Full Text CA-97-004 CANCER GENETICS NETWORK NIH GUIDE, Volume 26, Number 17, May 23, 1997 RFA: CA-97-004 P.T. 34 Keywords: Cancer/Carcinogenesis Genetics Social Psychology Ethics/Values in Science & Technol National Cancer Institute Letter of Intent Receipt Date: June 20, 1997 Application Receipt Date: September 12, 1997 PURPOSE The Extramural Epidemiology and Genetics Program (EEGP), Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI) invites applications from organizations with demonstrated excellence in human cancer genetics for resource-related cooperative agreements (U24s), a new mechanism for the National Cancer Institute. The purpose of this solicitation is to support the formation of a multi-center, interdisciplinary cooperative, the Cancer Genetics Network. This consortium will serve as an infrastructure for collaborative research investigations into the genetic basis of human cancer susceptibility, explore mechanisms for integrating this information into medical practice, and identify means to address the psychosocial, ethical and legal issues associated with human cancer genetics. To capitalize on advances in the area of hereditary cancer predisposition requires scientific resources and study populations which are currently unavailable to most human genetics programs. Thus a new infrastructure is needed that is a hybrid between the traditional models of Cancer Centers (with recognized scientific excellence) and the cooperative clinical trials groups (with efficient multisite recruitment). Funding through this RFA will be used to support the development of this new model of research infrastructure, the Cancer Genetics Network, in which potential study populations are preassembled through multiple participating centers and linked to a collective scientific expertise in cancer genetics. Through the formation of the Cancer Genetics Network consortium it is envisioned that participating groups will have access to resources, information, and expertise which are beyond the scope of any single institution or organization. The Cancer Genetics Network will also facilitate the exchange of human cancer genetics information and resources within the larger cancer genetics community. The Network will develop mechanisms to broaden access to genetic services and educational materials by both the public and health care professionals. It will establish a clearinghouse of human cancer genetics resources and develop means to extend access to and connections between cancer genetics researchers, providers of genetic services, and the general public. 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 Request for Applications (RFA), the Cancer Genetics Network, 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 Summary Report: Stock No. 017-001-00473-1) through the Superintendent of Documents, Government Printing Office, Washington, DC 20402-9325 (Telephone: 202-512-1800). ELIGIBILITY REQUIREMENTS Applications may be submitted by domestic and foreign, non-profit and for-profit organizations, public and private, such as universities, colleges, hospitals, laboratories, units of State and local governments, and eligible agencies of the Federal Government. Applications may represent a single organization or a consortium of several institutions or organizations. Collaborations which bring together groups with individual expertise in basic human cancer genetics research, clinical cancer genetics, epidemiology, genetic counseling, and education are encouraged. Applications from existing NIH-sponsored programs in clinical oncology, cancer epidemiology and genetics, and related areas which meet the requirements above (e.g., NCI Clinical Trials Cooperative Groups, the Community Clinical Oncology Program [CCOP], NCI-designated Comprehensive Cancer Centers, NCI Cooperative Family Registries for Breast and Colon Cancer Studies, and the NHGRI Cancer Genetics Studies Consortium) are encouraged, but consideration will not be limited to these applicants. Applications from minority individuals, women, and persons with disabilities as Principal Investigators are also encouraged. MECHANISM OF SUPPORT Support for this program will be through the resource-related cooperative agreement (U24). Hypothesis-driven R01 applications are NOT to be submitted in response to this RFA. A single consortium called the Cancer Genetics Network will be developed from the individual cooperative agreement awards for participating centers. As research resource, the Cancer Genetics Network will enhance the capability of investigators to identify and recruit individuals for genetic studies and will facilitate communication of scientific information and research collaboration among participating centers. Substantial NCI involvement with the recipients is anticipated during Network development, implementation, and operation. Under the cooperative agreement, NCI will support and/or stimulate the recipient's activity, working jointly with the participating centers in a partnership role. Participating organizations will be responsible for planning and executing the proposed consortium. Details of the responsibilities, relationship and governance of the project to be funded under cooperative agreements are discussed later in this document under the section "Terms and Conditions of Award." The total project period for applications submitted in response to the present RFA should not exceed five years. The anticipated award date is March, 1998. Because the nature and scope of the research proposed in response to this RFA may vary, it is anticipated that the size of awards will vary also. Awards and level of support will depend on the receipt of a sufficient number of applications of high merit. Although this program is