The CBCRP’s Strategy for Funding Research

The CBCRP’s Breast Cancer Research Council and staff set the priorities for the Program’s research funding. The following ten criteria are used by the Breast Cancer Research Council to set priorities that push the boundaries of research.

  1. The research helps form and nurture collaboration among California scientists, clinicians, advocates, community members, and others.
  2. The research helps recruit, retain, and develop high-quality California-based investigators who engage in breast cancer research.
  3. The research embodies innovative ideas (i.e., new drugs, new strategies, new paradigms).
  4. The research addresses the public health outcomes of prevention, earliest detection, effective treatments, and quality of life.
  5. The research leads quickly to more effective products, technologies, or interventions and their application/delivery to Californians.
  6. The research helps drive policy in both the private and public sectors on breast cancer in California.
  7. The research reduces disparities and/or addresses the needs of the underserved in California.
  8. The research complements, builds on, feeds into, but does not duplicate the research programs of other organizations interested in breast cancer.
  9. The research addresses a breast cancer need that is specific but not necessarily unique to the burden of breast cancer in California.
  10. The research is responsive to the perceived breast cancer research needs and expectations of the CBCRP as identified by scientists and the public in California.

To ensure that the CBCRP fulfills all of the criteria, the Council devised a two-part funding strategy, the Special Research Initiatives and Core Funding.

Five-Year Special Research Initiatives

The CBCRP's Special Research Initiatives address two overlapping questions:

The CBCRP launched the Special Research Initiatives in 2005 because the Program's previous efforts to increase research addressing these questions have not led to enough progress. California is an ideal laboratory for research into the environment's role in breast cancer and the reasons why some groups of women bear an unequal burden of the disease. The state has varied geography, heavily industrialized areas, and a large agricultural area. It has a mix of urban, suburban, small town, and rural communities. The state’s population is ethnically diverse. California also has communities with the highest rates of breast cancer in the nation.

The initiatives are the result of a thoughtful, thorough planning process that included analyzing years of nationwide and CBCRP-funded breast cancer research, and collecting feedback from breast cancer advocates, researchers, and the public.

The CBCRP is investing 30 percent of its research funds over five years, which will result in at least $18 million for these investigations.

To select the research that will lead to the most progress against breast cancer, the Program is following a carefully-crafted, two-year, publicly-accessible strategy development process. A steering committee of researchers and advocates from across the nation is guiding this process of developing strategy. The members of this committee include:

The CBCRP has been following a two-year process for developing the SRI funding strategy because the questions selected for investigation hold great promise for progress against breast cancer, but they are also difficult to research. There's no scientific consensus on where to begin. Information about previous research into these questions has up until now been available only through widely scattered sources.

The CBCRP's strategy development process is designed to avoid duplicating previous research and to base the Program's efforts on the most up-to-date knowledge and on the opinions of experts nationwide. The process allows time to make the best use of the state's resources by identifying and involving California institutions and organizations who can join forces to make progress against breast cancer. The goal is an integrated, coordinated statewide approach that ensures statewide solutions.

The process of developing this strategy moved forward in 2007. The CBCRP completed drafting a review of previous research into the impact of the environment on breast cancer and the reasons why some groups of women bear a greater burden of the disease. This draft, titled "Identifying Gaps in Breast Cancer Research," runs to hundreds of pages, considers the results of thousands of research studies, summarizes the latest thinking on these questions, and makes recommendations for research to be pursued under the Special Research Initiatives. "Identifying Gaps in Breast Cancer Research" is available to the public on the CBCRP Web site. A panel of science advisors, composed of experts from across the nation, reviewed and shaped "Identifying Gaps in Breast Cancer Research." A list of the science advisors, staff, and consultants who wrote and shaped "Identifying Gaps in Breast Cancer Research" is found in Appendix B.

During 2007, the CBCRP gathered ideas from a variety of sources concerning research to be conducted under the Special Research Initiatives. Four town hall stakeholder meetings were held in Fresno, Los Angeles, San Francisco, and Ukiah. Interested members of the public viewed a slide presentation summarizing important points from the "Identifying Gaps in Breast Cancer Research" review. Participants were then invited to submit ideas for research, during the meeting or later online. Two teleconferences and an online opportunity further encouraged the public to submit ideas. Those who participated in this process were later able to rate the ideas submitted. At the CBCRP symposium in September, attendees were also asked to rate submitted research ideas. Participants in this process included women affected by breast cancer, investigators, clinicians, government officials, and interested members of the public across California.

A 33-member strategy team of scientists, advocates, and clinicians from California and across the nation met twice during 2007 to consider input from the public and use the review of previous research to make specific recommendations for research to be funded. The strategy team, the members of which are listed in Appendix B, will make its recommendations during 2008.

As a result of the CBCRP's leadership in research into the role of the environment in breast cancer, the Program's director, Marion H.E. Kavanaugh-Lynch, has been appointed to the nine-member California Environmental Contaminant Biomonitoring Program Scientific Guidance Panel. The panel assists the Department of Health Services and California Environmental Protections Agency by providing scientific peer reviews and making recommendations regarding the design and implementation of the California Environmental Contaminant Biomonitoring Program.

Core Funding

After setting aside 30 percent of CBCRP research funds for the Special Research Initiatives, the remaining 70 percent is dedicated to challenging investigators to use the funds to maximum effect. During its fourteen-year history, the CBCRP has developed and fine-tuned a funding strategy designed to stimulate innovative research.

