To me, the NCI comprises the organization itself, as well the important work it supports throughout the nation and around the world to reduce the burden that cancer wreaks on families and communities. I bring to this position more than two decades of experience as a laboratory-based basic scientist and cancer-focused clinician, management expertise running a large and academically robust department of medicine, and leadership roles in major professional organizations. Still, the incredible depth and breadth of the NCI – and the unique vantage point that my new position affords me to view the vast cancer landscape more holistically – has impressed and inspired me beyond my expectations.

Thankfully, we have a National Cancer Plan ( [6](javascript:;)) to serve as a roadmap to guide our work and that of the broader cancer community.

The National Cancer Plan (available at [http://nationalcancerplan.cancer.gov](http://nationalcancerplan.cancer.gov)) is a broad and inclusive framework designed to capitalize on our progress and foster collaboration to accelerate progress against cancer. The current director of the NIH Dr. Monica Bertagnolli developed the plan in her former role as the NCI director in collaboration with the President's Cancer Panel ( [7](javascript:;)) and with input from across the cancer community. The NCI director leads the broad implementation of the plan to advance the National Cancer Program, and the President's Cancer Panel is charged with monitoring progress toward the plan's goals. The goals reinforce and are aligned with other important national-level cancer priority areas ( [8–10](javascript:;)).

Using the National Cancer Plan to unite the cancer community in coordinated action requires assembling its components (eight goals) to create synergies, leaning into opportunities to apply data-driven solutions, and breaking down barriers that stand in the way of progress. A year after its launch in April 2023, the National Cancer Plan continues to be a catalyst for organizing priorities, communicating about achievements, and identifying gaps and areas of opportunity. But there is so much more we can – and must – do with the opportunities outlined in the plan, to drive innovation for faster progress.

In this commentary, I present my perspective on the National Cancer Plan – seeing it in a new light. I first discuss the importance of the eight goals, then I present three examples that illustrate the power within the plan to drive more innovation in cancer research. My main message is this: the National Cancer Plan represents a whole that is greater than the sum of its parts, and the full potential of the plan is found in the spaces in between the goals, and where the goals intersect, interconnect, and come together to accelerate research through innovation. This is where we need to focus our energy in this new era of cancer research.

Eight goals form the centerpiece of the plan ( [Fig. 1](javascript:;)). I interpret the goals as domains of work that encompass all the efforts that can contribute to progress toward the ideal future states as described in the National Cancer Plan ( [11](javascript:;)). For example, to achieve the ideal future state of _Prevent Cancer_ (all people and society adopt proven strategies that reduce the incidence of cancer), it will take everyone from vaccine researchers, statisticians, family physicians, nurses, health educators, healthy people, dieticians, tobacco control advocates, policymakers, and the list goes on. My examples in this commentary focus on research, but _everyone_ has a unique role in realizing the potential of the plan—including many who do not identify as researchers.

Figure 1.

![Figure 1. Goals of the National Cancer Plan.](https://aacr.silverchair-cdn.com/aacr/content_public/journal/cancerdiscovery/14/4/10.1158_2159-8290.cd-24-0223/6/m_555fig1.jpeg?Expires=1728471295&Signature=Jsv5Wu58m9sbl3f7kjNaSKvdH2bz7z1pwyWdqiCnXVGTRvnKd7Bd5KCTQ-BTxJ8t-KgmNVehUk~wfBFOesYfs0t09OZ2RkzHAptdWxYiI1LoYgXj9liKoYIMgoBKWPIgU0AvRbT7hW~D9dE9MbBrl4YhpkKxknYWwD6sEuMqiwQfAYp-sWrd9YnImpD1D0BGIobWEUY1LyPZ608qNraAhLUQUCzAcZ9NXGEMZc9tkCK7h-sJGtCfk60pNGKtCxcNyCqFBjdFUuqT5ynyklfCfUW~ilbMsbo8Fo6JDmEAy0JY9zAAsIMtic3DzqyTPC8IcL764GKp8G6Cfen0oXrQBQ__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA)

