Sunday, August 13, 2017

Thinking About Its Demise: California Stem Cell Agency Launches Examination of Alternatives

California's $3 billion stem cell research agency, which is facing its financial demise in a few short years, has formed a team of its directors to tackle transition planning and examine possible alternatives, including ones that would extend its life.

The first meeting of the group of directors is tentatively scheduled for Sept. 18. Jonathan Thomas, chairman of the governing board of the California Institute for Regenerative Medicine(CIRM), as the agency is formally known, said earlier this summer:
"The legislature has asked that we put together and start thinking about a transition plan, which can contemplate a variety of factors."
In response to a question last week, a spokesman for the agency, Kevin McCormack, said that a notice with more details would be posted 10 days prior to the meeting.

At a meeting in June, Thomas laid out the need for the transition team. He said all options are on the table including asking the legislature for cash or to place a measure on the ballot for more bond funding.

The agency's only real source of money is state bonds, authorized by voters in 2004. It has roughly $600 million left. The agency has projected it will run out of cash for new awards in mid 2020, although that could vary, depending on whether it slows down the pace of awards.

Several directors at the board meeting in June expressed a "sense of urgency" about dealing with the fate of the agency. CIRM Director Jeff Sheehy, a member of the San Francisco board of supervisors and an HIV/AIDS patient advocate, voiced concern about the uncertain nature of the agency's future.

Sheehy said,
"It seems to me that we will be talking about a substantial scaling back of the organization in 2020....We've kind of created this expectation that we were going to go to 2018 and come back with new money."
Sheehy referred to talk that a new bond initiative might be launched in 2018, a move that the board's former chairman, Robert Klein, has publicly advanced. Sheehy said, however, that he spoke with Klein, who told him that he was now considering 2020 instead.  Klein's method would require the gathering of hundreds of thousands of valid voter signatures to place the proposal on the ballot and would bypass the legislature. 

The year 2020 includes a presidential election, which has higher voter turnout and generally is considered a better time to win approval of bond measures. Presumably, the agency might be able to secure extra funding to span any financial gap or, alternatively, lower the frequency of awards to stretch out the cash. 

The members of the transition group are Thomas, Sheehy, Art Torres, Steve Juelsgaard, Joe Panetta, Kristiina Vuori, Linda Malkas, Diane Winokur, Shlomo Melmed, Al Rowlett and Judy Gasson. Short bios on each of them can be found via this page. 

The California Stem Cell Report will carry an item with the date and location of the September meeting when it becomes available. 
Sphere: Related Content

Wednesday, August 09, 2017

Crossing the Two Million Mark: A Dozen Years of Readership on the California Stem Cell Report

Google's page view count for the California Stem Cell
Report as of 11:01 a.m. today 
The California Stem Cell Report this morning hit a readership milestone -- two million page views.

The count was recorded only about 18 months after chalking up one million page views, a number that took 10 years to reach. The blog began publication in January 2005, just as the Golden State's stem cell agency was getting underway. Since then 4,492 items have appeared. 

For those not familiar with Internet terms, a page view is recorded by Google each time a person opens his or her Internet browser on a particular page. It is an industry standard that it is used to help define readership, something akin to circulation numbers for newspaper.

The California Stem Cell Report (CSCR) is somewhat unique. It is the only independent web site devoted to the $3 billion ($6 billion if you count interest costs) California Institute for Regenerative Medicine (CIRM), as the agency is formally known. The report was created to dig deeply into the agency, focusing largely on public policy and economic issues and recording the agency's activities.

David Jensen, Mazatlan, Mexico
The blog is published and written by David Jensen, a retired editor and journalist who spent most of his career at The Sacramento Bee, but who also worked seven years for United Press International and two years as a press aide to Gov. Jerry Brown (1974-76). Over the last 12 years, Jensen has covered the agency while living on a sailboat as it navigated the west coasts of Mexico and Central America. He traveled back to California from time to time for meetings of the agency and interviews with its leaders.

As reported in 2015, the one-million figure then and the two-million figure now are both large and small. The figures are picayune compared to the readership for major news sites. But they are relatively large given the size of the potential audience.

The report's long-time estimate has been hat only about 3,000 to 4,000 persons worldwide are deeply interested in stem cell matters. When Randy Mills, former president of the stem cell agency, heard the estimate last year, he said he thought it was even less. 

The readership for the blog is mostly found in the United States, according to Google's statistics. But a significant component comes from Europe as well. Readers range from individuals seeking information about stem cell therapies to folks at such places as the National Institutes of Health, major research institutions in California as well as elsewhere (such as Harvard, Cedars-Sinai, Sanford-Burnham, Stanford, UC San Francisco, UC Irvine). 

