Nearly $1 Billion California Stem Cell Plan: 50 Clinical Trials, Therapy Cost to Consumers Not Addressed

The CIRM view of the dynamics of stem cell research over the next five years

Highlights

$575 million for clinical, translational

FDA big impediment

Patients want greater voice

Therapy cost to consumers not mentioned

The California stem cell agency will spend the bulk of its remaining $890 million for more advanced research, including as many as 50 new clinical trials, according to a plan released today.

Randy Mills, president of the $3 billion state research effort, is expected to discuss the proposal Thursday during a teleconference meeting of the agency’s governing board. The public can participate from 18 locations, including one in Atlanta.

The figures represent projected spending by CIRM.

Mills expects to spend $400 million on clinical ventures and about $175 million on translational research, the effort to transform basic discoveries into potential clinical use. Basic research would receive about $180 million between now and 2020. That’s when money for new awards would run out under Mills’ plan, which did not address the fate of the agency beyond that date.

The proposal was unveiled in part this week as a discussion item on the agenda for a meeting that comes in less than two days. The information was offered in a 30-page PowerPoint presentation with no supporting documents.

The plan also offered an overview of past activities of the California Institute for Regenerative Medicine (CIRM), as the agency is formally known.

Mills indicated that he had received input from 217 “stakeholders” as part of developing the proposal. The number referred to the persons who responded anonymously to an online survey. 

One of his conclusions from the input: Patient advocates “want a more active role.” He also reported, 

“Many of CIRM’s programs are still not widely known to all potential partners.”

Seventy percent of the stakeholders viewed the FDA “as the biggest impediment to the development of stem cell therapies.” Mills said his plan would “drive implementation of a new FDA paradigm.”

Mills also identified five key risks. They were:

• “There may be an insufficient number of meritorious therapeutic candidates to reach our goals.
• “There may be insufficient interest from qualified applicants to participate in key competitions.
• “The current limited funding of the agency could affect the ability to retain or attract personnel.
• “Investors may be uninterested in stem cell therapies.
• “The FDA may be unwilling to improve the regulatory environment. 

Some key parts of Mills’ strategic plan are well underway, such as the start of CIRM 2.0, the name for the effort to step up the funding pace for clinical awards.  At Mills’ request this summer, the board allocated $100 million this fiscal year for clinical work. He is proposing $85 million for next year.

By the end of this week, the agency will be involved in 15 clinical trials. The goal of taking part in 50 new trials does not include those efforts.

Basic research (termed discovery by CIRM) is scheduled for $15 million this year and $50 million in both 2017 and 2018.

Missing from Mills’ presentation is a discussion of the cost to consumers of potential therapies backed by the agency or whether the agency might want to focus on less costly efforts. That question was an early one for the agency. In 2006, the Consumer Watchdog group said,

 “Cures and treatments must be priced so all Californians can afford and benefit from them, not just a wealthy few.”

The issue is back in the news again with national stories highlighting huge drug costs and price increases. Reuters reported today,

“Americans are paying way over the odds for some modern cancer drugs, with pharmaceutical companies charging up to 600 times what the medicines cost to make, according to an independent academic study.” 

Democratic presidential candidate Hillary Clinton, who supports CIRM efforts, said this week she intended to eliminate “excessive profiteering” in the drug industry, triggering a sell-off in drug stocks.

Another strategic issue involves whether the agency should make choices between research that directly involves only a few thousand people versus research that would directly affect millions. Also missing is an overview of the agency’s move away from research involving human embryonic stem cells(hESC), the controversial human tissue that is freighted with moral and ethical questions. As of February, the agency reported that about 240 of its 667 awards involved hESC. 

The desire to fund research involving human embryonic stem cells was the motivating force behind creation of the agency in 2004 through a ballot initiative. The $36 million campaign used former President Bush's restrictions on federal funding for hESC research to build support. Bush's action had stirred an outcry among scientists and many patient advocates. Biotech companies also shied away from publicly backing hESC research because of the controversial issues.

