Sushi Just Got Even Better: Gel Made from Seaweed Improves the Shelf-Life of Stem Cells

The beauty of pharmaceutical drugs is their stability. Those ibuprofen pills in your medical cabinet can sit there for weeks, months, even years but still dull a sudden headache.

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Unlike ibuprofen pills, you can’t store stem cells in your medicine cabinet (Photo: Wikimedia Commons)

Stem cell-based therapies don’t have that luxury because, well, they’re made of living cells. Outside of the body, cells are the opposite of stable. To keep them alive and active, they need to be maintained in a precise mix of liquid nutrients and in a controlled environment of 98.6F with 5% oxygen, or frozen.

Fragile: handle with care
This tight set of conditions makes the processing, storage and transport of cell therapies to doctors and their patients tricky. Studies have shown that frozen bone marrow-derived stem cells start dying within two hours after thawing. Refrigerating them instead isn’t much better. In that case, cells could be stably held for 6-8hr. These methods don’t leave much time for carrying out the logistics of cell-based treatments and leave questions about the actual dose of intact cells in each treatment batch.

Based on a new report in Stem Cells Translational Medicine, scientists at Newcastle University in the UK have identified a method for improving the shelf-life of stem cells. This finding could go a long way toward lengthening the time window that a cell therapy dose remains intact which in turn will help lower manufacturing and treatment costs.

Sushi just got even better
The team focused on stem cells found in human adipose, or fat, tissue. These human adipose stem cells (hASCs) are a good source of mesenchymal stem cells (MSCs) which are known for their anti-inflammatory and wound healing effects, among other things. The team tested the impact on cell stability when storing them in alginate, a gel-like substance found in seaweed. They ran the test over three days at various temperatures ranging from about 40F to 75F. Here’s a 60 second video showing the alginate technique:

The tests showed that when stored in alginate between 52F and 66F, greater than 70% of the cells were recovered after three days with a max recovery of 86% at 59F. That 70% number threshold looms large because it’s the Food and Drug Administration’s (FDA) minimum acceptable recovery rate for cellular products. In comparison, none of the cell batches stored without alginate reached a 70% recovery no matter which temperature was tested.

The hASCs stored in alginate not only survived well they also functioned just as well as the cells stored without alginate. When transferred back to petri dishes, they still had the capacity to divide and their ability to be specialized into fat, bone and cartilage cells remained intact.

So what exactly is the “secret sauce” behind alginate’s protective effect? A Newcastle University press release summarized the teams’ idea of how the alginate “stem gel” works:

“They believe it may be acting like a corset, preventing the stem cell from expanding and being destroyed, a process known as lysing – which would normally occur within a day when unprotected cells are stored in their liquid state.”

Stem cell Band-Aid
And because the cells survived well even at room temperature while embedded in the alginate, the team has developed an exciting application, which Che Connon, the team’s leader and professor of tissue engineering, explained in the press release:

“This has lots of advantages and applications. For example, we have used them to make a bandage which contains human stem cells which could be applied to a wound such as an ulcer or burn to speed up the healing process.”

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Stem cells stored in alginate gel are stable at room temperature enabling a stem cell bandage for improved wound healing. Photo: Newcastle University, Mike Urwin.

The big picture
Although it may not be as glamorous as finding a cell therapy cure for a deadly disease, this alginate storage technique and others like it become critical for keeping the cell therapy supply chain streamlined, quality-controlled and cost-effective – especially as more and more stem cell-based clinical trials come on line and begin reaching approval for the general population.

Students use a 3D printer to sink their teeth into stem cell research

Student winners

L-R Alan Tan, Sid Bommakanti, Daniel Chae – prize winning science students

A 3D printer, some old teeth, and some terrific science were enough to help three high school students develop a new way of growing bone and win a $30,000 prize in a national competition.

The three teamed up for the Siemens Competition in Math, Science & Technology, which bills itself as “the nation’s premier research competition for high school students”.

The trio includes two from the San Francisco Bay area, where we are based; Sid Bommakanti from Amador Valley High School in Pleasanton, and Alan Tan, from Irvington High School in Fremont. The third member of the team, Daniel Chae, goes to Thomas Jefferson High School for Science and Technology in Alexandria, Virginia.

The three used mesenchymal stem cells – which are capable of being turned into muscle, cartilage or bone – which they got from the dental pulp found in wisdom teeth that had been extracted.

