Part 1. Overview Information

Key Dates

All applications are due by 5:00 PM local time of applicant organization.

Applicants are encouraged to apply early to allow adequate time to make any corrections to errors found in the application during the submission process by the due date.

No late applications will be accepted for this Funding Opportunity Announcement.

It is critical that applicants follow the instructions in the Research (R) Instructions in the SF424 (R&R) Application Guide, except where instructed to do otherwise (in this NOFO or in a Notice from NIH Guide for Grants and Contracts).

Conformance to all requirements (both in the Application Guide and the NOFO) is required and strictly enforced. Applicants must read and follow all application instructions in the Application Guide as well as any program-specific instructions noted in Section IV. When the program-specific instructions deviate from those in the Application Guide, follow the program-specific instructions.

Applications that do not comply with these instructions may be delayed or not accepted for review.

Part 2. Full Text of Announcement

Section I. Notice of Funding Opportunity Description

Purpose

This NOFO supports the development of cancer-relevant technologies suitable for use in low- and middle-income countries (LMICs). Specifically, the NOFO solicits applications for projects to adapt, apply, and validate existing or emerging technologies into a new generation of user-friendly, low-cost technologies for preventing, detecting, diagnosing, and/or treating cancers in people living in LMICs.

Applicants should have a working assay or device prototype (not necessarily already capable of cancer applications). The U01 project includes studies to both adapt this technology as well as demonstrate technical functionality and clinical performance for use of the device or assay in specific LMIC settings by meeting objective performance milestones followed by improvements and validations of the technologies in the LMIC settings. Projects proposed in response to this NOFO will require multidisciplinary efforts to succeed; therefore, all applicant teams must include expertise in engineering/assay/treatment development, oncology, and global healthcare delivery. Investigators responding to this NOFO must consider affordability and cost-effectiveness as well as usability at the point-of-need as part of their design criteria.

This funding opportunity is part of a broader NCI-sponsored Affordable Cancer Technologies (ACTs) Program.

Note: Throughout the following text, references to either the LMIC setting or the global health setting refer specifically to a target LMIC for a proposed technology. LMIC is defined according to the World Bank Country and Lending Groups and is inclusive of low- and middle-income countries, not including upper-middle income countries, for the purposes of this NOFO

Background

It is estimated that more than two-thirds of the 9.5 million annual cancer deaths in the world occur in LMICs. Furthermore, the incidence rate of cancer is on the rise in populations of many LMICs, with substantial inequalities in cancer survival rates across the world. Access to cancer prevention, screening, detection, diagnosis, and treatment is a significant challenge in many LMICs, especially in areas with limited infrastructure.

Prevention, early detection, and treatment are vital to successful cancer control. Unfortunately, many established cancer control technologies are not suitable for use in low-resource settings, either globally or in the U.S., due to expense, dependency on extensive medical infrastructure, or both.

Many leading edge, innovative technologies, such as lab-on-a-chip, portable ablative devices, portable imaging modalities, and liquid biopsies have potential for use in LMICs. Recent developments in consumer electronics, microfabrication, cellular phone communications, and hand-held computers have further improved prospects for adaptation into sensitive, low-cost versions suitable for use in low-resource settings. Additionally, various existing portable technologies and minimally invasive diagnostic/treatment methods might be suitable for low-resource settings.

The ACTs program supports resource-appropriate translational technology research for cancer where affordability and potential impact in low-resource settings are essential design components. Furthermore, technologies supported through the ACTs program are validated in real-world health settings in LMICs, leading to the promise of additional innovations (e.g., enable use by minimally trained health workers, appropriate for use at the clinical point-of-need, and allow robust adaptability to diverse environmental conditions and health systems). Lastly, the technologies advanced through the ACTs program may not only be relevant for LMICs but may additionally provide invaluable insights and tools appropriate for addressing cancer disparities domestically (i.e. urban and/or rural disparities).

Research Objectives

Applications in response to this NOFO must propose to adapt, apply, engineer, and validate existing or emerging technologies or assays into a new generation of technologies and assays for preventing, detecting, diagnosing, or treating of preventable or treatable cancers in specific LMIC healthcare settings.

Projects in response to this solicitation may include, but are not limited to:

• Modification of an existing assay or device such that it can be used for/is more appropriate for the detection or treatment of specific cancers in an LMIC;
• Simplifying or adding new features to a device or assay to enable the device to operate outside a laboratory in an LMIC (e.g., areas in which the people have limited access to electricity or where other environmental conditions, such as dust, heat, humidity, etc. must be considered);
• Adapting existing or emerging technologies that have not been previously used for cancer detection, diagnosis, or treatment in LMICs; and/or
• Performing statistically rigorous validation of the analytical and clinical performance of the device or assay to detect or treat a specific cancer in an LMIC.

Scope

The project must focus on a specific cancer type that is preventable or treatable in the proposed LMIC setting and must show promise to deliver medical utility for improved health outcomes. Suitable technologies/devices/assays to be proposed for development/adaptation must be based on a working prototype or an existing device (which will serve as a basis for adaptation), demonstrating general feasibility of the proposed approaches. After program implementation, the proposed technologies/devices are expected to provide clear clinical utility to the specific LMIC healthcare delivery system. The technology must comply with the applicable regulations and international standards/guidelines [such as Good Laboratory Practice (GLP), Good Manufacturing Practice (GMP), WHO guidelines, FDA Investigational Device Exemption (IDE) or local regulations in LMICs].

Note:

• Throughout the following text, references to either the LMIC setting or the global health setting refer to the specific LMIC settings in which the proposed technology will be studied.
• Cancers, including those caused by oncogenic viruses, remain an important comorbidity for HIV-infected populations even in the current era of worldwide access to antiretroviral therapy. Therefore, NCI encourages research concerning HIV-associated cancers and applications targeted at this population are within the scope of this announcement.
• Development of drugs, biologics, and cancer vaccines is NOT within the scope of this funding opportunity.

Cancers preventable/treatable in an LMIC Setting:

Because the focus of this NOFO is translation, it is important that proposed technologies be targeted towards preventable or treatable cancers within the technical capabilities and resource restrictions of the LMIC. Where possible, investigators should consider how their proposed intervention fits within local cancer prevention and control needs and priorities.

Local Context:

The device design and application should consider local cultural sensitivities that may impede adoption of the technology if not properly accounted for and addressed. Investigators should consider cultural, environmental, societal and demographic issues, including, but not limited to, distance to care, aging in place, and urban versus rural contexts. Local health care delivery models, availability of other companion technologies needed as part of the proposed intervention, and issues around patient contact and follow-up also should be considered. Potential barriers to uptake related to previous community interactions with foreign researchers, including possible mistrust, should be considered as well.

Additionally, investigators should consider the broader health setting and other health priorities in the local context. Possible intersections of the proposed work with key communicable diseases or other co-morbidities should be considered where appropriate.

Community Engagement:

Building trust with research participants is an essential feature of ethical biomedical research involving human subjects, and NIH encourages ongoing community engagement to help establish and maintain this trust. ACTs recipients are expected to incorporate relevant community engagement into their research activities. Community engagement can include approaches to empower communities to contribute to and become partners in the research and activities that engage diverse stakeholders to learn about and contribute to the projects.

