EXPIRED
This Program Announcement expires on October 22, 2003, unless reissued. DEVELOPMENTAL /PILOT PROJECTS IN CANCER COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) Release Date: December 17, 2001 PA NUMBER: PAR-02-040 National Cancer Institute (http://cancer.gov/) National Center for Complementary and Alternative Medicine (http://nccam.nih.gov/) Letter of Intent Dates: January 16, 2002, May 17, 2002, September 16, 2002, January 16, 2003, May 23, 2003, September 16, 2003 Application Receipt Dates: February 20, 2002, June 21, 2002, October 21, 2002, February 20, 2003, June 20, 2003, October 21, 2003 THIS PA USES "MODULAR GRANT" AND "JUST-IN-TIME" CONCEPTS. MODULAR INSTRUCTIONS MUST BE USED FOR RESEARCH GRANT APPLICATIONS REQUESTING LESS THAN $250,000 PER YEAR IN ALL YEARS. MODULAR BUDGET INSTRUCTIONS ARE PROVIDED IN SECTION C OF THE PHS 398 (REVISION 5/2001) AVAILABLE AT http://grants.nih.gov/grants/funding/phs398/phs398.html. PURPOSE The Office of Cancer Complementary and Alternative Medicine of the National Cancer Institute (NCI), and the National Center for Complementary and Alternative Medicine (NCCAM) invite research grant applications from interested investigators to conduct innovative developmental pilot research investigating Complementary and Alternative Medicine (CAM) in cancer. The intent of this initiative is to encourage and support the development of basic and clinical CAM cancer research and to provide the basis for more extended research projects by establishing the methodological feasibility and strengthening the scientific rationale for these projects. This announcement is also intended to stimulate and facilitate the entry of promising investigators into cancer CAM research through a program of exploratory investigator-initiated R21 grants. The exploratory/developmental (R21) grant mechanism is used for pilot projects or feasibility studies to support the exploration of feasibility, as well as the development, of projects investigating CAM in cancer and for the generation of preliminary data. The R21 mechanism is specifically intended to support innovative ideas where preliminary data are sparse or do not exist. The R21 supported projects are intended to serve as a foundation for planning and developing future research projects (R01s). The objective of this Program Announcement (PA) is to encourage applications from individuals who are interested in testing novel or conceptually creative ideas that may produce innovative advances in the understanding and use of CAM in cancer. RESEARCH OBJECTIVES The widespread use of a variety of nutritional, psychological and natural medical approaches, collectively termed complementary and alternative medicine (CAM), has been well documented. Recent surveys demonstrate that between 9 and 91% of U.S. cancer patients use CAM therapies at some time after their diagnosis. Despite the broad use of CAM treatment for cancer, there is a lack of data available to indicate whether these CAM practices are efficacious and safe. Various NIH advisory groups have cited the need for increased research on CAM approaches for the treatment of cancer and have encouraged the NIH to support the evaluation of CAM therapies. There is a paucity of R01 funded research grants in the field of cancer CAM. Therefore, to increase the number and quality of investigator-initiated R01 research grants on cancer CAM, the NCI"s Office of Cancer Complementary and Alternative Medicine and NCCAM developed this PA for Developmental/Pilot Projects in Cancer CAM. Applications will undergo competitive review organized by the NCCAM in collaboration with the NCI. The intent of this initiative is to encourage and support the development of basic, and clinical (prevention, therapeutic and palliative) CAM cancer research. Another goal of this initiative is to facilitate communication and collaboration between the CAM practitioner and the conventional cancer research communities. For the purpose of this PA, applicants must include modalities from the following broad program areas in CAM: Alternative Medical Systems (e.g., oriental medicine, Ayurvedic, homeopathy, naturopathy), Manipulative and Body-based Systems (e.g., chiropractic, osteopathic, massage therapy or unconventional applications of integrated conventional and physical therapies), Energy Therapies. These approaches focus either on energy fields purported to originate within or be conducted through the body (e.g., external qi gong, therapeutic touch, Reiki, intentional effects on living systems), or those from other sources [e.g., therapeutic application of electromagnetic (EM) fields including pulsed EM fields, magnetic fields, Direct Current (DC) fields]. Pharmacological or Biologically based Therapies (e.g., metabolic therapies and immunoaugmentative therapies as used by CAM practitioners or the public such as Coley"s toxin, Enzyme therapies, the Livingston-Wheeler system, the Revici system, or 714-X ) Herbal Medicine (Note: This