provided for in the financial plans of the NCI, awards pursuant to this RFA are contingent upon the availability of funds for this purpose. This RFA is a one-time solicitation. At this time the NCI has not determined whether or how this solicitation will be continued beyond the present RFA. It is anticipated that a re-issuance of this RFA would include competitive renewal applications from the centers participating in the pilot phase of the Network and new applications from institutions and programs not funded through this first solicitation. FUNDS AVAILABLE Approximately $5 million in total costs per year for five years will be committed to fund applications that are submitted in response to this RFA. This funding level is dependent on the receipt of a sufficient number of applications of high merit. It is anticipated that up to eight individual Network Center awards will be made. RESEARCH OBJECTIVES Background Since the retinoblastoma gene was identified in 1986, the number of cloned familial cancer susceptibility genes has increased rapidly. In aggregate the genes identified to date affect a large number of patients with cancer. For example, germline mutations at the BRCA1 and BRCA2 loci are thought to account for 5-10% breast cancer incidence and 2-5% ovarian cancer incidence. Genetic and epidemiologic studies suggest that other genes of markedly lower penetrance may also be important in determining cancer risk. These genes may modulate individual response to environment and explain variability in risk associated with different exposures. This latter category of susceptibility genes may have very large attributable risks for cancer and may be very common in the general population. Genetic testing for an increasing number of cancer susceptibility genes is becoming widely available in spite of the often uncertain clinical, legal, ethical, and psychosocial implications of these tests. However, testing and counseling even for the rare, familial susceptibility genes would exceed the capacity of the current health care delivery infrastructure. As predictive genetic testing becomes more widespread, there is a critical need to develop novel approaches to communicate high-quality and up-to-date information about cancer genetics and genetic testing to health care providers and potential consumers. The difficulty of this task is magnified by the rapid expansion of scientific knowledge regarding genetic susceptibility and cancer risk. To obtain answers to the next generation of questions in human cancer genetics, studies of unprecedented size and complexity will be required. By providing a research infrastructure to support multi-institutional collaboration, the Cancer Genetics Network will further understanding of the genetics of cancer susceptibility, facilitate the translation of cancer genetics into medical practice, and address pressing public health issues. Ultimately, research conducted using the Network infrastructure should be able to address critical questions, such as: (1) The Genetics of Cancer Susceptibility. The identification of cancer susceptibility genes is still in its infancy, and it is likely that the majority of susceptibility genes have yet to be identified. Even for the genes identified to date, there are still many questions to be addressed. What is the prevalence of germline mutations of familial cancer susceptibility genes in different populations? What is the penetrance of germline mutations in these genes? Is a single germline mutation in a familial cancer susceptibility gene sufficient for increased risk? Do all germline mutations in familial cancer susceptibility genes have the same phenotype? What is the risk conferred by genes of the lower penetrance class? Do the low penetrance genes modify the risk associated with germline mutations in cancer susceptibility genes? What are the environmental exposures that interact with susceptibility genes to cause cancer? (2) The Translation of Genetics into Medical Practice. The integration of genetic susceptibility information into medical practice holds significant promise of new approaches for cancer prevention and treatment. Unfortunately, many of the most basic questions concerning the clinical significance of germline mutations in familial cancer susceptibility genes are unanswered, and it is unclear how to use genetic susceptibility information to alter outcomes. Can adherence to public health cancer prevention strategies alter cancer morbidity and mortality among individuals with genetic susceptibility to cancer? Does prophylactic surgery to remove target risk organs improve survival? Do carriers of cancer susceptibility genes benefit equally from screening technologies such as mammography and PSA testing? Does genetic constitution influence response to cancer treatment? Can specialized prevention and treatment strategies be identified that take advantage of the knowledge of constitutional genotype? (3) Public Health Issues in Genetic Susceptibility. The opportunities afforded by advances in cancer genetics also raise enormous challenges. The consequences of widespread access to individual genetic information about susceptibility, even of uncertain clinical significance, are largely unknown. What are the ethical and psychosocial issues that will affect healthy individuals and their families who may carry cancer susceptibility gene mutations? How can people be helped to make informed decisions about testing for genetic susceptibility? How can information about genetic information be effectively and responsibly communicated to individuals, health professionals, and the general public? How can the nation's health care infrastructure be extended to accommodate the responsible delivery of wide