Relevant technologies include but are not limited to:

In Vitro diagnostic assays or technologies: Point-of-Care analytics for complex samples such as blood, saliva, or urine (e.g., lab-on-a-chip and biosensors that allow the performance of relevant chemical and/or biological assays outside of laboratory environments);

Imaging technologies: Portable, sustainable modalities for cancer detection, diagnosis, and treatment monitoring at the point-of-need (e.g., optical imaging, spectroscopy, and ultrasound). Further possibilities include leveraging machine learning algorithms to aid in image analysis, segmentation, integration of large data sets or other to evolve the clinical utility of artificial intelligence for cancer imaging. This can include the integration of modern computational or informatics methods (e.g., machine learning/vision, deep learning, neural networks, Machine Intelligence , integrated bioinformatics, predictive analytics, etc.) into preclinical and clinical imaging methods to enhance/optimize utility to detection, diagnosis, workflow, or treatment monitoring.

Treatment-related technologies: any type of treatment modality as well as technologies/devices that may aid/facilitate standard treatment modalities. In particular, tools for various, potentially portable, minimally invasive treatment methods are appropriate, including, but not limited to surgical devices, technologies related to drugs/vaccines/chemotherapy/immunotherapy, and tools for cryotherapy and laser therapy, radiofrequency ablation, low-power-density sonication, high-intensity focused ultrasound, and photodynamictherapy.

Note: The proposed technology may be lab-based, where appropriate. In this case, it is incumbent upon the applicant to address the availability of the lab equipment required, affordability and stability of reagents, and the technical expertise of local staff.

General Technology Characteristics:

The proposed technology should represent the state-of-the-art in terms of comparable technologies available in the local health setting.

Investigators must explicitly consider potential for adoption and scale-up in the local LMIC context as design criteria for technologies proposed in applications responding to this NOFO:

• Where there are existing technologies supported by public and private health centers, non-governmental organizations, charities, and development agencies for similar or related applications, the proposed technologies should be comparable in price.
• Considerations of availability, cost, and affordability should include disposables.
• Consideration around dissemination should stress achieving high uptake in the community.
• Technologies should be sustainable and affordable by local providers (either low enough in cost to easily replace, easily replaceable parts/ease of repair, or durability).

Additionally, design-thinking around usability at the point-of-need should be explicitly addressed for all proposed technologies. Such device characteristics may include the following:

• Ease of use: the device, technology, or assay must be suitable for use in the chosen setting by caregivers receiving local training in its operation and maintenance;
• Operable in locations with limited clinical infrastructure (e.g., limited access to electricity, landline communication, refrigeration, or central water supply); and
• Designed for use at the community level and/or in non-traditional healthcare settings;

Specific Desirable Attributes

• Simple to operate by locally trained healthcare staff or client (i.e., self-collection approaches);
• Rapid results (for diagnostic technologies);
• Risk stratified approaches for early detection or screening technologies;
• Connectivity to the internet or telephone network (e.g., to allow for telemedicine);
• Modular design to increase reliability ease-of-use, and to simplify maintenance;
• Incorporation of internal checks of device/assay performance, self-calibration, and error diagnosis;
• Open-source hardware or software; and
• Standard readily available off-the-shelf components, such as power supplies, software, or approved imaging probes;

Device Pre-requisites and Preliminary Data:

The applicants must have a working prototype or an existing assay/device (not necessarily already used for cancer applications) and preliminary data to demonstrate its potential for preventing, detecting, diagnosing, and/or treating cancer in people in LMIC settings.

Technology Development and Validation Studies in LMICs:

This funding opportunity is focused on translational technology research and includes both engineering and design components as well as clinical validation at the point-of-need in an LMIC. Because of the broad scope of this NOFO, it is expected that applicants will propose technologies that vary in readiness (beyond the initial prototype requirements stated above). As such, it is up to investigators to clearly delineate the engineering/design components of the project, define clear quantitative milestones for readiness to move into clinical validation studies, and design these studies.

Investigators are to adapt, apply, and/or engineer an existing prototype or existing device/assay/treatment for use in a low-resource setting. Applicants will have to demonstrate the analytical and clinical performance of the assay or technology for cancer, as well as its potential suitability for use in a low-resource setting.

Considerations for this phase of work include:

• Adaptation if needed and testing of the assay/device/treatment to demonstrate that its analytical and clinical performance is comparable to a currently used technology;
• Steps to ensure that the assay or device will be ready to be tested in an LMIC;
• Demonstration of a working relationship with the local LMIC site(s) where the clinical study will take place;
• Updated validation study design; and
• Plans for regulatory approval for validation study.

Note: The goal of this work is translational in nature, rather than being focused on early stages of technology development. Therefore, if a detection application relies on novel biomarkers, these biomarkers should have been previously validated or be currently in use in clinical settings for the cancer in question.

All the projects must include appropriate clinical studies to validate the use and benefits of the technology/device/assay/treatment and establish the device’s potential clinical utility in the targeted low-resource environments. The validation studies must be conducted in LMICs.

Expected outcomes of this phase of work include:

• Adequate accrual of patients with real-time review of quality control (QC) and endpoint data;
• Completion of the validation trial;
• Demonstration of performance, effectiveness, and promise of the validated technology for clinical utility;
• Development of a training plan for healthcare delivery users, to help assure progression toward clinical utility and benefit from the validated technology;
• Development of a dissemination plan (e.g., teaching or training sessions for the local population) to explain and promote the technology or intervention and disseminating research findings back to key local stakeholders, even if findings for the technology or device are unfavorable;
• Plans for completion of regulatory approval, and deployment for clinical use in the LMIC site or sites; and
• Report on the sustainability/durability of the device/assay in the low-cost environment.

All projects will be routinely assessed by NCI program staff to track the following:

• Successful achievement of design specifications/quantitative milestones for the engineering phase of the project;
• Meeting the recruitment goals for testing the assay/device;
• Analytical and clinical performance of the assay/device;
• Potential for meeting the broad goals of the initiative; and
• Potential of the plan for successful conduct of a clinical validation study in an LMIC, including statistical power to determine the technology's clinical performance, plans for IRB approval, and plans for human subject recruitment (including addressing applicable IDE/IND/local LMIC regulations).

Trans-network Interactions and Program Governance:

The recipients supported under this NOFO will be required to be members of a Steering Committee (for details, see Section VI.2. Cooperative Agreement Terms and Conditions of Award).

Researchers uncertain as to whether their intended technology development project meets the requirements of this NOFO are strongly encouraged to contact the Scientific/Research Contact listed below.

Non-Responsive Projects

The following aspects/characteristics remain outside the scope of the ACTs Program and this NOFO. Applications proposing projects with any of the following characteristics will not be reviewed:

The following aspects/characteristics remain outside the scope of the ACTs Program and this NOFO. Applications proposing projects with any of the following characteristics will not be reviewed:

• Projects lacking LMIC key personnel with substantial involvement in the research activities;
• Projects lacking performance sites in an LMIC;
• Pursuit of a biological or clinical hypothesis for which the innovation of the project resides in the biological question (i.e., traditional biological-hypothesis driven research) and NOT in the clinical/public health utility and technical capability being developed;
• Use of technologies for which an initial proof-of-concept has not already been demonstrated in a cancer-relevant biological system/ technologies not ready for advanced development and validation without substantial further developmental efforts;
• Biomarker discovery or biomarker validation; and/or
• Development of drugs, biologics, or cancer vaccines.

As there are several unique review considerations for this NOFO, applicants must address the requested items outlined for the Research Plan in Section IV.2. Application and Submission Information. An application lacking appropriate milestones and timeline, as determined by the NCI program staff, will not be reviewed.

Additionally, NCI will hold a pre-application informational webinar for this NOFO. Date, time, and other details will be posted at: http://www.cancer.gov/aboutnci/organization/global-health/events.

See Section VIII. Other Information for award authorities and regulations.

Investigators proposing NIH-defined clinical trials may refer to the Research Methods Resources website for information about developing statistical methods and study designs.

Section II. Award Information

NIH grants policies as described in the NIH Grants Policy Statement will apply to the applications submitted and awards made from this NOFO.

