Full Text CA-92-16 HYPOTHESIS DRIVEN CLINICAL CORRELATIONS IN HEMATOLOGIC MALIGNANCIES NIH Guide, Volume 21, Number 16, May 1, 1992 RFA: CA-92-16 P.T. 34 Keywords: Cancer/Carcinogenesis Blood Diseases Hematology Data Management/Analysis+ National Cancer Institute Letter of Intent Receipt Date: June 17, 1992 Application Receipt Date: September 16, 1992 PURPOSE The Cancer Therapy Evaluation Program (CTEP) of the Division of Cancer Treatment (DCT) and the Cancer Diagnosis Branch (CDB) of the Division of Cancer Biology, Diagnosis and Centers (DCBDC) at the National Cancer Institute (NCI) invite applications for cooperative agreements (U01) from institutions or consortia, such as DCT Clinical Trials Cooperative Groups, capable of and interested in performing hypothesis driven clinical correlative studies relevant to the cancer treatment or clinical outcome of patients with hematologic malignancies. It is essential for institutions to have access to biologic samples and outcome data for a sufficient number of patients on phase III clinical protocols to be able to test correlative hypotheses. Hematologic malignancies that are relevant to this Request for Applications (RFA) include leukemias, lymphomas, myelomas and myelodysplastic syndromes. Awards will be made as cooperative agreements which create an assistance relationship with substantial NCI programmatic involvement with the recipients during the performance of the project, as outlined in this RFA. The cooperative agreement mechanism is used to stimulate investigator interest and proposes to advise or assist in an important and opportune area of research. 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, Hypothesis Driven Clinical Correlative Studies in Hematologic Malignancies, 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 Domestic and foreign for-profit and not-for-profit organizations, governments and their agencies are eligible to apply. Applications from minority individuals and women are encouraged. It is essential for institutions to have access to biologic samples and outcome data for a sufficient number of patients on phase III clinical protocols to be able to test correlative hypotheses. The applicant institution must have access to a Central Operations Office and a Statistical Center for coordination of research activities and data analysis as defined below (see Definitions). The Central Operations Office and the Statistical Center need not reside at the Principal Investigator's institution. MECHANISM OF SUPPORT Support of this program will be through the cooperative agreement (U01), an assistance mechanism in which substantial NCI programmatic involvement with the recipients during performance of the planned activity is anticipated. The nature of NCI staff involvement is described below. Applicants will be responsible for the planning, direction, and execution of the proposed project. 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. This RFA is a one-time solicitation. If it is determined that there is a sufficient continuing program need, the NCI will invite recipients of awards under this RFA to submit competitive continuation cooperative agreement applications for review according to the procedures described below. FUNDS AVAILABLE Approximately $2,000,000 in total costs per year for four years will be committed to fund applications submitted in response to this RFA. This funding level is dependent on the receipt of a sufficient number of applications of high scientific merit. It is anticipated that 10-12 awards will be made. The total project period for applications submitted in response to the present RFA may not exceed four years. The earliest feasible start date for the initial awards will be August 1, 1993. Although this program is provided for in the financial plans of the NCI, the award of cooperative agreements pursuant to this RFA is also contingent upon the availability of funds for this purpose. RESEARCH OBJECTIVES A. Background Insights into the biologic function and clinical relevance of growth factors, genes that promote or suppress neoplasia, mechanisms of treatment sensitivity and resistance, and functions of the immune system provide important new clinical research opportunities for investigators studying patients with hematologic malignancies. While advances have been made relating biological characteristics to clinical behavior of the more common hematologic malignancies, fewer clinical correlations have been explored for the rarer disease types. Historically, defining prognostic factors has been a major effort in correlative research. In the case of acute leukemias, age, cell type, cytogenetic abnormalities, leukemic cell burden, and CNS involvement at presentation are commonly used as prognostic guides and treatment indicators. Currently, several well-defined laboratory tests are ready for inclusion in clinical correlative studies to determine their clinical relevance and value. For example, levels of bcr/abl transcripts are currently being evaluated as a marker for minimal residual disease in Philadelphia chromosome-positive chronic myelogenous leukemia. Technological advances in methodologies such as polymerase chain reaction (PCR), flow cytometry, immunohistochemistry, and in situ hybridization allow laboratory investigators to do numerous analyses on tumor specimens and to study tumor heterogeneity in a variety of tumor types. They allow investigators to address the biology of the disease in a much more detailed manner and to refine/develop