Building an NCI-Designated Cancer Center: Lessons from a Leader Who’s Done it

When Roy Jensen, MD, steps to the podium August 31 as the keynote speaker at this year's Tennessee Statewide Cancer Collaborative scientific meeting in Nashville, he'll be speaking to a city he knows intimately. He lived there for roughly 24 years, earning his medical degree at Vanderbilt, completing his residency and fellowship training, and later returning to the Vanderbilt faculty after a research stint at the National Cancer Institute. He stayed on faculty until 2004, the year he left for a job that would come to define his career: director of The University of Kansas Cancer Center.

Jessica Snowden, MD, vice chancellor for Research at UT Health Sciences and organizer of the meeting, deliberately sought out Dr. Jensen to headline this year's event, themed "From Discovery to Impact: Accelerating Cancer Solutions for Tennessee." Her reasoning was straightforward: UT Health Sciences is pursuing the same milestone Dr. Jensen chased and ultimately reached not once, but twice: designation as a National Cancer Institute (NCI) cancer center in 2012, followed by the far more demanding comprehensive designation in 2022. Few people in the country understand that climb as well as he does.

The Kansas program Dr. Jensen inherited in 2004 bore little resemblance to the institution it is today. The cancer center was seeing about 1,700 new patients a year and running on roughly $12 million to $14 million in annual research funding, modest figures even by the standards of the time, and far short of what the NCI expects from a designated center. "It was really all about identifying and deploying financial resources to grow the program and recruit senior leaders to the Cancer Center," Dr. Jensen said. Getting there took eight years of sustained effort before Kansas was ready to even apply.

When asked what made the difference, he doesn't point to a grant or a single recruitment. He points to a chancellor willing to take a risk. Robert Hemingway, then chancellor of the University of Kansas, publicly declared that NCI designation was the university's No. 1 institutional priority, an unusual and politically costly move. "They don't usually like to declare priorities," Dr. Jensen said of university leaders generally. "And they certainly don't like to prioritize their priorities, because essentially what you do is make everybody who's not priority number one mad. But he had guts to do that, and it was absolutely essential."

The declaration paid off almost immediately. It gave the cancer center credibility with the state legislature, which soon created a dedicated $5 million annual line item in the budget to support it. Jensen describes what followed in terms borrowed from business author Jim Collins' "Good to Great": a flywheel that, once turning, became easier and easier to push. Institutional backing plus a modest amount of flexible funding allowed the center to recruit the right leaders. Each recruitment made the next one easier.

A regional partnership added fuel to that flywheel. Johnson County, in the Kansas City metro area, passed a sales tax dedicated to funding an early-phase clinical trials unit for the cancer center generating just under $5 million a year at the outset and nearly $9 million today. That investment gave Kansas something it had never had: real access to Phase 1 clinical trials, close to home.

The impact on patients was measurable and significant. When Dr. Jensen's team began this work, about 15% of cancer patients in Kansas were leaving the state for treatment. That figure now sits below 5%. Patients no longer have to travel out of state to access the frontier of cancer therapy. It is available in their own backyard.

As Kansas built toward its first designation, Dr. Jensen and his colleagues made a deliberate strategic bet to position the center around drug discovery and development, leveraging two assets unique to the region - a KU School of Pharmacy that has ranked among the nation's top 10 for decades, and a lesser-known but robust cluster of pharmaceutical contract research organizations in Kansas City.

"At the time, that idea was not terribly popular," Dr. Jensen said. But as major pharmaceutical companies scaled back internal research in favor of acquisitions in the early 2000s, an opening emerged for academic centers to become discovery engines in their place. Kansas filled that gap. The strategy has since produced six KU-invented discoveries that have advanced into Phase 1 clinical trials, with more currently underway.

The Second Climb: Comprehensive Status

Reaching NCI designation in 2012 was only the first summit. Ten years later, Kansas achieved comprehensive cancer center status, a distinction that recognizes the full breadth of a program's basic, clinical, translational, and population science, along with its educational mission. Dr. Jensen said that second climb demanded depth across the board: a stronger basic science portfolio, clinical trials spanning a broader range of malignancies, expanded translational research - underscored by those six KU-invented products moving into the clinic - and a robust program for training the next generation of cancer researchers and clinicians. "Those are the pillars of comprehensive status," he said. "We laid out a strategic plan to strengthen those areas… and then just focused on making that happen."

Asked what trips up institutions pursuing NCI designation, Jensen says impatience born of short leadership tenures. Senior academic leaders often don't stay in place long enough to see a multi-year initiative through, he said, and that creates pressure to declare victory - or apply for designation - before an institution is truly ready.

"You have to be committed to the outcome and be focused on taking steps that ensure long-term success instead of opting for a short-term flash in the pan," Dr. Jensen said. "They focus on applying as early as they can, instead of focusing on applying when you're in a strong position that will lead to success. There's a difference between those two things."

From Discovery to Impact

The theme of this year's meeting, "From Discovery to Impact," is one Dr. Jensen has thought about across his entire career. He points to a milestone reported for the first time this year by the American Cancer Society: five-year cancer survivorship has climbed past 70%, up from less than 50% when the National Cancer Act first established the centers program in the early 1970s.

"The progress has been steady," Dr. Jensen said. "But 70% is still a C- in most grading systems. We still have a lot of work to do."

What's changed, he argues, is the nature of the challenge. Cancer research, he said, has shifted from a discovery problem (not knowing what to work on) toward something closer to an engineering problem, where the underlying science is understood and the work is refining how to apply it.

He points to two examples. CAR-T therapy re-engineers a patient's own immune cells to hunt down their cancer, a concept researchers no longer need to invent from scratch, only optimize by identifying the right targets for each disease. And after decades in which RAS mutations, present in roughly 70% of pancreatic cancers, were considered "undruggable," new RAS inhibitors developed through years of coordinated basic, translational, and clinical research have begun changing outcomes for patients with advanced disease.

"That's a great example of us not standing around scratching our head wondering how to cure pancreatic cancer," Dr. Jensen said. "We know that if we find an effective form of therapy against RAS, we're likely to be able to cure it. It's turning the process into more of an engineering endeavor."

Dr. Jensen's message is ultimately one of patient, deliberate ambition. Building a great cancer center, he suggests, isn't about a single breakthrough. It's about assembling the right people, developing a shared vision, and turning the flywheel year after year until it builds a momentum of its own.