Section III. Eligibility Information

1. Eligible Applicants

Higher Education Institutions

• Public/State Controlled Institutions of Higher Education
• Private Institutions of Higher Education

The following types of Higher Education Institutions are always encouraged to apply for NIH support as Public or Private Institutions of Higher Education:

• Hispanic-serving Institutions
• Historically Black Colleges and Universities (HBCUs)
• Tribally Controlled Colleges and Universities (TCCUs)
• Alaska Native and Native Hawaiian Serving Institutions
• Asian American Native American Pacific Islander Serving Institutions (AANAPISIs)

Nonprofits Other Than Institutions of Higher Education

• Nonprofits with 501(c)(3) IRS Status (Other than Institutions of Higher Education)
• Nonprofits without 501(c)(3) IRS Status (Other than Institutions of Higher Education)

For-Profit Organizations

• Small Businesses
• For-Profit Organizations (Other than Small Businesses)

Local Governments

• State Governments
• County Governments
• City or Township Governments
• Special District Governments
• Indian/Native American Tribal Governments (Federally Recognized)
• Indian/Native American Tribal Governments (Other than Federally Recognized)

Federal Government

• Eligible Agencies of the Federal Government
• U.S. Territory or Possession

Other

• Independent School Districts
• Public Housing Authorities/Indian Housing Authorities
• Native American Tribal Organizations (other than Federally recognized tribal governments)
• Faith-based or Community-based Organizations
• Regional Organizations
• Non-domestic (non-U.S.) Entities (Foreign Institutions)

Non-domestic (non-U.S.) Entities (Foreign Institutions) are eligible to apply.

Non-domestic (non-U.S.) components of U.S. Organizations are eligible to apply.

Foreign components, as defined in the NIH Grants Policy Statement, are allowed.

Applicant Organizations

Applicant organizations must complete and maintain the following registrations as described in the SF 424 (R&R) Application Guide to be eligible to apply for or receive an award. All registrations must be completed prior to the application being submitted. Registration can take 6 weeks or more, so applicants should begin the registration process as soon as possible. The NIH Policy on Late Submission of Grant Applications states that failure to complete registrations in advance of a due date is not a valid reason for a late submission.

• System for Award Management (SAM) Applicants must complete and maintain an active registration, which requires renewal at least annually. The renewal process may require as much time as the initial registration. SAM registration includes the assignment of a Commercial and Government Entity (CAGE) Code for domestic organizations which have not already been assigned a CAGE Code.
  • NATO Commercial and Government Entity (NCAGE) Code Foreign organizations must obtain an NCAGE code (in lieu of a CAGE code) in order to register in SAM.
  • Unique Entity Identifier (UEI) - A UEI is issued as part of the SAM.gov registration process. The same UEI must be used for all registrations, as well as on the grant application.
• eRA Commons - Once the unique organization identifier is established, organizations can register with eRA Commons in tandem with completing their Grants.gov registration; all registrations must be in place by time of submission. eRA Commons requires organizations to identify at least one Signing Official (SO) and at least one Program Director/Principal Investigator (PD/PI) account in order to submit an application.
• Grants.gov Applicants must have an active SAM registration in order to complete the Grants.gov registration.

Program Directors/Principal Investigators (PD(s)/PI(s))

All PD(s)/PI(s) must have an eRA Commons account. PD(s)/PI(s) should work with their organizational officials to either create a new account or to affiliate their existing account with the applicant organization in eRA Commons. If the PD/PI is also the organizational Signing Official, they must have two distinct eRA Commons accounts, one for each role. Obtaining an eRA Commons account can take up to 2 weeks.

Any individual(s) with the skills, knowledge, and resources necessary to carry out the proposed research as the Program Director(s)/Principal Investigator(s) (PD(s)/PI(s)) is invited to work with their organization to develop an application for support. Individuals from diverse backgrounds, including underrepresented racial and ethnic groups, individuals with disabilities, and women are always encouraged to apply for NIH support. See, Reminder: Notice of NIH's Encouragement of Applications Supporting Individuals from Underrepresented Ethnic and Racial Groups as well as Individuals with Disabilities, NOT-OD-22-019.

For institutions/organizations proposing multiple PDs/PIs, visit the Multiple Program Director/Principal Investigator Policy and submission details in the Senior/Key Person Profile (Expanded) Component of the SF424 (R&R) Application Guide.

Individuals from both the high-income countries (HIC), such as the U.S., and the LMIC institutions are eligible PDs/PIs. The main collaborating individual(s) from the proposed HIC and LMIC institutions must serve as PDs/PIs or other key personnel. Multi-PI applications are encouraged.

2. Cost Sharing

This NOFO does not require cost sharing as defined in the NIH Grants Policy Statement.

3. Additional Information on Eligibility

Number of Applications

Applicant organizations may submit more than one application, provided that each application is scientifically distinct.

The NIH will not accept duplicate or highly overlapping applications under review at the same time, per 2.3.7.4 Submission of Resubmission Application. This means that the NIH will not accept:

• A new (A0) application that is submitted before issuance of the summary statement from the review of an overlapping new (A0) or resubmission (A1) application.
• A resubmission (A1) application that is submitted before issuance of the summary statement from the review of the previous new (A0) application.
• An application that has substantial overlap with another application pending appeal of initial peer review (see 2.3.9.4 Similar, Essentially Identical, or Identical Applications)

Section IV. Application and Submission Information

1. Requesting an Application Package

The application forms package specific to this opportunity must be accessed through ASSIST, Grants.gov Workspace or an institutional system-to-system solution. Links to apply using ASSIST or Grants.gov Workspace are available in Part 1 of this NOFO. See your administrative office for instructions if you plan to use an institutional system-to-system solution.

2. Content and Form of Application Submission

It is critical that applicants follow the instructions in the Research (R) Instructions in the SF424 (R&R) Application Guide except where instructed in this notice of funding opportunity to do otherwise. Conformance to the requirements in the Application Guide is required and strictly enforced. Applications that are out of compliance with these instructions may be delayed or not accepted for review.

Letter of Intent

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.

By the date listed in Part 1. Overview Information, prospective applicants are asked to submit a letter of intent that includes the following information:

• Descriptive title of proposed activity
• Name(s), address(es), and telephone number(s) of the PD(s)/PI(s)
• Names of other key personnel
• Participating institution(s)
• Number and title of this funding opportunity

The letter of intent should be sent to:

Paul C. Pearlman, Ph.D.
National Cancer Institute (NCI)
Telephone: 240-276-5354
Email: [email protected]

All page limitations described in the SF424 Application Guide and the Table of Page Limits must be followed.

The following section supplements the instructions found in the SF424 (R&R) Application Guide and should be used for preparing an application to this NOFO.

All instructions in the SF424 (R&R) Application Guide must be followed.

All instructions in the SF424 (R&R) Application Guide must be followed.

All instructions in the SF424 (R&R) Application Guide must be followed.

All instructions in the SF424 (R&R) Application Guide must be followed.

All applications must have at least one LMIC researcher and at least one high-income country (HIC) researcher as key personnel. Since the global health technology field is multidisciplinary and cross-sectoral in nature, applicants should consider appropriate collaborations with researchers from diverse disciplines such as engineering, computer science, business, medicine, public health, and/or other relevant fields. In addition, applicants should consider partnering with individuals in public or private organizations, including health system entities, which could enable future research or implementation efforts within the relevant LMIC.

