Following an incredible response to the launch of our refreshed research strategy last week, we take the opportunity to answer some questions from the research community
Last week we launched our refreshed Research Strategy. It sets out our scientific priorities and how we will work with you, our world-class research community, to achieve this.
It puts discovery research and excellence at the heart of what we’ll do. It’s built around 4 objectives – to discover, detect, prevent, and treat – so that progress in understanding the fundamental biology of cancer leads to new prevention measures, tests and treatments.
To achieve this, we will spend £1.5bn over the next five years, investing in creative people and transformational research. We will support research to reduce cancer inequalities and improve outcomes for everyone. And we’ll involve people affected by cancer in our work.
If you missed the launch broadcast, you can catch up here.
We were delighted that the strategy stimulated a vibrant discussion, with many insightful questions from the cancer research community. In fact, so many questions were asked that we didn’t get a chance to address them all. Here, we answer those questions we couldn’t get to during the event.
Q. Other than inspiring a diverse range of students to study stem subjects, what is CRUK doing to remove barriers to increase ethnic diversity in the workforce?We’re developing a range of measures to address the structural issues of equality and equity in cancer research.
Our 2021 EDI in Research Action Plan called for our institutes to each publish their own action plans, which they’ve done. We’ve set up a cross-CRUK institute EDI working group to share EDI strategy plans, best practice and approaches to joint issues such as increasing the diversity of students and the wider workforce, considering not only ethnicity, but also gender and socio-economic background.
On the wider question of how we are removing barriers, we will soon be publishing our annual report on progress against the action plan, which shows the progress we’ve made in many areas, including grant applications and awards, diversity in funding reviews as well as areas where we still need to go further.
In 2022-23 we have specific work planned to offer PhD scholarships to underrepresented groups, to support a Black in Cancer conference, and we’ll continue looking at gender and social mobility by working with In2Science and In2Research and providing mentoring programmes, such as Women of Influence.
Q. It is great that CRUK strives for inclusivity and to address EDI imbalance. The balance of your grant panels is important to achieve this – and should include both gender and encompass institutes outside of London. You have said that you’ll be removing independent reviewers’ comments for grants and extensively relying on panels instead to help diversity of people and thought. How exactly will this help?
Expert review panels don’t represent a shift away from independent peer review – they’re just a different way of doing it, and we think having in-person discussions is generally a more valuable way of reviewing research applications than asking for written reviews. We considered the move away from written review carefully. We’ve observed that the change to review panels actually helps us to attract a greater diversity of people into our peer review processes – particularly representation from outside the UK, resulting in a good depth of discussions. The panel members remain independent of CRUK and we closely monitor the make-up of our panels to ensure we are including a diverse range of voices.
We advertise for members to join our review panels and committees. We select members based on the expertise required on the panel or committee and the diversity of backgrounds we believe is essential to fund the highest quality research. We strongly encourage those with relevant expertise to apply to join our review groups.
More information on changes to our peer review process.
Q. Relationships with universities is obviously very important with regard to diversity in research – how do we ensure diversity when early career researchers face contract precarity, with many of those choosing to leave academia?
We recognise the challenges many early career researchers face, including precarity around transitional career points. We will be reviewing our careers-related offerings and working with our funded locations to improve the research environment in this regard. This will include setting expectations with institutions regarding support during and beyond fellowships, working with partners across the sector to support flexible career options and diverse career paths, and further consulting with our early research community on some of the issues they face.
Q. What implications does the new CRUK Scotland Centre have for universities and health boards outside Glasgow and Edinburgh – I am thinking of Aberdeen?
Glasgow and Edinburgh were the only CRUK centres in Scotland before our recent centres review, so there are no specific implications for other Scottish institutions. We award centre funding on a five-year basis; the upcoming funding period will run from April 2022 until March 2027. We were pleased that the newly formed Scotland Centre was successful in the independent review process. The funding for the new centre brings together the strengths of each preceding centre and extends the increasingly close working relationships between the two universities, that both also have partnerships across Scotland. The centre award does not preclude other places in Scotland from applying to be CRUK centres in the future nor from applying for funding through other routes that they are eligible for. Moreover, the centre will be a focal point for wider collaboration in Scotland particularly given its translational focus.
Q. Can you clarify whether the significant contraction of the CRUK centre network was a strategic decision or because of the substantial reduction in budget for the next quinquennium?
While we did not set out to fund a specific number of centres, the budget for the 2022-27 funding period was around a third less than what we had for the 2017-22 period. Our overriding principles in determining which locations we funded were research quality and impact, and ensuring that sufficient funds were available to meet the centres’ aims. That necessitated some hard choices including significantly reducing the maximum amount of funding centres could apply for. Even with such measures, the funding could only go so far, resulting in the final make-up of the revised network.