spread genetic testing for cancer susceptibility genes? Goals and Scope The goal of the Cancer Genetics Network is to enable investigations addressing the broad range of outstanding issues in human cancer genetics outlined above. Through the formation of the Network, participating groups will have access to resources, information, and expertise that are beyond the scope of a single institution. The Network will operate as a cooperative, providing a framework for research designed by the consortium members and executed using the joint resources of the centers. To facilitate formation and effective operation of the Cancer Genetics Network, this RFA will provide a broad base of support for participating center activities relevant to Network implementation and function. Applicants may request support for operating basic registry and informatics systems and for expanding laboratory capabilities and other support functions to meet increased needs arising from Network participation. Administrative supplements will also be made available to the Network Participating Centers for innovative small projects and pilot studies, as described below. (1) Support of Basic Network Activities Basic activities of the Network include developing a collective data base or registry of potential research participants and establishing the ability to collect and store tissues for specific Network projects. Substantial effort should be directed towards basic activities such as: Recruitment of eligible individuals into the Network data system; Collection of core data from recruited participants; Tracking and follow-up of participants; Collection of biological specimens for specific Network projects; Maintenance of local informatics and communications capabilities; Interactive participation in the Network-wide informatics system. Thus budget requests should include personnel and consultant efforts that provide multidisciplinary support for these Network functions, particularly for areas of participant recruitment and follow-up, health education, genetic counseling, data management and quality assurance, and computer systems development and maintenance. (2) Expansion of Research Capabilities to Support Network Participation To enable investigators to answer urgent questions in cancer genetics such as those described above, applicants are encouraged to request support for activities which create and/or expand the submitting applicant's capacity to perform locally-based studies as well as the cooperative Network projects that use joint resources. Activities which may be supported include, but are not limited to: Support for personnel with expertise in laboratory-based genetic analysis, health education, family studies, molecular epidemiology, informatics, mathematical genetics, behavioral research, clinical genetics, and/or genetic counseling; Expansion of capability to collect, process, store, and exchange biological specimens and reagents; Development or expansion of informatics capacity, particularly in the areas of data management/analysis and electronic information capture, exchange, or distribution; Travel to support training and collaborative interactions within and between institutions; Support for consultants with relevant expertise from outside the Network participating center; Acquisition of equipment and instrumentation to expand the ability to perform genetic analyses; Development of educational materials and resources. (3) Developmental Activities and Pilot Research Studies Following implementation of the Network consortium, the Participating Centers will be allowed to request administrative supplements. These funds will be used to enhance activities of the Network as a whole and will be awarded for specific developmental activities and pilot studies as recommended by the Advisory Committee and approved by the Steering Committee. Examples of activities covered by the supplements include, but are not limited to: Development of high-priority Network-wide pilot studies. These may be extensions of pilot projects proposed in the applications of individual Network centers, or rapidly emerging new priorities which arise as a consequence of developments within the field; Workshops addressing problems in the area of cancer genetics; Consultants to provide expertise outside that contained within the cooperative; Sharing of education and information resources from within the Network and outside sources; Technology transfer between Network centers and from other relevant sources; Expansion of the basic Network infrastructure, e.g., to support referral and outreach activities. SPECIAL REQUIREMENTS Applicants must have existing programs of scientific excellence in human cancer genetics and ongoing clinical programs in genetic evaluation and counseling which provide access to a broad spectrum of individuals with expressed interest in predictive genetic testing for cancer risk. All applications must address the following questions in a clear and organized manner, as described below: (1) What existing resources, capabilities, and expertise does the applicant bring to the Network? (2) How will the support requested for expansion of capabilities enhance the applicant's ability to participate in Network functions? (3) What unique resources, capabilities, or expertise does the applicant bring to the Network? (1) Existing Resources, Capabilities, and Expertise Applications should include, at a minimum, descriptions of the following resources: The clinical program(s) in predictive genetic testing and clinical genetics on which the application is based; The clinic catchment population (source of participants) and potential for outreach beyond this group; Pre- and post-test counseling protocols; Laboratory