Abstract P4-15-03: An analysis of the National Institutes of Health (NIH) breast cancer research portfolio and the Department of Defense (DOD) breast cancer research program (BCRP) funding for metastatic breast cancer research in fiscal year 2016
Authors: Perkins Judy 
Published: March 2020

Abstract
Background: Approximately 90 percent of breast cancer mortality is due to metastasis - the spreading of primary tumor cells to distant organs. Despite a dramatic increase in early screening and improvements in available treatments for primary breast tumors, the number of women diagnosed with metastatic breast cancer (MBC)—an incurable disease with a median survival of 30 months upon diagnosis—has not changed significantly in the past two decades. Increasingly, patients with MBC and other advocates question the amount of funding being directed toward MBC research. However, answering this question has proven complex.
Methods: We evaluated the percent of funding distributed for MBC research by two primary research funding bodies—the NIH and the Department of Defense BCRP. Abstracts publicly-available through the NIH Research Portfolio Online Reporting Tools (RePORT) (Breast Cancer Disease Category, FY2016 [Actual]) and from the CDMRP BCRP website (All Award Types, FY2016) were exported to a Microsoft Excel file for analysis. Data included FY2016 budget allocation amounts and detailed abstracts for each project. A team of breast cancer patient advocates (all graduates of Project LEAD®) systematically reviewed each project abstract to assess whether the project informed, or was relevant to, MBC research. Advocate peer reviewers used a combination of keyword searches along with in-depth substantive evaluation of project abstracts according to predefined search terms and assessment criteria to determine whether a research project should be classified as MBC research. The BCRP-funded grants (n=87 active in 2016) were each reviewed by all four advocate peer reviewers. Due to the large number of NIH-funded grants (n=1693 active in FY2016), the collection of abstracts was divided by the team and each project was reviewed by at least two advocate peer reviewers. Projects for which there was disagreement on coding were reviewed by the larger team in an effort to reach consensus.
Results: In FY2016, of the total funds allocated by the DoD BCRP ($91,743,310), 57.6 percent of allocated grant funds ($52,827,805) went to projects classified as MBC research, 37.3 percent ($34,263,109) to non-MBC research, and 5.1 percent ($4,652,396) to projects that could not be classified by the peer reviewers (i.e., consensus not reached). Among FY2016 NIH-funded breast cancer research projects ($656,440,525), 14.6 percent of allocated grant funds ($96,356,077) went to projects classified as MBC research, 79.6 percent ($522,396,807) to non-MBC research, and 5.7 percent ($37,687,641) to projects not be classified by the reviews.
Conclusions: This strategy of a peer reviewed evaluation of two primary sources of federal funding for breast cancer research is a practical way to evaluate MBC research funding. It provides a repeatable process that can be used by breast cancer patient advocates to estimate funding for MBC research.
Citation Format: Judy Perkins. An analysis of the National Institutes of Health (NIH) breast cancer research portfolio and the Department of Defense (DOD) breast cancer research program (BCRP) funding for metastatic breast cancer research in fiscal year 2016 [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-15-03.