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DIET, DNA METHYLATION AND OTHER EPIGENETIC EVENTS, AND CANCER PREVENTION

RELEASE DATE: September 27, 2002

RFA: CA-03-016   
 
National Cancer Institute (NCI) 
 (http://www.nci.nih.gov/)
The Office of Dietary Supplements (ODS) 
 (http://www.nih.gov/icd/od)

LETTER OF INTENT RECEIPT DATE:  February 18, 2003
APPLICATION RECEIPT DATE:  March 18, 2003
 
THIS RFA CONTAINS THE FOLLOWING INFORMATION

o Purpose of this RFA
o Research Objectives
o Mechanism of Support 
o Funds Available
o Eligible Institutions
o Individuals Eligible to Become Principal Investigators
o Where to Send Inquiries
o Letter of Intent
o Submitting an Application
o Peer Review Process
o Review Criteria
o Receipt and Review Schedule
o Award Criteria
o Required Federal Citations

PURPOSE

The NCI and the ODS invite applications for new R01 and R21 grants which are 
focused on research leading to the elucidation of mechanism(s) by which 
dietary factors influence epigenetic processes as well as increasing the 
understanding of these processes in cancer prevention. The approach is to 
encourage collaboration between nutrition and epigenetic /DNA methylation 
experts to study bioactive food components with cancer preventative 
properties, and to examine key epigenetic events in cancer processes (i.e., 
carcinogen metabolism, cell division, differentiation, apoptosis) so that 
investigators can begin to establish linkages between epigenetics, methylation 
pattern, and tumor incidence/behavior. It is anticipated that the information 
gained will provide guidance for the development of dietary intervention 
strategies for cancer prevention.

In addition to the present announcement, the NCI and the ODS announce a 
related initiative about diet, DNA methylation and other epigenetic events, 
and cancer prevention utilizing an additional funding mechanism: Competing 
Supplements for existing NCI awardees 
(http://grants.nih.gov/grants/guide/pa-files/PAR-02-175.html) 
which can extend the goals of active grants to include studies related to the
 impact of diet and nutrition on epigenetic events. Contact individuals listed 
 under "INQUIRIES" of this RFA for further information.
 
RESEARCH OBJECTIVES 

Background

Cancer is a manifestation of both abnormal genetic and epigenetic events.  The 
importance of epigenetic events is that it represents a mechanism by which gene 
function is selectively activated or inactivated.  Actually DNA methylation is the 
covalent addition of a methyl group to the 5 position of cytosine within CpG 
dinucleotides and is a fundamental process that not only modulates gene expression, 
but is also key to regulating chromosomal stability.  A variety of regulatory 
proteins including DNA methyltransferases, methyl-CpG binding proteins, histone-
modifying enzymes, chromatin remodeling factors, and their multimolecular complexes 
are involved in the overall epigenetic process.  Since epigenetic events are 
susceptible to change they represent excellent targets to explain how environmental 
factors, including diet, may modify cancer risk and tumor behavior.  Abnormal DNA 
methylation patterns are a hallmark of most cancers, including those of high 
proportion in the United States i.e., colon, lung, prostate, and breast cancer.  

Preclinical and clinical studies provide intriguing evidence that part of the 
anticancer properties attributed to several bioactive food components, 
encompassing both essential and non-essential nutrients, may relate to DNA 
methylation patterns.  There are four ways in which nutrients may be 
interrelated with DNA methylation.  The first is that nutrients may influence 
the supply of methyl groups for the formation of S-adenosylmethionine (SAM).  
The second mechanism is that nutrients may modify utilization of methyl groups 
by processes including shifts in DNA methyltransferase activity.  A third 
plausible mechanism may relate to DNA demethylation activity.  Finally, the 
DNA methylation patterns may influence the response to a nutrient. These 
interactions are described in greater detail below.

Global DNA Methylation Patterns

Global hypomethylation, accompanied by region-specific hypermethylation, is a 
common characteristic among tumor cells.  Global genomic hypomethylation has 
been linked to the induction of chromosomal instability.  Hypermethylation is 
associated with the inactivation of virtually all pathways involved with the 
cancer process, including DNA repair (e.g., hMLH1, BRCA1, MGMT), cell cycle 
regulation (e.g., p16(INK4a), PTEN), inflammatory/stress response (e.g., COX-
2) and apoptosis (e.g., DAPK, APAF-1).  Thus, evidence exists that variations 
in the degree or site of DNA methylation can lead to abnormal DNA repair and 
influence multiple cancer related genes and thereby influence the incidence 
and behavior of tumors.

Stress including that resulting from dietary methionine/choline, folate, zinc, 
and selenium inadequacy, as well as excessive alcohol intake can lead to 
global DNA hypomethylation.  Interestingly, the continuous feeding of a diet 
deficient in choline and methionine is recognized to lead to global DNA 
hypomethylation and cause hepatocellular carcinomas in rats in the absence of 
any exogenous carcinogen.  Paradoxically, either deficient or excess dietary 
arsenic has also been shown to lead to global hypomethylation in rat liver.  
Treatment with excess retinoic acid can also lead to hypomethylation as 
recently shown in rat liver.  Clinically, global DNA hypomethylation has been 
observed in lymphocytic DNA from individuals consuming inadequate folate.  
While limitations in the supply of methyl groups appear to be a common 
mechanism, available data suggest that other factors determining DNA 
methylation, including DNA methyltransferase (Dnmt), may be influenced by 
bioactive food components.

