NCI’s Office of Centers, Training & Resources: Fostering Progress in Cancer Health Disparities Research

July 17-19, 2006Cancer Health Disparities Summit 2006

Bethesda, Maryland

NCI’s Office of Centers, Training & Resources: Fostering Progress in Cancer Health Disparities Research

July 17-19, 2006Cancer Health Disparities Summit 2006

Bethesda, Maryland

Ernest Hawk, MD, MPHNational Cancer InstituteOffice of Centers, Training & Resources

Ernest Hawk, MD, MPHNational Cancer InstituteOffice of Centers, Training & Resources

OCTR MissionOCTR Mission

Major OCTR goals• Cancer research infrastructure & capacity building• Translational cancer research• Anticipating cancer research manpower needs• Ensuring diversity among cancer scientists

Goals are supported by OCTR grants programs • Cancer Centers Branch (CCB)• Organ Systems Branch (OSB)• Cancer Training Branch (CTB)• Comprehensive Minority Biomedical Branch (CMBB)

Major OCTR goals• Cancer research infrastructure & capacity building• Translational cancer research• Anticipating cancer research manpower needs• Ensuring diversity among cancer scientists

Goals are supported by OCTR grants programs • Cancer Centers Branch (CCB)• Organ Systems Branch (OSB)• Cancer Training Branch (CTB)• Comprehensive Minority Biomedical Branch (CMBB)

OCTR’s Contributions to the Strategic Goal of Overcoming Cancer Health Disparities

OCTR’s Contributions to the Strategic Goal of Overcoming Cancer Health Disparities

• Institutional health disparities training & research capacity building

• Research in cancer health disparities• Outreach & education efforts to underserved

populations• Training

– Persons from minority/underserved groups for cancer research careers

– For research careers in health disparities• Education of professionals in health disparities

• Institutional health disparities training & research capacity building

• Research in cancer health disparities• Outreach & education efforts to underserved

populations• Training

– Persons from minority/underserved groups for cancer research careers

– For research careers in health disparities• Education of professionals in health disparities

Cancer Centers - MissionCancer Centers - Mission

• “To foster excellence in research across a broad spectrum of scientific and medical

concerns relevant to cancer”

&

• “to extend the benefits of research to patients, their families, and the general public through

clinical care, outreach, and education.”

• “To foster excellence in research across a broad spectrum of scientific and medical

concerns relevant to cancer”

&

• “to extend the benefits of research to patients, their families, and the general public through

clinical care, outreach, and education.”

- Support for 61 centers- More than $240M in 2005- Support for 61 centers- More than $240M in 2005

NCI-Designated Cancer Centers –Characteristics & Components

NCINCI--Designated Cancer Centers Designated Cancer Centers ––Characteristics & ComponentsCharacteristics & Components

StrongCenterDirector

StrongStrongCenterCenterDirectorDirector

CancerFocus

CancerCancerFocusFocus

Intra- & InterdisciplinaryCoordination &Collaboration

IntraIntra-- & Interdisciplinary& InterdisciplinaryCoordination &Coordination &CollaborationCollaboration

OrganizationalCapabilities

OrganizationalOrganizationalCapabilitiesCapabilities

Adequate &Appropriate

Facilities

Adequate &Adequate &AppropriateAppropriate

FacilitiesFacilities

InstitutionalCommitmentInstitutionalInstitutional

CommitmentCommitment

NCI-designatedCancer Center

NCINCI--designateddesignatedCancer CenterCancer Center

• Administration• Senior Leadership• Staff Investigators• Planning & Evaluation• Scientific Programs• Shared Resources

- Biostatistics, informatics, etc.• Protocol Review & Monitoring System• Protocol-specific Research Support• Data & Safety Monitoring• Data Sharing• Developmental Funds

- Pilot projects, recruitment, new shared resources, new technologies/methodologies, interim support

• Administration• Senior Leadership• Staff Investigators• Planning & Evaluation• Scientific Programs• Shared Resources