Q. There has been a concentration of clinical academic training opportunities to fewer CRUK centres. Will the focus on diversity and inclusion mean that opportunities to undertake a CRUK funded PhD will be available in all parts the UK?
We are continuing to support clinical academic training through our Clinical Academic Training Programme. The funding for this programme is not linked to CRUK centre awards, and so the recent centres quinquennial review had no impact on this. We’ll assess options towards the end of these programmes and will maintain our commitment to funding clinical academic training in research environments that are committed to advancing our EDI in research agenda. We also enable PhDs to be funded on our programme awards, which are of course nation-wide in reach.
Q. Can you elaborate on the fellowship opportunities for early career scientists? Specifically, will the Population Research Postdoctoral Fellowship be replaced with a new scheme?
We’ll continue to offer a broad range of fellowship opportunities, including options for those looking to establish independence as a group leader and those building towards leadership in their field, for both clinical and non-clinical researchers. We want to support a diverse range of disciplines relevant to our research strategy through these schemes, including population researchers and we will take proactive steps to engage that community. Whilst we won’t be running a dedicated population research postdoc fellowship, there are now greater funding opportunities for postdocs in those fields through our population and prevention research committee, such as project grants that postdocs can apply for as leads.
Q. Will there be training posts that non-centres and non-ECMCs can apply for to address EDI?
We are continuing our commitment to funding PhD training in excellent research environments. In our recent centres review, EDI plans were an integral part of the assessment so we will work with our centres to advance the EDI in research action plan over the next funding period. We will also continue to consider PhD posts on programmes and other strategic initiatives across our broader network and will be led by research excellence in determining these cases for support.
We’re supporting initiatives at both school and undergraduate level to attract and retain students in STEM subjects and are also developing plans for a positive action initiative at the PhD level to specifically target key underrepresented groups – we will announce more details in the next few months.
Q. Playing devil’s advocate (as a former clinician and now translational cancer researcher), I completely understand the ongoing focus on discovery science. However, many of our current standard-of-care cancer treatments have not been developed by such approaches with that level of underpinning science. Does an infatuation with discovery impede the funding and rapid clinical implementation of safe and effective re-purposed therapeutics?
We believe that funding discovery research integrated with clinical research will increase understanding of which therapeutics should be the focus of repurposing. By increasing understanding of how and why therapies succeed or fail in clinical trials, or increasing effective stratification of sub-groups we can accelerate repurposing programmes, and increase the likelihood of successfully identifying new indications. Too many clinical studies lead to binary outcomes of drug efficacy without generating further understanding as to why a particular drug does or doesn’t work.
It is true the majority of therapeutics today have been developed and refined through iterative clinical studies, with improvements in outcomes made incrementally. This has led to great process in some cancers, for example breast cancer. However, this approach has not worked for all cancers. Making progress for all people with cancer will only be enabled by improving our understanding of how cancer starts, grows and spreads. This understanding will allow us to target, combine and sequence treatments much more effective. This will of course include repurposing of existing treatments alongside testing novel approaches.
Q. Improving the clinical performance of currently available drugs could offer immediate impact for patients and address some of the inequality issues with cancer treatment. Therefore, why is improving drug delivery of cancer drugs not a priority for CRUK?
Improving drug delivery is an important opportunity for improving outcomes. For example, the real challenges in understanding if and how certain drugs cross the blood brain barrier. This is another example of where discovery science and other disciplines such as bioengineering and nanotechnology have a vital part to play. This is very much within the remit of the new research strategy.
Q. Where does behavioural science fit into the new research strategy? The pandemic has indicated that it plays an important role in public health. Will we get an appropriate balance of clinical and non-clinical research funded?
Behavioural science remains a crucial component of affecting change in health outcomes – we must understand the drivers of health-related behaviours and how to intervene in an effective and precise manner to deliver health benefit through prevention, detection and treatment. Our Early Detection and Diagnosis, and our Prevention and Population Research Committees will continue to explicitly call for behavioural research in those arenas. The CRUK strategic theme of discovery at the heart of what we do applies to behavioural research as much as to biomolecular research.
Q. Will there be any focus on funding researchers outside traditional cancer fields?
Following our 2014 research strategy, we set up initiatives to attract those not currently working in cancer to bring their expertise and insight to bear on cancer questions – these included project awards in cancer immunology and multidisciplinary research. The new strategy highlights a growing appreciation of whole-body physiology and opportunities in data science, so we want to continue building new networks and attracting those from other disciplines. We want to look at the range of options to do this, such as continuing to fund through existing schemes, convening researchers to explore collaborative opportunities, and working with a greater range of partners.
