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Research Leaders Praise Funding Increases

  1. Top of page
  2. Research Leaders Praise Funding Increases
  3. The Bottom Line on ARRA Funding and Cancer Research
  4. Cancer Community Optimistic on Obama

Money opens opportunities, presents new challenges

The stimulus funds represent an enormous amount of money relative to the NCI's existing budget, but the challenge is to invest the money in the first 2 years and produce results in terms of new discoveries and new jobs.—Robert C. Young, MD.

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The combined effect of both a 2.9% increase in the National Cancer Institute's (NCI) annual budget and a $1.26 billion boost in funds from the American Recovery and Reinvestment Act (ARRA) “will certainly be felt by laboratory scientists across the country,” NCI Director John E. Niederhuber, MD, notes in a recent NCI Cancer Bulletin.

NCI-designated Cancer Center leaders could not agree more. In interviews with CancerScope, they discussed the impact these increases will have on many fronts in the battle against cancer.

“Under the prior administration, we had a devastating impact on the loss of the next generation of scientists,” says Michael Caligiuri, MD, director of the Ohio State University Comprehensive Cancer Center in Columbus and member of the NCI Board of Scientific Advisors.“Pre- and postdoctoral fellows over the last 5 years have been unable to get jobs in universities and industry.”

Dr. Caligiuri hopes the infusion of new research funds will help turn that scenario around. “My generation won't cure cancer—there are far too many causes,” he notes. “We've got to provide jobs for those young people who want to go into the field so they see hope for a bright future for cancer research.”

This investment in the cancer battle not only will save lives, it will make good sense economically, Dr. Caligiuri adds. In Ohio alone, he notes, the annual economic losses associated with cancer are $8 billion—compared with the NCI's total budget of just $4.8 billion.

He hopes the stimulus funds will enable more money to be put into prevention and population sciences as well as more Research Project Grant (RO1)-funded investigators. In fact, NCI leaders announced in March that they will use this year's appropriations increase to raise the payline, or cutoff point, for 5-year grants to the 16th percentile and the payline for 5-year star grants (which go to first-time applicants beginning their academic careers) to the 22nd percentile. They also hope to allocate a substantial amount of ARRA funds to further increase the payline to the 18th percentile, and possibly beyond, through a combination of 2-year and longer-term grants.

“About a quarter of our young investigators have great ideas worth funding, and the RO1 is time-proven funding that allows them to test ideas in their labs,” Dr. Caligiuri says. But, he adds, “failure to get an RO1 grant [negatively] affects an investigator's chance of being promoted within the university.”

He is supportive of Dr. Niederhuber's idea to spread out some of the stimulus funds for these grants over a longer period—perhaps 4 years—to sustain jobs and long-term scientific endeavors. One area he is not keen on, however, is President Barack Obama's pledge to double the cancer research budget in 5 years. “I would rather see a 5% to 7% increase every year as a long-term solution than a simple doubling of the budget with no clear commitment thereafter—that's what we did last time, and it was a disaster,” he says.

New Discoveries and New Jobs

Robert C. Young, MD, chancellor of Fox Chase Cancer Center in Philadelphia, Pennsylvania, and chairman of the NCI Board of Scientific Advisors, believes the stimulus money presents an interesting challenge.

“The stimulus funds represent an enormous amount of money relative to the NCI's existing budget, but the challenge is to invest the money in the first 2 years and produce results in terms of new discoveries and new jobs,” says Dr. Young. “In science, that's more challenging than it might seem.”

One way National Institutes of Health (NIH) have responded to the challenge is to expand their Director's New Innovator Award program. It supports creative new investigators with highly innovative research ideas at an early stage of their career when they may lack preliminary data required for an RO1 grant application.

And although NCI can't restore grant funds that were cut previously (i.e., funds lost because of a lack of cost-of-living increases during the past several years), it can provide supplemental funds to existing grants, such as supporting equipment purchases under Cancer Center Support grants. It also may fund specific projects that weren't previously funded within ongoing grants—such as Specialized Grants of Research Excellence, he notes.

Dr. Young adds that the original intent of the stimulus bill's sponsor, US Senator Arlen Specter (R-PA), was to use the cancer funds to reset the baseline that had been lost during the previous 4 years of flat funding. Others support this effort, which would enable the funds to be spread out beyond the 2-year period specified in ARRA.

If this were to occur, “instead of funding 18% of approved grants, they might be able to fund 35%,” he notes. “If the stimulus money were put into the base, then that money would continue to come in, and as long as the NCI continued to get a 3% appropriations increase per year, they'd be in good shape.” Dr. Young points to statistics that the average new grant funds 7 researchers. At Fox Chase, the average income for researchers is $60,000. Considering that NIH leaders say they have at least 10,000 grants they could support with additional funds, they could provide 70,000 new jobs—a huge boon to biomedical research and the economy, he says.

Leading cancer organizations and patient advocacy groups are all weighing in with ideas about how the funds should be allocated, and the NCI is continuing to listen to their suggestions and to consult with Congress and lawyers about what can and can't be done, Dr. Young adds. “One of the most important things is that the country has reaffirmed its view of the importance of biomedical research,” he says.

Raising the Bar

“When budgets are flat, grants are more conservative,and investigators frame their questions in a way that the peer-review system feels it's very likely that solid answers will be obtained,” notes John Mendelsohn, MD, president, University of Texas M.D. Anderson Cancer Center in Houston.

The problem there, of course, is that scientists avoid risk. When budgets are higher, however, investigators are more apt to “raise the bar in entirely new ways of approaching things,” he says. “There's more risk, but the potential payoff is tremendous.” This is the scenario he envisions under the new funding environment for cancer research. In addition to generating new discoveries, increased investment in the field will help secure the United States' position as the leader in new drug and technology development, he adds.