biology-based tests that are/would be of prognostic value. Recently, new treatment regimens using differentiating agents and growth factors have been developed for certain leukemias (i.e., trans-retinoic acid for APL). While the precise mechanism by which these agents act and how these agents affect the biology of the disease remain to be eluciated, the significant progress in the molecular biology of retinoid and growth factor function indicates that this is a fertile area for correlative studies. Such correlative laboratory studies may be immediately relevant to cancer treatment. The NCI supports an extensive network of clinical and laboratory research studies related to cancer therapy through contracts, grants and cooperative agreements. CTEP supports a program of integrated national networks of clinical investigators and institutions (Clinical Trials Cooperative Groups) for the conduct of large scale, multi-institutional clinical trials. The primary goal of these trials is the definitive evaluation of clinical treatment programs. Presently, the Clinical Trials Cooperative Groups (CTCG) conduct approximately 500 clinical trials evaluating more than 23,000 patients per year. The CTCG have access to tumor specimens from large numbers of patients with hematologic malignancies. They maintain statistical databases and are capable of correlating laboratory data with the clinical outcome of patients. NCI also supports Cancer Centers that conduct phase III clinical trials and have access to statistical operations, headquarters, and consortia arrangements with other institutions and hospitals. This RFA is intended to promote collaborations and interactions between basic researchers and clinical investigators to advance research on clinical correlations that can improve therapeutic approaches. NCI is seeking to encourage hypothesis driven correlative laboratory studies linked to large scale clinical trials. In many instances the potential participants are already recipients of R01 or P01 support for their basic research and have developed preliminary data supporting a large scale analysis of a new prognostic factor. Likewise, many clinical investigators are supported through Cancer Centers (P30) and the Clinical Trials Cooperative Group mechanism (U10) for clinical research and have access to patient specimens with clinical follow-up. This initiative proposes to link these activities and provides a mechanism to obtain definitive data on the relationship of biological features and the clinical behavior of the tumors. B. Research Goals And Scope The objectives of this RFA are to foster collaborations and interactions between basic researchers and clinical investigators to advance therapeutic clinical research and conduct hypothesis driven correlative studies in hematologic malignancies that are ready for large scale evaluation. The CTEP and the CDB invite cooperative agreement applications (U01) from institutions or consortia, such as the DCT Clinical Trials Cooperative Groups and the NCI Cancer Centers, capable of and interested in performing hypothesis driven clinical correlative studies relevant to cancer treatment or clinical outcome in patients with hematologic malignancies. Hematologic malignancies relevant to this RFA account for significant cancer incidence, morbidity, and mortality. Special consideration will be given to studies with acute promyelocytic leukemia, multiple myeloma, chronic lymphocytic leukemia, acute myeloid leukemia, and acute lymphocytic leukemia. Each application is expected to be focused on a specific hematologic malignancy. Applicants may propose to undertake several correlative studies relevant to the specific hematologic malignancy during the grant funding period (up to four years). An individual scientist or a consortium of institutions may be included on more than one application. The correlative studies should be based on strong and testable hypotheses. A clear rationale should be given for the experimental design and technical methodologies selected. The hypotheses tested must relate to potential clinical applications such as development of new treatment strategies or identification of patient subsets for specific treatment approaches. Preliminary data from appropriate tumor models or analysis of patient specimens should be provided to support the feasibility of each study. This RFA is not for developing new techniques or assays. Assays must have already been demonstrated to be applicable to tissue samples and/or body fluids. The laboratory assays must utilize tumor specimens from patients receiving defined treatments in large clinical trials such as phase III clinical protocols. Applications must include a statistical section describing plans for analysis of data designed to test the hypotheses. Investigators must have access to sufficient numbers of patient specimens and patient outcome data from phase III clinical trials. All investigators are encouraged to work with multi-center organizations or form a consortium of institutions in order to access sufficient numbers of patients and clinical information to test the proposed hypotheses. To coordinate the above activities, each Institution must have a Central Operations Office and Statistical Center as defined below (see Definitions). Examples of therapeutic laboratory correlates of interest include, but are not limited to: (1) phenotypic or genotypic alterations that appear to correlate with the development of therapy resistance; (2) loss or inactivation of tumor