In a story posted on the KQED website Tan says they thought it would be cool to take something that is normally thrown away, and recycle it:

“When we learned we could take stem cells from teeth—it’s actually part of medical waste—we realized could turn this into bone cells,”

The students used a 3D printer to create a kind of scaffold out of a substance called polylatctic acid – it’s an ingredient found in corn starch or sugar cane. The scaffold had a rough surface, something they hoped would help stimulate the dental pulp to grow on it and become bone.

That’s what happened. The students were able to show that their work produced small clusters of cells that were growing on the scaffold, cells that were capable of maturing into bone. This could be used to create dental implants to replace damaged teeth, and, according to Alan Tan, to repair other injuries:

“We used dental pulp stem cells so that we could regenerate bones in various parts of our body so for example we could fix bones in your jaw and tibia and other places.”

The beauty of this approach is that the scaffold and bone could be implanted in, say, the mouth and then as the scaffold disintegrates the new bone would be left in place.

While they didn’t take the top prize (a $100,000 scholarship) they did have to see off some serious competition from nearly 1,800 other student project submissions to win a Team scholarship award.

The students say they learned a lot working together, and encouraged other high school students who are interested in science to take part in competitions like this one.

Sid Bommakanti “Both me, Alan and our other partner are interested in medicine as a whole and we wanted to make an impact on other people’s lives.”

Alan Tan: “I would say get into science early. Don’t be afraid to put yourself out there and talk to professors, talk to people, competitions like this are beneficial because they encourage students to get out there and interact with the real world.”

CIRM is helping students like these through its Stem Cell Education Portal,  which includes the materials and resources that teachers need to teach high school students about stem cells. All the materials meet both state and federal guidelines.

 

 

A meeting of minds: breaking down communication barriers between patients and doctors

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One of the things that has always surprised me about stem cell research, or any scientific research, is that so often the people with most at stake never meet. Researchers spend most of their time in the lab trying to develop new treatments so they don’t often get to meet the people who are depending on them to save or improve their lives, the patients.

To try and change that dynamic two Canadian medical groups recently brought together a mixture of researchers, health care professionals, patients and patient advocates to find ways to improve communications between these groups. The hope was that with better communication and better information they would collectively be able to make better decisions about how to manage patient health.

Communication barriers

Lisa Willemse, a writer who has worked with CIRM on some of our projects in the past, wrote a wonderful piece about the meeting for the online magazine Medium. In it she explores some of the areas that create communication barriers between these groups and how those barriers can be overcome.

The problems caused by these barriers are not trivial. They can result in patients not knowing about potentially life-saving clinical trials in the US, or turning to unproven, experimental therapies offered at overseas clinics. (Here’s a document that addresses some of those issues)

Lisa quotes one patient as saying:

“I didn’t know what I didn’t know! I had filled out an application online was accepted to a stem cell clinic in Panama. The cost per treatment was $21,000 and I didn’t know what questions to ask!”

Finding solutions

Happily the meeting came up with some thoughtful, really positive suggestions on ways to overcome these barriers. These include:

  • Ensuring specialists and other health care practitioners are kept up-to-date with clinical trial information, since these are where they turn first for advice.
  • Providing more support for patients from health care providers. They should not be expected to have all the answers but should at least be able to advise on informed consent and provide credible resources.
  • Developing improved ways to search for relevant clinical trials.
  • Creating basic explainers on clinical trials for patients to help them determine eligibility and understand protocol.

There were also suggestions on how researchers can do a better job of communicating with non-scientists, such as using jargon-free language to answer questions and providing a list of questions people should ask when considering any stem cell therapy. Here’s an infographic we put together on that topic.

Lessons learned

This meeting is a great example of the power and importance of bringing together these different groups, all of whom have shared interests and goals. It starts with a conversation that begins to break down barriers. Hopefully it gives doctors ideas on how they can better equip patients to make informed decisions about clinical trials; by meeting patients it helps researchers put a human face on the work they are doing; and hopefully it gives patients a sense that their voices are being heard, and their needs addressed.

This was one relatively small meeting in Canada but the lessons learned apply to every state, and every country and could point the way to creating a more responsive health care system that better meets the needs of all those involved.