Mills’ strategic plan is well along the way to completion and may well be approved by the board later this year with few significant changes. The public can weigh in, however, with comments on the proposal during the Thursday meeting from the 18 teleconference locations.  The addresses can be found on the agenda.

Comments, criticism and suggestions for the CIRM board can be emailed to Kmccormack@cirm.ca.gov.

The strategic plan revision is set for discussion only this week. Presumably board approval could occur at meetings in October, November or December, the next non-teleconference session.

(Editor's note: An earlier version of this item said 20 teleconference locations were available.)

Parkinson's and the California Stem Cell Agency: Advocates Cite 'Overwhelming' Need to Air Unhappiness

The California stem cell agency has posted a letter online from Parkinson’s patient advocates that says that an emotional outpouring at a July stem cell meeting grew out of an “overwhelming” need to protest agency delays in funding research.

The letter was signed by Sherrie Gould and Jenifer Raub, leaders of Summit4StemCell, a San Diego group, and was sent to the agency's board. Gould and Raub wrote about the July 23 meeting of the board during which the patients protested after they learned that no funding for the research they were backing would be available until about 2017. (See here for full text of the protest.)

The link to the Aug. 2 letter is part of the agenda for this Thursday’s teleconference meeting of the directors of the $3 billion research effort. It said, 

“Our group at Summit4StemCell (has) been regularly attending the CIRM meetings for the past 18 months. Out of respect for Jeanne Loring PhD, we have typically shown up in ‘silent solidarity’ but this meeting was different and many of us had an opportunity to speak publicly about our project, our progress and our desperate need for funding.

“The outpouring on Thursday (July 23) was spontaneous and unexpected. We at Summit feel strongly that we communicate with all board members that our presence at any of the CIRM board meeting is not orchestrated by Jeanne Loring, Dr. Melissa Houser (of the Scripps Clinic) or anyone from the Loring lab.

“We are a passionate group of dedicated Californians that believe strongly in the probability of success of this research using pluripotent stem cell technology. Dr. Loring has always counseled respect and brevity. We believe she would prefer that we be the face of the issue and not the strident voice.

“When confronted with the possibility that there could be no help (or hope) for over a year, the need to speak and be heard was overwhelming. We sincerely believe that you and the board heard us and will do all you can to find an exception or some way to help.” 

The reference to Loring, who is head of the stem cell program at the Scripps Research Institute in La Jolla, has to do with the Summit group’s support of her research. It also seems to be linked to an anonymous comment filed on the California Stem Cell Report’s account of the July protest.

The writer indicated that Loring had submitted an application earlier that was scored unfavorably by the agency, based on a conversation that the writer had overheard at the Oakland meeting. In response, Loring said no such conversation took place. She said an earlier application in another round did not meet CIRM criteria and was withdrawn. The agency does not publicly comment on such grant review processes, which are conducted in secret. It also does not release the names of unsuccessful applicants. (See Loring's and the writer's complete comments at the end of this item.)

Summit4StemCell is also not happy with teleconference nature of this week’s meeting. Earlier this month, they said their voice was “diminished” because of the inability to speak to the governing board face-to-face.

The California Stem Cell Report item on the teleconference/Parkinson’s flap is the most widely read post this month, exceeding the readership of the item dealing with the agency’s announcement concerning its $32 million stem cell bank. 

Text of Parkinson's Protest at July Meeting of California Stem Cell Board

Here is the text of remarks made by Parkinson’s patients at the July 23 meeting of the governing board of the California stem cell agency. We should note that the words do not convey the impassioned feelings that were expressed. The comments come from the agency’s transcript of the meeting.

I'm Ron Evans. I'm an ophthalmologist from Placerville, and my wife has Parkinson’s disease. Specifically I was noticing in an earlier talk, I think Dr. Mills presented some of the funding schedules, and for 20 -- well, for this year and up to, I think, 2016, they had zero dollars slated to fund translational projects. Is there a reason why there's a delay in that and not moving of that $40 million forward? 

