Memorandum submitted by the National Cancer
PROGRESS IN DEVELOPING THE VIRTUAL NATIONAL
CANCER RESEARCH INSTITUTE; ITS PRODUCTIVITY AND RELATIONSHIP WITH
THE CANCER RESEARCH FUNDERS FORUM
The NCRI was formally established on 1 April
2001. I was appointed as Administrative Director, at the end of
July 2001. Selection and interview was by a joint Public/Charity
Sector panel (Sir Paul Nurse, Sir George Radda, Dr Trevor Hince,
Sir John Pattison, Ms Jane Bradburn). Two further full-time staff
were appointed in October/November 2001. The NCRI also has two
part-time staff seconded to it by the Cancer Research Campaign
and the NHS R&D Programme.
Following the Prime Minister's Downing Street
Cancer Summit in May 1999, and concerns about the co-ordination
of cancer research a Cancer Research Funders Forum (CRFF) was
established. The Forum comprised the major research funders in
the UK including the Department of Health, Medical Research Council,
the Imperial Cancer Research Fund, the Cancer Research Campaign,
The Leukaemia Research Fund, the Ludwig Institute and Marie Curie
The CRFF partnership achieved a great deal in
a short space of time and details are given below. In September
2000 the NHS Cancer Plan announced that, in order to go further
in planning and co-ordinating the drive on cancer research, the
Department of Health's Director of Research and Development and
the National Cancer Director would work with all those involved
in the funding and delivery of cancer research, to come forward
with definitive proposals for a National Cancer Research Institute.
During the end of 2000 and the beginning of
2001 members of the CRFF jointly developed proposals for the NCRI.
In early 2001 Ministers approved the CRFF outline proposal for
the NCRI. The proposal was then considered and approved at a CRFF
meeting on 15 March 2001. The Secretary of State for Health then
announced that the NCRI would be established on 1 April 2001.
The NCRI evolved from the CRFF, was developed
by the CRFF and has now replaced the CRFF. As the NCRI, the CRFF
partnership has been extended to include a broader range of cancer
research funders and there is an NCRI Secretariat to conduct the
strategic analyses and build Strategic Partnerships to tackle
key issues. Industry is also now a member of NCRI and has representation
on the NCRI Board. In response to this the ABPI has established
a UK Cancer Group to "shadow" the NCRI and provide collective
input. Preliminary meetings have already been held with this group.
THE NCRI AND
The National Cancer Research Institute (NCRI)
is a partnership between government, the voluntary sector and
the private sector. Its purpose is to streamline and accelerate
the advancement of cancer research in the UK. The NCRI aims to
do this by developing an overall strategy for cancer research
in the UK and co-ordinating activities between Member Organisations.
The NCRI Secretariat is co-funded by the Public and Charity Sectors
on a 50/50 basis.
The Specific role of the NCRI is to:
Take a strategic oversight of cancer
research in the UK.
Identify gaps in current research
Plan and co-ordinate approaches between
funding bodies to fill gaps and take advantage of opportunities.
Monitor progress in implementing
agreed plans and in achieving agreed objectives.
All NCRI Member Organisations have agreed to
contribute to the development and implementation of a national
strategy for cancer research in the UK.
Member organisations include:
Cancer Research Campaign; Imperial Cancer Research
Fund; Leukaemia Research Fund, Ludwig Institute; Marie Curie Institute;
Medical Research Council; UK Departments of Health; Tenovus; Breakthrough
Breast Cancer; Association for International Cancer Research;
Yorkshire Cancer Research; Macmillan Cancer Relief; Also likely
to include other Research Councils (BBSRC, ESRC).
A comprehensive and reliable information base
is fundamental in research planning and priority setting. A clear
picture of how and where NCRI partners spend their money at any
one time is crucial to inform funding decisions within individual
organisations and to allow joint strategic planning between organisations.
Up until now it has been impossible to gather reliable information
on research activity in any one particular area of cancer research.
Development and analysis of the NCRI Cancer
Research Database will be the major priority for the NCRI and
the basis of its core business. The CRD will be established by
the spring of 2002 and will provide the information for a series
of ongoing reviews. Eventually it will also provide a public web-enabled
database of cancer research for the UK research community.
Once the database has been established, strategic
analyses of the CRD will be conducted in two stages:
Stage IAn initial matrix analysis will
be conducted. The CRD will be analysed for activity in key disease
areas (ie Lung, Breast, Colorectal etc) and also key disciplines
from basic through to psychosocial (ie aetiology, prevention/control,
The UK cancer research portfolio will be mapped
to identify activity in particular fields and disease types. Overall
spend will be examined against a background of disease burden.
The portfolio will also be mapped geographically in order to identify
centres of critical mass and inform the infrastructure analyses
(see 2 below). This exercise will, for the first time accurately
describe how much cancer research is going on in the UK and map
out what NCRI partners are spending their funds on and where the
resources are being spent.
