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We have a responsibility to spend our supporters' money wisely

Last year, our actual research spend was £355 million – that’s more than any other cancer charity.  All of this money comes from the generous donations of millions of people in the UK. It’s vital that we spend it wisely, and that people know how we decide what to fund.

Here’s a peek behind the scenes of our funding process.

Identifying good ideas
The simplest way to identify the best science is to ask cancer researchers to write to us with their ideas for new areas of research. We can then compare the proposals against each other and choose the best ones.

There are a lot of ideas to look at. In the past 12 months we have received over 900 requests for funding, which covered all sorts of cancer research, from chemistry to clinical trials. They ranged in size from a few hundred pounds to many millions. But how exactly do we assess all these requests and prioritise which should be funded?

Splitting up the budget
The first step is to break down the research budget into more manageable chunks. We set aside money for each major area of research, such as clinical trials or laboratory research – this is the job of our Scientific Executive Board. The Board sees the big picture and sets the balance between all the calls on the money.  But – as we’ll see later – they don’t ‘allocate’ spends to particular cancer types.

The Board also makes sure that we can respond to new developments in cancer research. For instance, over the past few years the Board has provided funding to support large genome-scanning studies. These aim to identify the small but significant variations in our genes that might affect cancer risk.

Our funding committees
Once the budget has been divided between the different research areas, the money is managed by our funding committees. These groups of cancer experts meet regularly to review lots of requests for funding and decide which should be supported.

Different committees consider different sorts of research. For instance, we have one committee that decides which clinical trials we should fund, and another that looks at what laboratory research we should be supporting. We also have a number of interview panels that assess researchers applying for fellowships. This sort of funding is designed to support researchers at the start of their careers.

One thing that we don’t do is divide up or allocate our budget based on different types of cancer. We will support research in any type of cancer, but what we fund is based entirely on the range of applications we receive and their quality.

Much of the laboratory work that we fund will give us information about cancers in general, and so this will help us in the fight against many different types of cancers. However, there are some cancers where we are taking steps to build up our research effort, such as lung, pancreatic and oesophageal cancers (part of our five-year strategy) – for example by encouraging researchers in these areas to apply for grants, or helping to provide research infrastructure.

Consulting experts
It’s important that our committees make the best possible decisions. And to make sure that they do, they take lots of advice from cancer experts across the world.

Every request for funding we receive gets sent to other experts in the same research area, who give us their advice. The people that provide the advice are peers of those applying for funding, which is why this crucial part of the process is called ‘peer review’.

Usually the experts write back with their comments on the request for funding, but sometimes they visit the researcher in person. This gives the experts a chance to examine their research ideas in more detail. They then  give us their opinion on whether we should be supporting the research.

Making good decisions
As well as just identifying the best research, our committees have to make decisions that are fair and transparent. This is particularly important for decisions about clinical trials.

The results from our trials may ultimately affect the way that doctors use a drug or deliver a treatment. There can be huge financial implications for both the NHS and pharmaceutical companies. We need to make sure the funding is allocated to the best possible trials, and that they are answering the key clinical questions – the end result has got to be a significant benefit for patients.

The way that our committees work is governed by strict guidelines. These cover everything from who is allowed to be a member to how they come to their decisions. The most important rule is that, where members might have a conflict of interest with a particular funding request, they don’t play any part in assessing that application whatsoever.

Paying for the research
If we decide to fund the research, we award a grant to the university to pay for the work to be done. These grants can last as long as 10 years, although most are between three and five years long.

In general, one grant supports one piece of research. Many of our researchers run their research teams by applying for a succession of short-term grants. However, sometimes it is better to have a bit more stability so they don’t have to keep applying for money. This is where our Institutes come in.

Providing more stable funding in our Institutes
About a third of our research budget supports work in our five institutes – those in London and Cambridge, the Paterson Institute in Manchester, the Beatson Institute in Glasgow and the Cancer Research UK-MRC Gray Institute for Radiation Oncology & Biology in Oxford.

We have invested in these Institutes to give the researchers there stable support and the best possible research environment. This allows our Institute scientists the freedom to take on longer term, more ambitious projects.

What are we trying to achieve?
Our vision is that together we will beat cancer. A key part of this is to carry out world-class research to improve our understanding of cancer and find out how to prevent, diagnose and treat different kinds of cancer.

Not all of the research that we fund will affect cancer patients straight away – for some projects, it may be many years before the benefits become obvious. Research is most productive when researchers follow new and exciting leads, even when the impact on cancer patients is not always immediately obvious.

But we have also set ourselves some ambitious goals and developed a research strategy. These are going to shape the things that we do for the next five years. We want to fund the best ideas that researchers send us, but we must make sure that all our research projects are helping us achieve our goals.