suppressor genes related to prognosis; (3) studies of chromosomal rearrangements or deletions that may be used as prognostic indicators; (4) correlation of expression of tumor growth factors or oncogenes with response to therapies; (5) characterization of tumor- associated antigens that may lead to new immunotherapies; (6) evaluation of use of serum or tumor markers that correlate with tumor progression; (7) analyses of expression of cellular receptors for growth factors or differentiating agents; (8) defining and targeting specific populations of cells for therapy; and (9) analysis of in vitro response of tumor cells to growth factors/differentiating agents. The cooperative approach outlined in this RFA allows for interactions among successful applicants and is designed to optimize use of patient resources, tissues, reagents and methods. Applicants must describe how they might interact with NCI and other awardees in the sharing of data and improvements in laboratory techniques and study design methodologies. SPECIAL REQUIREMENTS A. Definitions COOPERATIVE AGREEMENT - An assistance mechanism in which substantial NCI programmatic involvement with the recipient is anticipated during performance of the planned activity. APPLICANT INSTITUTION - An Applicant Institution may consist of a single institution or a consortium of institutions for the purpose of accessing a sufficient patient population for biologic samples and outcome data. An Applicant Institution functions as an integrated unit with a common goal and is under the guidance and direction of a single Principal Investigator. Each Applicant Institution is composed of investigators with expertise in clinical research and laboratory analyses. In this RFA, the terms Applicant Institution and Institution are used synonymously. PRINCIPAL INVESTIGATOR (PI) - The person from the Applicant Institution who submits the single application in response to this RFA and who is responsible for performance of the key personnel. The Principal Investigator is responsible for coordinating the Institution's activities scientifically and administratively. CENTRAL OPERATIONS OFFICE - An administrative unit that coordinates all Institution activities. Responsibilities include coordinating protocol development, study conduct, and quality control and study monitoring. The Central Operations Office need not be at the PI's institution. STATISTICAL CENTER - The consortium of institutions must have a Statistical Center for collection and analysis of patient and laboratory data. Responsibilities will include participation in the planning and coordination of study design methodologies, data management and analysis, data monitoring, and reporting of data. The Statistical Center need not be at the PI's institution. NCI PROGRAM DIRECTORS - The CTEP Program Director for this RFA from CTEP, DCT or the Chief, CDB, DCBDC who will be coordinating their Division's interactions and providing guidance for the overall program within the NCI (see INQUIRIES). NCI COORDINATOR - The Head, Medicine Section, Clinical Investigations Branch, CTEP, DCT who interacts scientifically with the Institutions. B. Terms Of Cooperation The cooperative agreements will require cooperation between an NCI Coordinator and the Principal Investigator of each of the Applicant Institutions. The NCI Coordinator will assist in coordinating the activities of the Institutions as defined below and in facilitating exchange of information. Nature Of Participation By NCI Staff The role of the Program Director, CTEP, and the Chief, CDB, as described throughout these terms of cooperation, is to assist and facilitate but not to direct research activities. The NCI Coordinator will interact scientifically with all the Institutions. Two levels of coordination are anticipated. The first level involves interactions between the NCI Coordinator and the individual Institution. During the period of the award, the awardee institution(s) will have the primary authority to determine research priorities and statistical needs. The NCI Coordinator may provide appropriate assistance by participating in the design of research activities, review of protocols, coordination of the tissue utilization, establishment of priorities, and review of progress. Although the Institution(s) are responsible for statistical analysis of data, computer processing and statistical evaluations may be provided from NCI resources if requested by the awardee. The second level of coordination involves interactions between the NCI Coordinator and Institutions funded for research on the same hematologic disease. It is expected that Institutions working on the same disease will participate in joint activities. The NCI Coordinator would facilitate such activities by coordinating the sharing of patient specimens, new reagents, improved laboratory techniques, data, and study design methodologies. Although investigators will have to demonstrate that they have access to the necessary numbers of patients and/or specimens to answer specific questions, other important correlations identified during the course of the funded research may require patient resources from more than one Institution. Because the size and numbers of tumor specimens are often limited, priorities would need to be set for the most effective use of available specimens. The awardee institution(s) will have the primary authority in setting these priorities. The NCI Coordinator can assist in this process by providing information on other ongoing studies and