(Randy) Mills (president of the stem cell agency, CIRM): Yes. So the funding for the $40 million here is on a -- starting as soon as it's approved by the board today. The numbers I put up on that slide were for the fiscal year 2016. So our fiscal year started July 1st and will end June 30th of next year. Between now and June 30th of next year, we will -- this program will be started, but we won't be through an entire cycle. Meaning we have to issue the program announcement, then there has to be time to complete the applications, and the applications come in and they go through the review process, and then after the review process, they come back to the board and the board approves them. We will not have gone through all of that cycle yet by June 30th. So the actual first awards that will come out of this will be in fiscal year 2017.
Evans: so essentially there has to be a certain legal process that it goes through before the funds are available or procedural if legal is not a good term.

Mills: Correct.

Evans: And maybe an amendment someone might even think of is the president, if he sees an exceptional project, could seek to sidestep that or make an exception. Thank you.

(Agency) Chairman Jonathan Thomas: other comments from members of the public? Please state your name.

Roos: My name is Ben Roos. I'm a young onset Parkinson’s at age 31. I think I want to see some action. I understand the procedures and policies, but this is a billion dollars of money that I voted for and the public voted for, and I’d like to see translation put into effect ASAP. And I’ve waited 15 years. I'm tired of waiting. This is a golden opportunity. I think you guys should -- the people at Scripps (Research Institute) here have a program which is under way. Ten million, for example, would help them get into the next stage of translation. And I would give it to them this year, not in 2016. Also I would urge my fellow Parkies to speak up. This translation thing is where the rubber hits the road. So we've all come a long way. Speak up.
(applause.)

Hoover: Chris Hoover. I'm a Parkinson's patient. I've addressed the board twice before, but the last one was with Dr. (Jeanne) Loring (head of the Scripps stem cell program) at the Claremont (Hotel), and we were the only ones there because There was a rainstorm of the year. We call that divine intervention. But I think what I want to do is summarize. We kind of feel like we're a round peg in a square hole. We came to you and we had our discovery stage pretty much done by ourselves. We've raised the money, we've done the research, and we’ve got the science. So clearly we're in the translational stage, and that's where we're at. They suggested that we pull our old application because where we're at didn't fit the old CIRM and that it would fit the new CIRM 2.0 better. I was here almost every meeting, and CIRM talked about doing a 60-day turnaround on applications under the 2.0. So I’m not hearing anything about that now. We're talking now June of the following year. And that's kind of -- we've been waiting a while here. We've attended every meeting. So I’m wondering if there's any way, when you approve the translational, that we can speed that process up. And my question is what happened to the 60-day turnaround that you talked about initially with the 2.0 presentation.

Chairman Thomas: Dr. Mills.

Mills: So the 60-day funding decision is for the clinical stage programs, which includes the last part of translational and the enabling Studies that are done. There would be no way to do it for the high volume applications though.

Hoover: Where do we fit in your process because we didn't to come to you in the discovery stage? We're where we are now. Our science is done. We're need funding to get FDA approval. I guess my question to the board is: Is there any way to accelerate the process? Then you'd have us out of your hair. Thank you.

Chairman Thomas: Mr. (Jeff) Sheehy(a patient advocate, CIRM board member).

Sheehy: I think that's a question for Dr. Loring. I'm not sure where you would be in the science in terms -- we had our train analogy. I don’t know. I don't know what pieces need to be done and how that fits.

Hoover: I guess what I meant was when can we get our application in? We just want our application in to get reviewed. That's what we're looking to do. And we've been at this for about a year. Thanks.

Loring: So, Jeff, what's the question?

Sheehy: You don't qualify for the preclinical that's currently open?

Loring: It's not open now. There isn’t another round open right now. I'm sorry. I'm confused. There's no RFA (request for application) that I know of that is open right now that would be appropriate for us. If there is, I’ll apply it.

