Expert Review Team Report for Institute of Cancer Research

Submitted by: Dr. Victor Ling
Chair, Expert Review Team
February 2011

Table of contents


Summary

  1. The Canadian cancer research community has maintained its traditional excellence in biomedical and clinical research. Excellence in CIHR funded investigators through the open competition mechanism is clearly evident. These include John Dick, Peter Dirk, Tony Pawson, Nahum Sonenberg, Tak Mak, Marco Marra, David Huntsman, Sam Aparicio and many others. With the leadership of the Institute of Cancer Research (ICR), pillars 3 and 4 research activities have been stimulated with significant success and acknowledged international excellence. The Palliative End-of-Life Care (PEOLC) initiative is such an example and a potential role model. Survivorship research might be something similar in the future. Investments in establishing a national tumour repository network (CTRnet) and in interdisciplinary training programs (Strategic Training Initiative in Health Research (STIHR)) are also success stories with impact. ICR has been responsive to national needs such as the medical isotope crisis and the access to quality care (wait times) program.
  2. The proposed ICR-led Personalized Medicine Initiative has the potential to become a large, successful, cross-cutting institute initiative. CIHR needs to be prepared for the societal changes of personalized medicine.
  3. Since the last CIHR international review, the funding landscape in cancer research in Canada has changed dramatically. A number of organizations with new money have been created, (e.g. Canadian Partnership Against Cancer (CPAC), the Terry Fox Research Institute (TFRI), the Ontario Institute for Cancer Research (OICR)) while the National Cancer Institute of Canada (NCIC) has been phased out as an independent funder. This has resulted in models for cancer research funding that are complicated and fragmented. This has put significant stress on the cancer research community. There is also a concern that basic research across all four pillars will be compromised as overall funding for investigator initiated 'open competition' projects is likely to decrease as non-government organizations (NGOs) move toward more targeted (strategic) team funding mechanisms. Some coordination amongst funders will be required to maintain essential capacity across the spectrum of cancer research at the national level and at the same time, be nimble to take advantage of new opportunities.
  4. In this context, ICR has done a tremendous job in bringing the cancer research community together through its effort in establishing a cooperative of cancer funders (i.e. Canadian Cancer Research Alliance (CCRA)). Being the single largest funder of cancer research in the country, ICR has the opportunity to become the voice of cancer research in Canada working within the context of CCRA. Researchers and stakeholders see ICR as the best qualified for such a national leadership. However, this is not without challenge as ICR will need to build increased branding awareness with the public. There are many competing voices. There is a need for more public outreach and professional communication about the mandate, activities and successes of ICR/CIHR. An appropriate strategy will need to be developed and additional resources may need to be made available to the Scientific Director of ICR to fully develop this opportunity.
  5. Some areas where ICR can have significant impact include:
    1. Bioinformatics/computational biology. This must be enhanced to keep pace with competitive research communities around the world.
    2. Development of a coherent national strategy for international collaboration. This is a stated focus of the ICR Scientific Director.
    3. More strategic partnerships with industry can facilitate knowledge transfers and provide new funding opportunities.
    4. Closer strategic programming with the Natural Sciences and Engineering Research Council of Canada (NSERC), Genome Canada, the Canadian Foundation for Innovation, and CPAC would leverage research.
    5. A long term strategic vision for cancer research in Canada would strengthen the mission and allow for prioritization of resources. ICR working with CCRA members have already produced a framework. The next step is for ICR to focus on its areas of priority in coordination with other funders.
  6. Within CIHR there are some issues that may need to be addressed
    1. Resources that the Scientific Director has available appear to be limited for the strategic development of the potential of ICR as the leader in the large and complex cancer research community. Mechanisms for insuring sustainability of successful initiatives such as those noted in point #1 above will need to be put in place.
    2. The peer review system is under strain. Although the creation of the Scientific Council and the College of Reviewers appears to help, it may be useful for Scientific Directors to be even more actively involved in the structuring of grants panels in the Open Operating Grant Program. This may be another mechanism to help the Scientific Director build community and sustain strategic initiatives.
    3. Establishment of longer term alliances with complementary CIHR institutes need to be further encouraged e.g. obesity, inflammation, aging, and gender research would seem ideal for partnering with ICR activities.
    4. Transition from one Scientific Director to the next is a delicate process where the organizational, administrative support system can easily become disrupted. This need to be looked into. A possible 4 plus 4 year term may be appropriate.
  7. The directional focus of the Scientific Director is strongly endorsed. This includes:
    1. building the cancer research community in partnership with others and giving it a home with ICR providing the national leadership.
    2. leading in interdisciplinary and team training for the next generation of cancer researchers.
    3. catalyzing the discussions around personalized medicine.
    4. bringing the Canadian cancer research community to become a more effective player in the international arena.

Section 1 – Institute mandate

Created in 2000 as one of the 13 institutes of the Canadian Institutes of Health Research (CIHR), the Institute of Cancer Research (ICR) has a mandate to support research that reduces the burden of cancer on individuals and families through prevention strategies, screening, diagnosis, effective treatments, psychosocial support systems and palliation. The ICR mandate transcends disciplines and encompasses all four health research themes: biomedical; clinical; health systems and services; and social, cultural and environmental factors that affect the health of populations. ICR's mission is to foster research based on internationally accepted standards of excellence that bear on preventing and treating cancer, and improving the health and quality of life of cancer patients and survivors.