testing procedures; Methods for assuring privacy and maintaining confidentiality of participant records, including specific protections for Internet-based data systems; Informed consent procedures; and Capabilities for collection, processing, and storage of biological materials. Relevant to the educational objectives of the Network, applicants should describe: Educational materials and interventions, in use or to be developed, particularly in the area of risks and benefits of testing for genetic susceptibility for cancer; Methods in place or planned for providing user-friendly access to rapidly changing scientific information and/or resource directories; Post-marketing' surveillance strategies for medical or social harms associated with pharmaceuticals or medical devices, particularly in relation to cancer genetic predisposition testing. Applicants should provide evidence of their capability and willingness to collaborate in development of common protocols during the first six months of the award and to participate in the conduct of collaborative research studies. They should present plans and/or approaches for fostering scientific collaborations through the Cancer Genetics Network. Applicants must also demonstrate their willingness to allow non-Network investigators to have access to Network data for high-priority research studies approved by the Steering Committee and Advisory Committee. Applicants are also encouraged to describe briefly (in 1 or 2 pages per project, in addition to the usual 25-page limit) at least one pilot study that they would envision as addressing important questions utilizing the unique resources that will be available through the Network consortium. While support for these pilot studies will not be provided through this solicitation, these studies may be funded through administrative supplements to be made available to the Network cooperative at a later date. (2) How Expansion of Resources will Enhance Network Participation Applicants should list the resources requested for expansion of existing facilities or capabilities (see "Goals and Scope" above) and provide a clear and detailed description of how these resources will impact the scope and/or function of the existing facility. This section should emphasize how the expansion of capabilities will contribute to the general functions of the larger Network system and how it will enhance the research potential of the Network as a whole. Applicants should also describe provisions to continue Network activities and collaborations should federal support terminate following the initial (pilot) phase of this initiative. (3) Unique Capabilities Applicants should highlight the aspects of their existing and proposed programs that offer unique expertise and/or unusual opportunities for Network projects. Examples include, but are not limited to: Expertise in highly specialized areas with potential applications in genetic testing and counseling, such as psychosocial aspects (including quality of life), risk communication and/or decision-making, and medical outcomes research (including costs and cost-effectiveness); Innovative laboratory procedures or analytic technologies; Experience in regulatory affairs, such as FDA approval of reagents (devices), laboratory certification, and surveillance for adverse effects; Access to special participant populations, such as ethnically diverse groups, cohorts with unique mutations (such as ATM heterozygotes); and Experience and/or expertise in state-of-the-art communications technology (such as informatics, telemedicine). Study Organization and Function A maximum of eight Network participating centers will be funded in the initial offering of this initiative. NIH intramural laboratories and/or clinical programs may be included as Network participating centers, as described below. Each participating center shall be headed by a single Principal Investigator who will provide scientific and administrative leadership for the Network functions and responsibilities. A Steering Committee (SC) will serve as the main governing board of the Network (see "Terms and Conditions of Award"). It will be responsible for the design and execution of Network-wide research protocols and the assembly of study populations which are required for their conduct. Its membership will include the Principal Investigators of the Network Participating Centers, the NCI Program Coordinator, directors of other coordinating groups, and a consumer representative. Additional members may be appointed by mutual agreement of the SC membership. An Advisory Committee (AC) will be composed of senior scientists with multidisciplinary expertise in cancer genetics research and will be responsible for reviewing, evaluating and prioritizing all research proposals involving use of Network resources or developmental funds. The AC will also provide advice to the SC on scientific matters, as appropriate and as needed. AC members may be nominated by SC members and will be appointed by the NCI for a two-year tenure. To facilitate the analyses of genetic testing information and to enhance the ability to conduct interdisciplinary research with clinical, population-based, and laboratory components, the Network will develop on-site databases and a central data repository as key Network resources. Recruitment of individual participants to the databases will target persons who express an interest in genetic testing for cancer predisposition, for any of a broad range of cancer-related gene mutations and polymorphisms. The databases will include both tested individuals (mutation carriers and non-carriers) and those who have considered testing but decided against it at the present time. Consent for inclusion in the databases