Combined, the multidisciplinary team must have expertise in the following areas:

• Engineering/assay development: Expertise relevant to the development of technologies, assays or devices and to ensuring their suitability for use in an LMIC.
• Oncology: Expertise in cancer detection/diagnosis and/or treatment is required to ensure the assay/device/treatment will show clinical effectiveness for screening, detection or diagnosis, and treatment of cancers that can be locally managed or treated in an LMIC setting.
• Sufficient expertise in global health care delivery is required to establish collaborations with health care workers in the local sites for validation and utilization of the assay or device. In addition, expertise is needed to assure cultural appropriateness of the overall project with respect to patient expectations, health care worker training, and deployment and acceptance of the assay/device/treatment. Examples of suitable collaborating partners in the target country or countries may include hospitals, medical schools, charities, local governments, community groups, Non-Governmental Organizations (NGOs), and governmental entities with expertise in the local setting.
  

Additionally, while not required, an industrial partner is encouraged to provide expertise in fabrication, help with governmental regulatory approvals including in-country regulatory expertise, and prepare, disseminate, and sustain the technology for clinical use.

R&R or Modular Budget

All instructions in the SF424 (R&R) Application Guide must be followed.

R&R Subaward Budget

All instructions in the SF424 (R&R) Application Guide must be followed.

All instructions in the SF424 (R&R) Application Guide must be followed.

All instructions in the SF424 (R&R) Application Guide must be followed, with the following additional instructions:

Milestones and Timelines

A timeline (Gantt chart) including milestones is required for the project duration. Milestones are goals that create go/no-go decision points in the project and must include clear and quantitative objective criteria for success. Annual milestones should function as indicators of a project's continued progress, thus revealing emergent difficulties, and will be used to evaluate the application not only in peer review but also in consideration of the awarded project for funding of non-competing award years.

Milestones/quantitative performance measures should be well-defined in the application. For examples of appropriate milestones, see https://imat.cancer.gov/applicant-resources/specific-application-requirements. At the end of the "Approach" section, milestones and timelines should be provided under separate headings. The following are particularly important:

• Provide appropriately detailed (quantitative) criteria by which milestone achievement will be assessed;
• Provide a detailed timeline for the anticipated attainment of each milestone and the overall goal; and
• Identify any impediments that could require an addendum to the research plan, milestones, and/or timeline with a discussion of alternative approaches.

Letters of Support: A letter of support from the LMIC clinical site(s) is required and should include information about the organization's technical and clinical expertise and capabilities, which populations are served, other funding sources, plans to deploy the technology in the stated setting, and other relevant information.

Resource Sharing Plan:

Individuals are required to comply with the instructions for the Resource Sharing Plans as provided in the SF424 (R& R ) Application Guide.

• All applications, regardless of the amount of direct costs requested for any one year, should address a Data Sharing Plan.

Other Plan(s):

Note: Effective for due dates on or after January 25, 2023, the Data Management and Sharing Plan will be attached in the Other Plan(s) attachment in FORMS-H application forms packages.

All instructions in the SF424 (R&R) Application Guide must be followed, with the following additional instructions:

• All applicants planning research (funded or conducted in whole or in part by NIH) that results in the generation of scientific data are required to comply with the instructions for the Data Management and Sharing Plan. All applications, regardless of the amount of direct costs requested for any one year, must address a Data Management and Sharing Plan.

Only limited Appendix materials are allowed. Follow all instructions for the Appendix as described in the SF424 (R&R) Application Guide.

• No publications or other material, with the exception of blank questionnaires or blank surveys, may be included in the Appendix.

When involving human subjects research, clinical research, and/or NIH-defined clinical trials (and when applicable, clinical trials research experience) follow all instructions for the PHS Human Subjects and Clinical Trials Information form in the SF424 (R&R) Application Guide, with the following additional instructions:

If you answered Yes to the question Are Human Subjects Involved? on the R&R Other Project Information form, you must include at least one human subjects study record using the Study Record: PHS Human Subjects and Clinical Trials Information form or Delayed Onset Study record.

Study Record: PHS Human Subjects and Clinical Trials Information

All instructions in the SF424 (R&R) Application Guide must be followed.

Delayed Onset Study

Note: Delayed onset does NOT apply to a study that can be described but will not start immediately (i.e., delayed start). All instructions in the SF424 (R&R) Application Guide must be followed.

All instructions in the SF424 (R&R) Application Guide must be followed.

Foreign Institutions

Foreign (non-U.S.) institutions must follow policies described in the NIH Grants Policy Statement, and procedures for foreign institutions described throughout the SF424 (R&R) Application Guide.

3. Unique Entity Identifier and System for Award Management (SAM)

See Part 1. Section III.1 for information regarding the requirement for obtaining a unique entity identifier and for completing and maintaining active registrations in System for Award Management (SAM), NATO Commercial and Government Entity (NCAGE) Code (if applicable), eRA Commons, and Grants.gov

Part I. Overview Information contains information about Key Dates and times. Applicants are encouraged to submit applications before the due date to ensure they have time to make any application corrections that might be necessary for successful submission. When a submission date falls on a weekend or Federal holiday, the application deadline is automatically extended to the next business day.

Organizations must submit applications to Grants.gov (the online portal to find and apply for grants across all Federal agencies). Applicants must then complete the submission process by tracking the status of the application in the eRA Commons, NIH’s electronic system for grants administration. NIH and Grants.gov systems check the application against many of the application instructions upon submission. Errors must be corrected and a changed/corrected application must be submitted to Grants.gov on or before the application due date and time. If a Changed/Corrected application is submitted after the deadline, the application will be considered late. Applications that miss the due date and time are subjected to the NIH Policy on Late Application Submission.

Applicants are responsible for viewing their application before the due date in the eRA Commons to ensure accurate and successful submission.

Information on the submission process and a definition of on-time submission are provided in the SF424 (R&R) Application Guide.

5. Intergovernmental Review (E.O. 12372)

This initiative is not subject to intergovernmental review.

All NIH awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.

Pre-award costs are allowable only as described in the NIH Grants Policy Statement.

Applications must be submitted electronically following the instructions described in the SF424 (R&R) Application Guide. Paper applications will not be accepted.

Applicants must complete all required registrations before the application due date. Section III. Eligibility Information contains information about registration.

For assistance with your electronic application or for more information on the electronic submission process, visit How to Apply Application Guide. If you encounter a system issue beyond your control that threatens your ability to complete the submission process on-time, you must follow the Dealing with System Issues guidance. For assistance with application submission, contact the Application Submission Contacts in Section VII.

Important reminders:

All PD(s)/PI(s) must include their eRA Commons ID in the Credential field of the Senior/Key Person Profile form. Failure to register in the Commons and to include a valid PD/PI Commons ID in the credential field will prevent the successful submission of an electronic application to NIH. See Section III of this NOFO for information on registration requirements.

The applicant organization must ensure that the unique entity identifier provided on the application is the same identifier used in the organization’s profile in the eRA Commons and for the System for Award Management. Additional information may be found in the SF424 (R&R) Application Guide.

See more tips for avoiding common errors.

Upon receipt, applications will be evaluated for completeness and compliance with application instructions by the Center for Scientific Review and responsiveness by NCI, NIH. Applications that are incomplete, non-compliant and/or nonresponsive will not be reviewed.

Applicants are required to follow the instructions for post-submission materials, as described in the policy

Section V. Application Review Information

1. Criteria

Only the review criteria described below will be considered in the review process. Applications submitted to the NIH in support of the NIH mission are evaluated for scientific and technical merit through the NIH peer review system.

For this particular announcement, note the following:

This NOFO is focused on new technologies or modifications of existing technologies that can have a significant impact on cancer detection, diagnosis, monitoring, and treatment in limited resource settings, such as those often encountered in low- and middle-income countries. Therefore, the potential of the proposed projects to result in a tool useful for a specific cancer-related clinical need of the targeted LMIC and suitable for an LMIC setting is essential and will be emphasized in assessing the overall merit of the applications. Priority will be given to technologies that are likely to be sustainable and projects with a high potential for fast, low-cost application in low resource settings.

