Tuesday, August 10, 2010

The state of research

So, what is going on in the neuroblastoma research world. I have not talked about it much as of late - mostly due to the sheer fact that I have been buried. However, I have secretly (or not so secretly for some) been reviewing a slew of research proposals. Over the last month I have been through about 30 neuroblastoma specific proposals. These are all research proposals for individuals attempting to receive funding. I absolutely love the privilege of reviewing scientific proposals and, to this day, there is nothing that gives me more nerdly joy than combing through neuroblastoma research.

I prefer combing through research proposals the most. From the perspective of understanding the science of neuroblastoma, these are the most fun because you are often exposed to unpublished research along with a wealth of published data that often serves as the basis for the proposals. The bottom line is that I get to see perspectives that are often not available through other means. I get to read research support and knowledge that is available no where else. I also get the answer to the question of "Why?" which is not always clear from published material. Additionally, given these opportunities, I get excellent insight into the way research is moving. I get to see the new ideas. I get to answer the question: What is on the horizon?

Now, with all of that being said, I must also say that I have never been more depressed by a set of scientific proposals that I have been as of late. This last group has been pathetic. It is not that the research has necessarily been bad. Some of it has been very good from a scientific perspective. Unfortunately, where it all seems to fail is in the "matter" category. I have never seen a group of proposals that mattered less to patients with neuroblastoma and I find that terribly distressing. Out of all of those proposals, I read one that I felt had the potential to eventually make a difference in the lives of children with neuroblastoma.


It is disappointing because I usually see much more. I usually see creative ideas that have a clear path into the clinic and a meaningful impact. This time though, for the most part, that was missing. In the cases where I did see some potential impact for children with relapsed disease, the science was so bad or the structure of the trial was so poor that I could not in good consciousness recommend it to anyone. In these cases, these were clearly drugs pushed forward in a desperate act to provide children with relapsed and refractory disease more options. Unfortunately, the science and rationale behind the proposals were incredibly weak. Hey, don't get me wrong, I want more options for kids with relapsed disease. I just want the options to be good ones - and not the ones I have seen recently. It is almost like people have gone from using strong scientific rationale which supports moving a drug into the clinic in favor of picking something at random because they want to believe really hard that something will work.

I have never seen a more disappointing crop.

Now, before anyone makes any assumptions, these musings have nothing to do with my position in the NANT, their trials, or for that matter, anything I have seen come out of COG. As long as I am mentioning major neuroblastoma groups it is also worth noting that this has nothing to with what I am seeing come out of Sloan. In my opinion, those groups, for the most part, are on track. In fact, for two of those groups in particular have some incredible hope brewing in their cauldrons.

No, what I am disappointed in is the research that eventually flows into the clinic (potentially into those groups) and sadly it was not up to par. I don't know what is happening in the research world but the last month has not brought me the joy that it usually does.

It seems to me there is a large group looking for funding that, instead, need a good dose of purpose.

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