category includes studies of whole plant products or extracts and does not include the study or isolation of active ingredients from herbal preparations except where identification and standardization of optimal whole product are the specific aim -- e.g. optimal ratio of glycosides and terpenoids in Ginkgo biloba -- or comparisons are being made to the whole product), Orthomolecular Medicine - This category includes the use of nutritional and food supplements, Co-enzyme Q10, carnitine, melatonin, vitamins) for therapeutic or preventive purposes. These products are usually used in combinations and at very high doses (5-10 fold) well above the Recommended Daily Allowance (RDA) when such RDAs have been defined. Mind-Body Medicine: Concept proposals in this category will be considered only if they are limited to those mind-body approaches that are used by the public or practitioners outside of a conventional medicine setting (e.g., transcendental meditation, imagery, hypnosis, biofeedback, music therapy, yoga, relaxation, spirituality, biological effects of consciousness). Mind- body approaches that are relatively integrated into conventional medicine (e.g., patient education, psychotherapy, cognitive-behavioral approaches, etc.) will NOT be considered unless physiologic endpoints (e.g., immune parameters) or disease parameters (response rate to conventional therapy, disease-free survival, overall survival) are the primary outcome measures, Applications may also focus on interactions between these modalities and non- CAM cancer treatment and therapies (e.g. Drug Interactions: studies to evaluate the potential interaction of antioxidant compounds and conventional chemotherapy and/or radiation therapy.) Most commercially available CAM products lack data on product characterization, purity, standardization or stability. Therefore, applicants are encouraged to discuss quality control of the source material for the proposed research. Authentication and characterization of the material will assure reproducibility for future trials. Dosing of most CAM interventions is rarely standardized, in fact a basic tenant of CAM is individualized diagnosis and treatment of patients. Thus, the applicant must carefully consider dosing. If the dosage is not established but based on traditional use, a citation(s) from a well- recognized, accessible source to support the proposed dosage should be referenced. If the dosage deviates from traditional use, this decision should be justified. It is the sole responsibility of the applicant to obtain all necessary clearances from the Food and Drug Administration (FDA) as required. It is expected that applicants will have contacted the FDA about necessity of an Investigation New Drug (IND) request well before submission of the current application. In addition, applicants are strongly encouraged to consult their local Institutional Review Boards (IRBs) concerning IND status and the IRB approval process. MECHANISM OF SUPPORT This PA will use the National Institutes of Health (NIH) exploratory/developmental (R21) grant mechanism. Responsibility for the planning, direction, and execution of the proposed project will be solely that of the applicant. The total project period for an application submitted in response to this PA may not exceed TWO years. Though the size of award may vary with the scope of research proposed, it is expected that applications will stay within the budgetary guidelines for an exploratory/developmental project, direct costs are limited to $150,000 (six budget modules). These grants are non-renewable and continuation of projects developed under this PA will be through the traditional unsolicited investigator initiated grant program. The earliest anticipated award date is September 2002. Specific application instructions have been modified to reflect "MODULAR GRANT" and "JUST-IN-TIME" streamlining efforts that have been adopted by the NIH. Complete and detailed instructions and information on Modular Grant applications have been incorporated into the PHS 398 (rev. 5/2001). Additional information on Modular Grants can be found at http://grants.nih.gov/grants/funding/modular/modular.htm. ELIGIBILITY REQUIREMENTS Applications may be submitted by foreign and domestic, for-profit and not- for-profit organizations, public and private, such as universities, colleges, hospitals, laboratories, units of State and local governments, and eligible agencies of the Federal government. Racial/ethnic minority individuals, women, and persons with disabilities are encouraged to apply as principal investigators. INQUIRIES Inquiries are strongly encouraged. The opportunity to clarify any issues or questions from potential applicants is welcome. Direct inquiries regarding programmatic issues to: Wendy B. Smith, Ph.D. Office of Cancer Complementary and Alternative Medicine National Cancer Institute Executive Plaza North 6130 Executive Blvd Suite #102, MSC 7302 Bethesda, MD 20892-7302 Telephone: (301) 