In addition, for applications involving clinical trials: A proposed Clinical Trial application may include study design, methods, and intervention that are not by themselves innovative but address important questions or unmet needs. Additionally, the results of the clinical trial may indicate that further clinical development of the intervention is unwarranted or lead to new avenues of scientific investigation.

A proposed Clinical Trial application may include study design, methods, and intervention that are not by themselves innovative but address important questions or unmet needs. Additionally, the results of the clinical trial may indicate that further clinical development of the intervention is unwarranted or lead to new avenues of scientific investigation.

Overall Impact

Reviewers will provide an overall impact score to reflect their assessment of the likelihood for the project to exert a sustained, powerful influence on the research field(s) involved, in consideration of the following review criteria and additional review criteria (as applicable for the project proposed).

Scored Review Criteria

Reviewers will consider each of the review criteria below in the determination of scientific merit and give a separate score for each. An application does not need to be strong in all categories to be judged likely to have major scientific impact. For example, a project that by its nature is not innovative may be essential to advance a field.

Significance

Does the project address an important problem or a critical barrier to progress in the field? Is the prior research that serves as the key support for the proposed project rigorous? If the aims of the project are achieved, how will scientific knowledge, technical capability, and/or clinical practice be improved? How will successful completion of the aims change the concepts, methods, technologies, treatments, services, or preventative interventions that drive this field?

In addition, for applications involving clinical trials

Are the scientific rationale and need for a clinical trial to test the proposed hypothesis or intervention well supported by preliminary data, clinical and/or preclinical studies, or information in the literature or knowledge of biological mechanisms? For trials focusing on clinical or public health endpoints, is this clinical trial necessary for testing the safety, efficacy or effectiveness of an intervention that could lead to a change in clinical practice, community behaviors or health care policy? For trials focusing on mechanistic, behavioral, physiological, biochemical, or other biomedical endpoints, is this trial needed to advance scientific understanding?

Specific for this NOFO:

Does the technology proposed address an appropriate cancer problem that is significant in the proposed settings of a given LMIC? What is the potential of the proposed technology to be sufficiently and broadly adopted by local healthcare providers in the proposed setting? How directly will the technology inform potentially actionable strategies to reduce cancer morbidity/mortality in the LMIC setting?

Investigator(s)

Are the PD(s)/PI(s), collaborators, and other researchers well suited to the project? If Early Stage Investigators or those in the early stages of independent careers, do they have appropriate experience and training? If established, have they demonstrated an ongoing record of accomplishments that have advanced their field(s)? If the project is collaborative or multi-PD/PI, do the investigators have complementary and integrated expertise; are their leadership approach, governance, and organizational structure appropriate for the project?

In addition, for applications involving clinical trials

With regard to the proposed leadership for the project, do the PD/PI(s) and key personnel have the expertise, experience, and ability to organize, manage and implement the proposed clinical trial and meet milestones and timelines? Do they have appropriate expertise in study coordination, data management and statistics? For a multicenter trial, is the organizational structure appropriate and does the application identify a core of potential center investigators and staffing for a coordinating center?

Specific for this NOFO:

Do HIC and LMIC investigators appropriately contribute to the proposed research activities (i.e., is there parity in the collaboration)? Is the team's expertise appropriate and sufficiently diverse to effectively manage the steps necessary to develop and test the technology in the chosen low-resource settings? For example, does the team include appropriate expertise for assay/device/treatment development including engineering, oncology, and site-specific global health expertise? What is the likelihood that all the collaborators and partners will be able to work together to effectively complete translation of the proposed technology for broader application in the global health setting?

Innovation

Does the application challenge and seek to shift current research or clinical practice paradigms by utilizing novel theoretical concepts, approaches or methodologies, instrumentation, or interventions? Are the concepts, approaches or methodologies, instrumentation, or interventions novel to one field of research or novel in a broad sense? Is a refinement, improvement, or new application of theoretical concepts, approaches or methodologies, instrumentation, or interventions proposed?

In addition, for applications involving clinical trials

Does the design/research plan include innovative elements, as appropriate, that enhance its sensitivity, potential for information or potential to advance scientific knowledge or clinical practice?

Specific for this NOFO:

How innovative are the proposed approaches in terms of combining low cost (at the manufacturing and operation levels) with functionality and usability in the selected low-resource setting?

Approach

Are the overall strategy, methodology, and analyses well-reasoned and appropriate to accomplish the specific aims of the project? Have the investigators included plans to address weaknesses in the rigor of prior research that serves as the key support for the proposed project? Have the investigators presented strategies to ensure a robust and unbiased approach, as appropriate for the work proposed? Are potential problems, alternative strategies, and benchmarks for success presented? If the project is in the early stages of development, will the strategy establish feasibility and will particularly risky aspects be managed? Have the investigators presented adequate plans to address relevant biological variables, such as sex, for studies in vertebrate animals or human subjects?

If the project involves human subjects and/or NIH-defined clinical research, are the plans to address 1) the protection of human subjects from research risks, and 2) inclusion (or exclusion) of individuals on the basis of sex/gender, race, and ethnicity, as well as the inclusion or exclusion of individuals of all ages (including children and older adults), justified in terms of the scientific goals and research strategy proposed?

In addition, for applications involving clinical trials

Does the application adequately address the following, if applicable

Study Design

Is the study design justified and appropriate to address primary and secondary outcome variable(s)/endpoints that will be clear, informative and relevant to the hypothesis being tested? Is the scientific rationale/premise of the study based on previously well-designed preclinical and/or clinical research? Given the methods used to assign participants and deliver interventions, is the study design adequately powered to answer the research question(s), test the proposed hypothesis/hypotheses, and provide interpretable results? Is the trial appropriately designed to conduct the research efficiently? Are the study populations (size, gender, age, demographic group), proposed intervention arms/dose, and duration of the trial, appropriate and well justified?

Are potential ethical issues adequately addressed? Is the process for obtaining informed consent or assent appropriate? Is the eligible population available? Are the plans for recruitment outreach, enrollment, retention, handling dropouts, missed visits, and losses to follow-up appropriate to ensure robust data collection? Are the planned recruitment timelines feasible and is the plan to monitor accrual adequate? Has the need for randomization (or not), masking (if appropriate), controls, and inclusion/exclusion criteria been addressed? Are differences addressed, if applicable, in the intervention effect due to sex/gender and race/ethnicity?

Are the plans to standardize, assure quality of, and monitor adherence to, the trial protocol and data collection or distribution guidelines appropriate? Is there a plan to obtain required study agent(s)? Does the application propose to use existing available resources, as applicable?

Data Management and Statistical Analysis

Are planned analyses and statistical approach appropriate for the proposed study design and methods used to assign participants and deliver interventions? Are the procedures for data management and quality control of data adequate at clinical site(s) or at center laboratories, as applicable? Have the methods for standardization of procedures for data management to assess the effect of the intervention and quality control been addressed? Is there a plan to complete data analysis within the proposed period of the award?

Specific for this NOFO:

How coherent is the plan to develop, test, and validate a technology/ assay/device/treatment that has potential for clinical utility in the chosen LMIC setting?

How appropriate is the design of the clinical validation trial (e.g., in terms of sufficient statistical power to assess the clinical effectiveness of the technology)? Does the application describe appropriate strategies for community engagement with clear objectives of what they expect to achieve?

