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A ROADMAP

FOR RESEARCH
We gratefully acknowledge the support of the following
organizations, the Members and Friends of the Canadian
Breast Cancer Research Alliance, in the development of the
National Breast Cancer Research Framework:

Canadian Institutes of Health Research


Health Canada
Public Health Agency of Canada

The following individuals contributed to the development


of the National Framework:
Dr. Phil Branton, Dr. Heather Bryant, Dr. Mario Chevrette,
Dr. Elizabeth Eisenhauer, Diana Ermel, Dr. Margaret Fitch,
Dr. Christine Friedenreich, Dr. Karen Gelmon, Dr. Eva Grunfeld,
Dr. Tom Hack, Dr. Claire Holloway, Dr. Tom Hudson,
Heidi Liepold, Dr. Victor Ling, Dr. Sylvie Mader, Dr. Ivo Olivotto,
Dr. Morag Park, Dr. Michael Pollak, Dr. Cathy Popadiuk,
Dr. Moira Stilwell, Dr. Jim Woodgett, Dr. Martin Yaffe.

Printed on Rolland Opaque50 containing 50% post-consumer fibre, certified EcoLogo


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THE NATIONAL BREAST
CANCER RESEARCH FRAMEWORK
A Roadmap for Research
As the most frequently diagnosed type of cancer among Canadian women,
breast cancer has received an increasingly large proportion of attention over
the last two decades. There is certainly more awareness, as well as vast
improvements in screening and treatment, but there is also consensus that
more research is required to successfully manage this complex disease.
To maximize Canada’s contribution to breast cancer research, now and in
the future, there is a need for more effective use of resources, increased
collaboration and agreement on a set of national research priorities.
To address this need, the Canadian Breast Cancer Research Alliance
established a broad-based consultation process to develop a strategic
framework for the funding of breast cancer research in Canada.
The National Framework for Breast Cancer Research is a Roadmap for
Research. It identifies research priorities, encourages collaboration among
funders and articulates a call to action aimed at all members of the Canadian
breast cancer community.

A NEW PARADIGM IN RESEARCH PRIORITIZATION


The National Framework is unique in its focus on research and its call for
collaboration among funders. Most significantly, this Framework:
• Defines strategic research priorities, covers all aspects of the breast
cancer research system and includes areas that could be relevant to
other cancer sites;
• Establishes a streamlined approach for achieving and measuring high
levels of scientific rigour and research impact;
• Is forward looking and acknowledges the importance of both short-term
and longer-term initiatives.

FOCAL POINTS FOR HIGH-IMPACT RESEARCH


Research priorities were selected through a rigorous, consultative process
to ensure agreement that each of these research advances would benefit
Canadians and improve Canada’s global competitiveness in cancer research.
The six research themes identified in the National Framework are:
• Mechanisms of Cancer Development
• Molecular Detection and Prediction
• Personalized Medicine
• Cancer Progression and Dissemination
• Psychosocial, Survivorship and Health Services
• Transferring Knowledge into Practice
The 17 high-impact research priorities are:

CSO
1
CATEGORY RESEARCH PRIORITY

Biology 1. Genetics – The genetic and epigenetic


basis of breast cancer development

2. Initiation – Deciphering the molecular pathways


implicated in breast cancer initiation

3. Metastasis – Understanding the cause of


metastatic breast cancer and identifying
new avenues for interventions

Etiology 4. Breast Cancer Risk – The influence of lifestyle and


environmental factors on the risk of developing
breast cancer

5. Breast Cancer Causes I – The genetics


and hormonal causes of breast cancer

6. Breast Cancer Causes II – Understanding the


interplay of multi-causal factors: genetics and
environmental

Prevention 7. Prevention (Interventions) – Interventions to study


the influence of lifestyle and environmental factors
on the risk of developing breast cancer

Early Detection, 8. Detection – Better approaches to early


detection and diagnosis
Diagnosis and
Prognosis 9. Biomarkers I – Development and evaluation
of new biomarkers (including biomarkers for
diagnosis) and the optimization of treatments
for individual patients