[View large](/view-large/figure/15623736/555fig1.jpeg) [Download slide](//aacr.silverchair-cdn.com/DownloadFile/DownloadImage.aspx?image=https://aacr.silverchair-cdn.com/aacr/content_public/journal/cancerdiscovery/14/4/10.1158_2159-8290.cd-24-0223/6/555fig1.jpeg?Expires=1728471295&Signature=2aBc6ySr-w1bERERieIdGySpEBoAGzQR3cexoqbYaAeHnKVeGqZ~OiJxk7oW6IEvuUMpJCRHeR4pvGlEc4pB4tf~dp5Knz0inCwzbTjT43yiSKQyfPBZPp890SHBZKcCFsygPiTwIKTjbyJUO5UPX0QUe4nS1zhcoLuZ~vQc3A~gbmMcu2JoTOa62ru2tKYmQyMf6xlKKOE5OwlWkiRhkme-po4LZSODlDJu0CFat75DoMeHgaG730i9APlnCHQiuJOE8AKti7IyU0HOE~QjO~HJxZEELrMCqMHfG3jRRo9Xd-Mrn-IO4l0myPDMRhF3PESZtePqkvU6AinOrplY1g__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA&sec=15623736&ar=741979&xsltPath=~/UI/app/XSLT&imagename=&siteId=1000003)

Goals of the National Cancer Plan.

Figure 1.

![Figure 1. Goals of the National Cancer Plan.](https://aacr.silverchair-cdn.com/aacr/content_public/journal/cancerdiscovery/14/4/10.1158_2159-8290.cd-24-0223/6/m_555fig1.jpeg?Expires=1728471295&Signature=Jsv5Wu58m9sbl3f7kjNaSKvdH2bz7z1pwyWdqiCnXVGTRvnKd7Bd5KCTQ-BTxJ8t-KgmNVehUk~wfBFOesYfs0t09OZ2RkzHAptdWxYiI1LoYgXj9liKoYIMgoBKWPIgU0AvRbT7hW~D9dE9MbBrl4YhpkKxknYWwD6sEuMqiwQfAYp-sWrd9YnImpD1D0BGIobWEUY1LyPZ608qNraAhLUQUCzAcZ9NXGEMZc9tkCK7h-sJGtCfk60pNGKtCxcNyCqFBjdFUuqT5ynyklfCfUW~ilbMsbo8Fo6JDmEAy0JY9zAAsIMtic3DzqyTPC8IcL764GKp8G6Cfen0oXrQBQ__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA)

[View large](/view-large/figure/15623736/555fig1.jpeg) [Download slide](//aacr.silverchair-cdn.com/DownloadFile/DownloadImage.aspx?image=https://aacr.silverchair-cdn.com/aacr/content_public/journal/cancerdiscovery/14/4/10.1158_2159-8290.cd-24-0223/6/555fig1.jpeg?Expires=1728471295&Signature=2aBc6ySr-w1bERERieIdGySpEBoAGzQR3cexoqbYaAeHnKVeGqZ~OiJxk7oW6IEvuUMpJCRHeR4pvGlEc4pB4tf~dp5Knz0inCwzbTjT43yiSKQyfPBZPp890SHBZKcCFsygPiTwIKTjbyJUO5UPX0QUe4nS1zhcoLuZ~vQc3A~gbmMcu2JoTOa62ru2tKYmQyMf6xlKKOE5OwlWkiRhkme-po4LZSODlDJu0CFat75DoMeHgaG730i9APlnCHQiuJOE8AKti7IyU0HOE~QjO~HJxZEELrMCqMHfG3jRRo9Xd-Mrn-IO4l0myPDMRhF3PESZtePqkvU6AinOrplY1g__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA&sec=15623736&ar=741979&xsltPath=~/UI/app/XSLT&imagename=&siteId=1000003)

Goals of the National Cancer Plan.

[Close modal](javascript:;)

To meaningfully put the whole together, we first need to focus on the individual parts (the goals). Four of the eight goals follow the arc of the patient experience – from cancer risk assessment, to mitigation, management, experience, survivorship, and health outcome. I think of these as the “health-centric” goals: _Prevent Cancer_, _Detect Cancers Early_, _Develop Effective Treatments_, and _Deliver Optimal Care_. They are directly geared toward health outcomes, which can be assessed by measures such as cancer incidence, cancer mortality, robust survivorship, and life expectancy. These health-centric goals exist mainly in the health and research ecosystem, although achieving them requires efforts from across society. Research – of all kinds – is an essential feature of each of these goals. Discovery science is the critical fuel that powers progress in these health-centric goals, from basic science as the building block to population science, epidemiology, translational studies, clinical research, implementation science and health policy research; our work is not complete until the benefits of research reach everyone.