Are the proposed milestones well-designed, quantitative, and scientifically justified? Do they provide objective measures of the performance of the project and the intended path of the research? Does the applicant address the capability and ability to address project milestones within the associated timeline (Gantt chart)? Are potential impediments that could require an addendum to the research plan, milestones, and/or timeline adequately addressed and are sufficient alternative approaches provided?

Environment

Will the scientific environment in which the work will be done contribute to the probability of success? Are the institutional support, equipment, and other physical resources available to the investigators adequate for the project proposed? Will the project benefit from unique features of the scientific environment, subject populations, or collaborative arrangements?

In addition, for applications involving clinical trials

If proposed, are the administrative, data coordinating, enrollment and laboratory/testing centers, appropriate for the trial proposed?

Does the application adequately address the capability and ability to conduct the trial at the proposed site(s) or centers? Are the plans to add or drop enrollment centers, as needed, appropriate?

If international site(s) is/are proposed, does the application adequately address the complexity of executing the clinical trial?

If multi-sites/centers, is there evidence of the ability of the individual site or center to: (1) enroll the proposed numbers; (2) adhere to the protocol; (3) collect and transmit data in an accurate and timely fashion; and, (4) operate within the proposed organizational structure?

Specific for this NOFO:

Is the range of proposed collaborations sufficient in terms of including appropriate organizations in the HIC and the LMIC site? How appropriate is the foreign site in the LMIC for the proposed validation trial? Are the commitments of all partnering institutions sufficient for the conduct of the proposed studies?

Additional Review Criteria

As applicable for the project proposed, reviewers will evaluate the following additional items while determining scientific and technical merit, and in providing an overall impact score, but will not give separate scores for these items.

Study Timeline

Specific to applications involving clinical trials

Is the study timeline described in detail, taking into account start-up activities, the anticipated rate of enrollment, and planned follow-up assessment? Is the projected timeline feasible and well justified? Does the project incorporate efficiencies and utilize existing resources (e.g., CTSAs, practice-based research networks, electronic medical records, administrative database, or patient registries) to increase the efficiency of participant enrollment and data collection, as appropriate?

Are potential challenges and corresponding solutions discussed (e.g., strategies that can be implemented in the event of enrollment shortfalls)?

Protections for Human Subjects

For research that involves human subjects but does not involve one of the categories of research that are exempt under 45 CFR Part 46, the committee will evaluate the justification for involvement of human subjects and the proposed protections from research risk relating to their participation according to the following five review criteria: 1) risk to subjects, 2) adequacy of protection against risks, 3) potential benefits to the subjects and others, 4) importance of the knowledge to be gained, and 5) data and safety monitoring for clinical trials.

For research that involves human subjects and meets the criteria for one or more of the categories of research that are exempt under 45 CFR Part 46, the committee will evaluate: 1) the justification for the exemption, 2) human subjects involvement and characteristics, and 3) sources of materials. For additional information on review of the Human Subjects section, please refer to the Guidelines for the Review of Human Subjects.

Inclusion of Women, Minorities, and Individuals Across the Lifespan

When the proposed project involves human subjects and/or NIH-defined clinical research, the committee will evaluate the proposed plans for the inclusion (or exclusion) of individuals on the basis of sex/gender, race, and ethnicity, as well as the inclusion (or exclusion) of individuals of all ages (including children and older adults) to determine if it is justified in terms of the scientific goals and research strategy proposed. For additional information on review of the Inclusion section, please refer to the Guidelines for the Review of Inclusion in Clinical Research.

Vertebrate Animals

The committee will evaluate the involvement of live vertebrate animals as part of the scientific assessment according to the following criteria: (1) description of proposed procedures involving animals, including species, strains, ages, sex, and total number to be used; (2) justifications for the use of animals versus alternative models and for the appropriateness of the species proposed; (3) interventions to minimize discomfort, distress, pain and injury; and (4) justification for euthanasia method if NOT consistent with the AVMA Guidelines for the Euthanasia of Animals. Reviewers will assess the use of chimpanzees as they would any other application proposing the use of vertebrate animals. For additional information on review of the Vertebrate Animals section, please refer to the Worksheet for Review of the Vertebrate Animals Section.

Biohazards

Reviewers will assess whether materials or procedures proposed are potentially hazardous to research personnel and/or the environment, and if needed, determine whether adequate protection is proposed.

Resubmissions

Not Applicable

Renewals

Not Applicable.

Revisions

Not Applicable.

As applicable for the project proposed, reviewers will consider each of the following items, but will not give scores for these items, and should not consider them in providing an overall impact score.

Applications from Foreign Organizations

Reviewers will assess whether the project presents special opportunities for furthering research programs through the use of unusual talent, resources, populations, or environmental conditions that exist in other countries and either are not readily available in the United States or augment existing U.S. resources.

Select Agent Research

Reviewers will assess the information provided in this section of the application, including 1) the Select Agent(s) to be used in the proposed research, 2) the registration status of all entities where Select Agent(s) will be used, 3) the procedures that will be used to monitor possession use and transfer of Select Agent(s), and 4) plans for appropriate biosafety, biocontainment, and security of the Select Agent(s).

Resource Sharing Plans

Reviewers will comment on whether the Resource Sharing Plan(s) (i.e., Sharing Model Organisms) or the rationale for not sharing the resources, is reasonable.

Authentication of Key Biological and/or Chemical Resources:

For projects involving key biological and/or chemical resources, reviewers will comment on the brief plans proposed for identifying and ensuring the validity of those resources.

Budget and Period of Support

Reviewers will consider whether the budget and the requested period of support are fully justified and reasonable in relation to the proposed research.

2. Review and Selection Process

Applications will be evaluated for scientific and technical merit by (an) appropriate Scientific Review Group(s) convened by NCI, in accordance with NIH peer review policy and procedures, using the stated review criteria. Assignment to a Scientific Review Group will be shown in the eRA Commons.

As part of the scientific peer review, all applications will receive a written critique.

Applications may undergo a selection process in which only those applications deemed to have the highest scientific and technical merit (generally the top half of applications under review) will be discussed and assigned an overall impact score.

Appeals of initial peer review will not be accepted for applications submitted in response to this NOFO.

Applications will be assigned on the basis of established PHS referral guidelines to the appropriate NIH Institute or Center. Applications will compete for available funds with all other recommended applications submitted in response to this NOFO. Following initial peer review, recommended applications will receive a second level of review by the appropriate national Advisory Council or Board. The following will be considered in making funding decisions:

• Scientific and technical merit of the proposed project as determined by scientific peer review.
• Availability of funds.
• Relevance of the proposed project to program priorities.

3. Anticipated Announcement and Award Dates

After the peer review of the application is completed, the PD/PI will be able to access his or her Summary Statement (written critique) via the eRA Commons. Refer to Part 1 for dates for peer review, advisory council review, and earliest start date.

Information regarding the disposition of applications is available in the NIH Grants Policy Statement.

Section VI. Award Administration Information

1. Award Notices

If the application is under consideration for funding, NIH will request "just-in-time" information from the applicant as described in the NIH Grants Policy Statement.

A formal notification in the form of a Notice of Award (NoA) will be provided to the applicant organization for successful applications. The NoA signed by the grants management officer is the authorizing document and will be sent via email to the recipient's business official.

Recipients must comply with any funding restrictions described in Section IV.5. Funding Restrictions. Selection of an application for award is not an authorization to begin performance. Any costs incurred before receipt of the NoA are at the recipient's risk. These costs may be reimbursed only to the extent considered allowable pre-award costs.

Any application awarded in response to this NOFO will be subject to terms and conditions found on the Award Conditions and Information for NIH Grants website. This includes any recent legislation and policy applicable to awards that is highlighted on this website.