CIHR Institute of Cancer Research – Internal Assessment for 2011 International Review, pg 1

Section 2 - Status of this area of research in Canada

Overall impression of the Canadian research landscape in this area

  1. Canada appears to have maintained first rate cancer research across a wide spectrum of activities. The creation of CIHR/ICR has allowed for the emergence of outstanding cancer research in pillars 3 and 4. For example, the PEOLC research program is world class.
  2. The major challenge for cancer research in Canada is that the funding landscape has become more heterogeneous with the demise of NCIC and the creation of a number of national and provincial initiatives with significant new money, notably CPAC, TFRI, and OICR. Moreover, the International reviewers learned that there is a lack of coordination between Provincial and Federal funding agencies.
  3. In the face of such a challenging landscape, ICR has played a leadership role in bringing the community together through the formation of CCRA. Recent activities of CCRA include the development of a pan-Canadian strategic framework for cancer research which should help to coordinate the activities of CCRA members.
  4. One issue for ICR will need to address is the concern that outstanding basic research across all four pillars may suffer as funding for investigator initiated 'open competition' is likely to decrease as NGOs focus on more targeted research in keeping with their mission.
  5. Certain infrastructure will need strengthening – particularly in bioinformatics to support large, data intensive initiatives such as personalized medicine – need to create infrastructure and sustain it.
  6. There is consensus that ICR is the right body to help bring coherence to cancer research in Canada by its leadership and working through CCRA.

Section 3 - Transformative Impacts of the Institute

Overall impression – to what extent has this Institute been transformative?

  1. ICR has been transformative in a number of fronts some of which are beginning to have real impact e.g. in the development of research capacity in pillars 3 and 4 (PEOLC), in helping to build a useful national tumour banking network, CTRnet, and in its leadership in creating the CCRA. These are notable and substantive accomplishments.
  2. A challenge is to continue to find resources and a viable mechanism to sustain successful initiatives while still allowing for resources to invest in more capacity building in underserved areas.

Section 4 - Outcomes

Overall impression – to what extent has this Institute been successful in achieving outcomes?

  1. Improved health outcomes from cancer research will require significant time. ICR has been putting the fundamentals into place such as building the community, by being an exemplary partner and by its emphasis on interdisciplinary training programs.
  2. The PEOLC initiative has been transformative.
  3. ICR has capitalized on some early wins by its leadership in the medical isotope crisis and in the access to quality care mandate.

Section 5 - Achieving the Institute mandate

Overall impression – to what extent has this Institute achieved its mandate?

  1. ICR has achieved its mandate with a great deal of success. It has built a broad spectrum cancer research community.
  2. ICR has recognized gaps in research capacity and built communities in those areas.
  3. ICR represents Canadian cancer research and brings it to the international arena for productive interaction.
  4. ICR's emphasis on interdisciplinary training and team research is timely.

Section 6 - ERT Observations & Recommendations

Overall impression of the performance of this Institute

Recommendations

  1. ICR has done a great job of building community, but needs resources to continue. The cancer research community is high profiled, large, and complex. It is challenging for the Scientific Director to be appointed to a nominal 50% time for such a task. Resources and a strategy need to be developed to increase the "branding" of ICR/CIHR to increase awareness by the public and policy makers.
  2. Transition from one Scientific Director to the next is a delicate process where the organizational, administrative support system can easily become disrupted
  3. The stated focus of the Scientific Director is strongly endorsed:
    1. building the cancer research community in partnership with others and giving it a home with ICR providing the national leadership
    2. leading in interdisciplinary and team training for the next generation of cancer researchers
    3. catalyzing the discussions around personalized medicine;
    4. bringing the Canadian cancer research community to become a more effective player in the international arena.

Appendix 1 - Expert Review Team

Chair - Dr. Victor Ling
Scientific Director, Terry Fox Research Institute
Distinguished Scientist, BC Cancer Agency
Professor, Departments of Biochemistry and Molecular Biology, and Pathology and Laboratory Medicine
University of British Columbia

Expert Reviewer - Dr. Margaret Tempero
Deputy Director and Director of Research Programs at the UCSF Helen Diller Family Comprehensive Cancer Center, Department of Medicine
University of California San Francisco, USA

International Review Panel – Professor Rudi Balling
Director, Luxembourg Centre for Systems Biomedicine
University of Luxembourg

Appendix 2 - Key Informants

Session 1 – Review of Institute

  1. Dr. Morag Park, ICR Scientific Director
  2. Dr. William Mackillop, Chair – Institute Advisory Board
    Head, Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute
    Professor and Chair, Community Health and Epidemiology
    Queen's University
  3. Dr. Heather Bryant
    Vice-President, Cancer Control, Canadian Partnership Against Cancer
    Clinical Professor, Departments of Community Health Sciences and Oncology
    University of Calgary
  4. Dr. Gerry Johnston
    Associate Dean, Research, Faculty of Medicine
    Professor, Department of Microbiology and Immunology
    Dalhousie University

Session 2 – Consultation with researchers

  1. Dr. Richard Doll
    Director of the Sociobehavioural Research Centre and the Provincial Leader for Cancer Rehabilitation, British Columbia Cancer Agency
    Adjunct Professor, Faculty of Health Sciences
    Simon Fraser University
  2. Prof. Alexander McEwan
    Director, Oncologic Imaging, Cross Cancer Institute
    Professor and Chair, Department of Oncology
    University of Alberta
  3. Dr. Fei Fei Liu
    Head, Division of Applied Molecular Oncology, Ontario Cancer Institute
    Professor, Faculty of Medicine, Departments of Medical Biophysics, Radiation Oncology and Otolaryngology
    University of Toronto

Session 3 – Roundtable with stakeholders

  1. Dr. Neil Hagen
    Head, Division of Palliative Medicine,
    Professor, Departments of Oncology, Medicine and Clinical Neurosciences
    University of Calgary
  2. Dr. Simon Sutcliffe
    Chair, Canadian Partnership Against Cancer
  3. Dr. Michael Wosnick
    Vice-President of Research, Canadian Cancer Society
    Scientific Director, Canadian Cancer Society Research Institute
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