will be obtained from participants in a manner independent of informed consent for genetic testing. The databases will be built using state-of-the-art informatics technology and will be designed to maximize confidentiality of information. Core information will likely include demographic, family history, environmental exposures and other risk factor data, and information on cancer occurrence and preventative practices. Individual participants will be followed annually to provide updates and will be asked to release genetic information to the Network if such information becomes available. The Network will provide registrants with periodic updates on the latest scientific findings about cancer genetics and new research protocols and projects for which they may be eligible through newsletters, electronic information transfer, or other approaches. The Network will directly support and coordinate the development and implementation of educational resources and programs in cancer genetics, both for health care providers and for the general public. Network sites will also be charged with developing innovative approaches to education and community outreach. An Informatics and Information Technology Group will be supported through a separate RFA and will serve as a resource to help meet the information management needs and requirements of the Network and its various functions. This group will develop and maintain an Internet-based data management system and a central data repository, expanding and enhancing the heterogeneous computer capabilities of the individual participating centers. Data security and confidentiality will be of primary importance in the design and implementation of this information system. Individual participating centers must demonstrate competency in the management and exchange of electronic data that will become part of the larger Network repository. Research proposals requiring Network resources may be submitted by Network investigators or by investigators unaffiliated with the Network. All proposals must be reviewed and considered to be of high priority by the AC and must be approved by the SC. Except for developmental activities and pilot studies supported through administrative supplements, funding for investigator-initiated research is not included in this RFA and should be sought from other sources. NIH intramural laboratories and/or clinical programs may participate as Network centers but may not receive salary, equipment, supplies, or other remuneration from this program. The intramural principal investigator must obtain appropriate NIH clearances. The Principal Investigator must incorporate into the application, in the usual format, a full description of the collaborative project, including technical details and methodology. The participation of an intramural scientist is independent of and unrelated to the role of the NCI Program Coordinator as described under "Terms and Conditions of Award." An intramural Network center will participate in a manner analogous to the Network center awardees and will be subject to the same requirements. Terms and Conditions of Award The Terms and Conditions of Award, below, will be included in all awards issued as a result of this RFA. It is critical that each applicant include specific plans for responding to these terms. These special Terms of Award are in addition to and not in lieu of otherwise applicable OMB administrative guidelines, HHS grant administration regulations in 45 CFR Part 74 and 92, and other HHS, PHS and NIH grant administration policy statements. The administrative and funding instrument used for this program is a resource-related cooperative agreement (U24). This is an assistance mechanism for support of a research resource in which substantial NIH scientific and/or programmatic involvement with the awardee is anticipated during performance of the activity. Under the cooperative agreement, the NIH purpose is to support and/or stimulate the recipient's activity by involvement in and otherwise working jointly with the award recipient in a partner role. Consistent with this concept, the prime responsibility for the activity resides with the awardee(s) for the project as a whole. 1. Awardee Rights and Responsibilities Awardees and NIH intramural laboratories/programs participating as Network centers will have primary rights and responsibilities to define projects and approaches and to plan and conduct the project including: a. The Awardee is responsible for enrollment and follow-up of Network participants, and for establishment and maintenance of mechanisms to ensure that data collection and management procedures have necessary quality control and assure confidentiality of data. b. The Principal Investigator will serve as a permanent member of the SC and will participate in the development of Network protocols and procedures. The awardee will be required to implement and comply with the common policies and procedures approved by the SC. c. The awardee will participate in common Network protocols and procedures. In addition, individual awardees may conduct single site (e.g., pilot) studies using their unique program and resources. Single site projects involving resources supported by Network funds must be reviewed and approved by the SC and AC, as described below. d. The Awardee must implement core data collection methods and strategies agreed upon by the SC. Each awardee/site must ensure that data will be submitted in a timely way to the central Network database. e. The Awardee must agree to provide access to Network resources to Network-affiliated and non-affiliated investigators, based on review and prioritization of the research proposals by the AC and approval by the SC. f. The Awardee must