The most highly read article during the past 12 years deals with the cost of a stem cell therapy. It has had 23,498 page views, far beyond the second best-read piece that counted 2,754 page views. Presumably the "cost" piece drew considerable attention from persons considering a stem cell treatment. The No. 2 article dealt with a call by the state controller for online posting of the economic interests of members of the CIRM governing board.

The blog has also served as a starting point or helpful reference for many journalists looking into the agency and has been described as "indispensable" by Los Angeles Times columnist Michael Hiltzik

The blog began shortly after the passage of the 2004 ballot initiative that created the agency and provided the bond funding for the program. CIRM is unique in California history and is one of the largest, if not the largest, single source in the world of funding for stem cell research, especially involving human embryonic stem cells. CIRM has had a major impact on stem cell science in California and has helped to sustain research interest in the field at a time when others were wary of involvement.

Its birth was unusual, probably the only scientific research effort ever triggered by the use of petitions signed by more than one million voters and then placed on the ballot for further voter approval. It additionally represents a rare confluence of big science, big business, big academia, big government, big politics, religion, morality and life and death. 

The blog itself is financed personally by Jensen, who has no financial ties to biotech, academia or industry or the agency. Google does place ads on the site, which generate about $150 every six months or so based on the number of people who click on an ad. A crowd funding pitch awhile back was unsuccessful. However, the blog does spin off occasional freelance pieces to The Sacramento Bee and Capitol Weekly Sphere: Related Content

Sunday, August 06, 2017

The Demise of California's Stem Cell Agency: Gone in Three Years or Perhaps Some Other Date?

The $3 billion California stem cell agency goes out of business in less than three years: True or false?

For those of you seeking certainty, the "definite" answer is maybe. The agency has been saying for a couple of years now that it will run out of funds for new awards by roughly the middle of 2020. However, prior to that estimate, the death knell for the research program was forecast for much earlier. In fact, it would have come this year, 2017.

The difference is the result of different projections at different times by different leadership of the California Institute for Regenerative Medicine (CIRM), as the Oakland-based agency is formally known. When Alan Trounson, an internationally known scientist, was president of CIRM, it produced  the 2017 figure. When Randy Mills, a longtime biotech business executive, took over three years ago, he redid the estimate and came up with 2020.

The difference is based on assumptions. And they involve the "burn rate" of CIRM's cash. With the support of the board, Mills reduced the rate at which money would be awarded thus extending its effective life.

Steve Juelsgaard, Iowa State photo
CIRM board member Steve Juelsgaard, a former top executive with Genentech, in June briefly highlighted the vagaries of CIRM's possible demise. According to the transcript of the board meeting, he told CIRM directors:

"So there are ultimately three possibilities, right? The one that's most looming is the ending of current funding at some point in the future. Right now we're targeting 2020..... However, we're the ones who can determine when that funding will end. If we think it's better to run past 2020 to give ourselves more runway, then we should formulate a plan that would allow us to go to 2021 or even a little bit beyond that to see what happens. So nothing is cast in stone yet (concerning) exactly when we're going to end up with our funding.
"The second one would be the opportunity to have a new bond measure passed, let's say, in 2020.  So what's the plan? If that were to happen, then the third one is going back to the old private-public partner approach which, as I understand it, is still on the table.
"So, in any event, I think what we need are side-by-side plans that look at all of those, that as time goes on and it becomes clear which of those is likely to occur, we can just put it into play. The one that's most likely to be put into play is the one that ends the organization. And then if one of the others comes in after the fact, we can then plug it in and continue on."
Later this week, the California Stem Cell Report will look at a new governing board committee that is examining the various end-of-life, CIRM scenarios. As an aside, during the 2004 ballot campaign that created CIRM, it was widely and erroneously believed that CIRM would have only a 10-year life. The 10-year figure dealt with the agency's bonding authority from the date when bonds were first issued. Sphere: Related Content

Friday, August 04, 2017

'A Reliable Voice of Reason:' A Look at a California Stem Cell Researcher/Blogger

Paul Knoepfler's TED talk has drawn more than one million views

The journal Science this week profiled UC Davis stem cell scientist and blogger Paul Knoepfler, describing him both as a consumer watchdog and a "dogged voice of caution."

In the article by Kelly Servick, George Daley,  dean of the Harvard Medical School, also called Knoepfler a "reliable voice of reason."  Daley noted that academics are "often more comfortable being provincial and insular, and not … mixing it up in the public debates."