The next set of four goals, as I think about them, are “empowering” goals: _Maximize Data Utility; Eliminate Inequities, Optimize the Workforce_, and _Engage Every Person_. These goals span all aspects of the cancer continuum and operate in the societal ecosystem. We must use all the resources, knowledge, and perspectives available throughout society to improve cancer outcomes. These goals should also be approached from multiple angles: research, program implementation, policy change, and individual behaviors.

Each goal has a value on its own, but when combined, they fuel a culture of innovation, creativity, and collaboration that represents a paradigm shift from an establishment that has historically been marked by narrow approaches to cancer research and care. This new era is in our immediate future, one that utilizes the National Cancer Plan to build on our progress and drive further innovation in cancer research. In other words, the key to the accelerated progress we need to see in cancer research lies in creative partnerships across the entire cancer community – and society – that blend unique perspectives, experiences, and expertise, that will unleash novel, nontraditional solutions that would not be possible when focusing on any one goal by itself. We need to do more of this, and the National Cancer Plan empowers us do that. The NCI has a role, along with other federal agencies, foundations, and industry partners that are dedicated to progress against cancer. We must work together especially because while opportunities are unlimited, time and resources are not.

To illustrate what these “new era” partnerships look like practically – and to encourage everyone to use the National Cancer Plan to identify and engage in more opportunities like these – I present three examples below. These stories show how the National Cancer Plan can help us align efforts, commit to shared goals, and identify novel methods of working across siloes and domains to chart the course to a more innovative, collaborative future. Relevant goals from the National Cancer Plan are shown in italics.

## SELF-COLLECTION FOR HPV TESTING TO IMPROVE CERVICAL CANCER PREVENTION (SHIP) TRIAL NETWORK

The nationwide SHIP trial network to _Prevent Cancer_ is a recent example of an extremely promising clinical trial, which I was honored to announce at the White House Cervical Cancer Forum in January 2024 ( [12](javascript:;)). Part of the NCI's Cervical Cancer Last Mile Initiative ( [13](javascript:;)), the SHIP trial network shifts the paradigm of cancer screening ( _Detect Cancers Early_) from the traditional top-down approach, to empowering the participants and beneficiaries of research by placing screening within their hands, literally, through self-sampling ( _Engage Every Person_). This is a novel method for HPV testing in the United States and has the potential to reach people who have been left behind due to geographic, socioeconomic, financial, demographic, or other barriers, by meeting people in the communities where they live ( _Eliminate Inequities_). The network also represents a broad collaboration involving government, private industry, professional societies, academia, and communities. This kind of innovation and collaboration is what it will take to help eliminate cervical cancer, and what we learn through SHIP will inform efforts to improve screening for other cancers.

## CHILDHOOD CANCER DATA INITIATIVE

The new era of cancer research is marked by rapid digitization and smart use of modern technology to _Maximize Data Utility_ to yield important insights and for the benefit of patients. This is especially important for young people with rare, hard-to-treat cancers and their families who lack resources or knowledge ( _Eliminate Inequities_) and thus face a dire prognosis because we simply do not have enough evidence to _Deliver Optimal Care_. How do we _Develop Effective Treatments_? We must _Engage Every Person_ and learn from every single child, adolescent, and young adult in this nation with a cancer diagnosis, to help others like them. This seems like a monumental task, but the NCI's Childhood Cancer Data Initiative (CCDI) has been leading these exact efforts – with incredible progress made already in just five years. As an expert in the extremely rare disease renal medullary carcinoma (RMC), which mostly affects young people, I have firsthand experience seeing the transformational impact on this community through basic science discovery, translational science, clinical research, advocacy, and community engagement. Up until a few years ago, RMC was a relatively unknown cancer, but RMC is now included in the CCDI data ecosystem, and we are making strides toward the goal to _Develop Effective Treatments_. We need to create similar improvements for other rare cancers affecting children, adolescents, and young adults. What it takes is a collaborative, multidisciplinary effort and health care providers engaging with patients, their families, and advocates to participate in research – if we do this at scale, we can transform more rare cancers to become manageable diseases.

