Memorandum submitted by the Cancer Research
Campaign and the Imperial Cancer Research Fund
RESEARCH BASE,
REVIEW AND
FUNDING OF
THE NHS CANCER
PLAN AND
ITS DELIVERY
TO DATE
The support for clinical cancer research in
the NHS is improving through the funding, from NHS R&D, of
the National Cancer Research Network (NCRN) directed by Professor
Peter Selby and the National Translational Research Network (NTRAC),
directed by Professor David Kerr. The establishment of the NCRN
is well in hand, that for the NTRAC slower as the call to establish
the first centres has only just gone out. Early evidence suggests
that progress with NCRN is good. The target of doubling the number
of patients entering clinical trials is demanding and it will
be a matter of time before we can see if this is achievable or
the funding sufficient.
One key factor in increasing the patients in
cancer clinical trials is the funding of the trials themselves.
In this area the Cancer Research Campaign is working with the
Medical Research Council to form a common assessment panel for
the peer review of clinical trials being put forward for funding
from the clinical research community, particularly from the tumour-specific
sub-groups established under the NCRI and building on the excellent
work of UKCCCR (see below). In addition the panel will assess
the trials coming forward for support within the NCRN which do
not require external additional funding, but to ensure that only
high quality trials make use of NCRN resources. A key to the success
of this common assessment panel will be the routing through it
by the MRC of its monies for cancer clinical trials—we anticipate
that this will be achieved so providing the clinical trials community
with a common route to potential funding.
A critical negative factor affecting clinical
cancer research is in relation to academic research-active clinical
staff. Here two key issues need to be addressed. One is the provision
of adequate training schemes to generate research orientated clinician-scientists.
To achieve this more flexibility is required from the Royal Colleges
in their formal professional training schemes to recognise the
importance of research training and allow time for it. Secondly
that academic clinical cancer research is seen as an attractive
career both in terms of remuneration (when compared with NHS consultants
and including their income from private practice) and protection
from the pressures of the routine NHS service load. Neither of
these have been adequately addressed and until they are there
will be difficulty in generating and retaining the type of research-active
clinician required to drive up treatment standards and therefore
increase cure rates for cancer. At present there is great difficulty
in filling cancer clinical chairs; in the last 6 months there
has been failure to make an appointment to at least two highly
regarded oncology chairs. The Committee will be aware that across
the UK's medical schools one in seven clinical chairs remain unfilled.
VIRTUAL NATIONAL
CANCER RESEARCH
INSTITUTE
The transition from the Cancer Research Funders
Forum to the National Cancer Research Institute took place on
1 April 2001, and with it the very real spirit of co-operation
and working together that had characterised CRFF. As this was
happening funding for NCRN and NTRAC was developing and oversight
of these activities moved into NCRI. Associated with this was
the `retirement' of the UK Co-ordinating Committee for Cancer
Research with its functions being taken on by NCRI and particularly
the very successful tumour-site-specific groups so important for
the generation of cancer trial protocols.
The CRFF members have formed the nucleus of
the NCRI and membership is now being extended to other relevant
bodies. An Administrative Director—Dr Liam O'Toole—was
appointed in the summer and the Committee might usefully contact
him for details (if you have not already done so) of current activity
and future work plan. In brief the NCRI is:
— establishing a common database and
classification of cancer research across the UK which will be
compatible with other international systems;
— continuing the prostate cancer initiative
funded by DH, CRC, ICRF and MRC under the auspices of CRFF;
— overseeing the establishment and
operation of NCRN and NTRAC;
— establishing the protocol for, and
joint support of, a national cancer clinical trials tumour sample
collection;
— establishing a close working relationship
with the NCI in the USA. A very successful joint meting with the
Director and other senior staff of NCI was held in April to identify
areas for transatlantic co-operation;
— undertaking a review of radiobiology
and radiation science research to establish the extent of research
in the UK and funding trends, the international status of UK research,
the areas for future development and the capacity of the UK to
support these.
The Cancer Research Campaign is very positive
about the NCRI and its ability to bring the various funders together
and contribute to truly joint activities across the UK. The first
6 months must be regarded as very successful.
THE ISSUE
OF CANCER
REGISTRATION
This remains a major concern and the potential
negative impact of proposed legislation on the ability to conduct
epidemiological-type research. For a detailed appraisal I would
refer the Committee to expert opinion like Professor Michel Coleman.
THE NEW
CANCER RESEARCH
NETWORKS
The Cancer Research Campaign has limited direct
experience of interacting with the treatment networks, but understands
that their establishment is proceeding at different rates across
the health regions. The cancer research networks, NCRN and NTRAC
are dealt with above.
In summary, the report from the Science and
Technology Committee generated much interest and `food for thought'
in the cancer research community. It came at a time when there
was growing appreciation of the need for the funders of cancer
research to work more closely together to maximise the UK's effort
and provided a further stimulus to this. An area of potential
concern, and variable interaction, is with the devolved assemblies;
the UK is too small for there not to be truly UK-wide co-ordination
and interaction. Finally, the Committee will not be unaware that
two ICRF-funded researchers shared in this year's Nobel Prize
for Medicine and that the CRC and ICRF are at the final stages
of a possible merger.
6 December 2001
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