The Altman Clinical and Translational Research Institute (ACTRI) at University of California San Diego received a five-year, $54.7 million Clinical and Translational Science Award (CTSA) from the National Center for Advancing Translational Science (NCATS), part of the National Institutes of Health (NIH). In a recognition of research excellence and performance, this grant is actually the third major award since UCSD’s ACTRI launched in 2010; approximately $144 million has been raised by top researchers at the University of California research center. With impressive leadership, the group embarks on the next stage of scaling out a dynamic, progressive, and innovative research operation.
Research “Intrapreneurs” in San Diego Life Sciences Hub
Back in 2010, CTSA secured its first grant, which essentially helped to get the research center off the ground, up and running, reported Gary S. Firestein, MD, founding director and dean and associate vice chancellor of clinical and translational research at UC San Diego School of Medicine. Many institutions struggle after that point, not necessarily easily making the transition from research “startup” operation to an operational center conducting ongoing research, including clinical trials. However, the UC San Diego group, led by Dr. Firestein, exhibited the organizational, operational and research-based leadership, maturity and acumen to produce results and to raise a second round of grants to establish ACTRI as a hub for clinical research and clinical trials within San Diego. In this way, the UCSD ACTRI team has accomplished an impressive feat and showing “intrapreneurship” in the process, leading the way to the latest funding and the expansion on a number of important fronts. Under Firestein’s leadership—and of course based on the dedicated support by a whole lot of talent that likes to be part of what is one of the most desirable places to live and work in North America, this group is building a formidable, valuable research network.
ACTRI: A Deep and Substantial Research Network
ACTRI is part of a national CTSA consortium and includes a prominent array of local partners, including UC San Diego, San Diego State University, Sanford Burnham Prebys Medical Discovery Institute, Salk Institute for Biological Studies, Rady Children’s Hospital—San Diego Veterans Affairs San Diego Healthcare System and numerous nonprofits and biotech/pharma companies.
Taking ACTRI to the Next Level: The Initiatives are Exciting
Now with $55 million, the ACTRI group plans on taking the research operation to another level—and based on performance thus far, the prognosis is excellent. In a quest to capitalize on lessons learned, insights, and breakthroughs over the past decade, the San Diego-based team will refine the fundamental research ongoing while infusing new resources into the mix—in essence to support the transition again—to launch the next wave of discovery and transformation. Some initiatives include:
Pipeline of Innovation
Now Dr. Firestein reports that that over the next five years they will bring “together basic scientists, engineers and clinicians to create a pipeline of innovation,” leveraging the Tricorder XPRIZE competition model and in the process facilitating collaboration among multidisciplinary teams of clinicians and scientists.
Talent Development & Expansion
Scientific and research talent is one of the key ingredients for success in the expanding and scaling research enterprise. The San Diego research team will continue to support and grow a scholar program supporting young faculty members establishing careers, as well as continuing to expand ACTRI’s Game Center, a program that uses virtual reality games to train investigators in team science as well as create new mentoring programs in grant-writing, the financial lifeblood of research.
Moving into the Health Systems for Real-World Evidence
An exciting new initiative is under way to help investigators not only develop ideas but actually move them into the community with a new Team Science Core. Here, mobile apps will be developed to help integrate clinical trials and the electronic health record, improving safety for research participants. This important step becomes a bridge to more systematic research involving real-world evidence and an important next step in overall research. Also valuable for biopharma, sponsors seek to conduct studies in this metropolitan region of approximately 3.5 million.
Serving Underserved & Vulnerable Communities
UC San Diego has always been active supporting various communities within San Diego. Although overall a wealthy city with exorbitant land and housing prices and continued economic polarization, homelessness and other social ills, in the city and surrounding metropolitan area adjacent to the U.S. and Mexican border, grapples with plenty of problems, including a poverty rate of 13.8%. The ongoing COVID-19 pandemic will only exacerbate challenges—the true impacts of the ongoing health crisis cannot be predicted. Research has been generally adversely impacted nationwide by a lack of diversity. With the rapid emergence of precision medicines, diversification in patient participation is a must. And San Diego is a diverse place—nearly 30% Hispanic; 16% Asian and just under 7% African American.