provide a semi-annual progress report to the NCI Program Coordinator. This report should include progress during the reporting period (including accrual and follow-up), staffing changes, a summary of project expenditures, manuscripts prepared during the reporting period, and priorities for the coming reporting period. g. The Awardee will cooperate in the scientific reporting of Network findings. The NCI will have access to and may periodically review all data generated under an award. Plans for joint publication with NCI extramural program staff of pooled data will be reviewed and approved by the Steering Committee. NIH policies governing co-authorship of publications with NCI extramural program staff will apply in all cases. h. The awardee(s) will retain custody of and have primary rights to the data developed under these awards, subject to Government rights of access consistent with current HHS, PHS and NIH policies. However, publication or oral presentation of results obtained under this Cooperative Agreement will require appropriate acknowledgment of NCI support. 2. NCI Staff Responsibilities The role of the Program Coordinator is to assist and facilitate, but not to direct, the activities supported by the Network. The NCI Program Coordinator will: a. Serve as liaison from the NCI, helping to coordinate activities among the awardees; b. Serve as scientific liaison between the awardees and other program staff at NCI with experience in multicenter studies, cancer genetics, and social and behavioral research; c. Serve as a full participant and voting member of the SC, and, as appropriate, SC subcommittee(s); serve as liaison between the SC and the AC, attending AC meetings in a non-voting liaison member role; d. Assist in the monitoring of field data collection, helping to ensure standardization in methods across Network participating centers; and assist in developing operating guidelines, quality control procedures, and consistent policies for dealing with recurrent situations that require coordinated action. The NCI reserves the right to reduce the budget, to withhold support, and to suspend, terminate or curtail a study or an award in the event of substantial shortfall in accrual, data reporting, inadequate quality control of data collection, refusal to carry out the recommendations of the SC and AC, or substantial failure to comply with the terms of the award. Periodic external progress reviews of the program will be carried out as NCI deems appropriate. 3. Collaborative Responsibilities a. Steering Committee (SC). The SC will serve as the main governing board of the Network. The SC will be responsible for development and implementation of the Network at the participating centers and for the design and execution of Network-wide research protocols. Its membership will include the Principal Investigators of the Network Participating Centers, the NCI Program Coordinator, directors of other coordinating groups, and a consumer representative. Additional members may be appointed by mutual agreement of the SC membership. This Committee will develop uniform policies and procedures for (a) data collection, management, and quality control; (b) access to Network resources for research purposes by Network and non-Network investigators (including policies governing authorship for research reports); and (c) dissemination of educational materials and scientific information. The SC will develop the criteria for review and prioritization of research proposals requiring the use of Network resources. The Committee will elect a Chairperson (other than the NCI Program Director) who will be responsible for coordinating the Committee's activities, for preparing meeting agendas, and for scheduling and chairing subsequent meetings. The NCI Program Coordinator will attend and participate in all meetings. At least three meetings will be held during the first year of operation, and two meetings a year thereafter, one of which will be with the AC. Applicants must request sufficient funds in their budgets to accommodate travel expenses for the PIs. Subcommittees will be established by the SC as it deems appropriate. The SC will be responsible for confirming the availability and accessibility of data for use by investigators requesting the use of Network resources for approved research proposals. The SC may nominate members for the AC. The SC will pay particular attention to conflict of interest issues in the conduct of all business matters and will bring such matters to the attention of the AC and of the NCI Program Coordinator. b. Advisory Committee (AC): The AC will be composed of senior scientists with multidisciplinary expertise in cancer genetics research. AC members may be nominated by SC members and will be appointed by the NCI for a two-year tenure. At least 75% of AC members will be non-government. The AC will be responsible for reviewing, evaluating and prioritizing all research proposals involving use of Network resources or developmental funds. The AC will evaluate all research proposals (those from Network investigators as well as from the research community) which require Network resources. All reviews will be held according to rules pertaining to the conduct of reviews for NIH grants, contracts, and cooperative agreements and to review procedures developed by the SC, with special attention to issues of conflict of interest (whether real or apparent). The AC will provide a recommendation to the SC as to the priority of the proposed research projects. The AC will also provide advice to the SC on scientific matters, as appropriate and as needed. The AC will meet jointly with the SC at least once yearly. Support for AC meetings and other AC functions will be provided by NCI