Availability and Utilization of Methyl Groups

SAM and S-adenosylhomocysteine (SAH), as components of methyl metabolism, are 
the substrate and product of essential cellular methyltransferase reactions.  
SAM is derived from an ATP-dependent transfer of adenosine to methionine via 
methionine adenosyltransferase and serves as the proximal methyl donor for 
most methylation reactions.  Cellular methyl acceptors include phospholipids, 
proteins, histones, neurotransmitters, RNA and DNA.  The formation of SAM 
requires a continuous supply of folate, methionine, choline, vitamin B12, 
vitamin B6, vitamin B2 and energy from the extracellular milieu.  
Polymorphisms in the methyl metabolism genes methionine synthase, 
methylenetetrahydrofolate reductase (MTHFR), and cystathione beta-synthetase 
affect concentrations of SAM and likely modify the susceptibility to cancer.  
Investigators are currently exploring the interaction between these 
polymorphisms, diet and DNA methylation.  For example, subjects homozygous for 
the C677T polymorphism in the MTHFR gene exhibited a significantly lower level 
of methylated DNA but only under conditions of low folate status. 

The Dnmts are a family of enzymes that catalyze the transfer of methyl groups 
from SAM to cytosine residues in DNA.  This produces 5-methylcytosine and SAH.  
Higher DNA methyltransferase activity has been observed in tumor cells 
compared to normal cells.  Chronic dietary methyl deficiency also increases 
DNA methyltransferase activity, which may be an attempt to compensate for 
diminished SAM supply.  Nutrient supply, therefore, appears to play a key role 
in regulating DNA methyltransferase activity.

Selenium is a dietary trace element that is recognized as having potential 
anticancer properties.  Interest in selenium as a prostate cancer preventative 
nutrient is showcased by the recent initiation of the SELECT trial by NCI 
(http://newscenter.cancer.gov/pressreleases/SELECT.html).  While selenium is 
known to modify several aspects of the cancer process, the one that is most 
critical for bringing about a phenotypic change remains to be established.  
Interestingly, increased selenium concentrations have been found to inhibit 
Dnmt1 activity in vitro and decrease Dnmt1 protein expression in vitro.  
Consistent with these data, selenium deficiency leads to increased Dnmt1 
protein expression in vitro. The effects of selenium on Dnmt activity suggest 
that dietary factors influencing methyl utilization may also modify DNA 
methylation patterns. 

Although the enzymes for direct methylation of DNA are well characterized, the 
demethylation process has been assumed to be a passive process.  A mammalian 
gene that codes for a protein that can catalyze demethylation recently has 
been described, however other attempts have yielded variable results. 
Demethylation activity has been hypothesized to be higher in non-neoplastic 
compared to neoplastic cells.  Loss of demethylation activity may account for 
some of the differences in methylation patterns between neoplastic and normal 
tissue.  The role, if any, of bioactive food components in regulating the 
demethylation process remains to be established.

Gene-Specific DNA Methylation Patterns

Fluctuations in the degree of CpG island methylation are key to regulating 
functional promoters by modifying the binding of transcription factors and 
methyl-DNA binding proteins.  Aberrant methylation of CpG islands on the 
promoter region may contribute to the progressive inactivation of growth-
inhibitory genes resulting in the clonal selection of cells with growth 
advantage during cancer development. 

While methyl-deficiency leads to global DNA hypomethylation, it also 
simultaneously leads to gene-specific hypomethylation and hypermethylation.  
Preclinical studies reveal that consumption of a methyl deficient diet leads 
to hypomethylation of specific CpG sites within several genes including c-myc, 
c-fos and c-H-ras.  This hypomethylation was accompanied by elevated levels of 
mRNA for these same genes.  Folate depletion was shown to produce gene-
specific, rather than global DNA hypomethylation in human nasopharyngeal 
carcinoma KB cells.  Interestingly, these investigators also reported that 
folate depletion led to hypermethylation of a 5" sequence of the H-cadherin 
gene, which accompanied diminished mRNA expression.  These data suggest that 
global DNA hypomethylation may incompletely predict the response to an 
individual dietary component. More probing studies are needed to characterize 
gene-specific changes brought about by bioactive food components.

Epigenetic events occurring in utero can lead to persistent changes in gene 
expression and can be modified by the diet.  For example, the diet provided to 
female mice of two strains during pregnancy modified the offsprings" hair coat 
color (increased agouti vs yellow) and DNA methylation patterns.  Expression 
of the yellow hair color in these mice is recognized to be controlled by 
hypomethylation of the agouti long terminal repeat (LTR), which was 
hypermethylated by dietary supplementation of the maternal diet with zinc, 
methionine, betaine, choline, folate and vitamin B12.  Expression of this 
yellow coat color is linked with increased risk of obesity, diabetes, and 
cancer.  While long-term health implications remain to be determined, these 
studies demonstrate that feeding a methyl-supplemented diet increased levels 
of DNA methylation in the agouti LTR and increased the proportion of agouti to 
yellow mice.  It should be noted that this effect occurred with control diets 
that are considered adequate for meeting nutritional needs.  These data point 
to the likelihood that in utero nutrient exposures can lead to genomic 
imprinting in the offspring and potentially modify cancer risk.