 

Board gives stem cell institute marching orders, and a road map

The poet T. S. Eliot once wrote: “If you aren’t in over your head, how do you know how tall you are?” Well, everyone at CIRM, California’s stem cell institute, is about to find out how tall we are.

Strategic Plan coverYesterday our governing Board approved a new Strategic Plan. To call it ambitious might be considered an understatement. Among the goals it commits us to achieving are:

  • Funding 50 new clinical trials in 5 years including 10 for rare or orphan disorders and 5 in conditions affecting children
  • Fostering enactment of a new, more efficient federal regulatory approval process for stem cell treatments
  • Introducing 50 new therapeutic candidates or devices into the development pipeline
  • Reducing the time it takes to move a stem cell treatment from the earliest Discovery stage into a clinical trial by 50%
  • Increasing the number of projects moving to the next stage of development by 50%

No easy task

Each goal by itself might be considered challenging. Taken together they are likely to stretch us all. And yet that’s why we joined CIRM, why we feel fortunate to be part of this mission. We have a chance to be part of a movement that could change the face of medicine as we know it. We knew it wouldn’t be easy. But now we know what we have to do to help achieve that.

As Randy Mills, our President and CEO, said in a news release, the goal in developing this Strategic Plan was to create a clear vision for the next five years of the Institute:

”We have around $900 million left to work with and we wanted a plan that used that money to the best possible effect, maximizing our chances of pushing as many new treatments to patients as possible. We didn’t want something ‘good enough’, we wanted something ‘great’. This plan is extremely ambitious, but also realistic in the goals it sets out and the way those goals can be met.”

The Strategic Plan – you can read it in full here – doesn’t just lay out goals, it also creates a road map on how to meet those goals. They include engaging industry more, being more creative in how we move the most promising projects from one stage of research to the next, and finding ways to change the regulatory approval process to help remove obstacles and speed up the progress of these therapies into clinical trials.

Aiming high

We know we may not achieve all our goals. As Randy Mills said at our Board meeting: “This is a difficult plan. These goals are not easy to achieve.” There are always risks in pursuing something so big and ambitious but no one ever achieved anything truly worthwhile by playing it safe. We are not interested in playing it safe.

We may start out by being, as T. S. Eliot put it “in over our heads”. But we’re confident we’ll be able to grow tall enough to make this plan work.

As Randy Mills told the Board: “If we are all in this together then the probability of success is high, and if we are successful then all this would have been worthwhile.”

Doing nothing is not OK: A call for change at the FDA

FDA-NotApprovedStampThe US Food and Drug Administration (FDA) is caught between a rock and a hard place. And CIRM is going to try and help them get out from under that.

As things stand today, if the FDA approves a therapy quickly and a patient later dies from it, then they are widely criticized. If they take a long time to approve a therapy and people die waiting for that treatment, then they are just as widely criticized.

So maybe it’s time to help them change that, by creating a new pathway that allows for a faster, more efficient, but equally safe, process of approving stem cell therapies.

This was a topic that CIRM’s President and CEO, Dr. Randy Mills, took on at last week’s World Stem Cell Summit. He highlighted our mission – accelerating stem cell therapies to patients with unmet medical needs – as the driving force behind everything we do, including regulatory reform:

“We have had the current FDA regulatory structure for cell therapy in place for 15 years, and in that 15 years not one stem cell therapy has been approved. The scoreboard is not lying, there’s a zero on it. Not one therapy has been approved. There is an issue here, we can’t ignore that fact and so we made it part of our proposed new Strategic Plan to try and remove this burden.

“There is an excessively long translational pathway to get an Investigational New Drug (IND) approval from the FDA (a necessary step to proceed with testing a therapy in a clinical trial). For non-cell therapies it takes 3-4 years to get an IND. For cell therapies it takes 6-8 years, twice as long.”

Mills says many potential therapies have been abandoned, or even stopped before they even got started, simply because the regulatory hurdles are so many and the costs so high.

“We are not anti-regulation, we are not anti-FDA, and we are not calling for the removal of rules and regulations around stem cell therapies, that would be bad for patients and research. These therapies have risks and we are not proposing any strategy that puts things on the market without any testing or safety data. But right now we are being so careful about safety to ensure patients are not put at risk while those same patients are dying from their disease.”

Chaohong Fan, MD, PhD, a Medical Officer at the FDA was in the audience and said the people at the FDA really want to help, that they feel it’s part of their mission.

