It’s always nice to be told you are doing a good job. It’s even nicer when it’s unexpected. That’s certainly the case when we, the Communications Team at the California Institute for Regenerative Medicine, found out we’d been named as a finalist for the Patient Advocacy Award (non-profit category) as part of the Phacilitate Advanced Therapies Awards.
To be honest, we didn’t even know we’d been nominated. But who cares. We are now in the final. And we are in good company. Our friends at Americans for Cures, were also nominated. They are advocates for stem cell research in California and were hugely instrumental in getting Proposition 14 passed in 2020, that’s the voter initiative that refunded CIRM with $5.5 billion.
While we may focus on different areas we all share a common goal, a desire to ensure that the voice of the patient is front and center in all that we do. At CIRM we have patient advocates on our Board and on the panel of experts who review applications for our funding. We have patient advocates helping guide the clinical trials we fund. And now, as we expand our efforts to reach out in every community in California, we have patients and patient advocates guiding that work as well.
We do this work because it’s important and because, without the support of the patient advocacy community, we wouldn’t be here.
It’s an old cliché that when you are in this position you say, “it’s an honor just to be nominated.” But in this case, it’s true.
Regina Karchner – Photo courtesy Nancy Ramos Photography
Our 2021-22 Annual Report is now online. It’s filled with information about the work we have done over the last year (we are on a fiscal calendar year from July 1 – June 30), the people who have helped us do that work, and some of the people who have benefited from that work. One of those is Regina Karchner.
Regina Karchner says she feels as if she’s been a patient advocate for people with brain cancer almost from birth. When she was three, her father died of a brain tumor. When she was 16 Regina was diagnosed with brain cancer. While she was in the hospital she heard about the Children’s Brain Tumor Foundation (CBTF) and as soon as she was able she became a volunteer with the organization. Today she is a social work regional coordinator at CBTF.
She says that as an advocate she feels she has a responsibility to help families deal with devastating news, to talk about death, and how to cope with the emotional trauma of it. She also advocates on behalf of survivors, like herself.
“I am just such an advocate for the need for long term programming for brain cancer survivors, because it’s so different from other cancers. The emotional, cognitive and physical impacts of brain tumors are dramatic, that’s even if the individuals survive.
“We are working with people in their 40’s who were the first group of childhood survivors and there’s nowhere to go that matches their needs, they can’t function enough to live independently and work full time. It’s a big problem in the medical world and even in schools, they don’t understand brain tumors, they don’t see it as a traumatic brain injury which it is and even the most well-intended schools don’t really know what to do or handle the patients.”
“We found that survivors with better social skills have a better quality of life, so we are now trying to focus on kids in elementary school, giving them the social skills they need to survive and that are hard to catch up on later in life. They can get math or history or other subjects anytime, but the social skills are essential”
Regina also serves on a CIRM Clinical Advisory Panel or CAP for a clinical trial for children with brain cancer. She says having the patient advocate at the table is vital to the success of the trial. “I help the researchers understand the needs of the patient, even understand why families don’t enroll in trials. 80% of families who have kids with brain tumors are on Medicaid so it’s a select group of people who can afford to be in these trials. Letting the researchers know that and coming up with ways to help them is so important.”
She says it’s challenging work, but also very rewarding. “It feels wonderful to help families in a time of need. I feel I grow as a person and as a parent, I have learnt so much that helps me in my personal life and being grateful for having a healthy family and being a healthy survivor myself.”
For many patients battling deadly diseases, getting access to a clinical trial can be life-saving, but it can also be very challenging. Today the governing Board of the California Institute for Regenerative Medicine (CIRM) approved a concept plan to make it financially and logistically easier for patients to take part in CIRM-funded clinical trials.
The plan will create a Patient Support Program (PSP) to provide support to California patients being evaluated or enrolled in CIRM-supported clinical trials, with a particular emphasis on helping underserved populations.
“Helping scientists develop stem cell and gene therapies is just part of what we do at CIRM. If those clinical trials and resulting therapies are not accessible to the people of California, who are making all this possible, then we have not fulfilled our mission.” says Maria T. Millan, M.D., President and CEO of CIRM.
The Patient Support Plan will offer a range of services including:
Clinical trial navigation, directing patients to appropriate CIRM-supported clinical trials.
Logistical support for patients being evaluated or enrolled in clinical trials.
Financial support for under resourced and underserved populations in CIRM-supported clinical trials, including the CIRM Patient Assistance Fund (PAF). This support includes transportation/travel expenses, such as gasoline, tolls, parking, airfare, taxi, train, lodging, and meals during travel.
