Full Text CA-92-13 IMPLEMENTATION GRANTS FOR GENE THERAPY PROGRAMS IN CANCER TREATMENT RFA: CA-92-13 P.T. 34 Keywords: Cancer/Carcinogenesis Gene Therapy+ Clinical Trial Biomedical Research, Multidiscipl National Cancer Institute Letter of Intent Receipt Date: April 3, 1992 Application Receipt Date: May 15, 1992 PURPOSE The Division of Cancer Treatment (DCT) of the National Cancer Institute (NCI) invites program project grant applications (P01) from interested investigators to establish interactive Gene Therapy Programs (GTP) with the goal of conducting gene therapy clinical trials for cancer treatment. The purpose of this RFA is to promote the design and implementation of clinical trials of gene therapy, to support the requisite preclinical studies establishing the scientific and technical basis for human studies, and to foster the development of interactions between basic scientists and clinical researchers necessary for bringing gene therapy to patient trials. The program project grant mechanism will support the establishment of broadly based, multi-disciplinary and multi-institutional research programs centered around this goal. The present Request for Applications (RFA) announcement is for a single competition with a specified application deadline of May 15, 1992. These awards are envisioned to serve as "implementation" grants for the initiation and development of new programs in gene therapy. Applications must be prepared and submitted in accordance with the aims and requirements described in the following sections. HEALTHY PEOPLE 2000 The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of "Healthy People 2000," a PHS-led national activity for setting priority areas. This RFA, Implementation Grants for Gene Therapy Programs in Cancer Treatment, is related to the priority area of cancer. Potential applicants may obtain a copy of "Healthy People 2000" (Full Report: Stock No. 017-001-00474-0) or "Healthy People 2000" (Summary Report: Stock No. 017-001-00473-1) through the Superintendent of Documents, Government Printing Office, Washington, DC 20402-9325 (telephone 202/783-3238). ELIGIBILITY REQUIREMENTS Applications may be submitted by domestic non-profit and for-profit organizations, public and private, such as universities, colleges, hospitals, laboratories, units of State or local governments, and eligible agencies of the Federal government. Applications may be submitted from a single institution or may include arrangements with one or more additional institutions, if appropriate. Applications from minority individuals and women are encouraged. MECHANISM OF SUPPORT Support of the program will be through the National Institutes of Health (NIH) program project research grant (P01). Responsibilities for the planning, direction, and execution of the proposed project will be solely that of the applicant. The total project period for applications submitted in response to the present RFA may not exceed four years. Investigators must follow the "Guidelines for Program Project Grant of the National Cancer Institute" in preparing an application. However, any specific instructions included in this RFA (see METHOD OF APPLYING and REVIEW PROCEDURES AND CRITERIA) will take precedence over the general program project guidelines. Except as otherwise stated in this RFA, awards will be administered under PHS grants policy as stated in the Public Health Service Grants Policy Statement, DHHS Publication No. (OASH) 90-50,000, revised October 1, 1990. Program project (P01) grants are awarded to an institution on behalf of a Principal Investigator for the support of a broadly based, multi-disciplinary, long-term research program with a specific major goal or basic theme. A program project generally involves the organized efforts of groups of investigators who conduct research projects related to the overall program goal. The grant may provide support for the projects and for certain common resources shared by individuals in the program project if sharing facilitates the total research effort. Each project supported under a program project grant is expected to contribute to and be directly related to the common theme of the program. The projects, under the direction of a project leader, must demonstrate an essential element of unity and interdependence. Each GTP application must have a minimum of three projects with at least one project focused on clinical studies. In addition, an administrative core will be needed to coordinate research activities and to obtain approvals through the regulatory channels. The application must clearly explain how the projected multi-disciplinary integrated program would accomplish the stated goal more efficiently and effectively than would a series of independent, individual grant-supported studies. Designation of a Principal Investigator as program director must be based upon accomplishment and experience as a scientist, the ability to assume both the leadership of the research group and the responsibility for scientific, professional, and administrative functions, and the commitment of a significant amount of his/her time to the project. Under current program project guidelines, each project in the program must have a designated project leader with a demonstrable record of accomplishment in clinical investigation or one of the basic science disciplines relevant to the particular subject of investigation. However, the participation of one junior, but