DCTD Convenes Workshop on The State-of-the-Science: Cancer Complementary and Alternative Medicine Therapeutics Research

On May 25-26, 2016, researchers with expertise in cancer therapeutics research, bioinformatics, computation modeling and databases, clinical trial design, and cancer complementary and alternative medicine (CAM) participated in a workshop at the National Institutes of Health (NIH) (agenda). CAM is defined as any medical system, practice, or product that is not considered standard care. The meeting Chair, Dan Xi, PhD, Program Director, and Director of the Research Development and Support Program, Office of Cancer Complementary and Alternative Medicine (OCCAM), DCTD, planned this comprehensive workshop with input from DCTD leadership and the workshop planning committee. This meeting was particularly exciting because this is the first time in 10 years OCCAM has convened a meeting with such scientific magnitude. The diverse group of about 70 attendees included individuals from NIH, FDA, academia, cancer centers, and integrative medicine programs. Workshop organizers were pleased to have representation from the National Natural Science Foundation of China (NSFC) and Chinese medicine physician scientists from China.

The goals of the meeting were to:

• assess the current status of evidence-based cancer CAM therapeutics research
• discuss the scientific gaps, needs, and future opportunities of cancer CAM therapeutics research in the era of precision medicine
• explore solutions for challenges preventing progress in the field
• provide suggestions to NCI regarding future initiatives and priority areas

A set of questions related to the goals and objectives were provided to participants before the meeting. The workshop opened with a presentation by Meg Mooney, MD, MBA, Branch Chief, Clinical Investigations Branch, Cancer Therapy Evaluation Program, DCTD, about the landscape of current cancer therapeutics research and precision medicine. Dr. Mooney's talk was followed by Dr. Xi's workshop introduction, a description of the main challenges of the CAM field, the objectives and proposed outcomes of the workshop, how CAM cancer research integrates with current cancer therapeutics research and precision medicine, and finally, an overview of NCI and NIH's Cancer CAM Portfolio Analysis. The eight topic-specific sessions included presentations reflecting the following critical areas of cancer CAM research:

• CAM Interventions and Immune-modulators -preclinical mechanisms, combinations with immune-, chemo-, targeted, and radiation therapies, and feasibility of phase II clinical trials.
• Molecular Mechanisms, Drug Discovery, and Systems/Network Pharmacology -mechanistic studies, developing new drugs or combination formulas, and utilizing bioinformatics, computation modeling tools, and databases.
• CAM Therapeutic Interventions and Microbiome -effects of the microbiome on treatment, effects of diet/supplement and herbs on the microbiome, and probiotic product standardization.
• Vitamins and Other Nutritional & Pharmacological CAM Interventions -feasibility of moving to statistically powered, biomarker-driven, and mechanistic-based randomized control trials.
• International Collaborations -Chinese medicine research in China: preclinical, clinical, and computation modeling, databases, and areas for future collaboration with NCI.
• Precision Medicine, Biomarkers, and Integrative Medicine Clinical Research -clinical trial design and incorporation of biomarkers in the era of precision medicine, and research related to integrative approaches during treatment (e.g. using diet, herb, exercise, and/or acupuncture to reduce neuropathy and other side-effects, and/or enhance the efficacy/outcome of treatment).
• Material Standardization and Drug-Herb Interaction - importance of studying drug-herb adverse effects, CAM product standardization and methodology research, and databases.
• NCI Research Resources and Funding Mechanisms -grant funding, including extramural and NIH Clinical Center collaboration, and NCI natural product and animal model resources.

This workshop provided a venue to identify new collaborative opportunities among this diverse, international research community. As a result, Beijing University of Chinese Medicine, one of the earliest established traditional Chinese medical universities in China, NSFC, and OCCAM are currently defining several priority areas for collaboration with NCI. In addition, in consultation with the speakers, Dr. Xi will lead the development of a white paper that will serve as a guide to future research. Additional meetings and workshops on specific topics in the field will be planned, and related working groups will be established in the coming months. Contact Dan Xi, PhD (xida@mail.nih.gov) with questions about OCCAM or the workshop.