National Cancer Institute NCI Cancer Bulletin: A Trusted Source for Cancer Research News
December 1, 2009 • Volume 6 / Number 23

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Special Issue: Cancer Research Training

Catalyzing a National Shift toward Translational Research

Translational research in oncology encompasses a wide variety of activities across many disciplines. What makes these efforts coherent is their goal: developing mature agents and approaches in the laboratory that are successfully translated to the clinic and used in diagnosing and treating cancer patients.

There is a growing consensus that this will become the new norm in health research, particularly for those studying complex problems such as cancer, and that it will replace the historic "silo" model, wherein researchers have come together only for meetings and research conferences but otherwise closely guard what happens in their laboratory.

Indeed, many of the research groups and training programs available on NCI's campus teach clinical and basic scientists how to work together in a team approach on specific problems in cancer research. The Translational Research in Clinical Oncology Course offered by CCR is one example. But there are resources available to the extramural community, as well, that enable the shift toward team science and collaboration that has become increasingly important for accelerating the pace of cancer discoveries.

NCI's K12 Paul Calabresi Award in Clinical Oncology is a grant designed for institutions with the primary mission of forging effective working relationships between basic researchers and junior- and senior-level clinicians in order to enhance their mastery of therapeutic research in oncology. Ideally, the Calabresi scholars will be prepared to independently conduct pilot/phase I, phase II, and phase III clinical trials when they complete their training.

Eighteen institutions around the country (16 programs were funded in FY 2008, 18 programs were funded in FY 2009) currently have K12 grants that last for 5 years and can be renewed. Under the supervision of a principal investigator and a number of faculty mentors, a handful of scholars from fields such as hematology-oncology, surgical oncology, radiation oncology, gynecologic oncology, and neuro-oncology are exposed to a curriculum and training regimen designed by the grant program to reflect that particular institution's strengths, interests, and needs.

Many of the programs are also designed to collaboratively train basic scientists in dual-track translational research programs. Ideally, the scholars master a model they can embody and disseminate as their careers unfold, and they go on to lead or participate in teams and projects in the larger research community.

"The ability to work in teams is not something that is typically part of the culture in science," said Dr. Jonathan Wiest, director of NCI's Center for Cancer Training. "Learning how to interact with large groups and keep everyone engaged, and giving people credit where credit is due, those are skills that people sometimes struggle to learn." Discussions among members of the team early on can make a big difference, he said. Everyone has a sense of their responsibility, the teamwork process, and the recognition that will be given to each participant.

Despite the culture shock that may occur as cross-disciplinary teams come together, data from the Association of American Medical Colleges, analyzed by the Federation of American Societies for Experimental Biology, show there are increasing numbers of Ph.D. researchers working in clinical departments.

"In fact, this demonstrates that people are doing more translational science," said Dr. Wiest, "because they're in the department, much in the same way that CCR is structured here at NIH." The trend is happening in industry as well, he noted, with companies sharing data, reagents, and tissue samples across states and even overseas.

Video teleconferencing, international shipping, and electronic transfer of data for cross-team analysis are making research collaborations easier. Even the way that grants are funded—with co-PIs, for example, so that multiple researchers can receive credit for the award within their institution and enhance their eligibility for career advancement and tenure—is making the process run smoother, Dr. Wiest said.

But there's still room for improvement. "There are avenues that we haven't pursued yet to encourage this type of research," he said. "With time, we will undoubtedly find new ways to ease the shift."

Dr. Lia Gore

"I wouldn't be where I am today without the K12," said Dr. Lia Gore, associate professor of pediatrics and medical oncology at the University of Colorado Denver School of Medicine. She was one of the first scholars selected to participate in the school's first K12 grant in 2001; she had just finished her postdoctoral fellowship work.

"I wanted to marshal resources that were not then organized around developing drugs for pediatric oncology. It's not the kind of thing junior faculty would normally get support for, but our K12 had its own set of goals that kind of dovetailed with that," she said. "Essentially, I was encouraged to find mentors and advisors who were experts in all of the pieces that were needed to create a do-it-yourself curriculum." The activity was novel yet driven by a palpable need at Denver's Children's Hospital.

Over the course of a year Dr. Gore traveled to NCI in Bethesda, MD, for a month at a time, where she says "people in the Investigational Drug Branch of NCI's Cancer Therapy Evaluation Program (CTEP) provided a kind of 'mini-fellowship' and taught me drug development from the ground up." They also steered her to the Pharmaceutical Management Branch in CTEP and to the FDA, where "I got a very privileged insider's view of what happens," she said. Back in Denver, Dr. Gore's idea began to take shape, and in 2004 she co-founded and is currently co-director of the Pediatric Oncology Experimental Therapeutics Investigators Consortium.

Since the late 1990s, Dr. Gore has directed more than 100 clinical trials in pediatric hematology/oncology, won numerous awards, and remains active in the University of Colorado's K12 program, now serving as a mentor for a new class of young scholars.

"The K12 positions allow you to meet the kind of people you might otherwise not have access to," she said. "I've been incredibly privileged, getting wisdom and support from some great people all along the way. I'm really a modest example of the kind of results the program can produce. It's an honor to be able to encourage others coming up to follow that path, because I really believe in it."