## TUMOR-INFILTRATING LYMPHOCYTES FOR ADVANCED MELANOMA

Cellular therapy for solid tumors is the latest landmark breakthrough in cancer treatment ( _Develop Effective Treatments)_ and is predicted to change medical oncology practice ( _Deliver Optimal Care_) in this new era of cancer research. The newly approved tumor-infiltrating lymphocytes (TIL) therapy for advanced melanoma represents the ideal scenario of cancer research: findings from decades of rigorous basic science research at the NCI (pioneered by Dr. Steven Rosenberg of the NCI Center for Cancer Research), translated into clinical research at an NCI-designated cancer center, partnership with a pharmaceutical company, and approval by the FDA ( [14–16](javascript:;)). Numerous contributions throughout a nearly 40-year journey led to this milestone, including by melanoma specialists who brought their disease into the immunotherapy space for the first time, and the various “failed” research results that led to success. Failing is succeeding in innovation; each lesson provides direction forward. Our partners at the Advanced Research Projects Agency for Health (ARPA-H) embody this culture of innovation with their investments in high-risk, high-impact solutions in cancer and other areas ( [17](javascript:;)). A 100% success rate means that we are not being bold enough. We set bold goals – that is what the new era of cancer research is about. The next generation of researchers are critical to this new era. Because of the work that led to this advance, many young people are entering the cancer field, which will help _Optimize the Workforce_. Looking at the National Cancer Plan reminds us that our work does not end with a research win. The price tag is currently very high for this drug, and we need to find ways to make the best treatment accessible to everyone who might benefit ( _Eliminate Inequities_).

These three exemplary stories illustrate that our work in the new era must include multiple goals of the National Cancer Plan to ensure that our investments are of the highest value. The framework in [Fig. 2](javascript:;) is how I see the goals coming together to accelerate progress toward our ultimate mission of improving health outcomes for everyone.

Figure 2.

![Figure 2. The National Cancer Plan: How the goals interact to improve health outcomes for everyone.](https://aacr.silverchair-cdn.com/aacr/content_public/journal/cancerdiscovery/14/4/10.1158_2159-8290.cd-24-0223/6/m_555fig2.jpeg?Expires=1728471295&Signature=o4VA7tXgxNN~-SItzE9MOjOG1kbSjvO3-0f2bIBN7TTHwc-W~cHqd01vghRA9G~RA4QA2OXnMAxzIY0L8OpYvEhlXAWpYfs7VQ4UMAHXmZ-ClDRkuhxLc8k-UyhDHwU-ci9D~2EnuLfKLz-h9LCWt7YIFGxDeowrJzbsLrqLWcT98OQGEQE0zqg2aZVNZ49MtcJpo1APvo6D-bQMtNUeTi1w07innyHy-rIHve--IKIsGoEYBMyiPP6~pP~shN0qScnk0AOAxbrL6ODUG~nsf2WSGaV9NrXSbSOZobmGZFlF1Lm4hRI5xeqwtL2h7UVcT8fAxWgjat-t1ucuwbHG-Q__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA)

[View large](/view-large/figure/15623748/555fig2.jpeg) [Download slide](//aacr.silverchair-cdn.com/DownloadFile/DownloadImage.aspx?image=https://aacr.silverchair-cdn.com/aacr/content_public/journal/cancerdiscovery/14/4/10.1158_2159-8290.cd-24-0223/6/555fig2.jpeg?Expires=1728471295&Signature=lMEdcbgHstV0cmwhStTqo4Pmiqp1s2Xrl1sbuDmFrzrFkdu4wqWdiVjgT5UzgFGwR9vDIsZEbKHJDtRm4RGeeAhgnVzRLA-dFqICZw-yba3~Hty6pjdIRkS9e4Q8CgupH4ZcctZxiuRXAsVwMISlUTe1-mF8o~05QSOQG33cce0qGIZHJ9F8cihJ3VGUKkDYagGjjPu8TuK04xRA4plU9bHJmL~oel7I0XWYamGS8G~GDzolAW2DBveVqYT~bk8zaHAO4LYoB36rd3YHg-YLwgyzz~Q3ro3dtjveOOUZ-pwNFZXZdmZWD5W4ILUlaIRxfS-~QkuQWXPghnJHyqzeBQ__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA&sec=15623748&ar=741979&xsltPath=~/UI/app/XSLT&imagename=&siteId=1000003)

The National Cancer Plan: How the goals interact to improve health outcomes for everyone.