Knoepfler began blogging seven years ago after -- at the age of 42 -- he was diagnosed with prostate cancer and given a roughly 50-50 chance of survival. He told Servick that he wanted to "expand how I had impact, beyond just the pure science." From the start, his blog went beyond science to patient advocacy.

Readers of the California Stem Cell Report are likely to be familiar with Knoepfler's blogging efforts, which are often reported here. We have followed his efforts since their inception. Over the years, his voice has grown to be heard in publications across the country. Just this week, he was widely quoted in coverage of the ground-breaking research into gene editing of human embryo.

(An aside from this writer, who is quoted in the Servick piece: One of the reasons that Knoepfler is quoted widely is that he returns media phone calls and can "speak English" -- meaning that he can explain science in terms that most persons can understand, at least those who read newspapers. That could have something to do with having an undergraduate degree in English.)

The Science article focused heavily on Knoepfler's writing about unregulated stem cell clinics, including research by him and Leigh Turner of the University of Minnesota that documented for the first time the size of that particular industry in this country. Their work counted 570 clinics with the most in California.

Why the focus on the unregulated treatments? Knoepfler told Science:
"'They were just saying, ‘Screw the rules, we're just going to set up shop and put up a website and start injecting people with stem cells....I saw that as a threat, first to patients, but to the field as well.'"  
Sphere: Related Content

Thursday, August 03, 2017

California Stem Cell CEO Search: Lid Still on Until Late September

The  governing board of the $3 billion California stem cell agency, which is seeking a new president, does not plan to have another meeting of its presidential search committee until possibly this fall.

The committee has held only one meeting since May 2, when Randy Mills announced he would be leaving at the first of July.  Maria Millan, formerly vice president for therapeutics, has been serving since July 1 as interim president. She has the backing of Mills to fill the slot permanently. 

The meeting of the search committee occurred July 17. And the agency has remained virtually mum on the process of selecting a new president to oversee what some call the final stage of its life. It is scheduled to run out of cash for new awards in about three years. 

Last Monday (July 31) , the California Stem Cell Report carried an item on the dearth of information about the process of selecting a new president, including the lack of a public timetable and addressing such questions as whether a search firm would be involved. The position carries a salary of up to $575,000.

Following publication of the item, Kevin McCormack, senior director for communications at the agency, sent the following email. 
"Just to be absolutely clear, this is exactly the same process we followed when we were looking for a replacement for Alan Trounson. Then, as now, we did not disclose the results of the closed session meetings of the Presidential Search Subcommittee nor described the contents or outcomes.  From the very beginning of this process, and we mentioned this at the last board meeting, the intention was for the subcommittee to meet and evaluate the options for finding a replacement for Randy and then for the matter to be taken up at the very next meeting of the full ICOC (the governing board). There is no 'lack of information' nor is there any intention of holding another Presidential Search Subcommittee meeting before the full board meeting in September."
The agency, however, has a record of difficulty in recruiting new presidents, including rejected offers and board discord on the desired qualities in a CEO.  It also has in the past disclosed such things as timetables and search firms and more. (See here, here and here.)
Sphere: Related Content

Wednesday, August 02, 2017

The Smell of Money and Gene Editing of Human Embryos -- Not to Mention the Breakthrough Science

"Horror to be avoided," "superbabies" and "what it means to be human" -- Just some of the language that turned up today concerning the news about the first human embryo editing experiment in the United States. 

Publications ranging from Wired to the Financial Times all had pieces discussing the work led by Shoukhrat Mitalipov of the University of Oregon in collaboration with researchers from California's Salk Institute, China and Korea. A search on Google news this afternoon turned up more than 1,000 citations dealing with the work.

Details of the science can be found in the journal Nature with a critique by UC Davis stem cell scientist Paul Knoepfler on his blog. He praised the research and said it "raises the stakes on future CRISPR use in humans." Elsewhere, the implications of the work also generated both heat and caution.

 The headline on a commentary in the Chicago Tribune said,
"Don't fear the rise of super babies. Worry about who will own genetic engineering technology."
The piece was written by bioethicist Arthur Caplan. He said,
"Freaking out over impending super babies and mutant humans with the powers of comic book characters is not what is needed....How close are they to making freakish super people using their technology? About as close as we are to traveling intergalactically using current rocket technology."
Caplan continued,
"We need to determine who should own the techniques for genetic engineering. Important patent fights are underway among the technology's inventors. That means people smell lots of money. And that means it is time to talk about who gets to own what and charge what, lest we reinvent the world of the $250,000 drug in this area of medicine."
Pam Belluck of the New York Times reported that the findings are "sure to renew ethical concerns that some might try to design babies with certain traits, like greater intelligence or athleticism."