on NCI priorities. Responsibilities Of Awardees The Awardee is responsible for the proposed research projects to advance the goals of the RFA and to define its approaches to attain these goals. It is the primary responsibility of the PI to state clearly the objectives of the Institution, to direct the research stipulated in the application, and to ensure that the results obtained are published in a timely manner. It is anticipated that decisions in all activities will be reached by consensus of the collaborators of an Institution under the leadership of the PI and that the NCI Coordinator will have the opportunity to offer input to this process. Awardees are required to have access to appropriate tumor tissue and clinical follow-up on patients receiving defined treatments in phase III clinical trials. Awardees must have the appropriate clinical and laboratory expertise to accomplish their objectives within the Applicant Institution. The Awardee(s) and the NCI Coordinator will meet initially to discuss research plans and establish priorities. Subsequent periodic meetings will be scheduled to review progress and coordinate research activities. It is envisioned that more than one Institution may be funded for research on the same hematologic disease. For these Institutions, sharing of data and reagents will be expected. In addition, new studies that may require the sharing of patient specimens or assays/reagents and the prioritization of research studies among the Awardees are envisioned. Therefore, each Institution should anticipate the need to attend two meetings per year to coordinate activities. The Government, via the NCI Coordinator, will have access to data generated under this cooperative agreement and may periodically review the data. However, the awardee institution will retain custody and primary rights to the data developed under these awards, and timely publication of major findings by the awardees is encouraged. Publication or oral presentation of work done under this agreement will require appropriate acknowledgement of NCI support. Arbitration Committee An arbitration panel of external consultants will be created as needed to resolve any irreconcilable differences of opinion between the NCI coordinator and the Institution(s) related to scientific/programmatic matters or implementation of a proposed operating policy. The panel will include one member selected by the Institution(s), one member selected by the NCI, and a third member chosen by the other two members of the arbitration panel. The NCI arbitration process for the cooperative agreement in no way affects the rights of awardees to appeal selected post award administrative decisions in accordance with PHS regulations at 42 CFR part 50, subpart D and HHS regulations at 45 CFR part 16. STUDY POPULATIONS SPECIAL INSTRUCTIONS TO APPLICANTS REGARDING IMPLEMENTATION OF NIH POLICIES CONCERNING INCLUSION OF FEMALES 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 females 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 females 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 females 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, together with a rationale for its choice. 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 the Research Plan, 1-4, AND summarized in Section 5, Human Subjects. Applicants 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 females 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 females 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 females 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 June 17, 1992, a letter of intent that includes a descriptive title of the proposed research, the name and address of the Principal Investigator, the names of other key personnel, the 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, it is requested in order to provide an indication of the number and scope of applications to be reviewed. The letter of intent is to be sent to: Dr. Roy S. Wu 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 APPLICATION PROCEDURES The PHS 398 research grant application form (rev. 9/91) is to be used in applying for cooperative agreements. These forms are available at most institutional business offices; from the Office of Grants 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. The RFA label available in the PHS 398 research application form 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 must be typed on line 2a of the face page of the application form. Submit a signed, typewritten original of the application, including the Checklist, and three signed, exact photocopies, in one package to 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, send two additional copies of the application to: REFERRAL OFFICER Division of Extramural Activities National Cancer Institute Westwood Building, Room 838 5333 Westbard Avenue Bethesda, MD 20892 Applications must be received by September 16, 1992. If an application is received after that date, it will be returned to the applicant. If the application submitted in response to this RFA is substantially similar to a research grant application already submitted to the NIH for review, but has not yet been reviewed, the applicant will be asked to withdraw either the pending application or the new one. Simultaneous submission of identical applications will not be allowed, nor will essentially identical applications be reviewed by different review committees. Therefore, an application cannot be submitted in response to this RFA that is essentially