Taking care from the bench to the bedside

Two of the United Kingdom's biggest cancer charities are to merge next month. Tony Durham looks at the benefits.

Next month a giant new cancer charity, Cancer Research UK, will arise from the merger of two familiar names in the field, the Cancer Research Campaign and the Imperial Cancer Research Fund. About 130 out of 3,200 or so jobs will be lost in the process, most of them in fundraising.

Andrew Miller, the former vice-chancellor of Stirling University who has been in charge of the merger since October and is interim chief executive of Cancer Research UK, says the charities used to spend much of their energy competing with each other for donors to the detriment of cancer research as a whole. But the £1 million-odd that will be saved on internecine marketing is not the main motive for the merger. Miller hopes that the new charity will be a more effective fundraiser, capitalising on the two organisations' complementary strengths. The ICRF, for example, is particularly good at direct marketing, while the CRC has a strong network of local activists running fundraising events. The CRC's director-general, Gordon McVie, is a tireless publicist who has reduced the fear and ignorance surrounding "the big C". The ICRF is basking in the glory of its director-general Sir Paul Nurse, who bagged a Nobel prize with colleague Tim Hunt in 2001, the awards' centenary year.

Miller is not greatly worried about the loss of two well-known "brands". According to market research, many donors say they give to "cancer research" but cannot name the specific charity. There are encouraging precedents in the United States, where merged charities have increased their total income, particularly in the second year after the merger. Gambling that this pattern will be repeated in the United Kingdom, Miller hopes to be able to put an extra £10 million to £15 million a year into scientific research, on top of the £132 million that the two charities currently distribute.

On the research side, the organisations could fit together well. The ICRF supports much work in basic biology; the CRC is more active in drug development and clinical trials. "What the new charity would want to do is to be active across the whole spectrum from the laboratory to the clinic, from the bench to the bedside," Miller says.

The charity will be looking for proposals that mesh fundamental biology with clinical research - a magical, circle-squaring category known as translational research. The hope is that findings from molecular biology, cell biology and genetics will be "translated" more rapidly into new treatments and diagnostic tests. Cancer research increasingly depends on expensive machines such as magnetic resonance scanners. But Miller, a biophysicist who was responsible for setting up the European Synchrotron Radiation Facility in Grenoble, maintains that when enough users share an expensive facility, the cost can be kept down. The merger, formally announced last month, will avoid duplication of expense on such equipment and may improve research. Get a critical mass of people working together at a synchrotron or a scanner, Miller argues, and you can establish a world centre of excellence. You can do world-beating research and attract more funding on the strength of it.

Another difference between the two organisations is that the CRC funds more research in universities; the ICRF does more in-house. Maintaining a balance between the two approaches will be vital. The charity will have a formidable list of cancer researchers on its payroll, but if they get all its money, there will be none left for university scientists who come up with serendipitous findings and novel approaches. Cancer Research UK will continue to operate a responsive-mode funding programme, Miller says. "We are putting together a system that will assess, on a level playing field, both intramural and extramural research."

It will be a complex situation for intellectual property rights (IPR). ICRF staff scientists get a modest percentage when their work is commercialised. University scientists funded by the CRC can sometimes do rather better, depending on their university's rules.

It costs more than £100 million to bring a new drug through clinical trials and to market. Only the big pharmaceutical companies have that kind of money. Both charities have set up "knowledge transfer" companies to strike deals with the drug companies, but it is a buyer's market and each company brings in only £1.5 million to £2 million a year. Miller is involved in discussions that could lead to a merger of the two companies or the creation of new, small companies charged with developing specific inventions.

"We want to try to hold on to the IPR longer so the value is more when it is released," he explains, adding that no medical charity can ever be entirely mercenary about its relationships with big business, given its relationship with donors. After all, donors are not going to be impressed if a promising test or treatment is canned because you held out for bigger royalties.