10. Biomarkers II – Clinical setting/clinical trials


to assess clinical sensitivity and specificity of
new biomarkers
CSO
CATEGORY RESEARCH PRIORITY

Treatment 11. New Treatments – Discovery and development


of new treatments for breast cancer

12. Clinical Trials – Clinical trials of new


promising therapies

Cancer Control, 13. Survivorship and Quality of Life Interventions


– Psychosocial and survivorship interventions
Survivorship and
Outcomes 14. Health-care Issues – Analysis of the financial
and health-care delivery issues facing breast
Research cancer patients (across the cancer continuum)

15. Knowledge Translation and Best Practices –


Interventions to improve knowledge translation
and disseminate best practices in breast cancer
across the cancer continuum

16. Link with Clinical Data – Developing


mechanisms to link clinical trial data with
administrative health databases for studies
on long-term outcomes and late effects

Scientific Model 17. Animal Models – Developing new animal


and cellular models to study response to
Systems therapeutics and mimic human breast
cancer development

1
The priorities have been organized using the Common Scientific Outline,
a system used by most national and international research granting agencies
to classify and categorize research.
REALIGNING EXISTING AND NEW FUNDING
In 2007, at least $46.8M was spent on breast cancer research in Canada,
with most of the investment being made in the form of investigator-initiated
operating grants, also known as discovery research. Although this type of
funding mechanism has historically received the major share of research
funding, there appears to be a general trend toward increased support for
more targeted research.

In assessing the funding needs for the National Framework’s 17 research


priorities, a continuation of balanced support for ongoing research initiatives
is endorsed. However, new thinking about research investment is also
encouraged, given that a third of the identified research priorities are not
currently funded in Canada.

Successful implementation of all aspects of the National Framework will


require additional funding for breast cancer research as well as some
additional investment in infrastructure and capacity development across
Canada’s research system.
CALL TO ACTION
All members of the breast cancer research community are invited to
become familiar with the National Framework document and to work
together to achieve the ultimate outcome: a world where no person
need fear breast cancer.
Breast cancer research funders across Canada are asked to adopt a set of
guiding principles (below) and to mobilize support for both foundational
research and the identified priorities.
Policy and practice influencers are asked to apply existing research findings
to policy and practice as they relate to breast cancer, cancer and chronic
disease, and to engage with researchers and academics to shape future
studies aligned with policy development.
Industry (e.g., pharmaceutical companies, biotechnology companies,
software developers, equipment manufacturers) is encouraged to participate
in new collaborative opportunities.
Provincial and hospital foundations are asked to allocate 10 per cent
of their funds to these national priorities.
Donors are encouraged to familiarize themselves with the National
Framework and to request that the organizations receiving their support
embrace these priorities and recommendations.

GUIDING PRINCIPLES
proposed to funders, to foster excellent high-impact research.

• Avoid duplicating research already underway when setting up local studies.


Be familiar with research results in the area of interest and leverage existing
research findings. Fund researchers to come together to help identify and define
high-leverage research questions;
• Explore possible linkages with global partners or funding collaboration with
existing global cohorts;
• Embed knowledge translation approaches within the research whenever
it makes sense;
• Integrate research and service delivery whenever possible, ensuring that the
health-care system will support the research; e.g., by having sufficient protected
clinician scientist time and salary support for administrative staff in clinical
trials groups;
• Adopt a broad perspective across research disciplines, recognizing that
multidisciplinary teams take time and require funding to learn to work
well together;
• Fund companion studies alongside clinical trials;
• Fund appropriate evaluation studies; e.g., the rapid assessment
of a new technology.
CBCRA’S COMMITMENT
CBCRA is committed to leading the implementation of the National
Framework, and to ensuring it is monitored, updated and evaluated.
As part of this commitment, CBCRA will also facilitate the development
of a network of funders aligned with the National Framework, fostering
new collaborations aimed at ensuring the most effective use of resources.

GET INVOLVED
To learn more about the National Breast Cancer Research Framework,
and to explore the full document:

  VISIT www.nationalframework.ca

To learn more about getting involved in moving the Framework forward:

  e-mail nationalframework@cbcra.ca

  CALL 416-596-6598

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