Is Cancer Research Insufficiently Academic?

If you follow trends in science research, especially biomedical research focused on cancer, you know that government (taxpayer-paid) funding for research is flat to down. More scientists are battling for less grant money.  At the National Institutes of Health (NIH) the percent of grant applications that are awarded funding are “in the lower teens” down from 30% just a few years ago.

academicResearchThis funding drought has brought a battle front and center that before now has been waged mostly in the background. It’s not ‘liberal’ vs. ‘conservative.’  It’s ‘fundamental research’ vs. ‘translational research.’  Fundamental (aka “basic” or “academic”) research seeks to understand what makes things tick—here, biological processes occurring mostly at the gene and molecular level. It’s the biological equivalent to cosmology, particle physics, or pure mathematics. 

“Translational” is the biology world’s way of saying, “taking the fruits of fundamental research and ‘translating’ them to applications beneficial to human beings.” Think engineering, and applied mathematics that bring us hardware and software technology. When it comes to treating cancer, “translational research” is where drugs and therapies come from.

A recent edition of the prestigious journal, Proceedings of the National Academy of Sciences, published an article titled, “Rescuing US Biomedical Research from Its Systemic Flaws.”* One of its four authors is Harold Varmus, who is the director of the National Cancer Institute (NCI), which certainly made me sit up and take notice.** 

The authors’ premise is that “the long-held but erroneous assumption of never-ending rapid growth in biomedical science has created an unsustainable hypercompetitive system that is…a recipe for long-term decline.”  Among causes of the decline, they cite (1) too many grant applications chasing too few dollars, (2) weaknesses in the peer review system, and (3) onerous government paperwork—all deleterious to performing excellent scientific research.  I’m sure this is all too true, and commend them for raising the issues and offering possible solutions.

However, along the way, the authors express their collective annoyance at translational research, stating, “one manifestation of this shift to short-term thinking is the inflated value that is now accorded to studies that claim a close link to medical practice…Overvaluing translational research is detracting from an equivalent appreciation of fundamental research of broad applicability without obvious connections to medicine,”

They are effectively saying, “we smart academic leaders think grubby real-world research that has direct application for treating ill people is detracting (i.e. taking too much money away) from unencumbered research that may or may not have any ultimate applicability.” This is not very different than high energy physicists saying, “Forget those smartphones; they’re just the fruit of the short-term thinking so endemic in translational research. We need more money to find the Higgs Boson,” or mathematicians saying, “Forget those speech recognition algorithms, we need more money to solve Fermat’s last theorem.”

There’s no question that government-funded basic research is essential. If it hadn’t occurred in areas like semiconductor physics, computational mathematics, and communication algorithms we wouldn’t have have those smartphones in the first place. But methinks the authors doth protest  a bit too much about the negatives of translational research.

Some of you know that I’m a “consumer reviewer” for the Prostate Cancer Research Program (PCRP), which is part of the Congressionally Directed medical Research Program (CDMRP) administered by the Department of the Army.  With its stated mission to “fund research that will lead to the elimination of death from prostate cancer and enhance the well-being of men experiencing the impact of the disease,” it’s definitely focused on almost all translational research all the time.

As a consumer reviewer, I have an equal vote on research grant proposals with the scientific reviewers (who are making sure the proposal is good science). My mission as a potential “consumer” of the fruits of the proposed research is to assess its potential impact and benefits on men like myself, who have, or will get this cancer. 

The NCI does not use “consumer reviewers” as part of its peer review process to award grants. In fact, the paper cited above calls for more rigorous standards for scientific reviewers, and its stated antipathy to translational research suggests they won’t be looking anytime soon for  consumer reviewers like me.

It’s worth noting that when it comes to budgets, the NCI spends more than three times the amount on prostate cancer research as the PCRP’s annual budget of about $80 million. That ratio holds generally true against other  types of cancer, as well. Given that the NCI does mostly fundamental research, it’s budgetarily tough to feel too sorry for them.

Yes, we absolutely need fundamental academic research. Otherwise there wouldn’t be any discoveries to translate to medicine.  But in their call to arms, it seems to me that our authors would do well to remember that the second definition of “academic” is “not of practical value; of only theoretical interest.”

So come on, Dr. Varmus (and you other guys), real people with real diseases who are real taxpayers pay billions each year to fund your basic research. We’re happy to do this. But not solely for the esthetic joy of advancing science and/or the greater glories of academia. Rather, we hope that one day we or our children or grandchildren will be able to enjoy tangible benefit from our investment. That requires considering the needs of the real world outside those pristine ivory towers and not whining too loudly about that grubby, money-sucking, “short-term thinking” translational research.

*The other authors are from University of California San Francisco, Harvard and Princeton: so these folks are not to be taken lightly.


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