Invariably, increased fruit and vegetable consumption is associated with 
reduction in cancer risk.  Evidence from a variety of sources suggests that 
flavonoids, including genistein may have merit as an effective deterrent of 
cancer.  Dietary genistein has been shown to lead to changes in DNA 
methylation patterns in prostate tissue of C57BL/6J mice.  After sequencing, 
it was determined that genistein consumption led to hypermethylation at 4 
specific CpG islands, including a dexamethasone-induced product gene (D44443).  
Neonatal exposure to the phytoestrogens coumestrol and equol has been found to 
lead to specific gene hypermethylation in the c-H-ras proto-oncogene in 
pancreatic DNA.  Data indicating that consumption of high fiber diets is 
accompanied by a reduction in estrogen receptor methylation in colon tissue 
from healthy subjects has also been noted.  Hypermethylation of the promoter 
CpG islands is recognized to contribute to the loss of function of several 
tumor related genes, including estrogen receptor (ER).  Overall, several 
studies illustrate that bioactive food components other than essential 
nutrients can influence DNA methylation processes.

Cell Responsiveness to DNA Methylation Defects

The ability of bioactive food components to reduce proliferation in normal 
cells has been reported to be less than in neoplastic cells.  For example, 
selenium preferentially induces growth inhibition and apoptosis in prostate 
cancer cells, but not in normal prostate cells.  Recently, the flavonoid 
apigenin has also shown selective growth inhibition in prostate cancer cells 
without affecting normal cells.  It is unclear if these differences in 
sensitivity relate to epigenetic and DNA methylation processes.  

The gene encoding the pi class glutathione S-transferase (GSTP1) is known to 
be silenced by CpG island methylation in prostate cancer cells.  It has been 
suggested that compensation for loss of GSTP1 activity is possible with 
inducers of general glutathione S-transferase activity and one such inducer is 
the isothiocyanate compound sulforophane found in cruciferous vegetables. That 
dietary factors might circumvent changes induced by aberrant DNA methylation 
patterns in cancer requires investigation.

The short-chain fatty acid butyrate induces cell cycle arrest, differentiation 
and apoptosis in colon cancer cells, but often induces opposite effects in 
normal colonic epithelial cells.  A stable transgenic cell line containing a 
lacZ reporter gene coupled with a hormone-inducible promoter was examined for 
reversal of methylation-mediated gene silencing.  In the methylated form, the 
promoter is unable to induce lacZ expression and is insensitive to 
reactivation by the histone deacetylase inhibitors trichostatin A and 
suberoylanilide hydroxamic acid.  In contrast, the short-chain fatty acids 
(including proprionic, butyric and valeric acid) were capable of overcoming 
methylation-mediated repression and restored lacZ expression to levels 
approaching that from an unmethylated promoter.

Retinoic acid provides an example that some nutrients may also restore 
methylation patterns and gene expression.  RA demethylated the retinoic acid 
receptor beta2  promoter in acute promyeocytic leukemia cells.  This led to 
cellular differentiation and accumulation of retinoic acid receptor beta2  
mRNA  in these cells.  It is unknown whether other bioactive food components 
also lead to DNA demethylation.

Sensitizing tumor cells to the bioactive food component can also be 
accomplished by using demethylating agents, such as 5-aza-2"-deoxycytidine (5-
aza-dC).  This compound has been used as a therapeutic agent for certain 
cancers, although treatment-associated side effects preclude its general 
usefulness.  Treatment of several cell lines with MLL (mixed-lineage leukemia 
or myeloid/lymphoid leukemia) translocations with 5-aza-dC increases the 
ability of all-trans retinoic acid or 1,25-dihydroxyvitamin D3 to cause 
differentiation.  This study suggests that methylation patterns can influence 
the response to bioactive food components.  These are intriguing results, but 
we need more. 

Other Epigenetic Events

Emerging evidence indicates that various chromatin states such as histone 
modifications (acetylation and methylation) and nucleosome positioning 
(modulated by ATP-dependent chromatin remodeling machines) determine DNA 
methylation patterning. Additionally, various regulatory factors interacting 
with the DNA methyltransferases may direct them to specific DNA sequences, 
regulate their enzymatic activity, and allow their use as transcriptional 
repressors. Continued studies of the connections between DNA methylation and 
chromatin structure and the DNA methyltransferase-associated proteins, will 
likely reveal that many epigenetic modifications of the genome are directly 
connected.  DNA hypermethylation is not likely to be an isolated layer of 
epigenetic control, but is likely to be linked to other pieces of the puzzle 
such as methyl-binding proteins, DNA methyltransferases and histone 
deacetylase. Our understanding of the degree of specificity of these 
epigenetic layers in the control of gene function remains incomplete.

Histone modifications have recently generated excitement in epigenetic 
research, culminating in the `histone code" hypothesis. The idea is that the 
modified histone tails provide binding sites for chromatin-associated 
proteins, which in turn induce alterations in chromatin structure and other 
downstream events. In particular, for silent chromatin domains, histone H3 
lysine 9 methylation by the Su(var)3-9 family of histone methyltransferases 
has been shown to play a key part in the formation of transcriptionally 
repressed chromatin by providing a high-affinity binding site for the 
chromodomain of the heterochromatic HP1 proteins.  Recent evidence suggests 
that histone methylation has considerable epigenetic regulatory impact and is 
likely influenced by dietary methyl group sufficiency.  Moreover, the recent 
finding that some histone methyltransferases function as tumor suppressors 
provides another rationale for continued exploration of the diet and 
epigenetic relationship in cancer prevention research.