Providing nurse navigator support for the psychosocial, emotional, and practical needs of patients and their families.
The funds for the PSP are set aside under Proposition 14, the voter-approved initiative that re-funded CIRM in 2020. Under Prop 14 CIRM money that CIRM grantees earn from licensing, inventions or technologies is to be spent “offsetting the costs of providing treatments and cures arising from institute-funded research to California patients who have insufficient means to purchase such treatment or cure, including the reimbursement of patient-qualified costs for research participants.”
Currently, the CIRM Licensing Revenues and Royalties Fund has a balance of $15.6 million derived from royalty payments.
“The patient support program and financial resources will not only help patients in need, it will also help increase the likelihood that these clinical trials will succeed,” says Sean Turbeville, Ph.D., Vice President of Medical Affairs and Policy at CIRM. “We know cell and gene therapies can be particularly challenging for patients and their families. The financial challenges, the long-distance traveling, extended evaluation, and family commitments can make it difficult to enroll and retain patients. The aim of the PSP is to change that.”
The overall objective of this funding opportunity is to establish a statewide program that, over five years, is expected to support hundreds of patients in need as they participate in the growing number of CIRM-supported clinical trials. The program is expected to cost between $300,000 to $500,000 a year. That money will come from the Medical Affairs budget and not out of the patient assistance fund.
The first phase of the program will identify an organization, through a competitive process, that has the expertise to provide patient support services including:
Maintaining a call and support center.
Assessing patient eligibility for financial assistance.
Reporting to CIRM on patients needs and center performance
You can find more information about the Patient Support Program on our website here and here.
It is estimated that as many as 90 percent of people in industrialized countries who die every day, die from diseases of aging such as heart disease, stroke, and cancer. Of those still alive the numbers aren’t much more reassuring. More than 80 percent of people over the age of 65 have a chronic medical condition, while 68 percent have two or more.
Current medications can help keep some of those conditions, such as high blood pressure, under control but regenerative medicine wants to do a lot more than that. We want to turn back the clock and restore function to damaged organs and tissues and limbs. That research is already underway and we are inviting you to a public event to hear all about that work and the promise it holds.
On June 16th from 3p – 4.30p PST we are holding a panel discussion exploring the impact of regenerative medicine on aging. We’ll hear from experts on heart disease and stroke; we will look at other ground breaking research into aging; and we’ll discuss the vital role patients and patient advocates play in helping advance this work.
The discussion is taking place in San Francisco at the annual conference of the International Society for Stem Cell Research. But you can watch it from the comfort of your own home. That’s because we are going to live stream the event.
No one likes to be taken for granted, to feel that people only like you because you have scads of cash and they want some of it. That’s why it’s so lovely when you feel you are appreciated because of all the things money makes possible.
That’s how it felt when we saw City of Hope’s news release about our funding to train the next generation of scientists and leaders in the field of regenerative medicine. CIRM has awarded COH $4.86 million as part of its Research Training Program in Stem Cell Biology and Regenerative Medicine.
The program provides stem cell and gene therapy research training for up to 6 graduate students and 12 postdocs at the Beckman Research Institute of City of Hope. In addition to 3 years of research, the training includes coursework, patient engagement and community outreach activities.
“This program originates from City of Hope’s longstanding expertise in conducting clinical trials and applying fundamental stem cell biology and gene therapy to the treatment of diseases. The program reflects City of Hope’s commitment to ensuring that future scientific leaders understand the varied needs of diverse patient populations, and the inequities that presently affect both biomedical research and the development of and access to innovative therapies.”
Students in the program will have access to world class research facilities and will also benefit from the fact that their classrooms and laboratories are within walking distance from where patients are treated. We believe the best scientists need to have experience in working both at the laboratory bench and at the bedside, not only developing new therapies, but being able to deliver those therapies in a caring, compassionate way.
Ronnie, born with a fatal immune disorder now leading a normal life thanks to a CIRM-funded stem cell/gene therapy: Photo courtesy of his mum Upasana
Whenever you are designing something new you always have to keep in mind who the end user is. You can make something that works perfectly fine for you, but if it doesn’t work for the end user, the people who are going to work with it day in and day out, you have been wasting your time. And their time too.
At CIRM our end users are the patients. Everything we do is about them. Starting with our mission statement: to accelerate stem cell treatments to patients with unmet medical needs. Everything we do, every decision we make, has to keep the needs of the patient in mind.
So, when we were planning our recent 2020 Grantee Meeting (with our great friends and co-hosts UC Irvine and UC San Diego) one of the things we wanted to make sure didn’t get lost in the mix was the face and the voice of the patients. Often big conferences like this are heavy on science with presentations from some of the leading researchers in the field. And we obviously wanted to make sure we had that element at the Grantee meeting. But we also wanted to make sure that the patient experience was front and center.
