Texas voters approve second life for state cancer funding agency

*Update, 6 November, 12:30 p.m.: On 5 November, Texas voters approved (64% to 36%) a ballot measure to extend the life of its pioneering state cancer research funding agency, CPRIT, by doubling, to $6 billion, the amount of bonds that can be issued to support the agency. Below is our 17 October story on the history of the agency and views on whether it has been successful.

Seven years ago, when Francesca Cole was ending her postdoc at Memorial Sloan Kettering Cancer Center in New York City, she got a Texas-size offer: a $3 million startup package to join the University of Texas's (UT's) MD Anderson Cancer Center in Houston. Most of that sum came from the $3 billion Cancer Prevention & Research Institute of Texas (CPRIT) in Austin, an unusual state initiative that voters approved in 2007.

On 5 November, Texas residents will decide whether to sustain CPRIT, the second largest public source of cancer funding in the United States after the federal government. At stake is its generous support for 123 tenure-track faculty like Cole, who investigates cancer and DNA repair. Most scientists use fruit flies or zebra fish, but she could afford to build a large team that probes DNA repair using more sophisticated—and expensive—animal models: 25 different genetically modified mice strains. "The CPRIT investment made a huge difference to my research success," says Cole, who has since won a prestigious New Innovator Award from the National Institutes of Health.

Texas residents appear likely to approve the ballot initiative, which would give CPRIT another $3 billion through bond sales; a recent poll found that two-thirds of voters support it. Yet some dissent remains from fiscal conservatives. State Senator Charles Schwertner (R) told the Austin American-Statesman in January that although CPRIT's goals are "unquestionably noble," funding cancer research is not a role for state government. He introduced a bill to have CPRIT become a self-sufficient agency, but it failed to advance.

Still, CPRIT and its supporters aren't letting up on their message that the agency has been a boon for Texas's research efforts and the state's economy. "The investment CPRIT has made has accelerated cancer research and the development of the cancer ecosystem in Texas beyond our expectations," says the agency's chief scientific officer, James Willson. Geneticist Richard Kolodner of the University of California, San Diego, who chairs CPRIT's external scientific review council, says the initiative will yield an even bigger payoff in the future. "Ten years is a short period of time for a scientific program."

California's $3 billion stem cell agency was CPRIT's original inspiration, although California was responding to federal restrictions on stem cell studies, whereas Texas wanted to bolster the state's research efforts and its biotech industry. After a smooth first few years, a scandal broke out in 2012 over a $18 million incubator award to MD Anderson that had not undergone scientific peer review. That, along with concerns that politics was skewing grant decisions, prompted CPRIT's chief scientific officer, Nobel laureate and biochemist Alfred Gilman, to resign in protest, along with most of its scientific council and many grant reviewers. After more problems led to a 10-month hold on new grants and a governance overhaul, the agency got back on track.

CPRIT has awarded more than $2.4 billion for 1447 awards split among clinical and translational research, recruitment, basic research, training, and prevention. It has supported shared resources such as bioinformatics facilities and advanced microscopes. The agency touts its practical impact, saying 36 cancer companies have used its money to launch, grow, or move to the state. They, in turn, have raised more than $3 billion from investors. A recent analysis commissioned by CPRIT concluded that the money it pumps into the economy generates $1.4 billion in annual economic activity and supports 10,000 jobs. And one "immediate" result of CPRIT's $250 million in prevention grants has been cancer screening and other services for 320,000 Texans a year, Willson says.

Kolodner highlights CPRIT's support for recruiting 181 researchers as "the gift that keeps on giving." They include heavyweights such as MD Anderson's Jim Allison, who won a Nobel Prize last year for his work on immunotherapies, and stem cell researcher Sean Morrison of UT's Southwestern Medical Center in Dallas. But one large investment had a shorter run than several CPRIT watchers say they expected. Mouse geneticists Neal Copeland and Nancy Jenkins, recruited in 2011 from Singapore to the Methodist Hospital Research Institute in Houston with a 5-year, $29 million joint package—half from CPRIT—retired after that money ran out. CPRIT, however, says the pair fulfilled their obligations, still serve as mentors and collaborate with labs, and were “a tremendous gain for cancer research in Texas.” In 2014, the agency capped its share of such awards to $6 million in order to recruit more scientists.

State of cancer funding Texas's cancer funding agency has handed out most of its initial $3 billion, boosting prevention services, academic research, and product development. Clinical research Recruitment Translational research Basic research Prevention Research training Research training $540.6 million $308.9 million $250 million $59.9 million $670.7 million $575.2 million 1447 awards $2.41 billion

CPRIT says its recruits have drawn additional grant money from other sources. Yet Texas's National Cancer Institute funding, which totaled $249 million in 2018, has risen only 16% since 2008, below NCI's overall budget growth of 23% over the same decade. Willson counters that since CPRIT's inception, NCI has tabbed two Texas sites as new Comprehensive Cancer Centers, which "catalyze something much greater than sum of the parts." (MD Anderson was already a center.) Willson adds that many early-career CPRIT scholars are just now getting their first NCI grants, and he says funding from private research foundations has ballooned.

CPRIT may still be an experiment, but Texas voters will almost certainly give it a chance to continue. That stands in contrast to California, where efforts to renew the California Institute for Regenerative Medicine face an uphill battle. Kolodner says, "I think sadly people probably relate to cancer much more than stem cells."

*Update, 18 October, 5:30 p.m.: This story has been updated to change the description of a large investment as a “misfire,” to correct when CPRIT recruitment’s cap started, and to include CPRIT’s comment on Neal Copeland’s and Nancy Jenkins’s contributions.