State's cancer agency faces an un­cer­tain fu­ture

Back­ers say CPRIT is in­valu­able; oth­ers seek end of tax­payer sup­port.

Austin American-Statesman Sunday - - FRONT PAGE - By Bob Sech­ler bsech­ler@states­

As it nears the 10th an­niver­sary of its cre­ation by Texas voters, a va­ri­ety of met­rics can be used to gauge the im­pact of the state agency charged with fight­ing cancer.

For in­stance, the Cancer Preven­tion and Re­search In­sti­tute of Texas — com­monly known as CPRIT — has re­cruited 135 re­searchers to the state, helped put in mo­tion 108 clin­i­cal drug tri­als and can boast of fund­ing 29 newly minted on­col­ogy com­pa­nies.

But two num­bers are start­ing to loom par­tic­u­larly large for CPRIT: $1 bil­lion and five years.

That’s the amount of tax­payer money CPRIT has left from its orig­i­nal $3 bil­lion au­tho­riza­tion to dole out in grants for cancer re­search, preven­tion and prod­uct devel­op­ment in the state — and how much longer it has to do it. CPRIT hit the two-thirds mark in its spend­ing last month.

The fate of CPRIT, widely con­sid­ered the na­tion’s sec­ond-largest source of fund­ing for cancer re­search be­hind the fed­eral govern­ment, is un­clear once ei­ther its money or time runs out. Some state law­mak­ers al­ready are lay­ing ground­work to op­pose what they view as the like­li­hood of an even­tual push by CPRIT back­ers for ad­di­tional tax­payer sup­port so it can con­tinue its mis­sion.

CPRIT Chief Ex­ec­u­tive Wayne Roberts said the agency is “to­tally fo­cused on how to spend the last $1 bil­lion” and isn’t en­gaged in any such plan­ning.

“If the Leg­is­la­ture wants CPRIT to be con­tin­ued (be­yond then), they will find a way to fund it at a level they deem to be ap­pro­pri­ate,” Roberts said.

CPRIT was au­tho­rized by vot-

ers in 2007 to is­sue $3 bil­lion in tax­payer-backed bonds — in in­cre­ments of up to $300 mil­lion per year — to pay “for re­search in Texas to find the causes of and cures for cancer.” The vote came after an emo­tional cam­paign that fea­tured famed cy­clist and cancer sur­vivor Lance Arm­strong trav­el­ing across the state in a bus dubbed “Sur­vivor One” to ad­vo­cate for it.

Cures for var­i­ous forms of cancer re­main elu­sive a decade after that vote. But progress in de­vis­ing treat­ments has been made, and pro­fes­sion­als in the health sciences sec­tor say CPRIT right­fully de­serves credit for help­ing fuel the gains and for seed­ing a grow­ing bio­med­i­cal in­dus­try in Texas.

“To the com­pa­nies that get CPRIT fund­ing, it is in­cred­i­bly im­por­tant,” said Tom Luby, who heads the Texas branch of John­son & John­son’s in­cu­ba­tor pro­gram for star­tups, known as JLABS, lo­cated in the Texas Med­i­cal Cen­ter in Hous­ton. “There is a high de­gree of fail­ure (for small on­col­ogy com­pa­nies with un­proven treat­ments), so rais­ing money from tra­di­tional sources can be very chal­leng­ing.”

To date, an es­ti­mated 72 per­cent of CPRIT’s grants have gone to fund re­search, 18 per­cent have gone to early stage com­pa­nies to help get promis­ing drug re­search off the ground, and 10 per­cent have gone for cancer preven­tion pro­grams across the state. Ac­cord­ing to CPRIT, the fund­ing has trig­gered $1.37 bil­lion in fol­low-on in­vest­ing by ven­ture cap­i­tal firms, re­sulted in slightly more than 79,000 di­rect and in­di­rect Texas jobs and has gen­er­ated dozens of clin­i­cal tri­als that have en­rolled a total of 9,782 pa­tients and helped Tex­ans more eas­ily ac­cess state-ofthe-art treat­ments.