She interviewed Hank Greely, director of Stanford's Center for Law and Biosciences
"'If you’re in one camp, it’s a horror to be avoided, and if you’re in the other camp, it’s desirable,' Dr. Greely said. 'That’s going to continue to be the fight, whether it’s a feature or a bug.'
"For now, the fight is theoretical. Congress has barred the Food and Drug Administration from considering clinical trials involving germline engineering. And the National Institutes of Health is prohibited from funding gene-editing research in human embryos."
Marcy Darnovsky, executive director of the Center for Genetics and Science in Berkeley, said in a news release,
"We have not yet engaged in processes that would promote the`broad societal consensus’ about human germline modification that the National Academies of Sciences and other prominent advocates of gene editing have recommended. Until that is achieved, we call on scientists around the world to refrain from research aimed at refining gene editing for use in human reproduction."
Bradley Fikes of the Union-Tribune in San Diego, a hotbed of biotech activity and the home of Salk, wrote that the study
"...brings to a head fundamental questions about what it means to be human, and whether changing the human genome would also change the human identity. And scientists — including those involved in the study — say it’s time for the public to speak up."
Given that this type of research is not funded by the United States government, just where the money came from is of interest. The Salk Institute had the answer. It said in a news release that the funding was provided by the "Oregon Health and Science University, the Institute for Basic Science, the G. Harold and Leila Y. Mathers Charitable Foundation, the Moxie Foundation, the Leona M. and Harry B. Helmsley Charitable Trust, and Shenzhen Municipal Government of China."

Some of the money "compensated" the women who provided the eggs, according to an article by Kelly Servick in the journal Science. Compensation, as opposed to expense reimbursement, is problematic in some areas of research. For example, it is banned in research that is funded by the $3 billion California stem cell agency.

The stem cell agency wrote about the research last week after the findings leaked out early. In February 2016, the agency convened a day-long session to examine issues involving gene editing. Last summer it issued new regulations that say that consent forms involving CIRM research must be modified to include a mention of genetic research. Added was the following phrase: "donated embryos [blastocysts], derived cells or cell products may be used in research involving genetic manipulation."

Regarding the future of the research, Mitalipov told the Financial Times that he wanted to perform regulated clinical trials at some point in the U.S. Unless something changes, he said that “unfortunately this technology will be shifted to an unregulated place." Sphere: Related Content

Monday, July 31, 2017

Zipped Up in Oakland: California Stem Cell Agency Mute on Search for New CEO

More than mum -- a good description for the $3 billion California stem cell agency this morning as it wrestles with what is likely its most important decision of 2017.

And that is finding a new president to oversee what some call the "last stage" of its life and its search for a stem cell therapy that will fulfill the expectations of the voters who created the research program in 2004.

The governing board of the California Institute for Regenerative Medicine (CIRM), as the Oakland-based agency is formally known, has held one meeting of its presidential search committee since Randy Mills announced his resignation May 2.

No public utterances emerged, however, from the July 17 session. Did the panel set a timetable for selecting a new president? No response. Will the board hire a search firm to help recruit? No response. Is the search committee going to meet again? No response. Simple questions that have been dealt with openly in past presidential searches at CIRM.

The search for a replacement for Mills has special significance. The agency expects it will run out of cash for new awards in three years or less. In the world of stem cell research, that may not be a nanosecond but it is a very short period of time.

Maria Millan, CIRM photo
It raises the likelihood of an exodus of staff from the program, which has also lost another linchpin in the organization, general counsel James Harrison. Without some certainty and confidence about the next three years, some CIRM employees, of which there are only about 50, may look to other enterprises for their professional futures. The likelihood of more departures could increase unless the board moves to shore up stability and to help retain the energy that Mills brought to the program.

Maria Millan, formerly the vice president for therapeutics, is interim president. Mills publicly endorsed her to fill his slot, which carries an annual salary of up to $575,000. She has been in place for one month. She too may be wondering about the stability of her position and whether she should be looking elsewhere for a position.

The next meeting of the governing board of the agency is set for Aug. 24. CIRM Chairman J.T. Thomas usually gives a report to the board at many meetings. He skipped that at the board meeting in July. Will he will brief the board at the August meeting on the presidential search? That has not yet been publicly disclosed. Sphere: Related Content