Stage IIFollowing the initial activity
analyses of the CRD a number of areas will be identified for more
detailed scientific analyses. In key areas Progress Review Groups,
based on the NCI model, will be established to identify key research
bottlenecks to progress in particular areas.
In addition the NCRI Secretariat will work with
NCRI Partners to analyse the state of major research infrastructure
in the UK and to co-ordinate the provision of key cancer research
What has been achieved in the four and a half
months since the first staff were appointed?
In the short-time the NCRI has been operational,
the NCRI has been set up from scratch as a discrete entity. Membership
has been agreed as has a formal workplan. Staff have been appointed
and working practices established.
The NCRI has gone a long way to establishing
a UK Cancer Research Database containing information on research
projects funded by all NCRI member organisations. Individual projects
are coded using the Common Scientific Classification (CSO), a
taxonomy of cancer research developed by the US National Cancer
Institute in partnership with other US and UK funders. This classification
will allow accurate portfolio analyses to be carried out across
a number of different cancer research funders. Data will be gathered,
classified, cleaned and entered onto the CRD to allow first analyses
in March/April of next year.
A new streamlined approach to the peer-review
of cancer clinical trials has been developed jointly between the
MRC and CRC, working closely with the NCRN. This will provide
a one-stop shop for peer-review of all therapeutic trials. The
new Clinical Trials Advisory and Awards Committee (CTAAC) will
be managed by the new merged CRC/ICRF charity and the MRC will
provide funding for it to allocate to new therapeutic trials.
Very large trials including screening and prevention trials will
continue to be reviewed through streamlined MRC channels.
With the elucidation of the complete human DNA
sequence through the Human Genome Project (HGP) and the unprecedented
breakthroughs in genomics, proteomics and bio-informatics many
molecular targets will be identified that can be applied in cancer
prevention, diagnosis and therapy. A large and well-characterised
human tumour tissue bank, with associated blood samples together
with high quality clinical information, is needed to investigate
emerging diagnostic and therapeutic interventions, especially
in the context of clinical trials, to bridge basic biomedical
science with practical clinical application. The NCRI partners
have agreed to develop a joint strategy for the routine collection
of biological samples collected in the context of clinical trials.
What did the NCRI Partners achieve in the 18 months
they worked together through the CRFF?
NCRI member organisations carried out a joint
field review of prostate cancer research in the UK. Strengths
and weaknesses were identified and NCRI members agreed to establish
an NCRI Strategic Partnership to tackle the issues. A core group
of NCRI partners (DoH, CRC, ICRF and MRC) provided £6 million
over five years to two NCRI Prostrate Cancer Collaboratives. These
Collaboratives are a new model for funding based on the NCI SPORE
NCRI Members (DoH, CRC, ICRF and MRC) are jointly
funding a National Generic Tumour Bank to draw together tumour
sample collections in key sites. work is progressing on co-ordination
of funding for tumour samples collected in during the conduct
of clinical trials with associated patient data.
The CRFF jointly developed a blueprint for
the establishment of the National Cancer Research Network (NCRN)
is funded by the Department of Health and co-ordinated by
a consortium involving the universities of Leeds and York and
the MRC Clinical Trials Unit. It will provide a world-class base
for the conduct of clinical trials and other well-designed research.
The initial aim is to double the number of cancer patients entering
trials in the UK. The NCRN will be a managed research network
mapping onto the cancer service networks across the country. The
quality, speed and co-ordination of clinical research will be
enhanced and research will be better integrated with cancer care.
The National Translational Cancer Research Network
(NTRAC) will lead on co-ordinating the NHS infrastructure support
for Phase I and early Phase II trials involving one, or a pair
of centres and will lead the NHS's contribution to early studies
translating advances in basic science into promising new treatments
for cancer through a network of centres National Translational
Cancer Research Network (NTRAC).
Close links are being forged with the USA National
Cancer Institute (NCI). A landmark joint NCR/NCI meeting took
place at Leeds Castle in March 2001. Both organisations formally
agreed to develop a close working relationship. The NCRI has been
working closely with the NCI in the development of its research
database. Both are structured in the same way so any analysis
of research activity in the UK can be directly compared with activity
at the NCI and other US cancer research funders. The NCRI has
agreed to collaborate on the new NCI initiative in Centers for
Population Health and Cancer (CPHC). Long-term plans include close
co-operation in the area of informatics.
The NCRI is also working with the EU Commission
and representatives of EU countries to establish a European Cancer
Research Manager's Forum. It's very early days and the challenge
in Europe is that the funding situation is very diverse and fractionated.
However, the opportunity exists to develop better communication
between cancer funders on a European level.
Liam B O'Toole
6 December 2001