Is the state of scientific knowledge regarding the nature of cancer 

 adequate to develop an effective plan for ameliorating the disease? The 

 fact that a program of research and development could be formulated 

 at all suggests that the current knowledge base is sufficient for this 

 purpose. Formulation of a detailed Plan was possible only because of 

 the diverse clues obtained from earlier research. 



The existence of crucial knowledge gaps is explicitly recognized in 

 the Plan. Indeed, much of the planned effort consists of basic (non- 

 targeted) research to extend the base of scientific knowledge. In this 

 regard, "The Strategic Plan" states: 



Our areas of ignorance are still large, and caution must be 

 exercised to assure that the total attack is well balanced 

 between non-targeted and targeted research. 



The pivotal role of basic research in achieving the Objectives of 

 the Program is emphasized also in the "Digest of Scientific 

 Recommendations for the National Cancer Program Plan": 



The very foundations of cell biology, molecular biology and 

 immunology must be strengthened and the entire structure 

 must be enlarged and possibly remodeled .... 



Accordingly, several approaches to the attainment of each major 

 Objective have been delineated and, within each approach, a large 

 number of Approach Elements, i.e., highly specific defined 

 subobjectives. To illustrate. Objective 3 above is to develop means to 

 prevent transformation of normal cells to cells capable of forming 

 cancers. The alternate approaches to that Objective are: (a) study the 

 nature and modification of the precancerous state and determine 

 mechanisms accounting for high degrees of stability of cell function; 

 (b) delineate the nature and rate of oncogenic cell transformations in 

 carcinogenesis (include aspects of cell culture and viruses); (c) 

 investigate cellular and organismal modifiers of the transformation 

 and promotion processes; (d) identify immunologic aspects of 

 transformation; and (e) study cell surfaces and cell membranes. 



The Approach Elements are numerous, as illustrated by the 

 following random sampling of "elements" associated with Objective 3: 

 to elucidate mechanisms of DNA replication and repair in normal and 

 cancer cells; to characterize the molecular basis for development, 

 stability, and inheritance of differentiated cells; to delineate the 

 interaction of precancerous cells with their host; to delineate cancer 

 genomes through manipulation of cells or chromosomes; to define the 

 relationship of mutagenesis to carcinogenesis; to characterize 

 molecular species involved in expression of cancer genomes; to extend 

 studies on the biology, molecular biology, genetics, and enzymology of 

 oncogenic viruses; to determine the role of hormones in cancer; to 

 determine the role of nutrition in cancer; to define the genetic basis of 



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