And we did just that. But more on that in a minute. First, let’s talk about why the voice of the patient is important.
Some years ago, Dr. David Higgins, a CIRM Board member and patient advocate for Parkinson’s Disease (PD), said that when researchers are talking about finding treatments for PD they often focus on the dyskinesia, the trembling and shaking and muscle problems. However, he said if you actually asked people with PD you’d find they were more concerned with other aspects of the disease, the insomnia, anxiety and depression among other things. The key is you have to ask.
Frances Saldana, a patient advocate for research into Huntington’s disease
So, we asked some of our patient advocates if they would be willing to be part of the Grantee Meeting. All of them, without hesitation, said yes. They included Frances Saldana, a mother who lost three of her children to Huntington’s disease; Kristin MacDonald, who lost her sight to a rare disorder but regained some vision thanks to a stem cell therapy and is hoping the same therapy will help restore some more; Pawash Priyank, whose son Ronnie was born with a fatal immune disorder but who, thanks to a stem cell/gene therapy treatment, is now healthy and leading a normal life.
Because of the pandemic everything was virtual, but it was no less compelling for that. We interviewed each of the patients or patient advocates beforehand and those videos kicked off each session. Hearing, and seeing, the patients and patient advocates tell their stories set the scene for what followed. It meant that the research the scientists talked about took on added significance. We now had faces and names to highlight the importance of the work the scientists were doing. We had human stories. And that gave a sense of urgency to the work the researchers were doing.
But that wasn’t all. After all the video presentations each session ended with a “live” panel discussion. And again, the patients and patient advocates were a key part of that. Because when scientists talk about taking their work into a clinical trial they need to know if the way they are setting up the trial is going to work for the patients they’re hoping to recruit. You can have the best scientists, the most promising therapy, but if you don’t design a clinical trial in a way that makes it easy for patients to be part of it you won’t be able to recruit or retain the people you need to test the therapy.
Patient voices count. Patient stories count.
But more than anything, hearing and seeing the people we are trying to help reminds us why we do this work. It’s so easy to get caught up in the day to day business of our jobs, struggling to get an experiment to work, racing to get a grant application in before the deadline. Sometimes we get so caught up in the minutiae of work we lose sight of why we are doing it. Or who we are doing it for.
At CIRM we have a saying; come to work every day as if lives depend on you, because lives depend on you. Listening to the voices of patients, seeing their faces, hearing their stories, reminds us not to waste a moment. Because lives depend on all of us.
Here’s one of the interviews that was featured at the event. I do apologize in advance for the interviewer, he’s rubbish at his job.
While the world has been turned upside down by the coronavirus pandemic, the virus poses an increased threat to people with Parkinson’s disease (PD). Having a compromised immune system, particularly involving the lungs, means people with PD are at higher risk of some of the more dangerous complications of COVID-19. So, this seems like an appropriate time for CIRM to hold a special Facebook Live “Ask the Stem Cell Team” About Parkinson’s disease.
We are holding the event on Tuesday, May 5th at noon PDT.
The initial reason for the Facebook Live was the CIRM Board approving almost $8 million for Dr. Krystof Bankiewicz at Brain Neurotherapy Bio, Inc. to run a Phase 1 clinical trial targeting PD. Dr. Bankiewicz is using a gene therapy approach to promote the production of a protein called GDNF, which is best known for its ability to protect dopaminergic neurons, the kind of cell damaged by Parkinson’s. The approach seeks to increase dopamine production in the brain, alleviating PD symptoms and potentially slowing down the disease progress.
Dr. Bankiewicz will be joined by two of CIRM’s fine Science Officers, Dr. Lila Collins and Dr. Kent Fitzgerald. They’ll talk about the research targeting Parkinson’s that CIRM is funding plus other promising research taking place.
And we are delighted to have a late addition to the team. Our CIRM Board member and patient advocate for Parkinson’s disease, Dr. David Higgins. David has a long history of advocacy for PD and adds the invaluable perspective of someone living with PD.
As always, we want this to be as interactive as possible, so we want to get your questions. You can do this on the day, posting them alongside the live feed, or you can send them to us ahead of time at info@cirm.ca.gov. We’ll do our best to answer as many as we can on the day, and those we don’t get to during the broadcast we’ll answer in a later blog.
The field of stem cell research and regenerative medicine has exploded in the last few years with new approaches to treat a wide array of diseases. Although these therapies are quite promising, they face many challenges in trying to bring them from the laboratory and into patients. But why is this? What can we do to ensure that these approaches are able to cross the finish line?
