The CBCRP's Strategy for Allocating Research Funds
A New Strategy for the Coming Five Years
To accelerate an end to breast cancer, the California Breast Cancer Research Program (CBCRP) has developed a new strategy for funding research over the next five years. In March 2010, after three years of intense analysis, the CBCRP's Breast Cancer Research Council—the program's highest decision-making body—voted for a bold, new funding strategy. Our strategy will generate new discoveries and approaches for preventing, detecting, and curing breast cancer, and for caring for those affected by the disease.
For the next five years, the CBCRP will focus our funding on:
Program Initiated Research: We are dedicating 50% of our annual funds for studies into three critical, under-investigated areas of breast cancer research:
- Identification and elimination of environmental causes of breast cancer.
- Identification and elimination of the reasons why some groups of women bear a greater burden of breast cancer, based on characteristics such as their race, their ethnicity, or the place where they live.
- Primary prevention of breast cancer. Primary prevention measures keep women and men from getting breast cancer, in contrast to secondary prevention, which is early diagnosis and treatment. The CBCRP will fund population-level interventions on known and suspected risk factors and protective measures, and also targeted interventions for high-risk individuals, including new methods for identifying and assessing risk.
For more on the program initiated research, see the section of this report titled, "Answering Urgent, Neglected Questions: Program Initiated Research."
Community Research Collaborations: We are allocating $2 million annually to support community-based participatory research. These research projects are collaborations between community organizations—such as breast cancer advocacy organizations, community clinics, or organizations serving under-represented women—and experienced scientists. Together, these teams investigate breast cancer problems that are important to that community, using culturally-appropriate research methods.
Innovative, Developmental, and Exploratory Awards (IDEAs): We are supporting ground-breaking research that applies novel methods, perspectives, and approaches that may lead to extraordinary outcomes. Applicants must show how their project is part of a step-by-step research process that will lead to practical applications, such as breast cancer diagnosis, treatment, or prevention.
Translational Research Awards: We are funding research that takes basic science findings quickly toward treatment, diagnosis, prevention or another application that can directly impact breast cancer, either in a medical clinic setting or through a public health measure.
Health Policy: We are allocating $150,000 annually to fund research into ways to shape policy to improve breast cancer prevention, diagnosis or treatment.
Conferences: We are supporting up to $50,000 in breast cancer conferences each year.
The new strategy focuses the CBCRP's funding in areas where the Program can have the most impact. Several types of research grants that the CBCRP has made in previous years and during 2010 will be discontinued starting in 2011. These include Postdoctoral Fellowships and Dissertation awards, because our evaluation showed that career development awards are offered by many other funding agencies, and because the CBCRP's IDEA grants can provide new researchers with opportunities to develop careers in breast cancer research. The Program is also discontinuing IDEA competitive renewal grants, which allowed recent recipients of CBCRP IDEA grants to compete for additional funding, because other research funding agencies offer similar grants. The application process for the IDEA grants is being changed to require applicants to submit a letter of intent. This saves applicants whose research ideas are unlikely to be funded from having to submit a full application. It also increases opportunities for success for applicants who are invited to submit a full proposal after submitting a letter of intent.
The CBCRP's Breast Cancer Research Council developed this new funding strategy through a careful, data-driven process of evaluation that included input from researchers and the public. For more on this process, see the "Improving the CBCRP through Evaluation" section of this Annual Report. A more detailed description of both the new strategy and the evaluation process that led up to it are published in "New Funding Strategy for the California Breast Cancer Research Program: The Way Forward," available on the CBCRP Web site.
Our new strategy is designed to meet the challenge of the CBCRP's declining source of funding, which is a statewide tax on tobacco products. By focusing our resources on the areas where the CBCRP has had the greatest impact, we will continue to lead the nation in meaningful advances against breast cancer.
The Grant-Making Process
Each year, the California Breast Cancer Research Program funds California investigators' research into the disease. These research projects may be completed during that year, but typically they run for more than a year.
The CBCRP's 16-member Breast Cancer Research Council recommends which research projects to fund. The members of the council are listed in the “California Breast Cancer Research Program Council (2010)” section of this annual report. The council uses two different processes to select research for CBCRP funding.
For Program-Initiated Research projects, the CBCRP selects the topics to be researched through a thoughtful, thorough planning process. This process includes analyzing years of nationwide and CBCRP-funded breast cancer research, and collecting feedback from breast cancer advocates, researchers, healthcare providers, policy makers, other funders, and the public, as well as groups of experts we convene to provide advice . Once the CBCRP selects topics to be studied, California researchers are then invited to participate.
For all Investigator Initiated Research—Community Research Collaborations, IDEAs, Translational Research awards, and Conference awards—California scientists select topics to be researched and submit applications.