through a mechanism outside this RFA. 4. Arbitration Procedures Any disagreement that may arise on scientific/programmatic matters (within the scope of the award) between award recipients and the NCI may be brought to arbitration. An arbitration panel will be composed of three members -- one selected by the awardee, a second member selected by NCI, and the third member selected by the two previously selected members. These special arbitration procedures in no way affect the awardee's right to appeal an adverse action that is otherwise appealable in accordance with PHS regulations at 42 CFR Part 50, Subpart D, and HHS regulations at 45 CFR Part 16. INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of the NIH that women and members of minority groups and their subpopulations must be included in all NIH-supported biomedical and behavioral research projects involving human subjects, unless a clear and compelling rationale and justification is provided that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research. This new policy results from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43) and supersedes and strengthens the previous policies (Concerning the inclusion of Women in Study Populations and Concerning the Inclusion of Minorities in Study Populations) which have been in effect since 1990. The new policy contains some new provisions that are substantially different from the 1990 policies. All investigators proposing research involving human subjects should read the "NIH Guidelines on the Inclusion of Women and Minorities as Subjects in Clinical Research" which have been published in the Federal Register of March 28, 1994 (59 FR 14508-14513) and reprinted in the NIH GUIDE FOR GRANTS AND CONTRACTS, Volume 23, Number 11, March 18, 1994. Investigators may obtain copies of the policy from these sources or from the program staff or the contact person listed below. Program staff may also provide additional relevant information concerning the policy. LETTER OF INTENT Prospective applicants are asked to submit, by June 20, 1997, a letter of intent that includes a descriptive title of the proposed project, the name, address and a telephone number of the Principal Investigator, the names of other key personnel and participating institutions, and the number and title of the RFA in response to which the application may be submitted. Although a letter of intent is not required, is not binding, and does not enter into the review of 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 conflicts of interest in the review. The letter of intent is to be sent to Susan G. Nayfield, M.D., M.Sc. at the address listed under INQUIRIES below. APPLICATION PROCEDURES The research grant application form PHS 398 (rev. 5/95) is to be used in applying for these grants. These forms are available at most institutional offices of sponsored research and may be obtained from the Office of Extramural Outreach and Information Resources, Division of Research Grants, National Institutes of Health, 6701 Rockledge Drive, MSC 7910, Bethesda, MD 20892-7910, telephone 301-710-0267, e-mail [email protected]. The RFA label available in the application form PHS 398 (rev. 5/95) 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 number and title of the RFA must be typed on line 2a of the face page of the application and YES must be checked. Submit a signed, typewritten original of the application, including the Checklist, and three 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 Suite 1040 6701 Rockledge Drive MSC 7710 Bethesda, MD 20892-7710 At the time of submission, two additional copies of the application must by sent to: Ms. Toby Friedberg Referral Officer Division of Extramural Activities National Cancer Institute Executive Plaza North, Room 636 6130 Executive Blvd. Rockville, MD 20850 (if hand delivered or delivery service) Bethesda MD 20892-7399 (if using U.S. Postal Service) It is important to send these copies at the same time that the original and three copies are sent to DRG; otherwise, the NCI cannot guarantee that the application will be reviewed in competition with other applications received on or before the designated receipt date. Applications must be received by September 12, 1997. If an application is received after that date, it will be returned to the applicant without review. The Division of Research Grants (DRG) will not accept any application in response to this RFA that is essentially the same as one currently pending initial review, unless the applicant withdraws the pending application. The 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. Funds requested by this RFA should be directed to support basic Network activities and for other personnel and activities that extend the capacity of an applicant site to meet the goals of the Network, as described above under "Goals and Scope." The costs of clinical genetic testing and counseling, beyond the counseling required for the Network recruitment and informed consent process, will not be covered under this award. Routine collection and storage of biospecimens from all Network participants will not be covered through this solicitation. Funds for expansion of tissue repository capabilities may be requested as an infrastructural resource for future Network research projects, as described under "Goals and Scope." The costs of collection, processing, and storing tissues for investigator-initiated research and for Network-wide projects must be covered by funds from other sources and should be included in the budgets for R01 (or other) applications which rely upon Cancer Genetic Network resources on a fee-for-service basis. The costs of collecting, processing, and storing specimens for developmental activities (e.g., development and standardization of new laboratory procedures) and for pilot studies will be covered by the Network through administrative supplements, also described under "Goals and Scope." REVIEW CONSIDERATIONS All applications will be judged on the basis of the scientific merit of the proposed project and the documented ability of the investigators to meet the OBJECTIVES of the RFA. Although the technical merit of the proposed protocol is important, it will not be the sole criterion of evaluation of a proposal. Review Method Upon receipt, applications will be reviewed for completeness by the DRG and for responsiveness to the RFA by the NCI. Incomplete applications will be returned to the applicant without further consideration. If NCI staff find that the application is not responsive to the RFA, it will be returned and will receive no further consideration. Applications that are complete and responsive to the RFA will be evaluated for scientific and technical merit by an appropriate peer review group convened by the NCI in accordance with the review criteria stated below. As part of the initial merit review, all applications will receive a written critique and undergo a process by which only those applications deemed to have the highest scientific merit, generally the top half of applications under review, will be discussed, assigned a priority score, and receive a second level review by the National Cancer Advisory Board. Review Criteria Applicants are expected to address all issues identified under SPECIAL REQUIREMENTS of the RFA. The review group will assess the scientific merit of the protocols and related factors, including: 1. The scientific excellence of the application and extent to which it addresses the goals and objectives of the RFA; 2. Scientific and technical excellence of the applicant's existing program in clinical cancer genetics, especially in the genetics of cancer susceptibility, the translation of genetics into medical practice, or public health issues in cancer genetics. 3. Availability of and access to a suitable catchment population; ability of proposed recruitment strategies to provide adequate numbers of enrollees to support active Network participation; adequacy of plans for inclusion of minority participants; 4. Demonstrated ability in meeting generally accepted standards for predictive genetic testing, including informed consent processes, pre-and post-test counseling, and laboratory procedures for genetic testing; 5. Evidence that appropriate steps have been taken to ensure the rights of human subjects including informed consent for genetic testing and for Network participation; adequacy of plans for maintaining privacy and confidentiality of participant information; 6. Demonstrated ability and willingness to carry out common protocols, and adequacy of plans for effective cooperation and collaboration with other participating centers and the NCI Program Coordinator; 7. Adequacy of existing physical facilities and resources of the applicants' Institution(s);how effectively the proposed resource expansion will enhance the applicant's participation in Network functions; and the unique resources and capabilities the applicant will bring to the Network; 8. Qualifications and research experience of the Principal Investigator and staff, particularly, but not exclusively, in the area of the proposed research; and the unique expertise the Principal Investigator, Co-Investigators, and Consultants will bring to the Network. The review group will also examine the proposed budget and will recommend an appropriate budget and period of support for each application that is recommended for further consideration. 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. AWARD CRITERIA The earliest anticipated date of award is March 1, 1998. The following will be considered for making funding decisions: 1. Scientific and technical merit of the proposed project as determined by peer review; 2. Adequate effort to represent the minority groups in the population sampled; 3. Availability of funds; 4. Program balance among geographic and research areas. INQUIRIES Written and telephone inquiries concerning the RFA and the opportunity to clarify any issues or questions from potential applications are welcome. Direct inquiries regarding programmatic and scientific issues to: Susan G. Nayfield, M.D., M.Sc. Extramural Epidemiology and Genetics Program National Cancer Institute Executive Plaza North, Suite 535 6130 Executive Boulevard MSC 7395 Bethesda, MD 20892-7395 Telephone: (301) 496-9600 Direct inquiries regarding fiscal matters to: Ms. Crystal Wolfrey Grants Management Specialist National Cancer Institute Executive Plaza South, Suite 243 6120 Executive Boulevard MSC 7395 Bethesda, MD 20892-7395 Telephone: (301) 496-7800, ext. 282 AUTHORITY AND REGULATIONS This program is described in the Catalog of Federal Domestic Assistance No.93.393, Cancer Cause and Prevention 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 42 CFR Part 52 and 45 CFR Part 74 and 92. This program is not subject to the intergovernmental review requirements of Executive Order 12372 or Health Systems Agency review. Unless otherwise noted all PHS grants policies apply. The Public Health Service strongly encourages all grant recipients to provide a smoke-free workplace and promote the non-use of all tobacco products. In addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain facilities (or in some cases any portion of a facility) in which regular or routine education, library, day care, health care, or early childhood development services are provided to children. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people. .
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