Hence, funding will support the Center for Life Course and Vulnerable Population Research to expand efforts of engagement with communities and ensure vulnerable and underserved populations are part of the research and clinical enterprise. It’s an important noble cause Firestein and team embrace.
Research Enterprise Expansion
Moreover, ACTRI will expand its Center for Clinical Research with two dedicated project managers, ethics support and clinical research infrastructure—all critical for this period of expansion and scale. Two new centers are planned to include 1) the Device Acceleration Center, and 2) Center for Excellence in Immunogenomics, both intended to bring scientists and clinicians together in teams to address unmet medical needs with an emphasis on science and medicine of immunity.
A Valuable Research Operation
Now with nearly 1,000 clinical and translational research faculty and staff in the 7-story, 359,000-square-foot Altman CTRI building, ACTRI represents an essential research hub of support for most clinical trials at UC San Diego Health; they offer support in the form of informatics tools, work space and trained personnel, an infusion center, an investigational drug pharmacy, a Phase I drug testing unit and education and training programs. With the new initiatives planned, including its efforts to help scale, the overall “valuation” of this endeavor continues to climb.
Clinical Trials Ongoing
UC San Diego Health is supporting approximately 2,400 clinical trials at any given time with an estimated 7,000 participants in active treatment. Approximately 250 new trials commence each year, including most recently COVID-19 related trials investigating an antiviral drug, an arthritis drug and a medication for hypertension.
COVID-19 Additional Activities
Dr. Firestein is an internationally recognized translational researcher and co-leader of the NCATS’ Accrual to Clinical Trials platform, which links electronic medical records of over 50 academic medical centers across the country. Note, this platform has been leveraged and now expanded to provide comprehensive medical data to COVID-19 researchers. The ACTRI has created an institutional COVID-19 biobank enabling development of novel diagnostics and treatment for the virus and has collaborated with UC San Diego Health for ongoing health screening of health care workers to assure safe workplaces.
Delivering Outcomes & Preparing to Scale Further
This latest funding and expansionary round will position UC San Diego ACTRI to execute on its strategic plans while capitalize on the going development and accumulation of valuable intellectual property, which can help not only contribute to further traditional philanthropic and government-based fund-raising efforts but also support UCSD ACTRI business development activity involving industry sponsors. Firestein and team are clearly driving something special that amounts to “community capital” in the San Diego—a treasure trove for that marvelous city. TrialSite News surveys major academic medical centers around the world and finds, at least at times, academic medical centers lack the sophisticated business development and marketing apparatus perhaps seen in the private sector. We suspect that the translational research “intrapreneurs” at UC San Diego are on the forefront of ensuring that the important research, development and associated outcomes—including the contributions to the San Diego economy not to mention health—are supported and scaled further.
Challenges are Opportunities for the Research Enterprise
An exciting present and future for UCSD ACTRI, but it won’t be immune from the standard challenges and pressures of growth. UCSD ranks 12th of all major research centers in terms of NIH funding in 2019 at $368.9 million.
This research enterprise is on the rise and faces a few critical challenges like its peers moving forward. As operations grow, they face opportunities and issues associated with 1) size and scope; 2) complexity of collaboration; and 3) growth of regulatory requirements; and 4) importance of sponsorship and entrepreneurial research all the while working tirelessly and furiously to A) maintain research integrity, while B) ensuring ongoing adherence to good scientific practice. Challenges in the form of whistleblower allegations for example can be looked at as a negative or as a positive—an opportunity to identify gaps in how research is conducted for positive and progressive-minded continuous improvement imperatives—which we emphasize is different than becoming bogged down in bureaucratic entanglement.
Gary S. Firestein, MD, founding director and dean and associate vice chancellor of clinical and translational research at UC San Diego School of Medicine
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