The number of National Cancer Institute (NCI)-designated cancer centers has grown to 70 across the country since the National Cancer Act of 1971 was signed into law authorizing the NCI director to create the Cancer Centers Program. Each cancer center that has achieved this level of distinction has followed a prescribed pathway since the program’s inception – the development, submission, and review of a Cancer Center Support Grant (CCSG). It is important to understand the main objective of a CCSG is not to directly support research projects like a typical R01, but to strengthen, enhance and increase ongoing cancer research with the ultimate goal of reducing cancer incidence, mortality and morbidity.

We are currently on track to accomplish something never achieved at UF before – the submission of a competitive application for consideration of NCI-designation for the University of Florida Health Cancer Center. The CCSG being written will provide the resources and infrastructure to facilitate the coordination of UF Health Cancer Center’s three interdisciplinary research programs from basic laboratory research to clinical investigations including therapeutic clinical trials to population sciences that look into the questions of how to reduce the risk, incidence and death from cancer, as well as enhance the quality of life for cancer survivors within our catchment area.

No one individual can write a CCSG – it is an epitome of team sports. Our grant being written will be around 1,200 pages, containing close to 500,000 words comprised of 14 distinct components overall. It will include six essential characteristics – administration, three shared resources, three research programs, community outreach and engagement, cancer research and career development, leadership, planning and evaluation, developmental funds, clinical protocol and data management, and protocol review and monitoring.

Twenty-one senior research members lead the authorship of the sections. Ten administrative staff members and four consultants are charged with distinct responsibilities to bring the elements together into a cohesive and consistently formatted document with overarching themes woven throughout in a single voice. They will also provide the critical data elements for the grant’s backbone and structure and vital feedback necessary to keep the process moving and on track to meet all milestones and deadlines.

Recently, our External Advisory Board conducted extensive reviews of the entire grant. Part of their assignment was to treat it as they would on a real review. They scored the sections critically and assigned a merit descriptor. The National Institutes of Health (NIH) uses a 9-point scale (multiplied by 10) for review criteria.  A 10-19 is an exceptional application; 20-29 is an outstanding application; 30-39 is an excellent application; 40-49 a very good one; 50-59 is only a good application; and, so forth. All of our narratives received at least an excellent from our EAB putting us in a favorable range to be funded.

The entire activity takes more than a year of writing and revising each component to reach the final version ready for submission to NCI.  But the fun does not stop with the submission of the application.  In order to receive designation from NCI, a rigorous review process and site visit must occur to assess our level of scientific excellence and our ability to meet the six essential characteristics of an NCI-designated cancer center. The reviewers evaluate the characteristics while determining scientific and technical merit of the application, and in providing an overall impact score of the center. A discussion of what the Site Visit entails will be provided in the next issue.