independent, investigator whose project is an integral part of the overall program and whose work would be closely related to that of the senior scientist project leaders of the other projects is encouraged by the NCI. This RFA is a one-time solicitation. If the NCI determines that there is a sufficient continuing program need, the NCI will invite recipients of awards under this RFA to submit competitive continuation applications for review according to the procedures described below in APPLICATION PROCEDURES. FUNDS AVAILABLE Approximately $5,000,000 in total costs per year for four years will be committed to fund applications submitted in response to this RFA. It is anticipated that six to eight awards will be made. First year budget requests should average $500,000 to $600,000 direct costs. Direct costs may be utilized to support the research activities of scientific and professional personnel, consultation services, equipment, supplies, travel, and publication costs. Support for research-related costs of obtaining regulatory approvals may be authorized. The initial set aside is not expected to completely fund the clinical trials; however, sufficient funds should be available for pilot clinical studies or for preclinical studies necessary for development of the clinical product and/or procedure and for regulatory approvals. Submission of competitive supplements for additional support is expected when the GTPs are ready to initiate or expand clinical trials. This funding level is dependent on the receipt of a sufficient number of applications of high scientific merit. The total project period for applications submitted in response to the present RFA may not exceed four years. Although this program is provided for in the financial plans of the NCI, the award of grants pursuant to this RFA is also contingent upon the continuing availability of funds for this purpose. The anticipated award date is September 30, 1992. RESEARCH OBJECTIVES BACKGROUND For the purposes of this RFA, gene therapy will be defined as the transfer of a functioning gene(s) into somatic cells to treat disease. For patients with cancer, genetically altering the characteristics of tumor cells or host normal cells ex vivo may enhance the effectiveness of certain forms of immunotherapy and chemotherapy. Ultimately, genes may be directly introduced into tumor cells in vivo to alter the malignant phenotype and halt tumor progression. Some of the initial applications of gene transfection techniques have been in the field of cancer immunotherapy. Several groups have successfully introduced cytokine genes (Interleukin-4 (IL-4), Interleukin-2 (IL-2), Tumor Necrosis Factor (TNF), interferon-gamma, and others) into murine tumor cells. Local production of these cytokines by the tumor cells not only prevents the outgrowth of the tumor, but in certain models also induces long-lasting systemic immunity to a subsequent tumor challenge. In some cases, immunization with gene-transfected tumor cells has resulted in the regression of a non-transfected, established tumor located at a distant site. Similar approaches in humans could lead to the development of enhanced in vivo T cell immune responses against tumors, that could be expanded by systemic administration of other cytokines or could be used to generate more potent and specific cytotoxic T cells (CTL) for adoptive immunotherapy. Evidence has also been presented that production of cytokines by adoptively transferred CTL may be necessary for producing an effective inflammatory response within the tumor. Clinical trials of both cytokine-transfected tumor-infiltrating lymphocytes and tumor cells transfected with the genes for TNF or IL-2 have recently been initiated. Gene therapy may prove useful in the field of cancer chemotherapy. For example, one of the major barriers to increasing chemotherapy dose intensity continues to be bone marrow toxicity despite advances in marrow transplant technology and the use of hematopoietic growth factors. Long-term transfection of genes into marrow hematopoietic stem cells has been demonstrated in murine models. Thus it may be possible to introduce genes for increased drug-resistance specifically into human stem cells, and through repopulation of the host with these cells, allow chemotherapy of increased intensity. Preclinical data suggest gene therapy could also be used directly to treat some tumors. The metastatic phenotype is often characterized by deletion of suppressor genes and/or activation of specific oncogenes. Introduction of the retinoblastoma (RB) tumor suppressor gene into RB-negative tumor cells, or incorporation of a specific anti-sense message in cells with activated oncogenes, has been shown to alter the neoplastic phenotype. The development and application of these technologies for patients with cancer could represent a major therapeutic advance. Although practical and theoretical limitations currently exist for the application of gene therapy in cancer patients, clinical trials have already been initiated. In research centers throughout the country substantial preclinical data have been obtained that could serve as the basis of additional clinical trials either immediately or within the near future. The purpose of this RFA is to promote the design and implementation of clinical trials of gene therapy, to support the requisite preclinical studies establishing the scientific and technical basis for human studies, and to foster the