Besides the existence of the Chemotherapy Concession (profit motive in drug selection) being one of the major factors working against the individualization of cancer chemotherapy based on testing the cancer biology, the NCI had made a feeble attempt years ago, to study assay-directed therapy of lung cancer on its own.
1. Their expertise was in establishing permanent cell lines and they only tested tumors after first culturing them to amplify their cell number (these were all passaged, grown up, multiplied, replated). The result was that their assay evaluability rate for primary lung cancers was only 11%.
2. The second problem they had is that they were selecting subpopulations. Subsequent work showed that you get different results when you test passaged cells compared to primary, fresh tumors.
3. The third problem is that the ability to get lung cancer to actually grow is an independent marker for virulent disease. It was actually the single greatest negative predictor for survival in one study.
So the NCI concluded that it was too much trouble and not all that useful. If they couldn't get it to work at the NCI, then of course no one can do it. That was the attitude thereafter.
"If the NCI can't do something, nobody can." What a heck of a way to do science!