Cancer research: joint planning for the future
Authors: P. Nurse, J. Pattison, G. Radda, L. O’Toole
Journal: Annals of Oncology (2003)

It is now >2 years since the major UK cancer research funders in the government, charity and private sectors agreed to establish the National Cancer Research Institute (NCRI) [1.Department of Health. The National Cancer Research Institute. [on-line] 2003; http://www.doh.gov.uk/research/rd1/strategicresearch/cancer/cancerresearch.htm#cri (5 August 2003, date last accessed).Google Scholar]. The role of the NCRI is to maintain a strategic oversight of cancer research in the UK, identify gaps and opportunities, and coordinate activities between member organisations in order to tackle major issues. So, is this partnership benefiting cancer research in the UK? Early on in this process, it was agreed that if the NCRI was to make an impact it would need to focus on issues that no single organisation could tackle effectively alone. Therefore, NCRI activities have initially concentrated on joint strategic planning and addressing national infrastructure needs. To date, the NCRI has been active in a number of key areas: setting up an NCRI Cancer Research Database; joint strategic reviews and planning; national infrastructure networks for clinical and translational research; and a national approach to tissue sample collection and cancer bioinformatics. Establishing the NCRI Cancer Research Database has been a major step forward and, for the first time, provides an up-to-date record of the cancer research portfolio being undertaken in the UK. In a partnership with the US NCI and the US Congressionally Directed Research Programmes, the NCRI has now made the UK portfolio available on a joint website—the International Cancer Research Portfolio (ICRP: www.cancerportfolio.org). Publication of the first analysis of the UK database has focused attention on research into prevention of cancer and research into supportive and palliative care (www.ncri.org.uk) [2.O’Toole L. Nurse P. Radda G. An analysis of cancer research funding in the UK.Nat Rev Cancer. 2003; 3: 139-143Crossref PubMed Scopus (11) Google Scholar]. The NCRI partners have agreed that both of these areas are in need of a more coherent national approach and the NCRI has established strategic planning groups (SPGs) to share information on current activities and explore new partnerships. The aim of these SPGs is to work together in order to create an environment in which research in these areas can flourish. These are manifestations of a significant cultural change. The level of communication between the major funders has increased significantly on a wide range of issues that include research into prostate cancer and radiotherapy, as well as prevention, and supportive and palliative care. Senior representatives in the funding bodies now discuss the way forward together. Jointly funded activities have emerged where appropriate, but more significantly, the thinking is more strategic in key areas. The NCRI partners continue to address the infrastructure issues underpinning cancer research. The National Cancer Research Network, whose role is to double patient recruitment into phase III trials, goes from strength to strength. Provision of new infrastructure and central coordination is already having an effect on recruitment into phase III cancer trials and work continues towards developing a more balanced national portfolio of trials and encouraging greater involvement of consumers in clinical trial development. The National Translational Cancer Research Network (NTRAC) brings together 10 major centres active in translational cancer research. NTRAC has the potential to coordinate activities and offer a coherent package of translational research expertise to the pharmaceutical industry. NTRAC is already forging new partnerships and has provided a focus for key developments around areas such as tumour banking. The ability to link data emerging from independent disciplines within the cancer research community is likely to become increasingly important. The NCRI is currently working on a strategic framework for the development of cancer bioinformatics in the UK. The long-term aim is to achieve an internationally compatible information platform that facilitates the integration of data from different cancer research databases (e.g. clinical or genomic). The potential benefits to both patients and the research community are enormous, but the challenges will be significant. Recently, the Department of Health, Cancer Research UK and the Medical Research Council announced the funding for another important piece of the national infrastructure for cancer research: the first phase of an NCRI National Cancer Tissue Resource (NCTR). The provision of high quality tissue samples linked to accurate clinical outcome data will be increasingly important for the study and treatment of many cancers. Not only are these resources of value to research aimed at understanding cancer, but they are likely to be crucial in the development of the next generation of cancer treatments and the avoidance of the unpleasant side-effects associated with many of today’s treatments. The NCRI partners recognise that if we are to grasp the opportunities offered by the development of new proteomic and genomic methodologies we need a radical overhaul of the way we collect, store and manage tumour samples. There is also a need for a coherent and ethical national framework to oversee the governance of tumour sample collections. In general, support from patient groups for ethical collection and use of removed tumour tissue is high. The NCRI NCTR will build infrastructure and workforce capacity to support routine acquisition, processing and distribution of biological samples linked to standardised histopathology and clinical outcome data. The NCRI NCTR will be established on the principles of inclusivity, accessibility and flexibility, and will function as a centrally-coordinated distributed network rather than a centralised tissue bank. In the long term, key elements of the NCRI NCTR will include a coordinating unit, a linked network of ‘Tissue Acquisition Resource Centres’, a linked network of ‘Tissue Processing Resource Centres’, and a central information system and bioinformatics hub. The NCRI partners acknowledge the complexity of this area and the importance of involving key stakeholders in the development of a new national initiative such as this. The NTRAC has carried out a major consultation exercise on behalf of the NCRI and studied different models both nationally and internationally, which has been crucial in creating a blueprint for progress in this area. The NTRAC has also been contracted by the NCRI partners to implement the first phase of the NCTR. The NCRI recognises that there is much work still to do, so it has agreed that a senior Chief Operating Officer should be appointed, reporting to a high-level management committee, to finalise the details of this first phase. Cancer Research UK will manage this process on behalf of the other funders and will also be responsible for establishingsystems to oversee access to the resource once it is established. There will be many challenges to overcome in setting up the NCRI NCTR and cultural changes will be needed. The NCRI partners have taken the first step, NTRAC has provided much needed momentum and it is now up to the clinical research community to embrace this opportunity and make it work. P. Nurse1, J. Pattison2, G. Radda3, L. O’Toole4* 1Cancer Research UK; 2National Health Service Research and Development; 3Medical Research Council;4National Cancer Research Institute, London, UK(*E-mail: [email protected])