Acetylation of core histone tails is a conserved mechanism modulating gene 
expression. It is able to relax higher order chromatin, to promote factor 
binding to DNA and to recruit unique biological complexes that mediate 
downstream functions. A switch from inactive to active chromatin is often 
accompanied by histone hyperacetylation of critical sites in gene regulatory 
regions. The antagonistic activities of histone acetyltransferases and histone 
deacetylases control the nuclear steady-state balance of this covalent 
modification.  In addition to any effect on methylation patterns, the short-
chain fatty acid butyrate has been shown to induce histone hyperacetylation in 
vitro and inhibit histone deacetylase in vitro.  Recent evidence demonstrates 
that butyrate promotes hyperacetylation of the upstream region of the RET gene 
(a proto-oncogene which encodes a tyrosine kinase receptor predominantly 
expressed in the developing embryo) and increases transcription of the gene. 
More probing studies are needed to characterize additional gene-specific 
acetylation changes brought about by bioactive food components.

Calorie restriction is one of the best-documented and most potent experimental 
manipulations for decreasing tumor development in rodents and increasing 
longevity in diverse organisms. The mechanisms underlying the antitumorigenic 
effects of caloric restriction have not yet been elucidated. Nevertheless, 
there is great interest in translating the anticarcinogenic effects of caloric 
restriction into prevention strategies. Recent observations suggest that a 
protein important for heterochromatin formation, Sir2, is central for caloric-
restriction induced longevity in animals.   Any role for Sir2 in cancer 
prevention requires elucidation.

Objectives and Scope

This RFA seeks to promote innovative, preclinical and clinical research to 
determine how diet and dietary factors impact DNA methylation and other 
epigenetic processes involved with cancer prevention.  Although much evidence 
exists that dietary components are linked to cancer prevention, the specific 
nutrients and sites of action remain elusive.  Diet, in fact, has been 
implicated in many of the pathways of cancer, including apoptosis, cell cycle 
control, differentiation, inflammation, angiogenesis, DNA repair and 
carcinogen metabolism.  These are also processes that are likely regulated by 
DNA methylation, and possibly other epigenetic events, which impact gene 
function.  The objective of this RFA is to begin to address the following 
issues: how bioactive food components regulate DNA methylation or other 
epigenetic events for cancer prevention, if bioactive food components can 
alter DNA methylation or other aberrant epigenetic events and restore gene 
function, and if these components can circumvent or compensate for genes and 
pathways that are altered by epigenetic events.

An important aim of this RFA is to encourage collaboration between nutrition 
and epigenetic/ DNA methylation experts to study bioactive food components 
with cancer preventative properties and to examine key epigenetic events in 
cancer processes (i.e., carcinogen metabolism, cell division, differentiation, 
apoptosis) in order to begin to establish linkages between epigenetics, 
methylation pattern, and tumor incidence/behavior. Thus, each application 
should demonstrate experience in nutrition and cancer prevention as well as 
DNA methylation or epigenetics.

Studies should also link phenotypic changes to epigenetic alterations induced 
by specific essential and non-essential nutrients. The resulting information 
will be critical for optimizing effective dietary intervention strategies for 
cancer prevention.  Investigators may choose from the full range of clinical 
and preclinical approaches.  The focus should be on how individual dietary 
components influence DNA methylation and other epigenetic events and how this 
correlates with phenotypic change. Very little information currently exists 
about gene-specific changes in DNA methylation as influenced by bioactive food 
components, furthermore, very little information exists to adequately evaluate 
the specificity of individual nutrients, the impact of intakes/exposures, and 
any acclimation with time and/or tissue specificity.  This RFA encourages the 
submission of novel approaches to unravel relationships between DNA 
methylation and other epigenetic events, diet, and cancer prevention.

A variety of technologies to assess DNA methylation sequences may be utilized.  
These can be broadly classified into techniques that measure the overall 
content or distribution patterns of 5-methylcytosine (i.e., methylated CpG 
island amplification, methylation-sensitive restriction fingerprinting, 
differential methylation hybridization, and Restriction Landmark Genomic 
Scanning) and those that examine known gene sequences (i.e., methylation-
sensitive single nucleotide primer extension, and combined bisulfite 
restriction analysis).  The use of genetically engineered animal models 
including transgenic or gene knockouts are appropriate.  The efficient 
utilization of molecular resources such as gene databases and bioinformatics 
may also be used to expedite identification of gene-specific methylation 
targets.   

The following are viewed as relevant examples for the development of the R01 
and R21 applications:
o Gene-specific changes in DNA methylation caused by excesses and limitations 
in bioactive food components. 
o Relationship between dietary induced global DNA hypomethylation and gene-
specific hypermethylation.
o Relationship between diet induced changes in DNA methylation and histone 
acetylation/methylation and control of gene function
o Temporality in DNA methylation patterns as influenced by bioactive food 
components.
o Bioactive food component regulation of DNA methylation/epigenetic processes, 
i.e., methylenetetrahydrofolate reductase, methionine synthase, DNA 
methyltransferases, demethylases (or various demethylation processes), 
methylcytosine-binding proteins, histone methyltransferases, histone 
aceyltransferases and deacetylases.
o Linkages between DNA methylation or other epigenetic pattern and the 
anticancer properties of bioactive food components.