Mills said he had no doubts that the people at the FDA are committed and passionate about what they do. He says it’s not that people at the FDA aren’t working, it’s that the process isn’t working, and needs to be transformed.

“At CIRM we are saying doing nothing is not OK. It’s not OK. So we are going to be working with patients and patient advocates, companies, researchers and the FDA to make change, to make it easier for patients to get access to the therapies they need.”

 

Why “Right to Try” laws are more feel good than do good

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L to R: Don Gibbons, CIRM; Jeanne Loring; Beth Roxland; Aaron Levine

In the last few years some 24 states have approved so-called “Right to Try” laws. These are intended to give terminally ill patients faster and easier access to experimental therapies. But a panel of experts at the World Stem Cell Summit in Atlanta today said they are more symbolic than anything and do little to actually help patients get much-needed therapies.

The Right to Try laws are modeled after a federal law that allows “compassionate use” of experimental medications and lets doctors prescribe investigational medicines being safely used in early stage clinical trials.

Beth Roxland, a bioethicist with Johnson & Johnson, says the name of the law is misleading:

“If you look at the actual text of these laws they only say you have the right to “ask” for these drugs. That right already exists in federal law but neither federal law nor these Right to Try laws say you have the right to access.”

Aaron Levine from Georgia Tech says it’s also misleading to assume that just because a state passes a Right to Try law that it has any legal impact. He says state laws don’t over rule the Food and Drug Administration’s (FDA) regulation of this area and so the federal government would still have the authority to stop this kind of access.

But Levine says these laws are interesting in that they are indicative of the growing determination of patients and patient advocates to work around obstacles to access and have a bigger say in their own care.

One of the audience members, William Decker from Baylor College of Medicine, says that in Texas a law was recently crafted saying that as long as a potential therapy had gone through a Phase 1 safety trial it should be offered to the public and the public should be able to pay for it.

“If you know how clinical trials work you know you can get almost any schlock through a Phase 1 trial and the kinds of things that you can get to the public without any idea if they work often turn out to not be very useful. We saw this as an avenue to promote fraud, and the last thing you should be doing to a dying patient is take their money or divert their attention away from something that might help them.”

Decker and his colleagues argued before the Texas Legislature that potential therapies should at least have to go through a Phase 2 trial to make sure they were not only safe but also showed some benefit for patients. In the end Texas lawmakers rejected the Phase 2 idea but did say patients could not be charged for the therapy, and there could be no compensation from insurers or anyone else for the manufacturer of the therapy.

He says removing the financial benefits and incentives pretty much ensured that no company would offer patients a therapy under this law.

Jeanne Loring, a CIRM grantee from the Scripps Research Institute, says that likely won’t stop other clinics in other states:

“Some stem cell clinics are using adipose (stem cells derived from fat) therapy as an option for every disease imaginable and I’m sure some will take advantage of these laws to say it gives them the right to offer these to patients and the patients will pay for them directly. “

Roxland says that may already be happening:

“I think there is some evidence on the stem cell side that companies have popped up in states that have these laws, to make it easier to offer their therapies to patients.”

The panel agreed that in most cases these laws don’t give patients any rights they don’t already have, but do give the appearance of making access easier. They said it’s feel-good legislation, allowing people to feel they are doing something without actually doing anything.

Aaron Levine said that while some companies may try to take advantage of these laws, the most serious ones won’t:

 “Almost any legitimate company that wants an FDA approved product wouldn’t want to take advantage of these laws. It could put their product at risk. Most companies that need to work with the FDA have no incentive to go this route.”

 

 

Call to Action by FDA at World Stem Cell Summit

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FDA Deputy Commissioner Dr. Robert Califf talking at the World Stem Cell Summit

The World Stem Cell Summit annual conference in Atlanta kicked off today with a clarion call from Dr. Robert Califf, the Deputy Commissioner for the Food and Drug Administration. He told the audience:

“We want you to accelerate translation to produce safe and effective therapies that can be delivered reliably”

It was a message that everyone in the room, scientists and patient advocates, would love to be able to comply with. The question of course is how do you do that in a way that puts the emphasis on both speed, to get the therapies to patients who need them, and safety, so you don’t put those patients at risk.

That’s quite a challenge considering that, as panel moderator Julie Allickson of Wake Forest Institute for Regenerative Medicine said:

“the estimate now is it costs $2.4 billion and up to ten years to take something to the clinic.”