A new article published in Cell Stem Cell titled Translating Science into the Clinic: The Role of Funding Agencies takes a deeper dive into these questions and how agencies like CIRM play an active role in helping advance the science. The article was written by Dr. Maria T. Millan, President & CEO of CIRM, and Dr. Gil Sambrano, Vice President of Portfolio Development and Review at CIRM.
Although funding plays an essential role in accelerating science, it is not by itself sufficient. The article describes how CIRM has established internal processes and procedures that aim to help accelerate projects in the race to the finish line. We are going to highlight a few of these in this post, but you can read about them in full by clicking on the article link here.
One example of accelerating the most promising projects was making sure that they make important steps along the way. For potential translational awards, which “translate” basic research into clinical trials, this means having existing data to support a therapeutic approach. For pre-clinical and clinical awards, it means meeting with the Food and Drug Administration (FDA) and having an active investigational new drug (IND) approved or pre-IND, important steps that need to be taken before these treatments can be tested in humans. Both of these measures are meant to ensure that the award is successful and progress quickly.
Another important example is not just giving these projects the funding in its entirety upfront, rather, tying it to milestones that guide a project to successful completion. Through this process, projects funded by CIRM become focused on achieving clear measurable objectives, and activities that detract from those goals are not supported.
Aside from requirements and milestones tied to funding, there are other ways that CIRM helps bolster its projects.
One of these is an outreach project CIRM has implemented that identifies investigators and projects with the potential to enhance already existing projects. This increases the number of people applying to CIRM projects as well as the quality of the applications.
Another example is CIRM’s Industry Alliance Program, which facilitates partnerships between promising CIRM-funded projects and companies capable of bringing an approved therapy to market. The ultimate goal is to have therapies become available to patients, which is generally made possible through commercialization of a therapeutic product by a pharmaceutical or biotechnology company.
CIRM has also established advisory panels for its clinical and translational projects, referred to as CAPs and TAPs. They are composed of external scientific advisors with expertise that complements the project team, patient advocate advisors, and CIRM Science Officers. The advisory panel provides guidance and brings together all available resources to maximize the likelihood of achieving the project objective on an accelerated timeline.
Lastly, and most importantly, CIRM has included patient advocates and patient voices in the process to help keep the focus on patient needs. In order to accelerate therapies to the clinic, funders and scientists need input on what ultimately matters to patients. Investing effort and money on potential therapies that will have little value to patients is a delay on work that really matters. Even if there is not a cure for some of these diseases, making a significant improvement in quality of life could make a big difference to patients. There is no substitute to hearing directly from patients to understand their needs and to assess the balance of risk versus benefit. As much as science drives the process of bringing these therapies to light, patients ultimately determine its relevance.
We often talk about the important role that patient advocates play in helping advance research. That was demonstrated in a powerful way last week when the CIRM Board approved almost $12 million to fund a clinical trial targeting a rare childhood disorder called cystinosis.
The award, to Stephanie Cherqui and her team at UC San Diego (in collaboration with UCLA) was based on the scientific merits of the program. But without the help of the cystinosis patient advocate community that would never have happened. Years ago the community held a series of fundraisers, bake sales etc., and used the money to help Dr. Cherqui get her research started.
That money enabled Dr. Cherqui to get the data she needed to apply to CIRM for funding to do more detailed research, which led to her award last week. There to celebrate the moment was Nancy Stack. Her testimony to the Board was a moving celebration of how long they have worked to get to this moment, and how much hope this research is giving them.
Nancy Stack is pictured in spring 2018 with her daughter Natalie Stack and husband Geoffrey Stack. (Lar Wanberg/Cystinosis Research Foundation)
Hello my name is Nancy Stack and I am the founder and president of the Cystinosis Research Foundation. Our daughter Natalie was diagnosed with cystinosis when she was an infant.
Cystinosis is
a rare disease that is characterized by the abnormal accumulation of cystine in
every cell in the body. The build-up of
cystine eventually destroys every organ in the body including the kidneys,
eyes, liver, muscles, thyroid and brain.
The average age of death from cystinosis and its complications is 28
years of age.
For our
children and adults with cystinosis, there are no healthy days. They take
between 8-12 medications around the clock every day just to stay alive –
Natalie takes 45 pills a day. It is a
relentless and devastating disease.
Medical
complications abound and our children’s lives are filled with a myriad of
symptoms and treatments – there are g-tube feedings, kidney transplants, bone
pain, daily vomiting, swallowing
difficulties, muscle wasting, severe gastrointestinal side effects and for some
blindness.