For all grants, the Breast Cancer Research Council selects research to fund based on recommendations from expert committees who review all research applications for scientific merit. To minimize conflicts of interest, review committees are composed of experts from outside California. These experts include scientists highly knowledgeable about the topics of the applications they consider. Each review committee also has advocate reviewers. These are women and men active in breast cancer advocacy organizations, many of them also living with the disease. The committees use a review process based on established practice at the federal government's National Institutes of Health, but tailored to focus on the assessing the qualities of the applications that are important to the CBCRP (e.g., impact on breast cancer, translation potential). The members of the CBCRP's review committees for 2010 are listed in the Appendix of this annual report.
Research Funded in 2010
The following table presents statistics on the 37 research projects the CBCRP funded in 2010. This is the last year the CBCRP will fund Dissertations, Postdoctoral Fellowships, and IDEA-Competitive Renewal awards.
Table 6. Research Funded in 2010 by Award Type
Grant Type |
Number of Projects |
Amount |
Percentage of Dollars Funded |
Program-Initiated Research |
3 |
$6,859,443 |
45.9% |
Dissertation Awards |
5 |
$380,000 |
2.5% |
Postdoctoral Fellowship Awards |
5 |
$448,467 |
3.0% |
Innovative Developmental and Exploratory Awards (IDEA) |
18 |
$3,957,673 |
26.5% |
IDEA-Competitive Renewal Awards |
1 |
$239,673 |
1.6% |
Community Research Collaboration Awards (CRC) |
2 |
$1,228,781 |
8.2% |
Joining Forces Conference Awards |
1 |
$25,000 |
0.2% |
Translational Research Awards |
2 |
$1,811,982 |
12.1% |
Totals |
37 |
$14,951,341 |
100% |
Priority Issues
Each research project funded by the CBCRP must meet a second set of criteria, in addition to those for the awards listed above. The subject of each project must also fall under one of the Program’s Priority Issue areas:
- The Community Impact of Breast Cancer
- Etiology and Prevention
- Biology of the Breast Cell
- Detection, Prognosis, and Treatment
The following table presents statistics on the 37 research projects the CBCRP funded in 2010 by Priority Issue:
Table 7. Research funded in 2010 by Priority Issue
|
Number of Projects |
Amount |
Percentage of Dollars Funded |
Community Impact of Breast Cancer |
5 |
$4,319,815 |
26% |
Etiology and Prevention |
4 |
$6,373,430 |
38% |
Detection, Prognosis and Treatment |
18 |
$4,507,438 |
27% |
Biology of the Breast Cell |
10 |
$1,671,431 |
10% |
Totals |
37 |
$16,872,114 |
100% |
Ten Goals for the CBCRP's Funding Strategy
The CBCRP's funding strategy is designed to achieve the following ten goals:
- California Specific: Fund research that utilizes resources particular to California and/or addresses a breast cancer need that is specific but not necessarily unique to the burden of breast cancer in California.
- Career Development: Fund research that helps recruit, retain, and develop high-quality California-based investigators who engage in breast cancer research.
- Collaboration: Fund research that uses multidisciplinary approaches and helps fosters collaboration among California scientists, clinicians, advocates, community members, patients, survivors, and others.
- Disparities: Fund research that addresses disparities, inequalities and/or underserved populations in California.
- Innovation: Fund innovative research (i.e., new drugs, new strategies, new paradigms, new applications of tested strategies in new populations and contexts).
- Non-duplicative: Fund research that complements, builds on, and/or feeds into, but does not duplicate, other research programs.
- Outcome Driven: Fund research that will improve public health outcomes (e.g., preventing breast cancer, detection of breast cancer, effective treatments and quality of life).
- Policy: Fund research and evaluation that will have policy implications for breast cancer in California.
- Responsive: Fund research that is responsive to the perceived breast cancer research needs, opportunities, and expectations of the CBCRP as identified by scientists and the public in California.
- Translation: Fund research that is on a critical path for practical application and leads to more effective products, technologies, interventions, or policies and their application/ delivery to Californians.
The following figure illustrates how the CBCRP's types of awards address the Program's goals.

Impacting Statewide and National Policy
The CBCRP's research strategy is designed not only to increase knowledge about breast cancer, but also to lead to solutions that will decrease the suffering caused by the disease. For example, the results from the CBCRP's first completed Special Research Initiatives study—on chemicals policy in California—have caught the attention of state and national policy makers. This research has the potential to shape policy to protect residents from chemicals related to breast cancer in California and throughout the country. Due to the extensive work CBCRP has done to evaluate and facilitate research on the environment and breast cancer, the director of the CBCRP, Dr. Marion H.E. Kavanaugh-Lynch, was invited to speak to the Institute of Medicine (IOM) Committee on Breast Cancer and the Environment: The Scientific Evidence, Research Methodology, and Future Directions, on the subject of “The California Breast Cancer Research Program’s Special Research Initiatives on Environment and Disparities” to inform their policy recommendations.