Each research project must fall under one of the CBCRP's Priority Issue areas:

Each research project must also qualify as one of the CBCRP types of awards:

The Translational Research award, offered for the first time during 2007, drew a high response from interested researchers. The CBCRP received over 50 letters of intent and 10 applications. Only one study was funded, due to limitations on CBCRP funds. This award replaces the CBCRP's previous Translational Research Collaboration Award, which was a mixed success. The requirements have been altered to stimulate research that moves most directly and quickly toward applications that will create progress against breast cancer.

Two goals underlying the CBCRP's funding strategy are the leveraging of Program funds to influence the research system nationwide, and enlarging the pool of breast cancer researchers.

Influencing the Research System Nationwide

The CBCRP is part of a much larger research system. The federal government funds breast cancer research through agencies like the National Cancer Institute and the Department of Defense. Nonprofit organizations and for-profit corporations also fund breast cancer research. Although the CBCRP is the largest state funding source for breast cancer research in California, these funds make up only a small part of the funds granted through the larger system. The CBCRP tries to influence this larger research system to move in new, creative directions.

An example is the CBCRP’s Innovative, Developmental, and Exploratory Awards (IDEAs). These awards were specifically designed to fund research that has a high potential for scientific payoff—and also a high potential for failure. When the CBCRP began funding breast cancer research in 1995, less than 10 percent of research proposals submitted to the nation’s funding agencies were successful. This led the people who decided what got funded—panels of research experts—to look for proposals that seemed most likely to succeed. Research scientists had to have done a significant portion of the research, and have strong preliminary data, before they could even get a grant. This made it hard for anyone to get funding in order to try out a high-risk idea. However, high-risk ideas are often the source of scientific breakthroughs.

If the research funded by an IDEA succeeds, the researcher may well be able to get another research funding agency to fund the next step. For example, in 2005, the CBCRP awarded Mark Moasser, M.D., at the University of California San Francisco, an IDEA grant. Dr. Moasser used it to investigate more effective treatments for a subset of breast cancers containing overactive proteins called HER-2 that drive the growth and spread of these tumors. Dr. Moasser's research goal was to discover why medications that effectively block the HER-2 protein do not work against these tumors. He discovered the molecule-level chemical reactions within breast cancer cells that allow the cells to get around the effects of medications that block the HER-2 protein. The National Institutes of Health recognized the importance of this discovery by awarding Dr. Moasser a grant in 2007 to test several treatment strategies for tumors with overactive HER-2 protein, based on the findings from his CBCRP-funded research. If the strategies Dr. Moasser is investigating succeed in laboratory studies, he plans to propose testing them with breast cancer patients.

The CBCRP uses additional methods to get creative new research going. These include encouraging researchers in California to submit exciting new ideas. The CBCRP also developed a new scoring system to help reviewers read proposals with a perspective toward rewarding highrisk research.

Enlarging the Pool of Breast Cancer Researchers

Another major goal of the CBCRP is to increase the number of talented scientists engaged in breast cancer research. Some of the Program’s grants have allowed investigators to specialize in, or concentrate much of their efforts on, breast cancer research. For example, the CBCRP awarded Karlene Cimprich, Ph.D., of Stanford University, two IDEA grants in 2002 and 2007. Dr. Cimprich's work centers on the normal processes within cells that repair damage to DNA that would otherwise lead to cells becoming cancer cells. She uses frog eggs as a model for human cells, because they have similar DNA repair processes. CBCRP funding allowed Dr. Cimprich to apply her research specifically to the DNA damage caused by mutated forms of the BRCA1 and BRCA2 genes. The normal version of theses genes is involved in DNA repair, but women who have inherited mutated versions of these genes are at very high risk for breast cancer. Currently, Dr. Cimprich is attempting to develop a molecular profile of breast tumors that have some of the same defects in cellular DNA repair systems as do tumors from women with BRCA1/2 mutations. The goal is to identify up to 25 percent of breast cancer patients who could potentially benefit from medications called PARP inhibitors that target tumors with defects in cell processes initiated by BRCA genes.

The CBCRP also makes it possible for new scientists to begin their careers as specialists in breast cancer research, through Postdoctoral Fellowship and Dissertation awards. Since the CBCRP's inception, the Program's Postdoctoral and Dissertation awards have launched over 200 new breast cancer research careers.

Funding by Priority Issue and by Award Type

Every research grant funded under the CBCRP’s Core Funding must fit within two separate sets of categories, the Priority Issues (research topic) and the Award Types. The Priority Issues are broad, to allow the Program to have an impact across a wide spectrum of breast cancer research. The Award Types, discussed on previous pages, are narrowly targeted to focus CBCRP funding where it will lead to the most rapid progress.

Below, two tables present statistics on the 35 projects funded during 2007 by Priority Issue and by Award Type.

Table 3. 2007 Grants Awarded by Priority Issue

      
Priority Issue
Number
of Grants
Amount
Percentage of
Total Funding
Community Impact of Breast Cancer
6
$1,935,241
27%
Etiology and Prevention
2
$911,413
13%
Detection, Prognosis and Treatment
14
$2,825,270
40%
Biology of the Breast Cell
13
$1,429,718
20%

Totals
35
$7,101,642
100%

Table 4. 2007 Grants Awarded by Award Type
Award Type
Number
of Grants
Amount
Percentage of
Total Funding
Dissertation
8
 $599,863
5.1%
Postdoctoral Fellowship
6
 $540,000
9.6%
Innovative Developmental and Exploratory (IDEA)
9
 $1,478,389
51.4%
IDEA-Competitive Renewal
3
 $1,004,677
4.7%
Community Research Collaboration (CRC) Pilot Award
3
 $566,641
14.8%
Community Research Collaboration (CRC) Full Award
3
 $2,020,512
13.7%
Joining Forces Conference Award
2
 $40,000
0.3%
Translational Research Award
1
 $851,559
0.4%

Totals
35
 $7,101,642
100%