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FDA's new acting chief tells of a sea change in care

Predicts more tailored response to patients

WASHINGTON -- The new acting chief of the Food and Drug Administration, Dr. Andrew C. von Eschenbach, said yesterday that he will be presiding over a transformation in medicine, as scientists understand diseases in a way that could improve doctors' ability to treat patients.

Von Eschenbach, tapped by President Bush as the temporary chief of the regulatory agency, said yesterday that discoveries about diseases at ''a molecular level" will lead to a new kind of healthcare.

Now, doctors treat illnesses based on how well other people have responded to a given treatment. Soon, they will develop a tailored response, built around specific understandings of the patient, the treatment and the disease, he said.

''We are discovering so much about diseases like cancer at the molecular level," said von Eschenbach, who is a urologic surgeon by training. ''Much of what we have done . . . has been based on a model of empiricism." Soon, doctors will be able to intervene with medical treatments more effectively matched to a specific patient's illness.

Preparing the FDA for such a transformation is among his goals, von Eschenbach said.

Von Eschenbach also said he would remain as chief of the National Cancer Institute, the government's main agency in researching cancer treatments, while running the FDA. He gave no indication of whether he expected to be nominated as permanent chief of the FDA.

Von Eschenbach replaces Commissioner Lester Crawford, who left two months after the Senate confirmed him for the post. Crawford had functioned as acting head for more than year.

Crawford's resignation, submitted Friday, gave no specific reason for his departure. His tenure was marked by criticism of the agency by those who said it had become more interested in benefiting drug companies than in protecting consumers.

Von Eschenbach declined to discuss in detail specific cases that have led to criticism of the FDA. These include those of Vioxx, one class of pain-relief medicine that has been only lately tied to heart problems, and Plan B, an emergency morning-after contraceptive that the FDA has yet to approve for over-the-counter sales despite assurances that it is safe.

Von Eschenbach had praise for colleagues at the FDA, calling the agency the ''gold standard" for food and healthcare regulation.

''I have an enormous amount of respect, admiration, and appreciation for them," he said, adding that he will continue many of the initiatives of his predecessors while looking to improve operations.

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