Fear of losing a prestigious federal grant may have been a factor behind the University’s strong push for the construction of the Yale-New Haven Hospital Cancer Center.
Previously unpublished details from interviews with former Yale administrators and a former National Cancer Institute official reveal why the School of Medicine committed itself, in an 2002 agreement between the Yale Cancer Center and the NCI, to building the new building now under construction — a move that saved the program’s status as one of the premier cancer centers in the country. The agreement, brokered over a lengthy negotiation process, kept Yale’s designation as a “comprehensive” cancer center, a label that attracts individual research grants, new faculty hires and patients for clinical trials.
David Kessler, dean of the medical school from 1997 to 2003, and Vincent DeVita, director of the Yale Cancer Center at the time, negotiated in 2002 with Brian Kimes — then associate director of the NCI — to delay the review process for the grant, which Kimes said Yale was “a hair” away from losing. The dialogue with NCI involved high-level Yale administrators, including Kessler and Yale President Richard Levin, Kimes said.
In the final compromise, the NCI allowed Yale to keep the grant without a formal review process for two more years, although it would not provide additional money beyond the first year. In exchange, Yale agreed to build the new cancer hospital, to spend $46 million to hire 11 new clinical investigators and to move administrative control of the medical oncology division to the new Yale-New Haven Hospital Cancer Center.
Both Levin and School of Medicine Dean Robert Alpern confirmed that construction of the cancer center was included in the 2002 agreement.
“We did make a commitment that we would be building a facility,” Levin said. “It obviously was delayed, but the building is under construction.”
A cancer building had been in the works well before the 2002 agreement, however. Gerard Burrow MED ’58, dean of the School of Medicine from 1992 to 1997, said the first plans for the center came with the 1992 recruitment of DeVita, a former NCI chief, as Yale Cancer Center director. Burrow said DeVita was the driving force behind Yale’s initial plans to build the cancer hospital.
But these 1992 plans did not immediately come to fruition. Burrow cited the cost of the project — the University was just emerging from years of deficits that the School of Medicine would not escape for several more years — and Yale-New Haven’s lack of interest in building a cancer hospital as factors contributing to the decade-long delay. He said YNHH wanted to be the community’s hospital, not only Yale’s.
“I think at that time, the hospital was not convinced that [the cancer hospital] was a priority,” Burrow said.
Burrow, who was named Levin’s special advisor on health affairs in 1997 after he left the School of Medicine, said the University had few doubts during the 1992 and 1997 grant reviews that the renewal process would be successful.
But by the 2002 review, the stakes were higher. The problem of limited clinical facilities had become more pressing, and Kimes said the cancer center director had too little authority over independent departments.
“[Yale was] partly concerned, because the standards for comprehensive centers had gone up, so it was unlikely it would be renewed,” Burrow said.
Kessler said the cancer hospital plan and $46 million pledge made in 2002 were also part of the recruitment package for Richard Edelson, who was already a Yale professor but would become Yale Cancer Center director the next year, a post he continues to hold.
Yale was one of the first academic health centers to earn the comprehensive cancer center designation, having done so in 1974. But the storied history of research was not reflected in the clinical realm, Kessler said.
“Where Yale was not strong, it didn’t have the clinical programs to match [the science],” he said. “And when you’re dealing with a comprehensive cancer center, obviously ‘comprehensive’ means great science and great clinical.”
Ira Mellman, professor of cell biology and scientific director for the cancer center, said Yale received an extension on its grant in 2002 because the cancer center and medical school were going through leadership changes, and without visible leadership, Yale’s chances of succeeding in the review would be slim.
The grant review that was originally scheduled for 2002 is now underway, including a site visit from NCI representatives at the end of this month.