APPENDIX 1
Memorandum submitted by Professors Will
Steward and Mr Andy Gescher, Department of Oncology and MRC Toxicology
Unit, University of Leicester
1. SUMMARY
We wish to show, using our research activities in
cancer chemoprevention as an example, that funding mechanisms
to support very important areas in clinically-orientated (translational)
cancer research do currently not exist in the UK and that this
situation requires urgently the formation of "Translational
Research Centres" or "Translational Research Initiatives".
2. INTRODUCTION
Cancer chemoprevention is a relatively new approach
to dealing with the cancer problem. The underlying idea is to
prevent, or postpone the onset of the disease before it is established
by the regular long-term intake of a tablet or a (standardised)
food additive. Successful cancer chemoprevention strategies would
save the NHS millions of pounds and would have an enormous impact
on the Health of the Nation. Little is known about how safe and
effective potential cancer chemopreventive agents are when administered
in high doses as drugs or food additives. Yet studies on cancer
chemopreventive agents are not supported by the pharmaceutical
industry, because the outcome of the clinical evaluation is so
long term (10-20 years) that it is incompatible with commercial
viability at the level of private industry.
3. THE PROBLEM
We direct a translational cancer research group
unique in Europe devoted to the discovery and development of cancer
chemopreventive agents with two senior scientists, eight assistants
and research students and two clinicians at the University of
Leicester. We are currently involved with two types of experiments
which are like the proverbial two sides of the same coin: (i)
the mechanistic evaluation of diet-derived agents with potential
cancer chemopreventive properties in experiments using cells in
culture and in rodents, and (ii) the study of their potential
side effects, tolerability, absorption, distribution and metabolism
in patients including the detection of biochemical short-term
changes in blood or excreta which might be indicative of cancer
preventive activity. Whilst the fundamental (laboratory-based)
research efforts which buttress our (clinical-orientated) translational
chemoprevention project here at Leicester University and elsewhere
are well funded by the MRC and other research councils, we (and
others in a similar situation to ours) have found it near impossible
to recruit urgently required funds from the established cancer
charities (CRC, ICRF) to implement the clinical research arm of
this relatively new approach.
4. FUNDING—THE
CURRENT SITUATION
Cancer research in the UK is primarily funded
by the two research charities, the CRC and ICRF. A few years ago
these well-established cancer research charities—quite understandably—made
the commitment to fund research activities primarily in their
own named establishments. The relatively few remaining funds for
projects beyond the boundaries of CRC/ICRF units/groups are open
to competition, generally with success rates of less than 10 per
cent. Submissions for research grant money are evaluated under
the most exclusive criteria and weighed against each other, ie
laboratory-based molecular biology projects are compared directly
with clinical-orientated studies. The result of this approach
is that neat lab-based molecular biology experiments in cells
based on glamorous hypotheses invariably fare much better in terms
of funding success than work with somewhat less predictable outcomes
which involve patients, even though these clinical projects may
have in the medium term an enormously beneficial impact on the
Health of the Nation.
5. SOLUTIONS
TO THE
PROBLEM
(a) The country needs funding for cancer
research from sources other than industry and the established
charities to support translational projects like the one we are
involved with.
(b) In funding terms different areas of cancer
research endeavours should not be evaluated together but completely
separately, ie translational-clinical projects should not be thrown
in with molecular biological basic science ones in the evaluation
process.
(c) The Government (through the DHS or MRC)
should establish "Translational Research Centres" or
"Translational Research Initiatives" to address specifically
the needs of clinically-orientated cancer research projects. These
would provide the urgently needed help to support translational
cancer research which might have a vast beneficial impact on the
Health of the Nation.
10 February 2000
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