The Need for CURE

The Need for CURE

Research-sustaining tobacco settlement funds could disappear forever without your help

Just over 10 years ago, in a moment of poetic justice, Pennsylvania passed legislation to establish CURE, the Commonwealth Universal Research Enhancement program, using money from the landmark $200 billion Tobacco Master Settlement Agreement. This innovative program directed tobacco settlement funds to colleges, universities, hospitals, and research institutions across the Commonwealth for research on cancer and many of the other diseases linked to tobacco use.

Thirty percent of CURE funding goes to competitive research grants, submitted by researchers to fund individual projects, while 70 percent goes to so-called formula grants, based on how much an institution receives in research funding from the National Institutes of Health.

Over the last decade, Wistar has been one of 39 formula grant recipients across the Commonwealth, receiving about $1.5 million each year, on average, to support pilot research projects. It has also been awarded a number of competitive grants, such as the $4.2 million grant to Hildegund C.J. Ertl, M.D., Wistar professor and the director of The Wistar Vaccine Center, to develop a “universal” vaccine to the influenza A virus that will protect against multiple strains of the constantly mutating virus and, thus, would replace the annual influenza vaccine.

Unfortunately, in his budget for fiscal year 2013, Governor Tom Corbett proposes defunding the CURE program, diverting almost $60 million in tobacco settlement funds into the general budget for other purposes.
For Wistar and many other organizations, this decision threatens research jobs and the loss of scientific experiments in which millions of dollars have already been invested. Wistar and its colleagues in the Pennsylvania Cancer Alliance (PCA), an organization that represents the Commonwealth’s leading cancer centers, are trying to rally support to see thatthis does not happen.

“Research is a costly endeavor, requiring consistent public support,” said Elizabeth O’Brien, Esq., Wistar’s Vice President for Legal and External Affairs and the organizer of PCA’s campaign to save CURE. “However, our hope is that this public investment in research will lead to new treatments that reduce the immense financial burden of caring for the long-term sick. No matter how well-intended the Governor’s budget proposal is, it reneges on a pledge made to the Commonwealth’s citizens to invest a portion of the tobacco settlement funds in preventing and curing disease.”

According to O’Brien, even if CURE is suspended for just this budget cycle, the effects would be catastrophic for biomedical research across the state. “Imagine setting a book down mid-chapter and picking it up again a year later. Most of us would have to re-read the portions already read,” O’Brien said. “If the CURE program is de-funded, we will have to terminate research projects and lay off some staff. And once discontinued, these projects cannot be easily restarted if funding is eventually restored.”  

CURE to early detection of lung cancer

Louise C. Showe, Ph.D.Wistar scientists know first-hand how CURE funds can make a difference to their research. This March, Wistar’s Louise C. Showe, Ph.D., was the lead recipient of a competitive CURE grant designed to change the way we detect and treat lung cancer.

Lung cancer remains the primary cause of cancer-related death, in part, because there is currently no efficient way to screen people for lung cancer at an early stage. In recent studies, Showe demonstrated the possibility of detecting early stage non-small cell lung cancer (NSCLC) by taking a snapshot of gene activity in blood-borne immune cells.

In biomedicine, to take a potentially useful blood test and turn it into a powerful diagnostic tool takes data. To get data, however, you need funding. Now, with a two–year, $1 million CURE grant, Wistar has the support it needs to create the first practical blood test for lung cancer.

With this funding, Wistar researchers will be able to analyze blood samples taken from lung cancer patient volunteers recruited through its partners on the grant at the Helen F. Graham Cancer Center at the Christiana Care Health System and Temple University Health System. The Helen F. Graham Cancer Center, which sees 94 percent of cancer patients in the state of Delaware, has already recruited 400 patients toward this end. The aim of their research is to further validate the blood test and create a simplified means of collecting and analyzing blood samples in order to devise a commercially viable test. 

“It has become clear to us that we are on the correct path, and we are working to further validate and expand our findings by studying more patient samples so that we have enough evidence to take this concept into clinical trials,” said Showe, a professor in Wistar’s Molecular and Cellular Oncogenesis Program and director of Wistar’s genomics facility. “With a simple blood draw, we can detect lung cancer, show the effectiveness of cancer surgery, by sampling the same patient’s blood for analysis after surgery and hopefully even determine if the cancer may return.”

“This funding will enable us to take that next step and turn biomedical discovery into medical reality,” Showe said.

In a 2009 study, Showe and her colleagues first demonstrated the correlation between the presence of NSCLC and gene expression patterns — changes in gene activity — within peripheral mononuclear blood cells (PBCs), white blood cells like leukocytes and lymphocytes important for an immune response.