Even if that dollar amount is higher than many think it would take to bring a stem cell therapy to a clinical trial it is an indication of the challenge the field faces.

Califf, who has only been at the FDA for 8 months, says that regenerative medicine is:

“not the only field exploding with scientific knowledge and seeing a future that’s very different from what we see today so it’s exciting but also an enormous challenge for the FDA. One of the real eye openers for me is to be at the FDA and hear about drugs that have been on the market for 45 years and we’re still learning about them.”

He says the first goal of the FDA has to be to protect the public, and that it’s hard to balance safety and innovation. “That’s an issue we struggle with every day.”

Califf was optimistic that the balance can be struck and progress can be made, but said that this can only truly be done if the patient is at the table as an active participant.

“Our national clinical research system is well intention but flawed. We need to have a new system that shares information right across the system and where patients are at the center. Patients should be driving the national research infrastructure. They are an essential part of change. It’s happening in Congress because they are hearing from constituents that this is what they want, a voice in the research being done that affects them.”

For the patients and patient advocates in the audience it was a welcome message. For years they have been calling for a louder voice in the research that affects them and their loved ones. Knowing they have a sympathetic ear in the FDA could be an encouraging sign that their voices are finally being heard.

We will be writing more as the conference unfolds so stay tuned!

 

 

 

Using baking ingredient to create “nano” bombs and destroy cancer stem cells

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“I am not a cook”. Richard Nixon and the baking ingredient that could help win the “war on cancer”

In 1971 President Richard Nixon declared a “war on cancer” and signed the National Cancer Act into law. Forty years later we’re still waging that war, and cancer is still one of the leading causes of death. But now researchers in Ohio have unveiled a new weapon; a nanobomb that targets cancer stem cells.

In treating invasive cancers the standard weapons are chemotherapy and radiation, but cancer stem cells are somehow able to evade these and lie dormant. Eventually they emerge from hiding and multiply and spread throughout the body, leading to a recurrence of the cancer.

So researchers at The Ohio State University Comprehensive Cancer Center turned to nanoparticles to try and target them. Nanoparticles for those of who aren’t up on the latest trendy science topics (something I plead guilty to) are particles between 1 and 100 nanometers in size. Just to put it in context, that’s about one billionth of a meter. In other words, very small indeed.

In the past when scientists tried to use nanoparticles to carry anti-cancer therapies such as therapeutic RNA to the tumor, the cancer cells simply enfolded the RNA nanoparticles in a kind of compartment called an endosome, which rendered them useless.

In a news release, principal investigator Xiaoming He said their new approach helps the nanoparticles escape from the endosomes and attack the cancer:

“We believe we’ve overcome this challenge by developing nanoparticles that include ammonium bicarbonate, a small molecule that vaporizes when exposing the nanoparticles to near-infrared laser light, causing the nanoparticle and endosome to burst, releasing the therapeutic RNA.”

In the study, published in Advanced Materials,   He and his team put micro-RNA miR-34a inside the nanoparticles. This is a molecule known to lower the levels of a  protein that cancer stem cells need for survival. When the ammonium bicarbonate was hit with the near-infrared laser it caused the endosomes to burst and released the miR-34a, killing the cancer cell.

When they tested this approach in a mouse model of human prostate cancer it significantly reduced the size of the tumors.

Because near-infrared lasers penetrate to about half an inch this method could be used for tumors near the skin surface, and for deeper ones would only require a minimally invasive surgery to deliver the necessary dose of light.

Ammonium bicarbonate, the ingredient used to help the nanoparticles swell up, is used by the food industry for some baked goods such as cookies and crackers. It’s a little odd to think that something used in such tasty treats could also be potentially deadly – think about that next time you are browsing the cookie aisle at the supermarket.

 

 

 

 

 

 

 

 

Meet the proteins that tell stem cells where to move and how

 

Protein word art

Word cloud art work which shows all the proteins identified by the researchers

The environment you grow up in can have a huge influence on how you turn out. That applies to people, and to stem cells too. Now a new study has identified 60 proteins that can have a big impact on how cells react to the world around them, and how they communicate with each other.

Just as it is easier for us to move across firm ground than it is to slosh our way through a soggy, muddy field, it’s easier for stem cells to move smoothly and quickly over a solid surface than over a soft, giving surface. This is particularly true for tumor cells, which move much faster on a hard surface than any other kind.