We started
the Foundation in 2003. We have worked
with and funded Dr. Stephanie Cherqui since 2006. As a foundation, our resources are limited
but we were able to fund the initial grants for Stephanie’s Stem Cell studies. When CIRM awarded a grant
to Stephanie in 2016, it allowed her to complete the studies, file the IND and
as a result, we now have FDA approval
for the clinical trial. Your support has changed the course of this
disease.
When the FDA
approved the clinical trial for cystinosis last year, our community was filled
with a renewed sense of hope and optimism.
I heard from 32 adults with cystinosis – all of them interested in the
clinical trial. Our adults know that
this is their only chance to live a full life. Without this treatment, they
will die from cystinosis. In every
email I received, there was a message of hope and gratitude.
I received an
email from a young woman who said this, “It’s a new awakening to learn this
morning that human clinical trials have been approved by the FDA. I reiterate
my immense interest to participate in this trial as soon as possible because my
quality of life is at a low ebb and the trial is really my only hope. Time is
running out”.
And a mom of a 19 year old young man who wants to be the first
patient in the trial wrote and said this, “On the day the trial was announced I started to cry tears of pure
happiness and I thought, a mother somewhere gets to wake up and have a child who
will no longer have cystinosis. I felt so happy for whom ever that mom would
be….I never imagined that the mom I was thinking about could be me. I am so
humbled to have this opportunity for my son to try to live disease free.
My own daughter ran into my arms that day and we cried tears of
joy – finally, the hope we had clung to was now a reality. We had come full
circle. I asked Natalie how it felt to
know that she could be cured and she said, “I have spent my entire life thinking
that I would die from cystinosis in my 30s but now, I might live a full life
and I am thinking about how much that changes how I think about my future. I never
planned too far ahead but now I can”.
As a mother, words can’t possible convey what it feels like to know that my child has a chance to live a long, healthy life free of cystinosis – I can breathe again. On behalf of all the children and adults with cystinosis, thank you for funding Dr. Cherqui, for caring about our community, for valuing our children and for making this treatment a reality. Our community is ready to start this trial – thank you for making this happen.
*************
CIRM will be celebrating the role of patient advocates at a free event in Los Angeles tomorrow. It’s at the LA Convention Center and here are the details. And did I mention it’s FREE!
Tue, June 25, 2019 – 6:00 PM – 7:00 PM PDT
Petree Hall C., Los Angeles Convention Center, 1201 South Figueroa Street Los Angeles, CA 90015
And on Wednesday, USC is holding an event highlighting the progress being made in fighting diseases that destroy vision. Here’s a link to information about the event.
Will CIRM be funding stem cell research after this year?
From even before we were created by the passage of Proposition 71 back in 2004, the voices of patients and patient advocates have been at the heart of CIRM’s existence. Today they are every bit as vital to the work we do, and even more essential if we are to be able to continue doing that work.
In 2004, the patient advocate community recognized that the research we fund could help them or a loved one battling a deadly disease or disorder. And over the last 15 years that’s exactly what we have done, trying to live up to our mission of accelerating stem cell treatments to patients with unmet medical needs. And with 54 clinical trials already under our belt we have made a good start.
But it’s just a start. We still have a lot to do. The problem is we are quickly running out of money. We expect to have enough money to fund new projects up to the end of this year. After that many great new ideas and promising projects won’t be able to apply to us for support. Some may get funding from other sources, but many won’t. We don’t want to let that happen.
That’s why we are holding a Patient Advocate event next Tuesday, June 25th from 6-7pm in Petree Hall C., at the Los Angeles Convention Center at 1201 South Figueroa Street, LA 90015.
The event is open to everyone and it’s FREE. We have created an Eventbrite page where you can get all the details and RSVP if you are coming. And if you want to get there a little early that’s fine too, we’ll be there from 5pm onwards so you’ll have a chance to ask us any questions you might have beforehand.
It’s going to be an opportunity to learn about the real progress being made in stem cell research, thanks in no small part to CIRM’s funding. We’ll hear from the researchers who are saving lives and changing lives, and from the family of one baby alive today because of that work.
We will hear about the challenges facing CIRM and the field, but also about a possible new ballot initiative for next year that could help re-fund CIRM, giving us the opportunity to continue our work.
That’s where you, the patients and patient advocates and members of the public come in. Without you we wouldn’t be here. Without you we will disappear. Without us the field of stem cell research loses a vital source of support and funding, and potentially-life saving therapies fall by the wayside.
We all have a huge stake in this. So we hope to see you next Tuesday, at the start of what may be the next chapter in the life of CIRM.
The Stem Cellar 