Luby, who worked in Bos­ton with John­son & John­son be­fore com­ing to Texas, also cred­its CPRIT with mak­ing the state in­ter­na­tion­ally known in health sciences cir­cles, say­ing CPRIT “put Texas on the map as a place to think about do­ing on­col­ogy drug devel­op­ment.”

Still, CPRIT’s rep­u­ta­tion hasn’t al­ways been ster­ling.

Bounc­ing back from scan­dal

A high-pro­file scan­dal in­volv­ing the al­leged mis­han­dling of $56 mil­lion in grants en­gulfed the agency in 2012. CPRIT’s top three ex­ec­u­tives at the time re­signed, and one was in­dicted — although he even­tu­ally was ac­quit­ted after con­tend­ing he had been made a scape­goat amid the en­su­ing po­lit­i­cal storm.

State law­mak­ers nearly shut­tered CPRIT in the wake of the scan­dal, pro­hibit­ing it from is­su­ing grants through much of 2013. The mora­to­rium was lifted after CPRIT’s man­age­ment struc­ture was over­hauled to in­clude more rig­or­ous over­sight.

Roberts, who was brought on board to help sta­bi­lize CPRIT shortly after the scan­dal broke and has steered it since then, said the agency has moved past it and has be­come known for “rig­or­ous peer re­view” and an “in­sis­tence upon main­tain­ing the in­tegrity of our pro­cesses.”

State law­mak­ers ap­pear to agree. They voted dur­ing the reg­u­lar leg­isla­tive ses­sion this year for a bill that, among other things, pro­longed CPRIT’s man­date an ex­tra two years by push­ing its so-called “sun­set” date — a term for the top-to-bot­tom re­view that state agen­cies pe­ri­od­i­cally un­dergo to de­ter­mine whether they should con­tinue to ex­ist — out to 2023, from 2021. CPRIT can’t is­sue grants in the fi­nal year be­fore its sun­set date.

The move to pro­long the life of CPRIT un­der its ex­ist­ing fund­ing au­tho­riza­tion won broad sup­port as some­thing of a feel-good vote that en­abled law­mak­ers to demon­strate sup­port for the fight against cancer. But an­other pro­posal, spon­sored by state Sen. Charles Sch­w­ert­ner, R-Ge­orge­town, came close to win­ning ap­proval as well, and it sig­naled that some might not be in­clined to give the agency an­other ex­ten­sion if it’s ac­com­pa­nied by a request for more tax­payer money.

Sch­w­ert­ner’s bill, which won ap­proval in the Se­nate but failed to make it onto the House floor, would have re­quired CPRIT to de­velop a plan to be­come self-suf­fi­cient once its ex­ist­ing tax­payer money runs out.

“I don’t think any­one can ar­gue against or op­pose the goal of cur­ing cancer,” Sch­w­ert­ner said. But “whether (pay­ing for re­search into it) is an es­sen­tial func­tion of state govern­ment, I think is a le­git­i­mate ques­tion to raise at this time.”

Sch­w­ert­ner, who chairs the Se­nate’s Health and Hu­man Ser­vices Com­mit­tee, said he ex­pects CPRIT sup­port­ers will even­tu­ally push for more state money to ex­tend the agency be­yond its new sun­set date, although there haven’t been any for­mal pro­pos­als to do so yet. He said he op­poses such a move.

“It doesn’t rise to a con­sti­tu­tional re­spon­si­bil­ity (of the state’s), and it cer­tainly doesn’t rise to the high­est pri­or­ity, in my opin­ion,” he said, given nu­mer­ous other de­mands on the state bud­get.

‘Ex­actly what they bar­gained for’

Sch­w­ert­ner’s pre­dic­tion that an ef­fort even­tu­ally will be made to pro­vide CPRIT with ad­di­tional tax­payer money ap­pears well­founded.