MECHANISM OF SUPPORT

This RFA will use the National Institutes of Health (NIH) research project 
grant (R01) and exploratory/developmental grants (R21) as award mechanisms.  
As an applicant you will be solely responsible for planning, directing, and 
executing the proposed project.  Future unsolicited, competing-continuation 
applications based on this project will compete with all investigator-
initiated applications and will be reviewed according to the customary peer 
review procedures. The anticipated award date is December 2003.

This RFA uses just-in-time concepts.  It also uses the modular as well as the 
non-modular budgeting formats (see 
http://grants.nih.gov/grants/funding/modular/modular.htm).  Specifically, if 
you are submitting an application with direct costs in each year of $250,000 
or less, use the modular format.  Otherwise follow the instructions for non-
modular research grant applications.

FUNDS AVAILABLE
 
NCI intends to commit approximately $2.5 million in FY 2004 to fund 7 to 10 
grants in response to this RFA.  The ODS intends to commit up to $800,000 in 
FY 2004 to fund 3 to 4 grants in response to this RFA. An R01 applicant may 
request a project period of up to 4 years. An R21 applicant may request a 
project period of up to 2 years and a budget for direct costs of up to 
$100,000 per year. Because the nature and scope of the proposed research will 
vary from application to application, it is anticipated that the size and 
duration of each award will also vary. Although the financial plans of NCI and 
the ODS provide support for this program, awards pursuant to this RFA are 
contingent upon the availability of funds and the receipt of a sufficient 
number of meritorious applications. At this time, it is not known if this RFA 
will be reissued.

ELIGIBLE INSTITUTIONS

 You may submit (an) application(s) if your institution has any of the 
following characteristics:

o For-profit or non-profit organizations 
o Public or private institutions, such as universities, colleges, hospitals, 
and laboratories 
o Units of State and local governments
o Eligible agencies of the Federal government  
o Domestic or foreign
o Faith-based or community based organizations

INDIVIDUALS ELIGIBLE TO BECOME PRINCIPAL INVESTIGATORS   

Any individual with the skills, knowledge, and resources necessary to carry 
out the proposed research is invited to work with their institution to develop 
an application for support.  Individuals from underrepresented racial and 
ethnic groups as well as individuals with disabilities are always encouraged 
to apply for NIH programs.   

WHERE TO SEND INQUIRIES

We encourage inquiries concerning this RFA and welcome the opportunity to 
answer questions from potential applicants.  Inquiries may fall into three 
areas:  scientific/research, peer review, and financial or grants management 
issues:

o Direct your questions about scientific/research issues related to diet and 
cancer prevention to:

Dr. Sharon A. Ross
Division of Cancer Prevention
National Cancer Institute
6130 Executive Blvd., Room 3157
Bethesda, MD  20892
Telephone:  (301) 594-7547
FAX:  (301) 480-3925
Email:  [email protected]

o Direct your questions about scientific/research issues related to dietary 
supplements to:

Rebecca B. Costello, Ph.D.
Office of Dietary Supplements
Office of Disease Prevention, Office of the Director
National Institutes of Health
6100 Executive Blvd., Room 3B01, MSC 7517
Bethesda, Maryland 20892-7517
Phone:  301-435-2920
Fax:  301-480-1845
Email:  [email protected]

o Direct your questions about peer review issues to:

Referral Officer
National Cancer Institute
Division of Extramural Activities
6116 Executive Boulevard, Room 8041, MSC 8329
Bethesda, MD 20892-8329
Telephone: (301) 496-3428
FAX: (301) 402-0275 
Email:  [email protected]

o Direct your questions about financial or grants management matters to:

Jane Paull
Grants Administration Branch
National Cancer Institute
6120 Executive Blvd., EPS-243
Bethesda, MD  20892
Telephone:  (301) 496-2182
FAX:  (301) 496-8601
Email:  paullj.gab.nci.nih.gov
 
LETTER OF INTENT
 
Prospective applicants are asked to submit a letter of intent that includes 
the following information:

o Descriptive title of the proposed research
o Name, address, and telephone number of the Principal Investigator
o Names of other key personnel 
o Participating institutions
o Number and title of this RFA 

Although a letter of intent is not required, is not binding, and does not 
enter into the review of a subsequent application, the information that it 
contains allows NCI staff to estimate the potential review workload and plan 
the review.
 
The letter of intent is to be sent by the date listed at the beginning of this 
document.  The letter of intent should be sent to:

Dr. Sharon A. Ross
Division of Cancer Prevention
National Cancer Institute
6130 Executive Blvd., Room 3157
Bethesda, MD  20892
Telephone:  (301) 594-7547
FAX:  (301) 480-3925
Email:  [email protected]

SUBMITTING AN APPLICATION

Applications must be prepared using the PHS 398 research grant application 
instructions and forms (rev. 5/2001).  The PHS 398 is available at 
http://grants.nih.gov/grants/funding/phs398/phs398.html in an interactive 
format.  For further assistance contact GrantsInfo, Telephone (301) 710-0267, 
Email: [email protected].
 