“I also think we have to look at cancer in a very broad way—in terms of prevention, early detection, treatment, and survivorship,” Dr. Mendelsohn says. “Plenty of groups have tried to do that, but I never felt we've had the resources to do the research and cover these bases in a comprehensive way. I hope the plan to double cancer funding is tied to a very aggressive planning process that would develop new strategies in these areas.”

The Bottom Line on ARRA Funding and Cancer Research

  1. Top of page
  2. Research Leaders Praise Funding Increases
  3. The Bottom Line on ARRA Funding and Cancer Research
  4. Cancer Community Optimistic on Obama
  • NCI-designated Cancer Center leaders and cancer advocates praise the $1.26 billion in cancer research funds for NCI provided by the American Recovery and Reinvestment Act (ARRA) as well as the 2.9% increase in the NCI's annual budget this year.

  • Increased funding for Research Project Grants (RO1), greater support for young investigators, and encouragement of more innovative, risk-taking science are benefits of the funding infusion.

  • Some express concerns about the ability to show substantial scientific results in the 2-year funding period specified by ARRA.

  • The cancer community is optimistic about pending legislation in Congress that will deal with cancer-related issues such as healthcare reform, Food and Drug Administration (FDA) jurisdiction over tobacco, and clinical trials coverage.

  • Cancer community leaders say this renewed commitment to biomedical research and tackling cancer are positive signs in the battle against the disease.

Cancer Community Optimistic on Obama

  1. Top of page
  2. Research Leaders Praise Funding Increases
  3. The Bottom Line on ARRA Funding and Cancer Research
  4. Cancer Community Optimistic on Obama

When President Obama cited cancer as a disease we should work to conquer in our time in his address to Congress, it was an unusual thing for a president to do, and we're delighted about it. —Daniel E. Smith.

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Cancer researchers and advocates not only are pleased about recent budget increases for research, they also are optimistic that key pieces of federal legislation will soon be enacted.

“We're off to a very fast start and have already seen a couple of wonderful accomplishments,” notes Daniel E. Smith, president of the American Cancer Society Cancer Action Network (ACS CAN), the nonprofit advocacy affiliate of the American Cancer Society.

The ACS CAN and other groups worked for the past 2 years for the successful passage of the State Children's Health Insurance Reauthorization Program(SCHIP), which Congress passed shortly after reconvening and which was signed into law by President Barack Obama.

“When President Obama cited cancer as a disease we should work to conquer in our time in his address to Congress, it was an unusual thing for a president to do, and we're delighted about it,” adds Smith.

ACS CAN Agenda

That commitment as well as the commitment by others in Congress gives hope to many in the cancer community. Other items on the ACS CAN's agenda include the following:

  • Providing more funding to the Centers for Disease Control and Prevention and for other control efforts. This goal would include more funds for the Breast and Cervical Cancer Early Detection Program, which enables uninsured women who make too much money to qualify for Medicaid to be screened for these cancers. In addition, advocates are working to develop a similar program for colon cancer screening.

  • Passing legislation that would give the FDA authority over tobacco. The legislation,which has strong bipartisan support, would require tobacco companies to disclose their ingredients, change their labeling, require proof of any health-related claims, and prohibit most marketing to children.

  • Continuing to push for healthcare reform. With President Obama's proposed $634 billion reserve fund for healthcare reform and many supporters in Congress, the ACS CAN is optimistic about this major piece of their legislative agenda.

“We're working hard to make sure that proposed legislation deals with providing adequate and affordable medical coverage,” Smith says, noting that cancer treatment is becoming a leading cause of bankruptcy in the United States. At the same time, he stresses that prevention is an important element of any reform effort. “Our whole system now is built around acute care,” he says. “We have to change it to one of prevention and disease management.”

Uniting in Their Work Against Cancer

Working in conjunction with ACS CAN is One Voice Against Cancer, started by Smith in 2000 as a working group of public health organizations dedicated to ensuring that the federal government provides the necessary investments for cancer research and application programs. It has since grown into an effective lobbying coalition on cancer funding.

“In the past, there was a rivalry and competition among the various cancer organizations, and the internal feud was creating problems on Capitol Hill,” notes lobbyist Tom Sheridan, who serves as a consultant to the coalition. “Dan reasoned that if the organizations could agree to some overall goals, and the pie is bigger, then those disagreements would be tertiary.”

Sheridan says that One Voice and others in the cancer community must set clear, realistic expectations for reasonable and measurable goals that can be achieved with the increase in cancer research funding. “President Obama wants more creativity, more accountability, and more innovation, and it's important that the cancer community—not just NIH—be very affirmative about their agenda and communicate which advances are closest to the cusp and are most likely to produce results,” Sheridan says.

He is optimistic about another piece of legislation that would create a tobacco tax trust fund for cancer research. Rather than having to start from scratch every year with budget appropriations, NCI could receive support from this long-term fund. “It would keep cancer research from being dependent on the winds of political forces,” Sheridan says. “We hope to see [it] pass in the next 2 years.”

Michael Caligiuri, MD, director of the Ohio State University Comprehensive Cancer Center in Columbus, also hopes to see pending federal clinical trial legislation pass this year. US Sen. Sherrod Brown (D-OH) and Rep. Steve Israel (D-NY) have introduced bills that would prevent insurance companies from denying coverage to patients participating in clinical trials for services that they would otherwise receive under their healthcare plans. Several states, including Ohio, have passed legislation in this area.

“Clinical trials help us move closer to the answers,” Dr. Caligiuri says, “and because only 3% of cancer patients enroll in them, the answers come much more slowly.”