Spurring Nationwide Research Progress
One goal underlying the CBCRP’s funding strategy is the leveraging of Program funds to spur nationwide progress in breast cancer research. 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 U.S. Department of Defense, Congressionally Directed Medical Research Programs. Nonprofit organizations and for-profit corporations also fund breast cancer research. Although the CBCRP is the largest state funding source for breast cancer research , 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 directions that will lead to research breakthroughs.
An example is the CBCRP’s funding of researchers with innovative ideas that have a high potential for scientific payoff—and also a high potential for failure. The CBCRP has taken a chance on many researchers with high risk ideas. When the research succeeds, the researcher is often able to get another research funding agency to fund the next step. One researcher who began her investigations into b reast cancer with CBCRP funding, Elizabeth Blackburn, not only received funding from other agencies to continue her research, she also received the 2009 Nobel Prize for Physiology or Medicine.
A number of researchers who started with CBCRP funding have recently received funding from the NIH to pursue research across a broad range of breast cancer topics:
- Craig Levin, Ph.D., of Stanford University is adapting Positron Emission Tomography (PET) for use in detecting breast cancer.
- Brian Hargreaves, Ph.D., also at Stanford, is modifying magnetic resonance imaging (MRI) technology with the goal of improving early diagnosis of breast tumors.
- Paul Henderson, Ph.D., at Lawrence Livermore National Laboratory is investigating chemical reactions resulting from breast tumor-related DNA damage. Measuring the tiny quantities of substances resulting from these chemical reactions may lead to a "fingerprint" that can be used to diagnose a tumor or predict whether it will respond to treatment.
- Melissa Dix, at Scripps Research Institute is identifying and cataloging enzymes called proteases and determining how they work in the growth of breast tumors and in the spreading of breast cancer to other parts of the body.
- Frank Pajonk, M.D., Ph.D., at the University of California Los Angeles is investigating how stem cells in breast tumors survive radiation therapy that kills other breast tumor cells. Preventing stem cell survival could keep tumors from growing back after radiation therapy.
- Brunhilde Felding-Habermann, Ph.D., at Scripps Research Institute is investigating a way to use normal stem cells as healers. She is working towards a therapy for breast cancer that has spread to the brain, harnessing the brain's own mechanism for healing and regenerating, neural stem cells.
- Robert West, M.D., Ph.D., at the Palo Alto Institute for Research and Education is studying the genes of cells called stromal cells that surround tumors and play a crucial role in tumor growth. Therapy aimed at stromal cells could work against tumors that resist other therapies.
To further spur research progress, the CBCRP uses additional methods. These include the establishment of our program-initiated research program, which stimulates new investigation in under-investigated areas that have a high potential to lead to breakthroughs in breast cancer causes and prevention, and our development of a new scoring system to help reviewers read proposals with a perspective toward rewarding high-risk 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, Lei Zhang, Ph.D., at the University of California, Los Angeles, is using a CBCRP grant to apply an already-developed method—salivary transcriptomics—toward a better way to detect early breast cancer. Dr. Zhang is testing saliva of women with early breast cancer and women who don't have the disease. His team is looking for biomarkers, substances found in saliva (or other body fluids or tissues) that signal the presence or absence of a disease. Salivary transcriptomics allows scientists to find very tiny amounts of these substances. So far, Dr. Zhang's team has found nine biomarkers that vary significantly between women who have breast cancer and those who don't. The research could lead to a saliva test to detect breast cancer, a much less invasive method than a mammogram.
Leveraging Funds for Promising Research
An additional goal of the CBCRP’s research strategy is encouraging and inspiring other research funding agencies to support cutting edge research. For example, the Avon Foundation for Women, which funds breast cancer research nationwide, has joined the CBCRP in supporting the Program’s ground-breaking Special Research Initiatives. The foundation, long a funder of breast cancer research, agrees that not enough has been done in the areas of environmental links to breast cancer and the reasons why some groups of women bear a greater burden of the disease. The Avon Foundation for Women awarded the CBCRP a $500,000 grant earmarked for the CBCRP Special Research Initiatives.
In addition, receiving a CBCRP grant to conduct breast cancer research also allows scientists to leverage additional funding. For example, for every $1 the CBCRP invested in the Program's Innovative, Developmental and Exploratory awards (IDEAs), investigators have been able to leverage another $5 for breast cancer research.