In 2011, the researchers further showed that such gene expression patterns change after a tumor is successfully removed by surgery and in many cases could return to normal. They also found a panel of genes that could distinguish between malignant tumors and non-cancerous lung nodules, suggesting that such a blood test could also guide treatment decisions and help prevent unnecessary surgeries.

This project began with a $3.4 million competitive CURE grant in 2003 to Wistar Professor David Speicher, Ph.D., who received funds to, in collaboration with Showe, begin screening blood for proteins and genes that might indicate lung cancer.

“Genomics technology, the ability to detect and determine gene activity, has dramatically improved in just the last decade, and so have the costs associated with scanning for gene activity,” Showe said. “However, there is little doubt that we could not go on without this CURE grant.”

Research Today for a Healthier Tomorrow

The efforts of the Showe laboratory and their colleagues highlight yet another way CURE benefits Pennsylvanians. Biomedical research is an inherently hopeful process, one that makes the wise assumption that hard work now will yield benefits in the future. Showe’s work may likely lead to a commercially-viable blood test for lung cancer. And indeed, this groundbreaking genomics-based technology may lead to blood tests for a host of other diseases.

“Pennsylvania’s investment in Dr. Showe’s work could save tens of thousands of lives otherwise lost to lung cancer and millions of dollars in medical expenses,” O’Brien said. “It seems shortsighted to end a program that can generate such useful healthcare solutions.”

Indeed, in the proposal to defund the CURE program, the Governor suggests applying the funds to long-term care. However, a brief look at health statistics in the Commonwealth provides compelling reasons to leave the program as is. One in three Pennsylvanians will be stricken with cancer in his or her lifetime; and, the Commonwealth’s proportional share of elderly and obese residents is among the highest in the nation. Age and obesity are both risk factors for cancer and a host of other diseases. 

Currently, through the CURE program, the Commonwealth is taking appropriate steps to address the growing disease-related needs of the state’s population for the foreseeable future. Research efforts across the state have already furthered our ability to prevent and control disease (see "How Wistar Puts CURE Formula Grants to Use"), which will lead to significant healthcare savings in the long term.

An ounce of CURE, it would seem, could lead to pounds of disease prevention.

A Sound Return on Investment

Pennsylvania is, by any measure, a national leader in biomedical research. Few states can boast such a thriving, collaborative set of academic and commercial biomedical institutions. In a competitive national landscape, however, one of the most worrisome aspects of the Governor’s proposal to defund CURE is the potential loss of leadership for the Commonwealth in this all-important economic sector.

CURE funding is critical to our ability to compete with other states for federal research dollars. Eliminating CURE support will cripple our competitiveness with research institutions in other states and countries, resulting in a long-term structural drag on the Commonwealth’s economy and its ability to create jobs.

How Wistar Puts CURE Formula Grants to Use

Since 2001, Wistar has received over $17 million in CURE grants, which it has then distributed to its scientists as starter funding for nearly 50 research projects. These funds help researchers tackle projects with great potential, for example:

GENE PROMOTER DATABASE:

An endless bounty of information hides within our genomes. Wistar Associate Professor Ramana Davuluri, Ph.D., used CURE funds to help build the Mammalian Promoter Database (MPromDb), which helps researchers mine the extensive genetic data available to help find gene promoters—regions along a DNA strand that tell a cell’s transcription machinery where to start reading in order to create a particular protein. With this information, researchers can design personalized diagnostics and therapeutics, or delve deeper into the study of gene regulation than previously thought possible.

THE CARE AND MAINTENANCE OF TELOMERES:

Our chromosomes are protected by stretches of DNA called telomeres, the gradual erosion of which is partly responsible for both aging and cancer cell evolution. When Wistar Associate Professor Emmanuel Skordalakes, Ph.D., joined the Institute in 2006, he received CURE funds to learn more about how telomeres work. In 2008, he published structure of the active region of telomerase, the enzyme that helps rebuild telomeres. It is an important step if researchers are to make cancer drugs that work by blocking the enzyme.

PREDICTING WEAKNESS IN INFLUENZA:

Influenza is constantly evolving, which means we need a new vaccine each year for protection. It was once thought that influenza viruses easily accepted the mutations that allow them to evade vaccines, but the lab of Wistar Assistant Professor Scott Hensley, Ph.D., has data that suggest that influenza viruses are actually crippled by these mutations and must acquire even more mutations to be able to survive. Predicting how flu evolves will allow scientists to create more effective and longer-lasting vaccines.

A Call to Action

TIME IS RUNNING OUT FOR CURE.

As this issue of Focus goes to print, the budget is still up for debate in Harrisburg with the deadline for a final budget in June. As you are reading this, you still have time to contact your state representatives to ask them to keep CURE funded.
Please visit PCA online today to see how you can help save CURE for tomorrow:
www.pennsylvaniacanceralliance.org