identical to one that has already been 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. Special Instructions for Preparation of Cooperative Agreement Applications The general instructions, e.g., for format and budget issues, included in the PHS 398 application packet must be followed. Because the Terms of Cooperation discussed above will be included in all awards issued as a result of the RFA, it is critical that each applicant include specific plans for responding to these terms. Plans must describe how the applicant will comply with staff involvement. Travel funds for two meetings per year for two representatives from an institution (one basic researcher and one clinician, one of whom must be the PI) must be included in the budget. This budget item will be negotiable. REVIEW CONSIDERATIONS A. Review Procedure Upon receipt, applications will be reviewed by the Division of Research Grants (DRG) for completeness. Incomplete applications will be returned to the applicant without further consideration. Evaluation for responsiveness to the program requirements and criteria stated in the RFA is an NCI program staff function. Applications that are judged non-responsive will be returned to the applicant by the NCI. An application judged to be non-responsive to this RFA may be submitted as an investigator-initiated research grant (R01) or program project grant (P01). The application would require modification in accordance with either the R01 or P01 guidelines. The revised application would not be considered an application for a cooperative agreement nor would it be considered a response to an RFA. Questions concerning the responsiveness of proposed research to the RFA are to be directed to program staff (see INQUIRIES). If the number of applications submitted is large compared to the number of awards to be made, the NCI may conduct a preliminary scientific peer review (triage) to eliminate those that are clearly not competitive. The NCI will remove from competition those applications judged to be noncompetitive for award and notify the applicant and institutional business official. Those applications judged to be both responsive and competitive will be further evaluated according to the review criteria stated below for scientific and technical merit by an appropriate peer review group convened by the Division of Extramural Activities, NCI. The second level of review will be by the National Cancer Advisory Board. B. Review Criteria The factors considered in evaluating the scientific merit of each application will be: o scientific, technical, or medical significance and originality of proposed research; o appropriateness and adequacy of the experimental approach and methodology proposed to carry out the research; o demonstrated expertise in both the appropriate basic and clinical sciences particularly relating to the responsibilities of the PI and key personnel; o adequacy of plans for effective collaboration among laboratory, clinical, and statistical investigators; o demonstration of availability of and access to appropriate patients receiving defined treatments on phase III clinical trials and/or to human tissue with the associated pathological data and clinical follow-up; o adequacy of the available facilities and data management resources. Evidence of the competence of the Central Operations Office and Statistical Center with regard to the mechanisms for quality control, study monitoring, data management and reporting, and data analysis; o plans for effective interaction and coordination among cooperating institutions within the applicant institution, with other institutions working on the same hematological malignancy, and with the NCI; o adequacy of provisions for the protection of human subjects; o adequacy of the plans for inclusion of females and minorities. The reviewers will also judge the appropriateness of the proposed budget and duration in relation to the proposed research. AWARD CRITERIA The anticipated date of award is August 1, 1993. In addition to the technical merit of the application, the NCI will consider how well the applicant institution met the goals and objectives of the program as described in the RFA, availability of resources, and study populations. INQUIRIES Written and telephone inquires concerning the objectives and scope of this RFA and inquires about whether or not specific proposed research would be responsive are encouraged and must be directed to Dr. Roy S. Wu or Dr. Sheila Taube at the addresses below. The NCI Program Directors welcome the opportunity to clarify any issues or questions from potential applicants. For technical information: Dr. Roy S. Wu NCI 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 Dr. Sheila E. Taube Chief, Cancer Diagnosis Branch Division of Cancer Biology, Diagnosis and Centers National Cancer Institute Executive Plaza South, Room 638 Bethesda, MD 20892 Telephone: (301) 496-1591 FAX: (301) 402-1037 For business information: Ms. Mable Lam Grants Management Specialist National Cancer Institute Executive Plaza South, Room 242 Bethesda, MD 20892 Telephone: (301) 496-7800, ext. 48 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 the authorization of the Public Health Service Act, Title IV Sections 301, 410, and 411, Part A (Public Law 78-410, 42 USC 241 as amended, Public Law 99-158, 42 USC 285a) and administered under PHS grants policies and Federal Regulations at 42 CFR Part 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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