I recently attended a large collaborative-research group meeting where, as part of the project, two members of the public were invited to attend the scientific research day. The program is broadly under the “cancer research” umbrella and the two members of the public were patient advocates whose lives had both been touched by cancer. One of the personal stories that was shared stressed that some areas of cancer research are very poorly supported compared to others, and this had inspired her to fight for research funding for the tumour type that had killed her husband.
This story got me thinking about research-funding disparities between different cancers, and about research funding in general. It dawned on me that the perception of funding and the reality of funding might be quite different due to the structure of scientific research, and the (often artificial) pressure that funders put on scientists to justify their work. This post explores some reasons for this discrepancy, and aims to encourage the general public and funders to look beyond a project’s keywords and focus instead on supporting the best quality science that will help all fields move ahead faster.
Not all “translational research” is clinical (or, “Breast cancer research” might not apply uniquely to breast cancer)
When most people hear about translational research in the biomedical sciences the first thing that typically springs to mind is the study of patient samples (or, at the very least, they think of the invention and testing of drugs). Naturally, when people hear about the billions of dollars put into breast cancer or prostate cancer research, they wonder why other cancers are not funded to the same extent. Often imbalances are justified by disease frequency (more people in developed countries have it so more money goes towards it); but it’s actually a whole lot more complicated than that.
A lot of the money that goes into particular cancer types does not uniquely support research into that specific cancer. For example, the cell cycle process that governs how fast and regularly cells divide (a key property of cancers) may be studied in the context of breast cancer, but the data collected actually informs research on all cancers that also fail to regulate this cellular process. This example would be listed as a breast cancer study in the funding portfolios, but the research is as applicable to other, less common, cancers like soft tissue sarcomas.
Model organism research (or, the pressure to create a cure impacts what gets funded)
There has been an incredible push on scientists who undertake research into basic biology to justify their research in the context of a translational agenda (e.g. what product will they create, what disease will they cure). That this will cut into researchers’ ability to find funding in these research areas was starkly evidenced in the 2016 Canadian Institutes of Health Research grant competition, where the success rate of grant proposals focused on non-murine model organism research was just 3.8 percent. In the U.S., similar concerns have been raised. The National Institutes of Health has tried to address this by performing a meta-analysis on NIH model organism research funding showing that model organism research remains stable relative to other areas, despite an overall research budget decline. Either way, a researcher would be foolish not to write in how their research in such models is related to health research outcomes.
And therein lies the problem: the connections that researchers are forced to draw tend to be in the most highly studied and published fields. This time, imagine a researcher is studying the cell cycle in yeast. They might make a compelling case that their research is related to cell division in colorectal cancer because there is an incredibly vast literature that supports this relationship. Similar to the breast cancer example above, the reality is that the process of cell division is actually related to virtually all cancers, but in this case the research would get tagged under colorectal cancer. It is unlikely that they would relate their research to the comparably small field of adrenocortical carcinoma research.
Together these issues make it difficult to know how much funding is specifically going into particular cancer research fields. Consequently, the exercise of rectifying perceived imbalances could be more harmful than helpful.
Model diseases (or, some cancers are just easier to study)
The third and final aspect that I feel it is important to touch on is that some diseases are much more tractable for studying certain biological processes. Just as we use less complicated animal models to understand aspects of biology that are not directly addressable in humans, some diseases are much more amenable to study in the lab. An example would be chronic myelogenous leukemia (CML). Significant amounts of funding have been invested in this relatively rare disease because it is an excellent system for studying the process of cancer – it has a known and unique genetic target, it is a very early stage of tumour (and less genetically complex) and it is a chronic blood disease (meaning one can study blood samples easily and over the entire course of disease). As a result of these features, a targeted therapy (a kinase inhibitor) was developed and an enormous amount of cancer biology was uncovered. Targeted therapy using kinase inhibitors has been incredibly successful and this disease system had been a paradigm for the development of kinase inhibitors in dozens of other cancers – all born from decades of research into a fairly rare (<1 in 100,000) and, dare I suggest, an “over-funded” area of disease biology.
We obviously need to find funding sources for research to continue in the numerous cancer subtypes that exist, but I would urge funders and the public to not get too wrapped up in the smoke and mirrors that grant writing can cause. Nor should we ignore the very practical aspects of using good model diseases to uncover general properties of cancer that can be widely applied, even if they do not have an obvious path to cures for specific diseases. Excellent basic science builds the framework for scientific discoveries of the future. We urgently need to focus on balancing top quality research in both basic and translational arenas even though it may skew the optics of which diseases get more or less funding.
While a broad portfolio of translational research funding may look quite attractive from the outside, it may not be the most effective way to progress in all fields of cancer biology. And, if top quality scientists leave Canada due to poor funding mechanisms for basic and top-calibre (not necessarily sexy!) translational research, we’ll slow down overall research progress dramatically.