- Biostatistics, informatics, etc.• Protocol Review & Monitoring System• Protocol-specific Research Support• Data & Safety Monitoring• Data Sharing• Developmental Funds

- Pilot projects, recruitment, new shared resources, new technologies/methodologies, interim support

Revised 10/10/05Revised 10/10/05

Cancer Center (22)Comprehensive Cancer Center (39)Planning Grant (7)

Cancer Center (22)Comprehensive Cancer Center (39)Planning Grant (7)

Current and Emerging NCI Cancer CentersCurrent and Emerging NCI Cancer Centers

93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 101992 2010

Organ-Disease Focus

Phase 1Pilot TranslationalResearch Concept

Major Organ SitesReached Critical

DensityOvarianSPOREs

Pre-clinical Development Focus

Minor Organ SitesReach Critical Density

Phase 2Expansion Plan

to All Organ Sites

Human Molecular Targets Focus

Phase 3Scientific

Diversification

11/29/2002

Vision for the SPORE Program

Phase 1

Emphasis on Basic Research intoPre-clinical StudiesInitiate Human End Point Studies

Phase 2

Emphasis on Human End Point StudiesInter-SPORE Collaborations-same siteInitiate inter-site dialogueInitiate linkages to other programs

Phase 3

Emphasis on inter-site researchCommon, molecular mechanisms forinterventionsLinks to other NCI programsPartnerships, collaborations with industry

GI SPOREs

BreastProstate

Lung SPOREs

SPOREs & Cancer Health Disparities Research

SPOREs & Cancer Health Disparities Research

• Funding translational research on health disparities

• Training minorities for careers in translational research (with CMBB)

• Increasing racial/ethnic diversity in biological specimens available in tissue repositories

• Tracking minority participation in early-phase translational/clinical trials funded by SPOREs

• Funding translational research on health disparities

• Training minorities for careers in translational research (with CMBB)

• Increasing racial/ethnic diversity in biological specimens available in tissue repositories

• Tracking minority participation in early-phase translational/clinical trials funded by SPOREs

Cancer Training Branch SupportCancer Training Branch Support

• Emphasis on “endangered” disciplines– Clinical research, cancer prevention, control,

behavior & population science

• Minority health/health disparities support – R25 & K07 mechanisms

• Overall, more than $150M in FY05

• Emphasis on “endangered” disciplines– Clinical research, cancer prevention, control,

behavior & population science

• Minority health/health disparities support – R25 & K07 mechanisms

• Overall, more than $150M in FY05

Scope of CTB Training & Career Development Opportunities

Scope of CTB Training & Career Development Opportunities

grad student postdoc new faculty established faculty

Fellowships Career (K) Awards

Research (R) Grant

T32, R25T

T32/K12/R25T

F32, K01, K07, K08, K23, K25

K22, K25 F33, K05, K24, K25

Career Timeline

White 103AA 3

Asian 24Hispanic 1

Unknown 6

Cancer Education Community Health Aides AlaskaCancer Control Capacity Building Native Researchers Deaf Community Cancer Diffusion StrategiesSowing the Seeds: A Program for Latinas

Sustaining Breast Cancer Control w Community Stylists

ResourceBuilding & Community Outreach

Kentucky Cancer Prevention & Control Training ProgramCancer Control Training in Multi-ethnic Hawaii

Long-term Training

Increasing Diversity in Cancer Clinical ResearchMinority Pre-Doctoral Education to Reduce Disparities

Short termResearchTraining

Grant TitleEducation Approach

CTB R25E GrantsCTB R25E Grants

CMBB MissionCMBB Mission

• Increase the number of competitive minorities in cancer research

• Raise the competitive research capacity of Minority-Serving Institutions (MSI)

• Serve as a resource/model for U.S. programs/organizations with similar objectives

• Increase the number of competitive minorities in cancer research

• Raise the competitive research capacity of Minority-Serving Institutions (MSI)

• Serve as a resource/model for U.S. programs/organizations with similar objectives