SPECIFIC INSTRUCTIONS FOR MODULAR GRANT APPLICATIONS: Applications requesting 
up to $250,000 per year in direct costs must be submitted in a modular grant 
format.  The modular grant format simplifies the preparation of the budget in 
these applications by limiting the level of budgetary detail.  Applicants 
request direct costs in $25,000 modules.  Section C of the research grant 
application instructions for the PHS 398 (rev. 5/2001) at 
http://grants.nih.gov/grants/funding/phs398/phs398.html includes step-by-step 
guidance for preparing modular grants.  Additional information on modular 
grants is available at 
http://grants.nih.gov/grants/funding/modular/modular.htm.

USING THE RFA LABEL: The RFA label available in the PHS 398 (rev. 5/2001) 
application form must be affixed to the bottom of the face page of the 
application.  Type the RFA number on the label.  Failure to use this label 
could result in delayed processing of the application such that it may not 
reach the review committee in time for review.  In addition, the RFA title and 
number must be typed on line 2 of the face page of the application form and 
the YES box must be marked. The RFA label is also available at: 
http://grants.nih.gov/grants/funding/phs398/label-bk.pdf.

All application instructions outlined in the PHS 398 application kit are to be 
followed, with the following requirements for R21 applications:  

1.  R21 applications will use the "MODULAR GRANT" and "JUST-IN-TIME" concepts, 
with direct costs requested in $25,000 modules, up to the total direct costs 
limit of $100,000 per year. 

2. Although preliminary data are not required for an R21 application, they may 
be included.

3.  Sections a-d of the Research Plan of the R21 application may not exceed 25 
pages, including tables and figures.  

4.  R21 appendix materials should be limited, as is consistent with the 
exploratory nature of the R21 mechanism, and should not be used to circumvent 
the page limit for the research plan.   Copies of appendix material will only 
be provided to the primary reviewers of the application and  will not be 
reproduced for wider distribution.  The following materials may be included in 
the appendix:

o Up to five publications, including manuscripts (submitted or accepted for 
publication), abstracts, patents, or other printed materials directly relevant 
to the project.  These may be stapled as sets.   Surveys, questionnaires, data 
collection instruments, and clinical protocols.  These may be stapled as sets.  
Original glossy photographs or color images of gels, micrographs, etc., 
provided that a photocopy (may be reduced in size) is also included within the 
25 page limit of items a-d of the research plan.
 
SENDING AN APPLICATION TO THE NIH: Submit a signed, typewritten original of 
the application, including the Checklist, and three signed, photocopies, in 
one package to:
 
Center for Scientific Review
National Institutes of Health
6701 Rockledge Drive, Room 1040, MSC 7710
Bethesda, MD  20892-7710
Bethesda, MD  20817 (for express/courier service)
 
At the time of submission, two additional copies of the application must be 
sent to:

Referral Officer 
Division of Extramural Activities 
National Cancer Institute 
6116 Executive Blvd., Room 8041, MSC-8329
Rockville, MD 20852 (express courier)
Bethesda MD 20892-8329

APPLICATIONS HAND-DELIVERED BY INDIVIDUALS TO THE NATIONAL CANCER INSTITUTE 
WILL NO LONGER BE ACCEPTED.  This policy does not apply to courier deliveries 
(i.e. FEDEX, UPS, DHL, etc.) 
(http://grants.nih.gov/grants/guide/notice-files/NOT-CA-02-002.html)  
This policy is similar to and consistent with the policy for applications
 addressed to Centers for Scientific Review as published in the NIH Guide Notice 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-012.html.

APPLICATION PROCESSING: Applications must be received by the application 
receipt date listed in the heading of this RFA.  If an application is received 
after that date, it will be returned to the applicant without review.
 
The Center for Scientific Review (CSR) will not accept any application in 
response to this RFA that is essentially the same as one currently pending 
initial review, unless the applicant withdraws the pending application.  The 
CSR will not accept any application that is essentially the same as one 
already reviewed. This does not preclude the submission of substantial 
revisions of applications already reviewed, but such applications must include 
an Introduction addressing the previous critique.

PEER REVIEW PROCESS  
 
Upon receipt, applications will be reviewed for completeness by the CSR and 
for responsiveness by the NCI and ODS program staff. 

Incomplete applications will be returned to the applicant without further 
consideration.  And, if the application is not responsive to the RFA, CSR 
staff may contact the applicant to determine whether to return the application 
to the applicant or submit it for review in competition with unsolicited 
applications at the next appropriate NIH review cycle.

Applications that are complete and responsive to the RFA will be evaluated for 
scientific and technical merit by an appropriate peer review group convened by 
the Division of Extramural Activities (DEA) at NCI in accordance with the 
review criteria stated below.  As part of the initial merit review, all 
applications will:

o  Receive a written critique
o  Undergo a process in which only those applications deemed to have the 
highest scientific merit, generally the top half of the applications under 
review, will be discussed and assigned a priority score
o  Those that receive a priority score will undergo a second level review by 
the National Cancer Advisory Board.
 
REVIEW CRITERIA

The goals of NIH-supported research are to advance our understanding of 
biological systems, improve the control of disease, and enhance health.  In 
the written comments, reviewers will be asked to discuss the following aspects 
of your application in order to judge the likelihood that the proposed 
research will have a substantial impact on the pursuit of these goals: 

o  Significance 
o  Approach 
o  Innovation
o  Investigator
o  Environment
  
The scientific review group will address and consider each of these criteria 
in assigning your application"s overall score, weighting them as appropriate 
for each application.  Your application does not need to be strong in all 
categories to be judged likely to have major scientific impact and thus 
deserve a high priority score.  For example, you may propose to carry out 
important work that by its nature is not innovative but is essential to move a 
field forward.

