|
INTRODUCTION
The long-term support of cancer research by the government ultimately depends on how well we collectively meet the challenge to translate discoveries into a measurable reduction of cancer risk and burden on the population. The NCI depends on P30 (Cancer Center Support Grant) supported Cancer Centers to facilitate interdisciplinary science in cancer research programs in the United States.
The emphasis placed on translational research in the majority of P30 centers has been reflected by their success in competing for P50 Specialized Programs of Research Excellence (SPOREs). The P50 SPORE program, in turn, has extended the capabilities of the Centers by providing direct support for translational research projects, specimen banks, and pilot studies on specific disease sites. All but two SPOREs are in NCI-designated cancer centers.
The current 5 year period has allowed accelerated growth of both the P30 centers and P50 SPORE budgets. While creating opportunities for further advances, this growth must be differentiated and also be framed by the need to anticipate more modest future federal budget growth.
The mission of cancer centers and SPOREs extends well beyond the NCI grant base. There are many other sources of research support, health care delivery activities, and services provided that extend into the communities and populations they serve. Awardee institutions have much more flexibility than the NCI in:
- Developing direct associations with each other, with local community organizations, industry, and other awarding entities;
- The ability to retain intellectual property rights on discoveries;
- Rendering interventions and treatments in both research and non-research settings.
P30 Centers and P50 SPORE awards, in turn, must be structured to allow institutions to:
- Adapt fluidly to the exponential growth in our knowledge of the genetic, molecular, cellular and environmental processes responsible for the development of cancer;
- Assure the rapid development of state-of-the- art interventions and clinical trials based on this knowledge.
Broader partnerships must be facilitated if the goals of more rapid movement of discoveries into clear benefits to communities and populations are to be realized. This is a vital goal to NCI and the national cancer program. Since NCI depends on both P30 cancer centers and P50 SPOREs to undergird many of these functions, we need the Working Group's advice on how to use NCI's finite resources most effectively in facilitating the work of Center awardees and institutions in developing broader partnerships, collaborations, and outreach in order to reduce the cancer burden through activities that span the continuum from prevention to treatment to survivorship.
CHARGE
The Working Group shall prepare a draft fact finding report to transmit to the National Cancer Advisory Board in order to:
- explore how these awards can be used to maximize translation of research discoveries into interventions directed to people;
- set clear priorities to accommodate goals in view of prospects for more moderate growth expectations for NCI award mechanisms;
- (through these awards, explore possible incentives to coordinate and lead activities that leverage NCI support with other governmental, private, philanthropic and industrial partners to meet high priority national needs and objectives; and to catalyze greater community and regional involvement Cancer centers;
- consider how P30 and P50 awards may play a greater role in developing the objectives of a national agenda focused on reducing cancer risk and burden in the population, as defined by the NCI Progress Review Group (PRG) reports. These PRG activities have:
- Defined a broad based series of goals, research priorities, opportunities and gaps in a number of site-specific cancers;
- Emphasized the need for more translational research;
- Outlined comprehensive research and treatment agendas far beyond what could be directly supported by the NCI alone, yet they clearly depend on NCI programs to drive progress.
- suggest goals for these specific Centers programs over the next 5 years and measures that could be applied to evaluate the progress and success of these activities.
QUESTIONS TO BE EXPLORED
In continuing to conceptualize the NCI Centers program as a central part of the backbone of a national effort, we will need to consider:
- How to balance geographic distribution, breadth and depth in an increasingly competitive funding environment?
- What budgetary parameters to control (e.g., caps, success rates, total numbers of awards, required elements, new components), viewed against both the scientific opportunities and emergent priorities?
- Activities could be funded through other NCI, public and private award mechanisms vs. what can uniquely or best be accomplished with NCI P30 and P50 support?
- Can the current guidelines and structural elements of the P30 centers and/or P50 SPOREs be better aligned or modified to achieve more directly and rapidly the broader goals/priorities of research that will lead to reducing the cancer burden in the population?
- Whether there are certain current investments in cancer center resources that are not as directly aligned with this priority and could be decreased or replaced via other mechanisms to permit more strategic translational investments, such as facilitation of industry-sponsored and other clinical trials and population studies?
- If there are there better ways for P30 and P50 centers and leaders to complement and coordinate with each other, both scientifically and in terms of service, outreach and community impact, especially when they reside in the same geographic area?
- What kinds of incentives (e.g., greater flexibility in the use of developmental funds, etc.) can be built into NCI cancer centers awards to facilitate leveraging the resources of the institutions with other federal and philanthropic research agencies, industrial partners, and local communities and state governments to achieve the goals of increased translation and reduction of the cancer burden?
- If incentives can be identified to encourage cancer centers both individually and regionally to become important players in coordinating resources of the community and developing plans to achieve the broader objective of reducing cancer risks and burdens?
- If more of the P30 budget can relate to the innovative roles a center may be called upon to accomplish in the new paradigm of molecular medicine, rather than in the direct support of the traditional underlying base of funded research, while still facilitating that research?
- If there are ways NCI staff can stimulate closer networking with grantees and external entities to facilitate both research and improved communications at all levels, and provide a consistent, more unified interface with the public?
- . What measures of progress should we take to evaluate these programs?
SUMMARY
NCI is looking for a report with recommendations that will:
- Serve as a blueprint for optimal alignment of goals, policies, guidelines, strategies, resources and metrics;
- Help affirm for the American people that their money invested in the NCI Cancer Centers program has been well spent, and has generated a leadership network capable of making progress on difficult problems; and
- Chart a direction for the future that will have a measurable impact on reducing the burden of cancer on people.
Optimizing both Centers programs to make measurable progress against these objectives will assure continued strong support for this vital collective mission.
|
