House Appropriations Committee Takes Important Actions on Melanoma, Cancer Funding and Skin Cancer Prevention

On May 8, 2019, by a 30-23 party line vote, the House Appropriations Committee approved its version of the Fiscal 2020 Labor, Health and Human Services (LHHS) Appropriations bill. The House bill provides $41.1 billion for the National Institutes of Health, a $2 billion increase above the 2019 enacted level, and $6.9 billion above the President’s budget request.

The House Appropriations Committee provided a total of $6,444,165,000 for the National Cancer Institute, an increase of $300,273,000, or 4.88% over the Institute’s Fiscal 2019 level. Within NIH, the bill includes $195 million for the Cancer Moonshot initiative, and $6.249 billion in direct appropriation for the National Cancer Institute.

The House Appropriations Committee Report accompanying the Fiscal 2020 LHHS Appropriations bill includes melanoma-specific language. The Committee accepted ALL of the melanoma language requested by the Melanoma Research Foundation and its numerous Congressional champions who submitted the NIH melanoma language to the Appropriations Committee. That language reads as follows:

Melanoma. —The Committee encourages NCI to support research from development of experimental models to identify mechanisms and associated biomarkers of risk for development of melanoma, new technologies for early detection as well as trials that develop population-based evidence for screening, including ophthalmologic, and sun protection practices. The Committee also encourages collaboration with the FDA to develop scientific review pathways that more efficiently evaluate new sunscreen ingredients.   

Discovery of biomarkers of response and resistance is critical at this point in melanoma research. The Committee urges NCI to support mechanistic research into response and resistance to therapy, and to develop a strategic plan across the public and private sector to systematically focus on biomarker research with the most advanced technologies (genetic, gene expression, or protein-based), so that physicians have the diagnostic tools to deliver personalized medicine to each patient. The Committee also urges NCI to continue the advances in adjuvant therapy by extending research to earlier stage disease and testing shorter, less toxic and more economical regimens. The Committee further encourages research to understand mechanisms that underlie clinical dormancy to provide an effective means of preventing tumor recurrence and improving quality of life and longevity of survivors.

The Committee is aware symptomatic brain (CNS) and leptomeningeal (LMD) metastases remain difficult to treat and may become the last frontier in systemic therapy in melanoma and other cancers. The Committee urges expanding research to identify treatments for CNS and LMD melanoma, which may pave the way for advances in other cancers.

Melanoma is a heterogeneous cancer and includes rare subtypes such as uveal melanoma, the most common cancer of the eye, as well as mucosal and pediatric melanoma. States have difficulty capturing and defining cases due to the complex nature of arriving at the true diagnosis. The Committee encourages NCI to support research through national registries to better understand natural history, epidemiology, as well as patient reported and clinical outcomes in these rare melanoma subtypes.

The Committee requests an update on these requests in the fiscal year 2021 Congressional Justification.

The House Appropriations Committee’s Fiscal 2020 LHHS bill includes a $2 million increase for the Centers for Disease Control and Prevention Skin Cancer Prevention activities, for a total of $5 million. The MRF worked with the American Academy of Dermatology in support of this increase.

Now that the House Appropriations Committee has reported out its version of the Fiscal 2020 LHHS Appropriations bill, the next step is Senate Appropriations Committee action on its version of the bill. We understand that the Senate LHHS Appropriations Subcommittee may consider its 2020 LHHS bill during the first week of June. Ultimate resolution of funding for NIH and the NCI will have to wait until the House and Senate conference their respective versions of the 2020 LHHS bill, which will likely not occur until later this year.