Strategies in Research Funding
CBCRP carries out its mission through four broad strategies: (1) by supporting the best, most innovative research; (2) funding the training of new researchers; (3) fostering the collaboration of new teams of researchers; and (4) fostering dissemination of research results to scientists, health care professionals and the public.
Although CBCRP is the largest California-based funder of breast cancer research, it is part of a much larger research enterprise in which the federal government (the National Cancer Institute within the National Institutes of Health, and the Department of Defense Breast Cancer Research Program), the private non-profit sector (voluntary health organizations and foundations), and the private for-profit sector (pharmaceutical companies and biotechnology firms) spend more on breast cancer research. Within this larger system, NIH supports the basic research to gain fundamental knowledge about health and disease processes; the DOD Program invests in breast cancer-targeted research, emphasizing innovation, translation and minority communities; foundations target specific projects and the private sector focuses on applications such as new drugs, diagnostic tools, and medical devices that are likely to produce a profit.
The challenge for CBCRP is two-fold:
- to determine specific, critical areas that are not being cultivated by these other sectors that CBCRP can impact, and that will feed into or be fed by the work of these other sectors.
- to narrow this list of specific, critical areas to fit its budget.
Research Priorities
Our role is not to support the full range of research activities necessary to confront cancer - this is the role of much larger, national and federal agencies. Our role, instead, is to:
- Identify the critical areas within the full range of research (behavior, epidemiology, cancer control, prevention, detection, diagnosis, treatment, quality of life, basic sciences) that are not being cultivated by other agencies.
- Identify the gaps in current knowledge and barriers to gaining that knowledge that we can reduce or eliminate.
- Stimulate new ideas that can be fed into the federal and for-profit research sectors.
CBCRP's goals are to foster innovation and discovery, facilitate their application to the care of people with breast cancer and those at risk, and topple barriers to progress. The central question in determining the Program's priorities is:
“What critical elements can CBCRP add to rapidly achieve the prevention and cure of breast cancer?”
In setting priorities and planning for the future, we rely on our diverse constituencies to help us identify new opportunities, gaps, and barriers to progress, as well as to help us create new programs and improve existing ones.
Vision, creativity, planning, meticulous and methodical work, and an occasional stroke of luck - all are needed to achieve progress in breast cancer research. Most critical, however, is recognizing and acting on promising research opportunities at key points in time, and ensuring that new opportunities are being generated.
With these considerations in mind, the Breast Cancer Research Council established the following priorities for research funding in 1999:
- Enhance understanding of the etiology (causes) of breast cancer
- Increase understanding of the biology of the normal breast
- Enhance understanding of the pathogenesis (development) of breast cancer
- Develop new approaches to prevent breast cancer
- Develop more effective techniques for the earlier detection of breast cancer
- Develop health care policy and health care delivery strategies that will serve women more effectively
- Explore innovative treatment modalities
- Increase understanding of, and support for, the socio-cultural, behavioral and psychological issues of women with breast cancer or at high risk for the disease
Award Types
Research Training: Maintenance of Needed Human Resources
The relentless rate of deaths due to breast cancer over the last several decades has prompted CBCRP to provide for the training of new investigators - the human resources needed to ensure sustained progress in the fight against breast cancer. Through three award types, CBCRP endeavors to attract new investigators to breast cancer research. Postdoctoral Fellowship Awards, New Investigator Awards, and Training Program Awards allow researchers early in their careers to receive training in breast cancer research. Together, these awards bring new minds into the fight against breast cancer, and ensure the human resources required to eradicate the disease.
Targeted Research Efforts
The Council identified three specific topics that it felt were (1) especially important to making progress in breast cancer research; and (2) not well supported by other research funding agencies. It set aside $1.0-$1.5 million for each of the following topics:
Sociocultural, Behavioral and Psychological Aspects of Breast Cancer — This Request for Applications encouraged qualitative and quantitative research into sociocultural, behavioral and psychological issues affecting women with respect to the risk or occurrence of breast cancer.
Basic Breast Biology Relevant to Development of Breast Cancer — This Request for Applications encouraged studies aimed at achieving a greater knowledge of the normal breast, through all stages of development and change, in order to better understand anomalous changes that may lead to cancer.
Breast Cancer Prevention, Risk Identification and Risk Reduction — This Request for Applications encouraged research that will enable more effective and appropriate prevention interventions by increasing our knowledge of modifiable breast cancer risk factors.
Innovation in Research
The Council has encouraged researchers to develop and explore innovative and risky concepts in the specific priority areas that it judged important. Innovative Developmental and Exploratory Awards (IDEAs) allow researchers to take risks and explore new concepts in breast cancer etiology, pathogenesis, prevention, earlier detection, treatment, health policy, and delivery of health care that could lead to breakthroughs in these fields.
Through these efforts to explore new concepts and build on existing knowledge, the resulting improvements in prevention, detection and cure of breast cancer will advance the day when we can say with confidence that breast cancer is no longer a threat to the people of California.
Putting Research to Use — Initiatives in Collaboration, Translation and Dissemination
Research in and of itself does not save lives. It is only when the discoveries made through research are translated into new prevention, detection and treatment modalities that the research will have a positive impact.
We know that progress has its roots in discovery. But we also know that a gap exists between discovery and application that will not be closed unless we set in place structures that will speed the engine of discovery, create bridges among all components of the breast cancer research enterprise, and encompass the care of those with cancer and those at risk into the research system.
There are many barriers to application and translation of research results. Perhaps the most significant barrier is that the same person who made the initial discovery can rarely carry out this work. In this age of information overload, it is a challenge for most of us to stay fully informed in one field. It is the rare individual who can be fully informed and expert in more than one. In addition, turning a new idea into a discovery requires intense focus on details, rather than on the “big picture.” And yet, in the path from new idea, to discovery, to development, to practical application, multiple fields of expertise are required, and the same focus on detail that was required to make the discovery can prevent a scientist from seeing the potential uses of his or her discovery.
To meet this challenge and overcome these barriers, CBCRP is building a system of “bridges” among all aspects of research — between research and clinical practice, between research and industry, and between research and communities. Our activities in the following areas are helping to not just span the gap between discovery and application in the clinic and the community, but to transform the process by which we bring discoveries to the benefit of people.
We must nurture and strengthen the ties between diverse research areas, and between the research system and those whose lives breast cancer touches, to ensure that the benefits reaped by new ideas and new technology flow directly into the reduction of suffering from cancer.
Translational research is critical to develop fully the major advances made by basic scientists in areas such as molecular genetics, regulatory proteins, and cellular signaling into new detection technologies, targeted treatments, and prevention strategies.
Two award types stimulate and support collaborative research — one for collaborations between experienced research scientists and community members/agencies (the Community Research Collaboration (CRC) Award), and one for collaborations between research scientists in different fields and institutions (the Translational Research Collaboration (TRC) Award). Both types of award were designed to offer a one-year Pilot Award to foster the development of teams and their projects, and larger 3-year awards for full projects.