Individual awards are based on the application submitted to, and as approved by, the NIH and are subject to the IC-specific terms and conditions identified in the NoA.

ClinicalTrials.gov: If an award provides for one or more clinical trials. By law (Title VIII, Section 801 of Public Law 110-85), the "responsible party" must register and submit results information for certain applicable clinical trials on the ClinicalTrials.gov Protocol Registration and Results System Information Website (https://register.clinicaltrials.gov). NIH expects registration and results reporting of all trials whether required under the law or not. For more information, see https://grants.nih.gov/policy/clinical-trials/reporting/index.htm

Institutional Review Board or Independent Ethics Committee Approval: Recipient institutions must ensure that all protocols are reviewed by their IRB or IEC. To help ensure the safety of participants enrolled in NIH-funded studies, the recipient must provide NIH copies of documents related to all major changes in the status of ongoing protocols.

Data and Safety Monitoring Requirements: The NIH policy for data and safety monitoring requires oversight and monitoring of all NIH-conducted or -supported human biomedical and behavioral intervention studies (clinical trials) to ensure the safety of participants and the validity and integrity of the data. Further information concerning these requirements is found at http://grants.nih.gov/grants/policy/hs/data_safety.htm and in the application instructions (SF424 (R&R) and PHS 398).

Investigational New Drug or Investigational Device Exemption Requirements: Consistent with federal regulations, clinical research projects involving the use of investigational therapeutics, vaccines, or other medical interventions (including licensed products and devices for a purpose other than that for which they were licensed) in humans under a research protocol must be performed under a Food and Drug Administration (FDA) investigational new drug (IND) or investigational device exemption (IDE).

2. Administrative and National Policy Requirements

All NIH grant and cooperative agreement awards include the NIH Grants Policy Statement as part of the NoA. For these terms of award, see the NIH Grants Policy Statement Part II: Terms and Conditions of NIH Grant Awards, Subpart A: General and Part II: Terms and Conditions of NIH Grant Awards, Subpart B: Terms and Conditions for Specific Types of Grants, Recipients, and Activities, including of note, but not limited to:

• Federal wide Research Terms and Conditions
• Prohibition on Certain Telecommunications and Video Surveillance Services or Equipment
• Acknowledgment of Federal Funding

If a recipient is successful and receives a Notice of Award, in accepting the award, the recipient agrees that any activities under the award are subject to all provisions currently in effect or implemented during the period of the award, other Department regulations and policies in effect at the time of the award, and applicable statutory provisions.

Should the applicant organization successfully compete for an award, recipients of federal financial assistance (FFA) from HHS will be required to complete an HHS Assurance of Compliance form (HHS 690) in which the recipient agrees, as a condition of receiving the grant, to administer programs in compliance with federal civil rights laws that prohibit discrimination on the basis of race, color, national origin, age, sex and disability, and agreeing to comply with federal conscience laws, where applicable. This includes ensuring that entities take meaningful steps to provide meaningful access to persons with limited English proficiency; and ensuring effective communication with persons with disabilities. Where applicable, Title XI and Section 1557 prohibit discrimination on the basis of sexual orientation, and gender identity, The HHS Office for Civil Rights provides guidance on complying with civil rights laws enforced by HHS. See https://www.hhs.gov/civil-rights/for-providers/provider-obligations/index.html and https://www.hhs.gov/civil-rights/for-individuals/nondiscrimination/index.html.

HHS recognizes that research projects are often limited in scope for many reasons that are nondiscriminatory, such as the principal investigator’s scientific interest, funding limitations, recruitment requirements, and other considerations. Thus, criteria in research protocols that target or exclude certain populations are warranted where nondiscriminatory justifications establish that such criteria are appropriate with respect to the health or safety of the subjects, the scientific study design, or the purpose of the research. For additional guidance regarding how the provisions apply to NIH grant programs, please contact the Scientific/Research Contact that is identified in Section VII under Agency Contacts of this NOFO.

• For guidance on meeting the legal obligation to take reasonable steps to ensure meaningful access to programs or activities by limited English proficient individuals see https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/fact-sheet-guidance/index.html and https://www.lep.gov.

• For information on an institution’s specific legal obligations for serving qualified individuals with disabilities, including providing program access, reasonable modifications, and to provide effective communication, see https://www.hhs.gov/civil-rights/for-individuals/disability/index.html.

• HHS funded health and education programs must be administered in an environment free of sexual harassment, see https://www.hhs.gov/civil-rights/for-individuals/sex-discrimination/index.html. For information about NIH's commitment to supporting a safe and respectful work environment, who to contact with questions or concerns, and what NIH's expectations are for institutions and the individuals supported on NIH-funded awards, please see https://grants.nih.gov/grants/policy/harassment.htm.

• For guidance on administering programs in compliance with applicable federal religious nondiscrimination laws and applicable federal conscience protection and associated anti-discrimination laws see https://www.hhs.gov/conscience/conscience-protections/index.html and https://www.hhs.gov/conscience/religious-freedom/index.html.

Please contact the HHS Office for Civil Rights for more information about obligations and prohibitions under federal civil rights laws at https://www.hhs.gov/ocr/about-us/contact-us/index.html or call 1-800-368-1019 or TDD 1-800-537-7697.

In accordance with the statutory provisions contained in Section 872 of the Duncan Hunter National Defense Authorization Act of Fiscal Year 2009 (Public Law 110-417), NIH awards will be subject to the Federal Awardee Performance and Integrity Information System (FAPIIS) requirements. FAPIIS requires Federal award making officials to review and consider information about an applicant in the designated integrity and performance system (currently FAPIIS) prior to making an award. An applicant, at its option, may review information in the designated integrity and performance systems accessible through FAPIIS and comment on any information about itself that a federal agency previously entered and is currently in FAPIIS. The Federal awarding agency will consider any comments by the applicant, in addition to other information in FAPIIS, in making a judgement about the applicant’s integrity, business ethics, and record of performance under Federal awards when completing the review of risk posed by applicants as described in 45 CFR Part 75.205 and 2 CFR Part 200.206 Federal awarding agency review of risk posed by applicants. This provision will apply to all NIH grants and cooperative agreements except fellowships.

The following special terms of the award are in addition to, and not in lieu of, otherwise applicable U.S. Office of Management and Budget (OMB) administrative guidelines, U.S. Department of Health and Human Services (DHHS) grant administration regulations at 45 CFR Part 75, 2 CFR Part 200 and other HHS, PHS, and NIH grant administration policies.

The administrative and funding instrument used for this program will be the cooperative agreement, an "assistance" mechanism (rather than an "acquisition" mechanism), in which substantial NIH programmatic involvement with the recipients is anticipated during the performance of the activities. Under the cooperative agreement, the NIH's purpose is to support and stimulate the recipients' activities by involvement in and otherwise working jointly with the award recipients in a partnership role; it is not to assume direction, prime responsibility, or a dominant role in the activities. Consistent with this concept, the dominant role and prime responsibility for the project as a whole resides with the recipients, although specific tasks and activities may be shared among the recipients and the NIH as defined below.

Recipients will retain custody of and have primary rights to the data, technologies, and software developed under these awards, subject to Government rights of access consistent with current HHS, PHS, and NIH policies.

Primary responsibilities of the PD/PIs:

• Defining the overall research objectives and approaches;
• Determining experimental approaches, designing protocols, setting project milestones, and overseeing the conduct of experiments;
• Overseeing and coordinating the effort of the multi-disciplinary team and participating institutions and ensuring their optimal integration;
• Overseeing the conduct of research projects and ensuring their scientific rigor;
• Ensuring compliance with the applicable mandatory regulations (including protection of human subjects) in the U.S. and an LMIC as required by specific research activities;
• Adhering to the NIH policies regarding intellectual property, data release, and other policies that might be established during the course of this activity;
• Participating as members of the Steering Committee;
• Implementing guidelines and procedures developed by the Steering Committee;
• Participating in monthly teleconferences with NCI program staff;
• Attending annual Steering/PI Committee meetings organized in collaboration between the Steering Committee and the NCI Center for Global Health.