One way that we plan to achieve our goals is through our new Cancer Research UK Centres.These aren’t new buildings, but local partnerships with other charities, universities, cancer networks and NHS Trusts. The Centres will have to make sure that their research has a direct effect on improving patient care and public health.

We will continue to support high-quality research in the Centres through grants from funding committees. But we will also provide extra funding to pay for things such as new research equipment and training programmes for junior researchers.

Telling the world
The final step in research is to let people know what we have done. Researchers tell the world about their results by publishing in academic journals. We make sure that our supporters know what we have done with their money through things like our News & Resources website, this blog, and various newsletters.

Research never stops. All our researchers are building on years of work by generations of scientists before them. Each piece of work that we fund sparks off new ideas for future projects, all of them taking us a step closer to beating cancer. And if the researchers want to carry on and explore these new areas of research? Well, they send us their ideas for our committees to look at, and the whole process starts again.

This process has led to a point now where we know more about cancer than ever before in history. And as we reveal and understand more and more of cancer’s secrets, wewill see more people being diagnosed earlier, treated more effectively and – crucially – surviving the disease for longer.

Simon Vincent, Head of Personal Awards and Training

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Comments

Kat Arney May 10, 2011

Hi Craig,
There’s loads of information about the progress we’ve made in beating cancer over the years in the “Progress and Achievements” section of our website. You can browse by decade, by treatment type and by cancer type.
http://info.cancerresearchuk.org/cancerandresearch/progress/

For example, we were involved in the development of the new prostate cancer drug Abiraterone which is showing great promise in clinical trials. And our researchers were instrumental in the development on PARP inhibitors, which are also looking good in trials for breast and ovarian cancer caused by certain gene faults. There are plenty more examples of our progress on our website.

Best wishes,
Kat

Craig May 10, 2011

Temozolomide, by your own admission, was discovered in the 1980’s. Any new advances in the last 20 or so years that can be attributed to your organisation??

Kat Arney November 2, 2009

Hi Paul,

Cancer is not one disease, but more than 200. Although sadly many thousands of people still die from cancer every year around the world, it’s important to highlight that significant progress has been made in improving survival from many types of cancer, through research. For example, survival rates from childhood cancer have risen from one in four children surviving in the 1960s, to three out of four today. Testicular cancer survival rates have risen from 70% in the 1970s to over 95% today. Breast and bowel cancer survival rates have also improved significantly, and overall, average long-term (10+ years) survival from cancer has doubled over the past thirty years.

There is more about our progress and impact on our website: http://info.cancerresearchuk.org/cancerandresearch/progress/index.htm

But there are other types of cancer – such as lung, pancreatic and oesophageal cancers – where progress has not been so good. As part of our research strategy we are putting extra research effort into these cancers. We know that research into cancer does save lives – we have already seen significant successes, as mentioned above – so we can expect to see survival rates continuing to climb in the future.

To answer your second question, the information generated by our researchers is published in scientific journals. Companies do not pay us to access the information we generate (although, obviously, they have to subscribe to the independent journals that publish our work). However, we do have licensing deals that are negotiated by our wholly-owned technology transfer company, Cancer Research Technology. This enables us to license new discoveries, such as drugs or diagnostic techniques, to companies for further development and marketing. We then receive a royalty on any profits they make, which is reinvested in our research.

A good example of this is the brain tumour drug temozolomide, which was discovered by Cancer Research UK-funded scientists. You can read more about the story of temozolomide here:
http://info.cancerresearchuk.org/cancerandresearch/progress/cancer_drugs/drug_discovery/temozolomide/index.htm

Developing cancer drugs costs a lot of money. Doing lab research and running clinical trials is very expensive, and many potential drugs turn out to be unsuitable. To use a metaphor, you have to kiss an awful lot of frogs to find the prince. We’ve written extensively about the cost of cancer care, and new schemes designed to cut the cost of cancer drugs here on the blog. You might find the following links interesting:

http://scienceblog.cancerresearchuk.org/2009/01/06/the-pharmaceutical-price-regulation-scheme-cutting-the-cost-of-cancer-drugs/
http://scienceblog.cancerresearchuk.org/2008/11/04/great-news-for-patients-as-government-announces-cancer-drug-access-package/
http://scienceblog.cancerresearchuk.org/2008/10/21/ncri-session-the-cost-of-cancer-care/

Hope this is useful.
Kat

Paul Spencer November 2, 2009

Two points, 1)My cousin was involved in cancer research 40 years ago and yet after millions of pounds invested cancer still remains one of the most prolific killer deseases, why?
2)Do the drug companies have access to the research, do they pay for the information. Why are cancer prohibiting drugs so expensive. They claim because of the cost of research, presumably their own.
Confused.