It’s not just speed that is affected by the kind of surface you place stem cells on. For example certain stem cells placed on a hard surface will specialize and turn into bone, whereas if you place those same cells on a very soft surface they will turn into nerve cells.

The problem is we didn’t know much about why that was the case, we didn’t understand the mechanism at play that caused those cells to behave that way.

Now we do.

A team at the University of Manchester in England tackled this problem by researching integrins; these are receptors that are responsible for cell-to-cell communication, cell growth and function. Integrins are typically found at the surfaces and edges of cells and provide proteins with a convenient place to hang out when they interact with the world around them.

The researchers looked at 2400 examples of these integrin-protein clusters and, using mass spectrometry, narrowed their search down to 60 proteins that they identified as being essential in linking information from the integrins to the rest of the cellular world.

The work was published in Nature Cell Biology. In an accompanying news release Dr. Jon Humphries, one of the lead researchers, talked about the significance of the work:

“Understanding how cells sense their environment is an important step in understanding how, for example, cancer cells move or how stem cells take on different jobs.”

His colleague, Professor Martin Humphries, says understanding how cells sense where they are and how to behave gives us new insights into how we can use that knowledge to better control their movement:

“Our findings on how cells sense their environment have unlocked an important key to understanding how we can persuade cells to form different tissues and how we might stop cell movement in diseases such as cancer.”

 

 

Giving Thanks by Looking Forward

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The CIRM Team gather to give Thanks

Thanksgiving is traditionally a time of reflection, a time to look back and express gratitude for all the good things that have happened in the past year. At CIRM we have a lot to be thankful for but this Thanksgiving we are looking forward, not backward. We’re unveiling our new Strategic Plan, our blueprint for the future, and we would love to hear what you think about it.

Randy Mills, our President and CEO, calls the Strategic Plan “a bold, new vision” for what we hope to achieve over the next five years. After reading it we hope you’ll agree.

Taking it on the road

We actually began this process several months ago with a talking tour of California. Randy Mills went around the state talking to researchers, academics, company officials, patients and patient advocates – anyone who has a stake in what we do. He posed a few simple questions such as: “what’s impeding progress?” and “how do you think we could do better?” and asked them what they thought we should focus on in the next five years.

As you can imagine we got a wide range of answers, but there was also surprising agreement on some key issues – such as the need to push for regulatory reform to help remove some of the obstacles slowing down the ability of researchers to move their therapies into clinical trials.

Bold ideas

The plan is an ambitious one, but then as Sherry Lansing, the cancer Patient Advocate member of our Board, says in a news release, why aim low:

“As we enter what could be CIRM’s last phase, we want to show the people of California that we are doing everything we can to fulfill the hopes of all those who voted to create the agency when they supported Proposition 71 in 2004.  That’s what this Strategic Plan demonstrates. It’s an ambitious plan, but you never achieve anything worthwhile by playing it safe. Too many lives are at stake for us to do anything less than work as hard as we can, as long as we can, to achieve as much as we can.”

Over the course of the next five years we hope to:

  • Launch 50 new clinical trials covering at least 20 unique diseases or conditions, and including at least 10 rare and 5 pediatric indications
  • Increase the number of projects advancing to the next stage of development by 50%
  • Work with patient advocates, the FDA and researchers to develop a new, more efficient regulatory process for cell therapies
  • Reduce the time it takes a stem cell therapy to move from discovery into a clinical trial by 50%

But wait, there’s more

And that’s just a taste of what we are planning. For the full picture you need to check out the Strategic Plan. But as Randy Mills says, we don’t want you to just read it. This process began with us asking you for your thoughts. Now we want to end it the same way.

“Your input was invaluable in helping us chart an ambitious course and giving us the inspiration to be bold and think outside of the box. Now, as we get ready to put this new vision for the agency into action, we want to share it with the public, with patients and patient advocates, scientists and researchers, and give them a chance to let us know what they think.”

Here’s where you can find the Strategic Plan.

What do you think?

If you have any thoughts or comments send them to me by 5pm, Thursday, December 3rd at kmccormack@cirm.ca.gov

The Strategic Plan is due to go before the CIRM Science Subcommittee on Monday, November 30th and the full Board for its approval on Thursday, December 17th.