State Sen. Jane Nelson, who chairs the pow­er­ful Se­nate Fi­nance Com­mit­tee, voted in fa­vor of his bill this year but has been a long­time ad­vo­cate for state fund­ing to fight cancer, and she re­cently told the American-States­man that she “would cer­tainly sup­port al­lo­cat­ing re­sources to help pre­vent and erad­i­cate” it given “the hu­man and fi­nan­cial toll this dis­ease takes.” She added that the po­ten­tial amount is un­cer­tain and will be de­pen­dent on many fac­tors.

“We hoped — but never as­sumed — that roy­al­ties and other in­come would be avail­able to help sus­tain the in­sti­tute,” said Nelson, R-Flower Mound, who played a ma­jor role in cre­at­ing CPRIT.

Un­der Sch­w­ert­ner’s bill, CPRIT would have been re­quired to de­vise a plan by Dec. 1 next year “to be­come fi­nan­cially self-suf­fi­cient and to con­tinue op­er­a­tions with­out state funds other than patent roy­al­ties and li­cense rev­enues” from the re­search and com­pa­nies it pre­vi­ously has funded once its ex­ist­ing money runs out.

Roberts, how­ever, said CPRIT wasn’t set up to do that.

“If the Leg­is­la­ture had in­structed us to de­sign a self-suf­fi­ciency port­fo­lio back in 2007, the ra­tio (among CPRIT’s cat­e­gories of grants) would be com­pletely flipped,” he said. “In fact, there prob­a­bly would be no grants for preven­tion and ba­sic re­search,” and all the money would go for prod­uct devel­op­ment in later-stage com­pa­nies with a higher like­li­hood of pay­ing off fi­nan­cially.

The agency’s grants for re­search and prod­uct devel­op­ment con­tain roy­alty com­po­nents for the state, but it has re­ceived a total of only about $3.2 mil­lion in such pay­ments so far. The fig­ure should grow sig­nif­i­cantly in com­ing years, Roberts said, but the amount is un­cer­tain and could be far in the fu­ture.

He said his goal in the time re­main­ing be­fore CPRIT’s new sun­set date ar­rives “is to make sure that we are wor­thy of a dis­cus­sion (that the agency) be con­tin­ued” long term.

“I think we are do­ing ex­actly what the cit­i­zens of Texas in­tended” when they voted to fund CPRIT a decade ago, Roberts said. “At the end of the day, when we do ride off into the sun­set, the Leg­is­la­ture and the cit­i­zens of Texas will say they got ex­actly what they bar­gained for.”

If CPRIT even­tu­ally is abol­ished, how­ever, ex­ec­u­tives in the health sciences sec­tor say the void will be felt.

“From our point of view, (CPRIT) has been tremen­dously im­por­tant,” said Ken Mose­ley, se­nior vice pres­i­dent at Bel­licum Phar­ma­ceu­ti­cals in Hous­ton, which re­ceived $5.7 mil­lion from CPRIT in 2011 and about $17 mil­lion last year. Bel­licum, which has gone from a hand­ful of em­ploy­ees in 2011 to more than 120, is de­vel­op­ing cel­lu­lar im­munother­a­pies for hema­to­log­i­cal can­cers and solid tu­mors, as well other dis­eases.

With­out CPRIT, Mose­ley said, “I hon­estly don’t know where the money would have come from (in 2011) to de­velop our drug and start the clin­i­cal tri­als in so many sites.”

State law­mak­ers nearly shut­tered CPRIT in the wake of the scan­dal, pro­hibit­ing it from is­su­ing grants through much of 2013.


CPRIT was au­tho­rized by voters in 2007 after an emo­tional cam­paign that fea­tured famed cy­clist and cancer sur­vivor Lance Arm­strong as an ad­vo­cate.

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