Primary Responsibilities of NIH Program Staff:

NCI Program Officials have substantial programmatic involvement that is above and beyond the normal stewardship role in cooperative agreement awards. The substantially involved NCI Program Official, acting as Project Coordinator, will coordinate in a centralized fashion the various activities of the recipients. Additionally, an NCI Program Official will be responsible for the normal scientific and programmatic stewardship of the award and will be named in the award notice. Additional Program Officials who are not responsible for the normal scientific and programmatic stewardship of the award, may be designated as Project Scientists. Specific responsibilities of the NCI Program Officials will include, but will not be limited to, the following aspects:

• Providing input on experimental and clinical approaches, assisting in designing protocols, and consulting on updates to project milestones;
• Providing advice to the recipients on specific scientific, analytical, and clinical issues;
• Assisting and advising recipients with regard to various regulatory and compliance issues;
• Participating in monthly teleconferences with PDs/PIs to monitor progress and facilitate cooperation;
• Monitoring progress of the projects towards meeting milestones and adherence to the strategic goals of the program;
• Tracking monthly accrual of participants for clinical testing to ensure proper completion of this essential step;
• Participating in the activities of the Steering Committee and the implementation of its guidelines and procedures;
• Stimulating interactions among awardees;
• Attending annual Steering/PI Committee meetings.

The NCI reserves the right to adjust funding, withhold, suspend, or terminate the support to those Consortium recipient institutions that are unable to meet the performance requirements set forth in these Terms and Conditions of Award, or significantly change the level of performance.

Areas of joint responsibility include:

Steering Committee: The Steering Committee will be the main governing body and will be composed of the following voting members:

• PIs from each cooperative agreement award (one vote per award even when multiple PIs are designated); and
• NCI-assigned Project Scientists, a representative from the NCI Center for Global Health, and a representative from the NCI SBIR Development Center, will collectively have one vote for the NIH.
• The Chair of the Steering Committee (who cannot be an NIH staff) will be selected by the Steering Committee.

Other NIH staff members may participate in the activities of the Committee as needed as non-voting members.

Primary responsibilities of the Steering Committee:

The Steering Committee will be responsible for communication and coordination among funded projects, including sharing ideas, logistics, and solutions to technical issues. When feasible and appropriate, the Steering Committee will seek to establish consensus on platform interoperability in areas such as control software, data analysis, communication protocols, and standard power sources. Other shared advice may include the promise of clinical potential, manufacturability, regulatory issues, and deployment into local resource-limited settings. The members of the Steering Committee will meet once a year in person and by conference calls as needed.

The Steering Committee, in collaboration with the NCI, will also be responsible for planning the scientific content of the annual investigator meeting.

Dispute Resolution:

Any disagreements that may arise in scientific and/or programmatic matters (within the scope of the award) between award recipients and the NIH may be brought to Dispute Resolution. A Dispute Resolution Panel composed of three members will be convened. It will have three members: a designee of the Steering Committee chosen without NIH staff voting; one NIH designee; and a third designee with expertise in the relevant area who is chosen by the other two; in the case of individual disagreement, the first member may be chosen by the individual recipient. This special dispute resolution procedure does not alter the recipient's right to appeal an adverse action that is otherwise appealable in accordance with PHS regulation 42 CFR Part 50, Subpart D and HHS regulation 45 CFR Part 16.

3. Data Management and Sharing

Note: The NIH Policy for Data Management and Sharing is effective for due dates on or after January 25, 2023.

Consistent with the NIH Policy for Data Management and Sharing, when data management and sharing is applicable to the award, recipients will be required to adhere to the Data Management and Sharing requirements as outlined in the NIH Grants Policy Statement. Upon the approval of a Data Management and Sharing Plan, it is required for recipients to implement the plan as described.

4. Reporting

When multiple years are involved, recipients will be required to submit the Research Performance Progress Report (RPPR) annually and financial statements as required in the NIH Grants Policy Statement.

A final RPPR, invention statement, and the expenditure data portion of the Federal Financial Report are required for closeout of an award, as described in the NIH Grants Policy Statement. NIH NOFOs outline intended research goals and objectives. Post award, NIH will review and measure performance based on the details and outcomes that are shared within the RPPR, as described at 45 CFR Part 75.301 and 2 CFR Part 200.301.

The Federal Funding Accountability and Transparency Act of 2006 (Transparency Act), includes a requirement for recipients of Federal grants to report information about first-tier subawards and executive compensation under Federal assistance awards issued in FY2011 or later. All recipients of applicable NIH grants and cooperative agreements are required to report to the Federal Subaward Reporting System (FSRS) available at www.fsrs.gov on all subawards over $25,000. See the NIH Grants Policy Statement for additional information on this reporting requirement.

In accordance with the regulatory requirements provided at 45 CFR 75.113 and 2 CFR Part 200.113 and Appendix XII to 45 CFR Part 75 and 2 CFR Part 200, recipients that have currently active Federal grants, cooperative agreements, and procurement contracts from all Federal awarding agencies with a cumulative total value greater than $10,000,000 for any period of time during the period of performance of a Federal award, must report and maintain the currency of information reported in the System for Award Management (SAM) about civil, criminal, and administrative proceedings in connection with the award or performance of a Federal award that reached final disposition within the most recent five-year period. The recipient must also make semiannual disclosures regarding such proceedings. Proceedings information will be made publicly available in the designated integrity and performance system (currently FAPIIS). This is a statutory requirement under section 872 of Public Law 110-417, as amended (41 U.S.C. 2313). As required by section 3010 of Public Law 111-212, all information posted in the designated integrity and performance system on or after April 15, 2011, except past performance reviews required for Federal procurement contracts, will be publicly available. Full reporting requirements and procedures are found in Appendix XII to 45 CFR Part 75 and 2 CFR Part 200 Award Term and Conditions for Recipient Integrity and Performance Matters.

Section VII. Agency Contacts

We encourage inquiries concerning this funding opportunity and welcome the opportunity to answer questions from potential applicants.

eRA Service Desk (Questions regarding ASSIST, eRA Commons, application errors and warnings, documenting system problems that threaten submission by the due date, and post-submission issues)

Finding Help Online: https://www.era.nih.gov/need-help (preferred method of contact)
Telephone: 301-402-7469 or 866-504-9552 (Toll Free)

General Grants Information (Questions regarding application instructions, application processes, and NIH grant resources)
Email: [email protected] (preferred method of contact)
Telephone: 301-480-7075

Grants.gov Customer Support (Questions regarding Grants.gov registration and Workspace)
Contact Center Telephone: 800-518-4726
Email: [email protected]

Paul C. Pearlman, Ph.D.
National Cancer Institute (NCI)
Telephone: 240-276-5354
Email: [email protected]

Referral Officer
National Cancer Institute (NCI)
Telephone: 240-276-6390
Email: [email protected]

Dawn Mitchum
National Cancer Institute (NCI)
Telephone: 240-276-5699
Email: [email protected]

Section VIII. Other Information

Recently issued trans-NIH policy notices may affect your application submission. A full list of policy notices published by NIH is provided in the NIH Guide for Grants and Contracts. All awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.

Awards are made under the authorization of Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284) and under Federal Regulations 42 CFR Part 52 and 45 CFR Part 75 and 2 CFR Part 200.