(1) SIGNIFICANCE:  Does this study address an important question about the 
role of (a) bioactive food components in DNA methylation or other epigenetic 
event involved with cell vulnerability to cancer or cellular responsiveness to 
cancer prevention? Do studies focus on how dietary components influence DNA 
methylation or other epigenetic event and how this correlates with phenotypic 
change.  Will these research projects advance the field of nutrition and 
cancer prevention from observational to more probing studies?

(2) APPROACH:  Are the conceptual framework, design, methods, and analyses 
adequately developed, well integrated, and appropriate to the aims of the 
project?  Does the applicant acknowledge potential problem areas and consider 
alternative tactics? 

(3) INNOVATION:  Does the project employ novel concepts, approaches or 
methods? Are the aims original and innovative?  Does the project challenge 
existing paradigms or develop new methodologies or technologies?

(4) INVESTIGATOR:  Is the investigator appropriately trained and well suited 
to carry out this work? Is experience in nutrition and cancer prevention as 
well as DNA methylation or epigenetics demonstrated in the application?  Is 
the work proposed appropriate to the experience level of the principal 
investigator and other researchers (if any)?

(5) ENVIRONMENT:  Does the scientific environment in which the work will be 
done contribute to the probability of success?  Do the proposed experiments 
take advantage of unique features of the scientific environment or employ 
useful collaborative arrangements (i.e., between nutrition and epigenetic /DNA 
methylation experts)?  Is there evidence of institutional support?

ADDITIONAL REVIEW CRITERIA: In addition to the above criteria, your 
application will also be reviewed with respect to the following:

o PROTECTIONS:  The adequacy of the proposed protection for humans, animals, 
or the environment, to the extent they may be adversely affected by the 
project proposed in the application.

o INCLUSION:  The adequacy of plans to include subjects from both genders, all 
racial and ethnic groups (and subgroups), and children as appropriate for the 
scientific goals of the research.  Plans for the recruitment and retention of 
subjects will also be evaluated. (See Inclusion Criteria included in the 
section on Federal Citations, below)

o DATA SHARING:  The adequacy of the proposed plan to share data.

o BUDGET:  The reasonableness of the proposed budget and the requested period 
of support in relation to the proposed research.

RECEIPT AND REVIEW SCHEDULE

Letter of Intent Receipt Date:      February 18, 2003
Application Receipt Date:           March 18, 2003
Peer Review Date:                   June-July, 2003
Council Review:	                    September 2003
Earliest Anticipated Start Date:    December 2003

AWARD CRITERIA

Award criteria that will be used to make award decisions include:

o Scientific merit (as determined by peer review)
o Availability of funds
o Programmatic priorities.
 
REQUIRED FEDERAL CITATIONS 

MONITORING PLAN AND DATA SAFETY AND MONITORING BOARD: Research components 
involving Phase I and II clinical trials must include provisions for 
assessment of patient eligibility and status, rigorous data management, 
quality assurance, and auditing procedures.  In addition, it is NIH policy 
that all clinical trials require data and safety monitoring, with the method 
and degree of monitoring being commensurate with the risks (NIH Policy for 
Data Safety and Monitoring, NIH Guide for Grants and Contracts, June 12, 1998: 
http://grants.nih.gov/grants/guide/notice-files/not98-084.html).  

Clinical trials supported or performed by NCI require special considerations.  
The method and degree of monitoring should be commensurate with the degree of 
risk involved in participation and the size and complexity of the clinical 
trial.  Monitoring exists on a continuum from monitoring by the principal 
investigator/project manager or NCI program staff or a Data and Safety 
Monitoring Board (DSMB).  These monitoring activities are distinct from the 
requirement for study review and approval by an Institutional review Board 
(IRB).  For details about the Policy for the NCI for Data and Safety 
Monitoring of Clinical trials see: 
http://deainfo.nci.nih.gov/grantspolicies/datasafety.htm.  For Phase I and II 
clinical trials, investigators must submit a general description of the data 
and safety monitoring plan as part of the research application.  See NIH Guide 
Notice on "Further Guidance on a Data and Safety Monitoring for Phase I and II 
Trials" for additional information: 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-038.html.  
Information concerning essential elements of data safety monitoring plans for 
clinical trials funded by the NCI is available:  
http://www.cancer.gov/clinical_trials/

INCLUSION OF WOMEN AND MINORITIES IN CLINICAL RESEARCH:  It is the policy of 
the NIH that women and members of minority groups and their sub-populations 
must be included in all NIH-supported clinical research projects unless a 
clear and compelling justification is provided indicating that inclusion is 
inappropriate with respect to the health of the subjects or the purpose of the 
research. This policy results from the NIH Revitalization Act of 1993 (Section 
492B of Public Law 103-43).