development of interactions between basic scientists and clinical researchers necessary for bringing gene therapy to patient trials. The program project grant mechanism will support the establishment of broadly-based, multi-disciplinary and multi-institutional research programs centered around this goal. RESEARCH GOALS AND SCOPE The Cancer Therapy Evaluation Program is seeking applications for research program project grants (P01) to establish interactive Gene Therapy Programs (GTP) with the goal of conducting gene therapy clinical trials for cancer treatment. The applications should be focused on a specific clinical therapeutic approach. These awards are envisioned to serve as "implementation grants" for the development of a collaborative effort between a multi-disciplinary and, possibly, multi-institutional group of investigators to rapidly move forward new approaches in gene therapy of cancer into the clinic. Funds should be used to conduct the necessary preclinical studies to prepare a clinical product or procedure for human trials and to gain regulatory approval to conduct such trials. The Cancer Therapy Evaluation Program will provide assistance in gaining regulatory approvals. NCI is encouraging investigators to forge new collaborations with other research institutions and industry to obtain the necessary expertise in all aspects of the research program. Initial approaches to gene therapy would involve the alteration and administration of human somatic cells. Future techniques may include approaches such as the direct administration of genetic material to patients. Examples of gene therapy for the treatment of cancer include: o implantation of tumor cells transfected with functioning cytokine genes to elicit an immune response; o insertion of genes into host effector cells that will enhance their ability to recognize and bind tumor specifically and/or will potentiate the inflammatory response of the host at the site of tumor; o insertion of genes into normal cells of the host, such as bone marrow stem cells, that will increase their resistance to the toxic effects of chemotherapy; o in vivo introduction of genes into cancer cells that will restore suppressor gene function or neutralize the function of activated oncogenes that maintain the neoplastic phenotype. Investigators are not limited to the above studies; however, all studies must be therapeutic in intent and not solely diagnostic. It is anticipated that each GTP will have multiple subprojects and shared common resources. Examples of areas of research for subprojects would include development of the appropriate high efficiency retroviral vectors, helper viruses, or producer cell lines; establishment of animal models for efficacy studies; preclinical toxicology in cell culture systems and animal models; and the initial clinical studies. The time table for the conduct of clinical studies should be reflected in the individual budgets with a larger proportion of funds for preclinical studies, if necessary, in years 1 and 2. Budgets should average $500,000 to $600,000 direct costs per year as the initial awards are for the initiation and implementation of new interactive Gene Therapy Programs. Grantees can request up to four years of support. SPECIAL INSTRUCTIONS TO APPLICANTS REGARDING IMPLEMENTATION OF NIH POLICIES CONCERNING INCLUSION OF WOMEN AND MINORITIES IN CLINICAL RESEARCH STUDY POPULATIONS NIH and ADAMHA policy is that applicants for NIH/ADAMHA clinical research grants and cooperative agreements will be required to include minorities and women in study populations so that research findings can be of benefit to all persons at risk of the disease, disorder or condition under study; special emphasis should be placed on the need for inclusion of minorities and women in studies of diseases, disorders and conditions which disproportionately affect them. This policy is intended to apply to males and females of all ages. If women or minorities are excluded or inadequately represented in clinical research, particularly in proposed population-based studies, a clear compelling rationale should be provided. The composition of the proposed study population must be described in terms of gender and racial/ethnic group. In addition, gender and racial/ethnic issues should be addressed in developing a research design and sample size appropriate for the scientific objectives of the study. This information should be included in the form PHS 398 in Section 2, A-D of the Research Plan AND summarized in Section 2, E, Human Subjects. Applicants/offerors are urged to assess carefully the feasibility of including the broadest possible representation of minority groups. However, NIH recognizes that it may not be feasible or appropriate in all research projects to include representation of the full array of United States racial/ethnic minority populations (i.e., Native Americans (including American Indians or Alaskan Natives), Asian/Pacific Islanders, Blacks, Hispanics). The rationale for studies on single minority population groups should be provided. For the purpose of this policy, clinical research includes human biomedical and behavioral studies of etiology, epidemiology, prevention (and preventive strategies), diagnosis, or treatment of diseases, disorders or conditions, including but not limited to clinical trials. The usual NIH policies concerning research on human subjects also apply. Basic research or clinical studies in which