Q. How are you assessing the impact of Grand Challenge grants. For the amount of funding, one would expect the bar is very high on judging it a success. Has the overall grand challenge approach had a significant impact on patient outcomes.
Cancer Grand Challenges is focused on solving cancer’s toughest challenges. It was co-founded by CRUK, the US National Cancer Institute (NCI) and other funding partners, after assessment of the success and proof of principle demonstrated by CRUK’s Grand Challenge initiative, in which we looked at the impact of the scientific outputs.
As the initiative is challenge led, we will assess the success of Cancer Grand Challenges by measuring the progress made by funded teams against these challenges. There are currently seven multidisciplinary teams across six challenges, which are currently largely discovery and translation in nature. The first four teams (funded in 2017) are already demonstrating key success. For example, the Mutographs team has challenged the classical view that all carcinogens directly cause mutations and suggests that non-mutagenic agents play a greater role in tumour promotion than originally thought.
Cancer Grand Challenges is overseen by two independent committees, featuring world renowned cancer researchers, clinicians, behavioural scientists and people affected by cancer.
To look at the wider impact of the Cancer Grand Challenges initiative we will also look at its impact on our future leaders, global advocacy and the tools and collaborations produced as a result.
Q. CRUK have gone for big funding schemes – grand challenges and large centre grants – which places extensive grant funding in the hands of a relatively few number of PIs. Is this the right way to increase diversity of ideas and approaches?
We will continue to support a large community of researchers at all career stages based on excellence. We have one of the largest national postdoctoral fellowship communities and a widely distributed network of funded researchers supported via many project and programme grants. Our centres’ funding supports many PIs. By funding core facilities, local infrastructure, providing local development funds and studentships individuals can bid for, we believe centres play a key role in generating novel and innovative approaches. It is also key to bringing in individuals with no current CRUK funding and those who don’t currently work in cancer research into the field.
Cancer Grand Challenges was set up to identify specific barriers which, if removed, would be transformative and unlock the potential for patient benefit by funding a portfolio of novel and innovative research to encourage multidisciplinary approaches and attract new thinking to cancer research. We encourage diverse teams working across a breadth of disciplines, including biomedical sciences, software development and technology, engineering and physical sciences, behavioural, health, population and social sciences.
So far we’ve funded seven teams, featuring 73 research groups and spanning nine countries. Across these teams there are seven principal investigators, 60 co-investigators, over 240 researchers and 35 collaborators. It is a network of nearly 700 investigators convening to solve the biggest cancer challenges.
Q. Clinical research and access to trials should be at the heart of the NHS. Due to all the service issues, staff shortages and system pressures it feels like this is being forgotten. Less patients are being recruited to studies and hospitals cannot cope. Are CRUK going to look to address this for cancer patients?
We totally agree that clinical trials for cancer patients should be a standard offering to patients throughout the UK. It is undeniable that clinical research has suffered throughout the pandemic, and even yet is struggling to recover to pre-pandemic levels of activity. Through our policy efforts we continue to lobby the UK government to increase investment in the NHS, to support the UK clinical workforce by providing more dedicated time for research and to take urgent action to accelerate the recovery of the clinical research portfolio.
Q. Are there any more specific objectives around engaging partners and industry to tackle paediatric/teenage/rare cancers where numbers are low and there are inequalities in paediatric access to drugs compared to adults?
We recognise that it is vital to work with partners to combine expertise, resources, tools, funding, and more for paediatric cancer research, not only to supporting clinical trials and drug development, but also in discovery science and building capacity within the research community. We have engaged with multiple partners in the UK and globally who are very interested in research into cancers that affect children and young people and we are keen to work with other like-minded organisations.
We already have a strong track record of working in partnership in this area. In 2021 working with Children with Cancer UK, we co-funded the Cancer Research UK–Children with Cancer UK Innovation Awards. This funding is supporting five new teams of world-leading scientists, with up to £1m each, to embark on five very distinct research projects to improve our understanding of the underpinnings of children’s and young people’s cancers.
Working in collaboration with Stand Up To Cancer, we delivered an international funding call in 2020 to drive multidisciplinary, transatlantic collaboration and knowledge sharing. We funded 3 transatlantic teams for up to $1m.
Additionally, we also have a long-standing partnership with the devolved UK government health departments to support our ECMC Paediatric Network to deliver early phase clinical trials for children and young people with cancer.
We are further exploring how to drive industry engagement and develop research partnerships in order to progress science, technologies and treatments for the benefit of paediatric patients and will share new initiatives in due course.