All investigators proposing clinical research should read the AMENDMENT "NIH 
Guidelines for Inclusion of Women and Minorities as Subjects in Clinical 
Research - Amended, October, 2001," published in the NIH Guide for Grants and 
Contracts on October 9, 2001 
(http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-001.html),
 a complete copy of the updated Guidelines are available at 
http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm.
The amended policy incorporates: the use of an NIH definition of 
clinical research, updated racial and ethnic categories in compliance with the 
new OMB standards, clarification of language governing NIH-defined Phase III 
clinical trials consistent with the new PHS Form 398, and updated roles and 
responsibilities of NIH staff and the extramural community.  The policy 
continues to require for all NIH-defined Phase III clinical trials that: a) 
all applications or proposals and/or protocols must provide a description of 
plans to conduct analyses, as appropriate, to address differences by 
sex/gender and/or racial/ethnic groups, including subgroups if applicable, and 
b) investigators must report annual accrual and progress in conducting 
analyses, as appropriate, by sex/gender and/or racial/ethnic group 
differences.

INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS: 
The NIH maintains a policy that children (i.e., individuals under the age of 
21) must be included in all human subjects research, conducted or supported by 
the NIH, unless there are scientific and ethical reasons not to include them. 
This policy applies to all initial (Type 1) applications submitted for receipt 
dates after October 1, 1998.

All investigators proposing research involving human subjects should read the 
"NIH Policy and Guidelines" on the inclusion of children as participants in 
research involving human subjects that is available at 
http://grants.nih.gov/grants/funding/children/children.htm. 

REQUIRED EDUCATION ON THE PROTECTION OF HUMAN SUBJECT PARTICIPANTS: NIH policy 
requires education on the protection of human subject participants for all 
investigators submitting NIH proposals for research involving human subjects.  
You will find this policy announcement in the NIH Guide for Grants and 
Contracts Announcement, dated June 5, 2000, at 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-039.html.  A 
continuing education program in the protection of human participants in 
research in now available online at: http://cme.nci.nih.gov/

HUMAN EMBRYONIC STEM CELLS (hESC): Criteria for federal funding of research on 
hESCs can be found at http://grants.nih.gov/grants/stem_cells.htm and at 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-005.html.  Guidance 
for investigators and institutional review boards regarding research involving 
human embryonic stem cells, germ cells, and stem cell-derived test articles 
can be found at 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-044.html. 
Only research using hESC lines that are registered in the NIH Human 
Embryonic Stem Cell Registry will be eligible for Federal funding (see 
http://escr.nih.gov).   It is the responsibility of the applicant to provide 
the official NIH identifier(s)for the hESC line(s) to be used in the proposed 
research.  Applications that do not provide this information will be returned 
without review.

PUBLIC ACCESS TO RESEARCH DATA THROUGH THE FREEDOM OF INFORMATION ACT: The 
Office of Management and Budget (OMB) Circular A-110 has been revised to 
provide public access to research data through the Freedom of Information Act 
(FOIA) under some circumstances.  Data that are (1) first produced in a 
project that is supported in whole or in part with Federal funds and (2) cited 
publicly and officially by a Federal agency in support of an action that has 
the force and effect of law (i.e., a regulation) may be accessed through FOIA.  
It is important for applicants to understand the basic scope of this 
amendment.  NIH has provided guidance at 
http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm.

Applicants may wish to place data collected under this RFA in a public 
archive, which can provide protections for the data and manage the 
distribution for an indefinite period of time.  If so, the application should 
include a description of the archiving plan in the study design and include 
information about this in the budget justification section of the application. 
In addition, applicants should think about how to structure informed consent 
statements and other human subjects procedures given the potential for wider 
use of data collected under this award.

URLs IN NIH GRANT APPLICATIONS OR APPENDICES: All applications and proposals 
for NIH funding must be self-contained within specified page limitations. 
Unless otherwise specified in an NIH solicitation, Internet addresses (URLs) 
should not be used to provide information necessary to the review because 
reviewers are under no obligation to view the Internet sites.   Furthermore, 
we caution reviewers that their anonymity may be compromised when they 
directly access an Internet site.

HEALTHY PEOPLE 2010: The Public Health Service (PHS) is committed to achieving 
the health promotion and disease prevention objectives of "Healthy People 
2010," a PHS-led national activity for setting priority areas. This RFA is 
related to one or more of the priority areas. Potential applicants may obtain 
a copy of "Healthy People 2010" at http://www.health.gov/healthypeople/

AUTHORITY AND REGULATIONS: This program is described in the Catalog of Federal 
Domestic Assistance No. 93.3393 (Cancer Cause and Prevention Research) and is 
not subject to the intergovernmental review requirements of Executive Order 
12372 or Health Systems Agency review.  Awards are made under authorization of 
Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 
and 284) and administered under NIH grants policies described at 
http://grants.nih.gov/grants/policy/policy.htm and under Federal Regulations 
42 CFR 52 and 45 CFR Parts 74 and 92. 

The PHS strongly encourages all grant recipients to provide a smoke-free 
workplace and discourage the use of all tobacco products.  In addition, Public 
Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain 
facilities (or in some cases, any portion of a facility) in which regular or 
routine education, library, day care, health care, or early childhood 
development services are provided to children.  This is consistent with the 
PHS mission to protect and advance the physical and mental health of the 
American people.

The Office of Dietary Supplements (ODS) was mandated by Congress in 1994 and 
established within the Office of the Director, National Institutes of Health 
(NIH). The Dietary Supplement Health and Education Act (DSHEA) [Public Law 
103-417, Section 3.a] amended the Federal Food, Drug, and Cosmetic Act "to 
establish standards with respect to dietary supplements." This law authorized 
the establishment of the ODS.





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