CMBB Strategies to Reduce Cancer Health Disparities

CMBB Strategies to Reduce Cancer Health Disparities

1. Continuing Umbrella of Research Experiences (CURE) – Train underrepresented minority individuals to become

competitive cancer researchers

2. Minority-Serving Institution/Cancer Center Partnership (MI/CCP) Program – Increase MSI cancer research capabilities – Increase underrepresented minority researchers– Improve NCI-designated CC activities that address

underrepresented minority populations

1. Continuing Umbrella of Research Experiences (CURE) – Train underrepresented minority individuals to become

competitive cancer researchers

2. Minority-Serving Institution/Cancer Center Partnership (MI/CCP) Program – Increase MSI cancer research capabilities – Increase underrepresented minority researchers– Improve NCI-designated CC activities that address

underrepresented minority populations

High School Undergrad Predoctoral Postdoctoral Junior Investigator

ResearchSupplementsResearchSupplements

Cancer Education Grant: R25T

Cancer Education Grant: R25T Clinical Oncology

Training Grants: K12Clinical OncologyTraining Grants: K12

Transition Career: K22

Transition Career: K22

Continuing Umbrella Research Experiences

Supplements to the CURE:Supplements to the CURE:

Fellowships:F31Fellowships:F31

Career Awards:K01K08K23

Career Awards:K01K08K23

Cancer Center Grant: P30Cancer Center Grant: P30

TrainingGrants:T32TrainingGrants:T32 Cancer Center:

P30 MD/PORCancer Center: P30 MD/POR

R

0

1

CMBB Career Development Portfolio“CURE”

CMBB Career Development Portfolio“CURE”

AI (Ojibwe)U. of MNSmoking Intervention

AAStanford U.Breast Cancer Prevention: Differential Trust & Cancer Care

Hispanic womenU. of HISmoking & Weight Control

AA womenFL A&M U.Identification of Elderly AA Women at Risk for Diagnosis of Late-stage Breast Cancer

AA, CaucasianU. of NCDiet, Colon Cancer & Cancer Communications

AA, Hispanic, Caucasian

Baylor College of Medicine

Breast Cancer Chemoprevention: Role of SES, Ethnic/Racial Background, Knowledge & Attitudes

Target PopulationSiteStudy

0

100

200

300

400

Nu

mb

er

4.3 25.8 11.5 20.6 14.9

Fiscal Year

Number of Trainees 186 194 244 272 328 377

Yearly % Change

1999 2000 2001 2002 2003 2004

CMBB Research Training & Career Development Awardees/Appointments* (by FY)

CMBB Research Training & Career Development Awardees/Appointments* (by FY)

*Does not include trainees supported by U54 & U56 grants

U54 - 3 partnershipsU56 - 11 partnershipsP20 - 9 partnerships

U54 - 3 partnershipsU56 - 11 partnershipsP20 - 9 partnerships

Current NCI-Sponsored Minority Serving Institution-Cancer Center Partnerships

Current NCI-Sponsored Minority Serving Institution-Cancer Center Partnerships

Guam

University of Puerto Rico

Future Opportunities to Advance NCI’s Mission to Reduce Health Disparities

Future Opportunities to Advance NCI’s Mission to Reduce Health Disparities

• Databases– Track health disparities research conducted by

cancer centers & SPOREs

• Coordination

– Align research areas of emphasis & training program priorities

• Assessment tools

– Evaluate health disparities training

• New Initiatives (TRWG, CaBIG)

• Databases– Track health disparities research conducted by

cancer centers & SPOREs

• Coordination

– Align research areas of emphasis & training program priorities

• Assessment tools

– Evaluate health disparities training

• New Initiatives (TRWG, CaBIG)

AcknowledgementsAcknowledgements

• H. Nelson Aguila• Marilyn Gaston • Jorge Gomez• Belinda Locke• Peter Ogunbiyi• Sanya Springfield• Devi Vembu• Jaye Viner• Linda Weiss

• H. Nelson Aguila• Marilyn Gaston • Jorge Gomez• Belinda Locke• Peter Ogunbiyi• Sanya Springfield• Devi Vembu• Jaye Viner• Linda Weiss