435-7980 FAX: (301) 480-0075 Email: [email protected] Mary Ann Richardson, DrPH National Center for Complementary and Alternative Medicine 6707 Democracy Blvd, Suite 102 Bethesda, MD 20892-5475 Telephone: (301) 402-1272 FAX: (301) 480-3621 Email: [email protected] Direct inquiries regarding fiscal matters to: Ms. Eileen Natoli Grants Administration Branch National Cancer Institute EPS-Room 243 Bethesda, Maryland 20892 Telephone: (301) 496-8791 FAX: (301) 496-8601 Email: [email protected] Direct inquiries regarding review matters to: NCI Referral Officer Division of Extramural Activities National Cancer Institute 6116 Executive Boulevard, Room 8109, MSC 8329 Bethesda, MD 20892-8329 Rockville, MD 20852 (for express/courier service) Telephone: (301) 496-3428 Fax: (301) 402-0275 Email: [email protected] Dr. Martin Goldrosen Office of Review National Center for Complementary and Alternative Medicine 6707 Democracy Blvd., Suite 106 MSC 5475 Bethesda, Maryland 20892-5475 Telephone: (301) 496-4792 Fax: (301) 480-2419 Email: [email protected] LETTER OF INTENT Prospective applicants are asked to submit a Letter of Intent by the dates listed on the front page of this PA that includes a descriptive title of the proposed research, the name, address, and telephone number of the Principal Investigator, the identities of other key personnel and participating institutions, and the number and title of the PA in response to which the application may be submitted. 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 IC staff to estimate the potential review workload and plan the review The Letter of Intent is to be sent to Dr. Wendy B. Smith at the address listed under INQUIRIES. APPLICATION PROCEDURES. The PHS 398 research grant application instructions and forms (rev. 5/2001) at http://grants.nih.gov/grants/funding/phs398/phs398.html must be used in applying for these grants and will be accepted at the standard application deadlines (http://grants.nih.gov/grants/dates.htm) as indicated in the application kit. This version of the PHS 398 is available in an interactive, searchable format. The modular grant concept establishes specific modules in which direct costs may be requested as well as a maximum level for requested budgets. Only limited budgetary information is required under this approach. The just-in- time concept allows applicants to submit certain information only when there is a possibility for an award. It is anticipated that these changes will reduce the administrative burden for the applicants, reviewers and NIH staff. All clinical trials supported or performed by NIH require some form of monitoring. 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 NIH program staff to 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 of the NCI for Data Safety Monitoring of Clinical Trials see http://deainfo.nci.nih.gov/grantspolicies/datasafety.htm. For NCCAM"s Policy and guidelines on safety monitoring see http://nccam.nih.gov/research/policies/datasafety/index.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 to http://www.nci.nih.gov/clinicaltrials/conducting/dsm-guidelines. SPECIFIC INSTRUCTIONS FOR MODULAR GRANT APPLICATIONS The modular grant concept establishes specific modules in which direct costs may be requested as well as a maximum level for requested budgets. Only limited budgetary information is required under this approach. The just-in- time concept allows applicants to submit certain information only when there is a possibility for an award. It is anticipated that these changes will reduce the administrative burden for the applicants, reviewers and NIH staff. The research grant application form PHS 398 (rev. 5/2001) at http://grants.nih.gov/grants/funding/phs398/phs398.html is to be used in applying for these grants, with modular budget instructions provided in Section C of the application instructions. The title and number of the program announcement must be typed on line 2 of the face page of the application form and the YES box must be marked. Submit a signed, typewritten original of the application, including the checklist, and three signed, exact, single-sided 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) To expedite the review process, at the time of submission, send two additional copies of the application to: NCI Referral Officer National Cancer Institute 6116 Executive Boulevard, Room 8109, MSC 8329 Bethesda, MD 20892-8109 Rockville, MD 20852 (for overnight/courier service) Telephone: (301) 496-3428 FAX: (301) 402-0275 Applications must be received by the receipt dates listed at the beginning of this program announcement. REVIEW CONSIDERATIONS Applications will be reviewed for completeness by the Center for Scientific Review. Incomplete applications will be returned to the applicant without further consideration. Applications that are complete will be evaluated for scientific and technical merit by an appropriate scientific review group convened by the National Center for Complementary