Published April 4, 2018
Christopher P. Austin, director of the National Institutes of Health’s (NIH) National Center for Advancing Translational Sciences (NCATS), recognizes that translational science has a problem.
“If you tell somebody at the grocery store that you work at the NIH’s National Cancer Institute, they pretty much know what you do because everybody knows what cancer is,” he said. “When you say you work at the National Center for Advancing Translational Sciences, most people think you’re in linguistics.”
Austin was the keynote speaker at the 2018 Annual Forum of UB’s Clinical and Translational Science Institute (CTSI) held March 21 in the Jacobs School of Medicine and Biomedical Sciences.
In fact, the kind of translation NCATS supports is the translation of basic scientific discoveries in biology, genetics, data science and other rapidly expanding fields into improved treatments and better health outcomes for patients.
“In the past 35 years, science has changed so much as to be almost unrecognizable,” said Austin, “but if we’re honest with ourselves and ask if the clinical encounter and the clinical care of patients has changed in the kind of historic way science has changed, the answer has to be no.”
This translational problem, he said, is “the problem of our era in biomedical research.”
“It’s not good enough to have good intentions,” Austin said. “It’s not even good enough to do great science. Those two things are required, but we have to measure what we’re doing and measure it against patient impact or else we’re not doing our job.”
The NCATS director and members of UB’s leadership addressed an audience of more than 100 researchers, faculty members and students at the forum, which is held annually to update the Buffalo clinical and translational research community about recent accomplishments and future plans for the CTSI.
Among its many functions, NCATS administers the Clinical and Translational Science Award (CTSA) Program, which aims to advance clinical and translational research at more than 50 universities and academic health centers nationwide.
UB was awarded a four-year, $15 million CTSA Program grant in August 2015. That moment marked the culmination of a 10-year effort by the university and its clinical and research partners, including Kaleida Health and Roswell Park Comprehensive Cancer Center, to prepare the ground in Buffalo to become one of the nation’s elite CTSA Program hubs.
Michael E. Cain, vice president for health sciences and dean of the Jacobs School, said in his introductory remarks that UB’s initial planning application for a CTSA Program award received praise for having many “pillars and islands” of excellence. A concerted effort to strengthen ties between Buffalo Translational Consortium partners and the growth of the Buffalo Niagara Medical Campus, he said, “demonstrated that we were working together as a truly collaborative group.”
He credits UB President Satish K. Tripathi — first as provost while driving the UB 2020 strategic plan and later as president — with spearheading the effort to unite Buffalo’s biomedical community, choose the most effective leadership and create the infrastructure that resulted in a successful CTSA Program application.
“The investment we are making in research support tools, informatics, infrastructure, and training and education are essential to generate new discoveries and move promising findings in basic science and clinical research from the bench to the bedside,” said Tripathi in remarks delivered at the forum. “The CTSA Program award allows UB to fully leverage and build upon the substantial research strength and clinical collaborations we have developed over the years with our partners on the Buffalo Niagara Medical Campus.”
Austin spoke via video link after being detained by, of all things, a snowstorm in Washington, D.C. Three of his colleagues from NCATS managed to get out in advance of the storm, however. They met with some of Buffalo’s clinical and translational researchers, pilot studies investigators, scholars and administrative leaders, and toured the new Jacobs School and the Clinical and Translational Research Center, which is the home of the CTSI.
Michael Kurilla is director of the Division of Clinical Innovation (DCI) at NCATS, and oversees the national CTSA Program. Erica Rosemond is a program director in DCI and has served as NCATS’ liaison to UB’s CTSI from the beginning. Accompanying them to Buffalo was Samantha Jonson, special assistant to the NCATS Office of the Director.
The scientific imperative that drives NCATS and the CTSI is the well-known gap between basic scientific discoveries and the practical implementation of that knowledge in the form of improved health care. “The problem affects everybody,” said Austin. “It is our obligation to our patients, and to the taxpayers who pay us, to deliver on the promise of that science for their health and well-being.”
Those sentiments were echoed by Timothy F. Murphy, SUNY Distinguished Professor of Medicine and director of UB’s CTSI, in his annual State-of-the-CTSI address at the forum. “Everything that we do is connected with our community,” Murphy said, “and our community, the city of Buffalo in particular, is 50 percent underrepresented minority, and 30 percent live below the poverty level. We are focused particularly on including those populations so they feel the benefits of participating in clinical research.”
Among the milestones achieved by the CTSI and its research partners in the roughly two-and-a-half years since the institute was founded has been the expansion of recruitment to clinical studies, which is perhaps the single greatest obstacle to the translation of basic scientific discoveries into working treatments. Recruitment has increased from 400 patients in 2015 to 1,600 in 2017.
“Our investigators have tripled recruitment of people experiencing health disparities in this period of time,” said Murphy. He attributes the surge to several factors, including the consortium’s investment in growing clinical and translational research, a renewed focus on recruiting underserved populations and a number of high-recruitment studies that were conducted in the past year.
Murphy said investment in the CTSI’s Translational Pilot Studies Program has also contributed to the recent growth of clinical and translational research in Western New York. From 2010 to 2015, institutional funding of the program by Buffalo Translational Consortium partners generated a 13-to-1 return on investment in terms of extramural funding that resulted from the pilot study projects. The addition of CTSA Program funding and additional institutional support since then has tripled the amount of dollars awarded through the program, and a comparable return on investment is anticipated as the more recently initiated projects advance.
“The CTSA Program is in many ways a catalyst,” said Murphy, “One of the strengths of our CTSI is that our priorities and our institutional priorities align with one another, and we communicate on everything that’s related to clinical and translational research.”
Other achievements outlined in Murphy’s presentation include streamlining of regulatory systems and procedures across UB’s health disciplines; standardization and increased access to local electronic health records for study and recruitment; improved communication within UB’s health sciences schools and among clinical and research partners in the region and across the national CTSA Program network; and implementation of mentored career development opportunities for aspiring translational researchers.
“Developing a new intervention can take 15 or 20 years,” said Austin, “but even when a new intervention is developed and shown to be useful, it takes an equal amount of time for every patient who could benefit from that intervention to get it.” The answer, he said, is not to continue a scattershot trial-and-error approach, “but rather to study this as a scientific problem and figure out what the rules are to transform this from a random process to a predictive science. That’s what we’re all about.”
Also presenting at the annual forum were Heather Ochs-Balcom, associate professor in the Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, along with Veronica Meadows-Ray, community research partner and patient advocate; Margarita Dubocovich, SUNY Distinguished Professor in the Jacobs School and director of the CTSI Workforce Development core; Jason Davies, assistant professor in the departments of Neurosurgery and Biomedical Informatics in the Jacobs School and a KL2 Scholar; and Jason Muhitch, assistant professor in the departments of Urology and Immunology at Roswell Park Comprehensive Cancer Center and a Buffalo Translational Consortium Scholar.
The 2017 Clinical Research Achievement Awards were presented by Anne B. Curtis, SUNY Distinguished Professor, Charles and Mary Bauer Professor and chair of the Department of Medicine in the Jacobs School. Andrew Talal, professor in the Department of Medicine in the Jacobs School, and Robert Rychtarik, senior research scientist in UB’s Research Institute on Addictions, presented on their winning research projects.