Openness on $10M at UAMS called key

At stake, status for cancer center

The road to becoming a National Cancer Institute-designated cancer center includes “transparency” regarding the use of a roughly $10 million state annual allocation toward that goal, University of Arkansas for Medical Sciences Chancellor Cam Patterson said.

Act 580, passed this year by the state Legislature, designated the funds — set to be raised largely through tobacco and e-cigarette taxes — to support the health sciences hub and medical school’s cancer center drive. The money is allocated for the coming fiscal year.

While specific uses for the money are “not very granular at this point,” Patterson said recently that being forthcoming about how the funds will be spent is a priority as UAMS ramps up its push to become the state’s first National Cancer Institute-designated cancer center.

“[For] someone whose tax dollars [are] potentially going towards this, can you explain to them the benefit that they are getting?” Patterson said. “We want to make sure, with each investment, that we can tell a story like that.”

He said he plans to report to the state Legislature annually about the plans for and impact of the allocation, adding that such reporting was helpful when he worked in previous po

sitions.

Candor has a heightened importance for UAMS because of its financial difficulties over the past few years.

Those difficulties included an anticipated budget deficit that contributed to layoffs in early 2018 and an incident in which an internal audit revealed the misuse of restricted funds at the Myeloma Center, one of UAMS’ star programs.

“While a lack of transparency may not have gotten us into some of our financial challenges, it made it more difficult to get out of the challenges that had developed,” Patterson said.

It’s unlikely that those past problems will affect an anticipated bid for National Cancer Institute status, because a review of such issues isn’t part of the assessment process, a spokesman for that agency said.

National Cancer Institute-designated centers are institutions that have successfully competed for a cancer center support grant. The program doled out more than $300 million in fiscal 2018, according to agency websites.

A successful application would add UAMS to a list of 70 such centers in the U.S.

For designees, the program tends to have a snowball effect in terms of resources, Patterson said, because there is additional funding that only National Cancer Institute centers are eligible to apply for.

The status also matters because some treatments and clinical trials are available only to patients at National Cancer Institute-designated centers.

Patterson said state legislative support is expected to be “transformative” in UAMS’ effort and demonstrates a commitment to National Cancer Institute evaluators.

He said legislators took into account their own experiences with cancer among family members and friends, information distributed by UAMS about the impact of cancer on their legislative districts, and explanations of what National Cancer Institute status could mean for cancer patients in the state.

That includes black men in the Delta who are disproportionately affected by colorectal and prostate cancers, and women in the state’s south, who are showing higher rates of breast cancer.

“Nobody’s going to come here from Washington, D.C., or New York [City] to solve those problems for us,” he said.

It’s not clear exactly how much UAMS will receive because of the type of tax-based funding involved, but Patterson said he’d received a “backstop” commitment from Gov. Asa Hutchinson for at least $10 million.

In a statement, Hutchinson called National Cancer Institute status “important for UAMS and for Arkansans.”

“An NCI designation will give UAMS the opportunity to apply for more grants and to generate more funding for cancer research. In turn, more Arkansans will be able to stay in state for the critical care they need,” he said.

UAMS officials have projected that it will take four to seven years to prepare an application in order to apply for designation through the National Cancer Institute, but Patterson said he wants to push toward the shorter end of that timeline.

Work toward the status is expected to include such things as potential partnerships with other UA campuses and state departments, hiring as many as 20 scientific study investigators already receiving funding through the National Cancer Institute, and completing the hiring process for the new director of the Winthrop P. Rockefeller Cancer Institute.

That hire, which Patterson had hoped to announce in April, has been delayed by the schedules of candidates, and the process could extend for another few weeks, he said.

PATIENT IMPACT

Having a National Cancer Institute-designated center in the area would allow Arkansas cancer patients to stay closer to home for specialized treatment.

“We intend to sell to the [National Cancer Institute] that we are getting [the agency] access to the entire state,” Patterson said.

“If you have unresponsive breast cancer, and you live in Arkansas, you fall into one of two buckets right now.

“You are someone who has the resources to travel to a place like MD Anderson [Cancer Center] to get experimental therapy, or you fall into the bucket where you can’t afford that — and you just don’t get the best treatment.”

The cancer centers program was established in 1971 under the National Cancer Act, which was signed by President Richard Nixon. Grantees must report data and research to the National Cancer Institute every year.

Cancer patients living in rural areas — such as much of Arkansas — struggle with transportation, limited access to specialists and overall poorer outcomes, said Dr. Monica Bertagnolli, president of the American Society of Clinical Oncology.

Because of those barriers in receiving care, the benefit of having high-quality treatment centers in the region can be significant.

Bertagnolli pointed to outreach in Appalachia conducted by The Ohio State University Comprehensive Cancer Center — Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, a National Cancer Institute-designated comprehensive cancer center.

“There are people who simply can’t afford to travel for great distances to receive specialty care, and oncology is very much specialty care,” she said.

She called the news of UAMS’ work toward a National Cancer Institute application “fantastic.”

It’s not clear how many organizations are putting together similar applications. The American Association of Cancer Institutes doesn’t formally track how many organizations have expressed interest in competing for the grants, according to a spokesman.

But the process, Dr. Roy Jensen said, tends to require the full support of an organization’s leadership.

Jensen is director of the University of Kansas Cancer Center and led its bid to become a National Cancer Institute designee.

From start to finish, it took about eight years to put together the materials so it could apply, but the status has been “a huge boon to the research efforts here,” Jensen said.

The medical center has “tremendously grown” its research portfolio, seen growth in its clinical program and is now seeing about 6,500 patients a year throughout the system, more than double what it served previously.

Jensen said a $5 million line item in the state budget approved by legislators in 2007 was really “the juice” that allowed for a successful grant application.

“You just can’t [have] everybody stand together and say, yes, we’re going to do this. You actually have to have resources to make it happen,” he said. “Nothing happens without those resources.”

Jensen also is board president for American Association of Cancer Institutes and serves on a committee that evaluates National Cancer Institute grants.

He said his best advice for aspiring National Cancer Institute centers is to invest in recruiting, which he called ultimately more important than facilities.

“The more resources that you can devote to people, that’s the key thing,” he said.