and Alternative Medicine and National Cancer Institute in accordance with the standard NIH peer review procedures. As part of the initial merit review, all applications will receive a written critique, and may undergo a process in which only those applications deemed to have the highest scientific merit, generally the top half of applications under review, will be discussed, assigned a priority score, and receive a second level review by the appropriate national council or advisory board of participating ICs. Review Criteria The five criteria to be used in the evaluation of grant applications are listed below. The goals of NIH-supported research are to advance our understanding of biological systems, improve the control of disease, and enhance health. The reviewers will comment on the following aspects of the application in their written critiques in order to judge the likelihood that the proposed research will have a substantial impact on the pursuit of these goals. Each of these criteria will be addressed and considered by the reviewers in assigning the overall score weighting them as appropriate for each application. Note that the application does not need to be strong in all categories to be judged likely to have a major scientific impact and thus deserve a high priority score. For example, an investigator may propose to carry out important work that by its nature is not innovative but is essential to move a field forward. Because the exploratory/developmental grant mechanism (R21) is designed to support innovative ideas, preliminary data as evidence of feasibility of the project are not required. However, the applicant does have the responsibility for developing a sound research plan approach, including appropriate statistical analyses and sample size calculations where appropriate. Innovation of the project and potential significance of the proposed research will be major considerations in the evaluation of this mechanism. 1. Significance. Does this study address an important problem? If the aims of the application are achieved, how will scientific knowledge be advanced? What will be the effect of these studies on the concepts or methods that drive this field? 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 method? 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 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? Is there evidence of institutional support? The initial review group will also examine: o the appropriateness of proposed project budget and duration, o the adequacy of plans to include both genders, minorities (and their subgroups), and children as appropriate for the scientific goals of the research and plans for the recruitment and retention of subjects, o the provisions for the protection of human and animal subjects, o the safety of the research environment, o the adequacy of the proposed plan to share data 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. INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS 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. It is the policy of NIH 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 clear and compelling 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 was published in the NIH Guide for Grants and Contracts, March 6, 1998, and is available at the following URL address: http://grants.nih.gov/grants/guide/notice-files/not98-024.html. Investigators also may obtain copies of the policy from the program staff listed under INQUIRIES. Program staff may also provide additional relevant information concerning the policy. REQUIRED EDUCATION IN THE PROTECTION OF HUMAN RESEARCH PARTICIPANTS All investigators proposing research involving human subjects should read the NIH policy on education in the protection of human research participants now required for all investigators, which is published in the NIH Guide for Grants and Contracts, June 5, 2000 (Revised August 25, 2000), available at the following URL address: 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 is now available online at http://cme.nci.nih.gov/. 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 PA 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. Reviewers are cautioned 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 PA, Developmental/Pilot Projects in Cancer Complementary and Alternative Medicine, is related to priority area of cancer and seeks to increase life expectancy and quality of life. 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. 93.395 (NCI) and 93.213 (NCCAM). 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 and Federal Regulations 42 CFR 52 and 45 CFR Parts 74 and 92. This program is not subject to the intergovernmental review requirements of Executive Order 12372 or Health Systems Agency review. The PHS strongly encourages all grant recipients to provide a smoke-free workplace and promote the non-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.
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