Figure 2.

![Figure 2. The National Cancer Plan: How the goals interact to improve health outcomes for everyone.](https://aacr.silverchair-cdn.com/aacr/content_public/journal/cancerdiscovery/14/4/10.1158_2159-8290.cd-24-0223/6/m_555fig2.jpeg?Expires=1728471295&Signature=o4VA7tXgxNN~-SItzE9MOjOG1kbSjvO3-0f2bIBN7TTHwc-W~cHqd01vghRA9G~RA4QA2OXnMAxzIY0L8OpYvEhlXAWpYfs7VQ4UMAHXmZ-ClDRkuhxLc8k-UyhDHwU-ci9D~2EnuLfKLz-h9LCWt7YIFGxDeowrJzbsLrqLWcT98OQGEQE0zqg2aZVNZ49MtcJpo1APvo6D-bQMtNUeTi1w07innyHy-rIHve--IKIsGoEYBMyiPP6~pP~shN0qScnk0AOAxbrL6ODUG~nsf2WSGaV9NrXSbSOZobmGZFlF1Lm4hRI5xeqwtL2h7UVcT8fAxWgjat-t1ucuwbHG-Q__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA)

[View large](/view-large/figure/15623748/555fig2.jpeg) [Download slide](//aacr.silverchair-cdn.com/DownloadFile/DownloadImage.aspx?image=https://aacr.silverchair-cdn.com/aacr/content_public/journal/cancerdiscovery/14/4/10.1158_2159-8290.cd-24-0223/6/555fig2.jpeg?Expires=1728471295&Signature=lMEdcbgHstV0cmwhStTqo4Pmiqp1s2Xrl1sbuDmFrzrFkdu4wqWdiVjgT5UzgFGwR9vDIsZEbKHJDtRm4RGeeAhgnVzRLA-dFqICZw-yba3~Hty6pjdIRkS9e4Q8CgupH4ZcctZxiuRXAsVwMISlUTe1-mF8o~05QSOQG33cce0qGIZHJ9F8cihJ3VGUKkDYagGjjPu8TuK04xRA4plU9bHJmL~oel7I0XWYamGS8G~GDzolAW2DBveVqYT~bk8zaHAO4LYoB36rd3YHg-YLwgyzz~Q3ro3dtjveOOUZ-pwNFZXZdmZWD5W4ILUlaIRxfS-~QkuQWXPghnJHyqzeBQ__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA&sec=15623748&ar=741979&xsltPath=~/UI/app/XSLT&imagename=&siteId=1000003)

The National Cancer Plan: How the goals interact to improve health outcomes for everyone.

[Close modal](javascript:;)

Seeing the National Cancer Plan goals in this integrated way, they are far more than just eight goals. The whole is more than the sum of its parts. The ultimate mission for all of us in the cancer community is to guide change that encompasses all elements of our work, integrating discovery science as the fuel to the health-centric goals, turning those gears to effect improved outcomes and better disease management and survivorship – for everyone. The empowering goals support and accelerate the health care system and society writ large to elevate the conversation, to spur action beyond the cancer field or even the public health system, and to change the landscape of cancer for generations to come. Scientists must ask bold questions, and collaborations need to involve researchers, clinicians, advocates, public and private partners, patients, and families. We need to ensure that a strong and diverse workforce is engaged in meaningful efforts that make the most of their strengths. Most importantly, we need to connect with and engage all people of all ages and backgrounds – to understand their risk for cancer, to be informed consumers with the supports where needed to effectively interact with and benefit from their health care system, and to be active participants in a new era of cancer research marked by innovative approaches to solving problems in cancer.

In this roadmap, while the destinations are clear, the paths will be different, unexpected, winding, and unpredictable in many cases. The National Cancer Plan is a flexible tool, not a prescriptive manual. Ultimately, we are all driving in the same direction, and the National Cancer Plan will help us innovate, monitor, and celebrate our speed of progress and key milestones. The NCI is poised to lead this new era by example with a culture of innovation and collaboration, using the National Cancer Plan to empower a broad community to work together in those spaces between the goals to end cancer as we know it. I look forward to hearing from you about how you are using the plan to drive innovation and collaboration in your areas of work.

Now, let's get back to work – people with cancer are waiting for us.

## Authors’ Disclosures

No disclosures were reported.

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