Cancer center grant is underfunded

The birthplace of chemotherapy and future home of a $467 million cancer hospital has not received federal funding on its cancer center support grant for almost two years, according to National Cancer Institute data and Yale administrators.

The Yale Cancer Center’s core grant funds large-scale support for research and clinical activities, and also designates Yale as one of only 39 “comprehensive” cancer centers nationwide — a status that is up for renewal this year along with the grant itself. Though some Yale administrators said simply having the grant is more important than how much money the University gets from it, others said the relatively small grant is not providing researchers and clinicians with the resources they need to combat one of the country’s greatest killers.

In the last three fiscal years, the grant has been funded under a special arrangement reached before School of Medicine Dean Robert Alpern’s arrival, he said. Cancer center core grants normally last five years, but NCI extended it for one year with additional funding, followed by another two years during which Yale could keep the grant in name, but would fund it using University money or anything left over from the year before.

NCI agreed to give Yale enough time to let the new medical school dean, cancer center director, and chief of medical oncology settle in before tackling the lengthy grant renewal process, Alpern said. In exchange for the grant extension, Yale agreed to increase its commitment to clinical cancer care.

“The feeling was that Yale was not doing enough clinical work,” Alpern said.

He said there were two possible causes for that feeling, a lack of oncologists and an inadequate clinical facility — a factor that provided an additional incentive to build the controversial Yale-New Haven Hospital Cancer Center, Alpern said.

“There was a feeling that the NCI would not renew the grant until those two were fixed,” he said. “There was in essence a promise that we would build the new [cancer hospital].”

An examination of data from the NCI’s Financial Management Branch reveals that the Yale Cancer Center’s core grant has decreased in value annually since the fiscal year 2002. In 2002, Yale was in the middle of the pack, receiving about $2 million a year. But in the fiscal year 2003, the University received half the amount of the year before, leaving Yale with the second-lowest grant among all cancer centers identified by NCI — “comprehensive” or otherwise. By the fiscal year 2005, during the no-cost extension, Yale’s grant yielded just $82,000 from the government, which was carried over from the previous year. The largest such grant that year was more than $10 million to the Dana Farber Cancer Institute in Boston.

Alpern said the grant’s size reflects Yale’s broader approach to biomedical research.

“Some schools are very focused on cancer,” he said. “Yale’s NIH grants are more spread out.”

He said some non-NCI grants support cancer research, but those do not count in the core grant’s calculations, which are based on a percentage of Yale’s NCI funding, not overall National Institutes of Health funding.

Alpern said the core grant is “mostly [for] prestige,” though it does provide some money for core facilities.

Jose Costa, deputy director of the cancer center, said having a large grant is less important than being a comprehensive cancer center.

“Between the level of funding and the designation, the designation is more important,” he said.

Ira Mellman, a cell biology professor and the scientific director of the cancer center, said he agreed that the grant serves mostly for prestige, but the core facilities supporting basic and clinical research would benefit from a larger grant.

“I would say the grant is abysmally small and doesn’t come close to what needs to be done,” he said.

The core grant does not support specific projects. Rather, like the Clinical and Translational Science Award announced last week by NIH, it provides funding for facilities that individual labs or clinicians could not afford to purchase or operate. The facilities demand expert operators and extensive, regular maintenance, said James Alwine, director of the core facilities for the Abramson Cancer Center at the University of Pennsylvania.

“It’s much more scientifically efficient,” he said.

In general, Alwine said, core facilities offer DNA sequencing, cell sorting and support for clinical activities.

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