It is not everyday that you get to hear a Nobel laureate or the former director of the NIH speak. It is even less frequent that you get to hear someone who was both. For me, yesterday was such a day. Harold Varmus, MD, Nobel laureate, former director of NIH, and current president of Memorial Sloan-Kettering Cancer Center, gave The Julia Hudson Freund Memorial Lecture here at Washington University School of Medicine. His talk was titled "The New Age in Cancer Research" and in it he discussed his research over the years replicating in mouse models the behavior of cancer in humans, specifically as it relates to oncogene dependence and drug response. The common thread running through the several impressive examples was the need for clinical oncologists and molecular oncologists to work together more closely to tackle the many challenges facing cancer treatment and research. His research and his efforts at NIH and MSKCC have done much to bring these two spheres of work together. As discussed in a recent post, there is another sphere that also needs to be considered: medical bioinformatics. Just as bringing clinicians and researchers together has led to better understanding of cancer and better treatment of cancer patients, informatics will have much to contribute as new sequencing technologies and other data-rich platforms are applied to cancer.

One of the major difficulties in merging these three spheres is the wildly different environments in which each group operates: different educations, different languages/jargons, different motivations and rewards, different customers, etc. These differences results in poor communication, especially when presenting data. Each culture wants high-level information about the other cultures while receiving detailed information about theirs. Often when cross-disciplinary meetings take place, each person presents detailed information in their discipline and checks their email when someone from a different discipline presents her detailed information. Tools and data portals are usually geared toward a specific audience, making them marginally useful to people with a different background. One way to address this difficulty is to cross train people in several disciplines. Dr. Varmus has started such a program, the Gerstner Sloan-Kettering Graduate School of Biomedical Sciences which offers a cross-disciplinary degree in cancer biology. Such programs are important and will undoubtedly produce terrific researchers and results, but not everyone has access to such programs or the mental agility to succeed in them. Thus, we need to focus on ways to present complex ideas and data in ways that speak to numerous audiences. This may be several different presentations or a single presentation that allows people to see high-level information and drill down into the data using methods and views familiar to them. Obviously designing such agile interfaces is not easy; it will require cross-disciplinary teams versed in medicine, biology, informatics, computer science, and interface design. To make this (and other important collaborations) happen, we need institutions and funding agencies to rethink how they measure and reward investigators and clinicians. Collaboration, communication, and information sharing must replace publications and number of patients as requirements for funding and the measurement of success.