human tissues cannot be identified or linked to individuals are excluded. However, every effort should be made to include human tissues from women and racial/ethnic minorities when it is important to apply the results of the study broadly, and this should be addressed by applicants. For foreign awards, the policy on inclusion of women applies fully; since the definition of minority differs in other countries, the applicant must discuss the relevance of research involving foreign population groups to the United States' populations, including minorities. If the required information is not contained within the application, the application will be returned. Peer reviewers will address specifically whether the research plan in the application conforms to these policies. If the representation of women or minorities in a study design is inadequate to answer the scientific question(s) addressed AND the justification for the selected study population is inadequate, it will be considered a scientific weakness or deficiency in the study design and will be reflected in assigning the priority score to the application. All applications for clinical research submitted to NIH are required to address these policies. NIH funding components will not award grants or cooperative agreements that do not comply with these policies. LETTER OF INTENT Prospective applicants are asked to submit by April 3, 1992, a letter of intent 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 RFA in response to which the application is being submitted. Although a letter of intent is not required, is not binding, and does not enter into the review of subsequent applications, the information is helpful in planning for the review of applications. It allows NCI staff to estimate the potential review workload and to avoid conflict of interest in the review. The letter of intent is be sent to: Ms. Diane Bronzert Program Director, Cancer Therapy Evaluation Program Division of Cancer Treatment National Cancer Institute Executive Plaza North, Room 734 Bethesda, MD 20892 Telephone: (301) 496-8866 FAX: (301) 480-4663 Applicants who use express mail or a courier service are advised to follow the carrier's requirements for showing a street address. The address for the Executive Plaza North is: Executive Plaza North, Room 734 6130 Executive Blvd. Rockville, MD 20852 APPLICATION PROCEDURES The research grant application form PHS 398 (revised 10/88 or 9/91) must be used in applying for these grants. These forms are available at most institutional business offices; from the Office of Grant Inquiries, Division of Research Grants, National Institutes of Health, Room 449, Westwood Building, 5333 Westbard Avenue, Bethesda, MD 20892, telephone 301/496-7441; and from the NCI Program Director named below. Copies of the "Guidelines for the Program Project Grant of the National Cancer Institute" (revised 1987) for the development of a program project grant application are available from the Program Director and from the NCI Referral Officer, Division of Extramural Activities, NCI, Room 848, Westwood Building, 5333 Westbard Avenue, Bethesda, MD 20892. In addition to following the format instructions contained in the Guidelines, include the expanded material listed below: o A brief overview of the intended program project and its components; o A description of laboratory and clinical facilities available for use by the proposed project; o Ongoing relevant research studies identifying existing projects and sources of support; o Past research by members of the proposed investigative group relevant to the application; o Specific information on the institution's present patient load and projections for patient involvement in clinical investigations; o The academic positions and major research interests of the program director and his/her professional staff who will be involved in the work of the program project; o Time line indicating plans for obtaining regulatory approvals and initiating clinical studies; o Collaborative arrangements with other laboratories and investigators and delineation of the role and anticipated manner of participation and interaction of the project leader(s), consultants, and collaborators; o Justification for the use of the PO1 mechanism instead of the R012 (individual research grant) mechanism. The RFA label available in the 10/88 and 9/91 revision of application form PHS 398 must be affixed to the bottom of the face page. Failure to use this label could result in delayed processing of the application such that it may not reach the review committee in time for review. In addition, the RFA number and title "Implementation Grants for Gene Therapy Programs in Cancer Treatment" must be typed on line 2 of the face page of the application form and the YES box must be marked. Applicants from institutions that have a General Clinical Research Center (GCRC) funded by the NIH National Center for Research Resources may wish to identify the GCRC as a resource for conducting the proposed research. In such a case, a letter of agreement from either the GCRC program director or the Principal Investigator of the GCRC must be included with the application. Submit a signed, typewritten original of the application, including the Checklist, and four signed, exact photocopies, in one package to the Division of Research Grants at the address below. The photocopies must be clear and single sided. Division of Research Grants National Institutes