TO FRIENDS AND COLLEAGUES THROUGHOUT THE BIOMEDICAL COMMUNITY:

The pace of change in the U.S. biomedical enterprise has accelerated to a dizzying pace in recent months, as multiple trends—scientific, clinical, demographic, financial, technological, and societal—have converged.

We have surely entered the era of information-based medicine, in which a more precise understanding of disease origins to prevent, diagnose, treat and monitor disease in a truly individualized way for every person is now feasible, albeit not available uniformly.

The challenges, of course, remain daunting. The demographics of an aging population threaten a staggering 20 million new cases of cancer globally by the year 2030, up from 12 million per year today.¹ The tsunami of data that results from high-throughput technologies is still engulfing us. Our research institutions are still functioning for the most part as silos, not only within their own facilities but also between one another, with potentially illuminating information imprisoned inside paper records or barred by electronic systems that cannot interoperate.

Fortunately, we are making significant progress against these challenges, and informatics solutions can address many of the technical hurdles. A 21st century biomedical system is predicated on the availability of a nationwide, interoperable, interconnected information technology platform that enables information sharing. The NCI identified the need early in this decade for such an informatics initiative—unprecedented in scope for the biomedical community—and developed caBIG^® (cancer Biomedical Informatics Grid) to enable rapid information exchange among previously disconnected laboratories, institutions, and sectors.

caBIG^® is an enabler of individualized cancer medicine, a catalyst for change, and a model for unifying research and care in cancer and beyond. Although it is customized for cancer, it is remarkably "BIG" in potential.

As an enabler, caBIG^® now provides the electronic infrastructure for the cancer community to conduct every step along the bench-tobedside continuum: to manage biorepositories; to oversee clinical trials from planning through implementation through regulatory submission; to conduct molecular discovery; to integrate clinical images; and to connect researchers and institutions with a system that addresses legal, regulatory, policy, intellectual capital and contractual barriers to data exchange.

As a catalyst, caBIG^® continually brings the need for inter-disciplinary communication and collaboration to the forefront, provoking cultural shifts and action that might otherwise be postponed. By making data easily accessible, caBIG^® accelerates discovery. Beyond simply "speeding up" 20th century processes with electronic methods, caBIG^® is changing the way those processes are done, and the way researchers think about their explorations.

Finally, caBIG^® is serving as a model by which research and care can be united, so that the knowledge gained in the care setting can be harnessed to fuel research discoveries and those discoveries can be channeled back into care in a seamless virtuous cycle—called the rapid learning health care system—that uses all information as a source of knowledge for improving patient care.

The Sequencing of the Human Genome was once called a "race to the starting line." Similarly, the unprecedented caBIG^® initiative—which has engaged thousands of individuals and hundreds of institutions in the past five years—has now crossed the starting line of a new national highway of connectivity and information exchange that promises to transform biomedicine in cancer and beyond.

Ken Buetow, Ph.D.
Director, Center for Bioinformatics and Information Technology
National Cancer Institute
March 1, 2009

¹ World Cancer Report 2008, International Agency for Research on Cancer (http://www.iarc.fr/en/Publications/PDFs-online/World-Cancer-Report).