of Health Westwood Building, Room 240 Bethesda, MD 20892** At the time of submission, two additional copies of the application must also be sent to: Referral Officer Review Logistics Branch Division of Extramural Activities National Cancer Institute Westwood Building, Room 848 5333 Westbard Avenue Bethesda, MD 20892 Applications MUST be received by May 15, 1992. If an application is received after that date, it will be returned. The Division of Research Grants (DRG) will not accept any application in response to this announcement that is essentially the same as one currently pending initial review, unless the applicant withdraws the pending application. The DRG will not accept any application that is essentially the same as one already reviewed. This does not preclude the submission of substantial revisions of applications already reviewed, but such applications must include an introduction addressing the previous critique. REVIEW CONSIDERATIONS Review Procedures Upon receipt, applications will be reviewed by the DRG for completeness. Incomplete applications will be returned to the applicant without further consideration. If the application is not responsive to the RFA, NCI staff will contact the applicant to determine whether to return the application to the applicant or submit it for review in competition with unsolicited applications for the next review cycle. Questions concerning the relevance of proposed research to the RFA may be directed to program staff as described in the INQUIRIES section. Applications may be triaged by an NCI peer review group on the basis of relative competitiveness. The NCI will withdraw from further competition those applications judged to be noncompetitive for award and notify the applicant and institutional business official. Those applications judged to be both competitive and responsive will be further evaluated, using the review criteria stated below, for scientific and technical merit by an appropriate peer review group convened by the Division of Extramural Activities, NCI. Applications must be sufficiently complete for review without a site visit. The second level of review by the National Cancer Advisory Board considers the special needs of the Institute and the priorities of the National Cancer Program. Reveiw Criteria The factors considered in evaluating the scientific merit of each response to this RFA will be: o Significance and originality of the research from a scientific and technical viewpoint. o Feasibility of proposed research. o Clinical and basic research experience, training, time availability, and research competence of the investigators involved. o Adequacy and appropriateness of the methodology and protocol design. o Potential for accomplishing specific aims and initiating clinical trials within the time frame proposed. o Adequacy of available resources and environment (facilities, equipment, statistical collaboration, patient population, and others). o Documentation of support from collaborators and consultants through letters of commitment. o Adequacy of plan for the inclusion of women and minorities. o Appropriateness of the proposed budget and duration in relation to the proposed research. Review criteria for program project grants as stated in the "Guidelines for the Program Project Grant of the National Cancer Institute" will also apply. AWARD CRITERIA The anticipated date of award is September 30, 1992. In addition to the technical merit of the application, NCI will consider how well the GTPs meet the goals and objectives of the program as described in the RFA. Applications with requested budgets greatly exceeding the suggested budget of $500,000 to $600,000 direct costs per year may be at a disadvantage with respect to final NCI funding decisions. INQUIRIES Written and telephone inquiries concerning the objectives and scope of this RFA and inquiries about whether or not specific proposed research would be responsive are strongly encouraged and should be directed to program staff listed below. The program staff welcome the opportunity to clarify any issues or questions from potential applicants. Direct inquiries regarding programmatic issues to: Ms. Diane Bronzert Program Director, Cancer Therapy Evaluation Program Division of Cancer Treatment National Cancer Institute Executive Plaza North, Room 734 Bethesda, MD 20892 Telephone: (301) 496-8866 FAX: (301) 480-4663 or Mario Sznol, M.D. Senior Investigator, Investigational Drug Branch Cancer Therapy Evaluation Program Division of Cancer Treatment National Cancer Institute Executive Plaza North, Room 715 Bethesda, MD 20892 Telephone: (301) 496-8798 FAX: (301) 402-0428 Direct inquiries regarding fiscal matters to: Ms. Marian Focke Grants Administration Branch National Cancer Institute Executive Plaza South, Room 242 Bethesda, MD 20892 Telephone: (301) 496-7800, extension 46 FAX: (301) 496-8601 AUTHORITY AND REGULATIONS This program is described in the Catalog of Federal Domestic Assistance No 93.395, Cancer Treatment Research. Awards are made under authorization of the Public Health Service Act, Title IV Part A (Public Law 78-410, as amended by Public Law 99-158, 42 USC 241 and 285) and administered under PHS grants policies and Federal Regulations at 42 CFR 52 and 45 CFR Part 74. This program is not subject to the intergovernmental review requirements of Executive Order 12372 or Health Systems Agency review. .
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