Sheehy: So there's not an RFA. So you’re really in the middle of the translation stage.

Loring: That's right. We are. We call it preclinical, but it really is translation as you define it.

Chairman Thomas: additional public comment?

Raub: I’m Ray Raub. My wife has Parkinson's, and we've been involved with Dr. (Melissa) Houser and Sherrie (Gould). At any rate, here's where we are. And if there's an exception that can be made, here's why we need it. We have scraped together almost $2 million. We've done it ourselves. We've done it on the backs of our friends. We don't have a lot of those left. They don't answer the phone anymore when we call because they know why we're calling. But we've done this and we've gotten awfully far. We've accelerated what we're doing. We're trying to get through the FDA. We've got functioning sets of dopaminergic neurons. We're ready to put them into a lot of the people that you've heard from today. We won't be able to do it without your help. We're tapped. And we've accelerated what we’ve been trying to get through the FDA. We've probably got about three months more of funding left. We need help, and we can't wait till the end of the fiscal year 2016, till next year. We'll find a way to do it. If you can't help, we'll find a way somehow. Anything you can do. And as I said, if there was ever a situation when exception was warranted, I swear this is it. Thanks.

(Marie) Duliege (CIRM board member): I just want to clarify. First of all, I just want to say how moved we are with all of your coming and your testimony about what you are going through and what you've done on your side to accelerate the process. But I want just to clarify one simple thing that I didn't get clear answer. Is there currently an opportunity to apply for a grant for the research that Dr. Loring is trying to do, or is there not? It's a very simple answer. In which court is the ball?

Mills: For translational activities, that's what we're voting on now.

Duliege: I’d like for everybody. Is there an opportunity for Dr. Loring to apply for a grant for the research that she's trying to do?

Mills: If we approve this, then there will be a program announcement issued, and that's what this funding is for.

Duliege: Thank you very much.

Chairman Thomas: Additional comments from members of the public?

Radunsky: My name is Mike Radunsky, and I’m involved in Dr. Loring's program. You've heard from me several times. And I feel a little bit like the counsel members' statements are a way to say, well, we gave you a chance to apply, but you’re telling us that we have to wait another year before the funding comes in. That's what we saw, a big zero in the 2016 funding. And there were three digits in all the columns for everything else. And the fact that it's going to take nine months to review a grant that we've been discussing with you for a long period of time is a little bit onerous. I think, again, as Ray Raub asked, if there's ever a time for an exception, this is it. I have two small children that I’m taking care of with Parkinson’s disease. And if I don't find something that's going to help me with this, I don't know if I'm going to get to the end of this without severe financial hardship. And I’m extremely lucky to be involved in this program, but I would like to ask you guys to help me stay lucky by getting there, Helping us get the money faster so that I can continue to work and supply for my family.

Chairman Thomas: additional comments from members of the public?

Raub : Hello. My name is Jenifer Raub, and my husband is going to make me cry. I just ask you to please speed this up. Tell us when we can apply, not September.

Chairman Thomas: Dr. Mills.

Mills: For the scheduling, so everyone knows, the concept plan that's before you for translation has the first application deadline, meaning the application would have to be in, is in March, which means the application would post this year. There would be time to obviously be responsive to the application and the application available in March.

Chairman Thomas: any other comments from members of the public? 

Raub: Only me. My name is Jenifer Raub, and that's outrageous.

Burkes: My name is Dennis Burkes. I'm a patient, Parkinson’s patient. And this reminds me of the old saying, "Water, water everywhere and not a drop to drink." Down in San Diego we sit amongst other research institutes that are sitting on hundreds of millions of dollars. Guess what they're doing? They’re trying to figure out how they're going to dispense that money, and they’re just dragging that out and dragging that out. And it's so frustrating to all of us. If there's something wrong with the science here, if you know something or some reason this shouldn't proceed, then tell us. Don't let bureaucracy and policy and procedure stop this project from moving forward and taking another year because we're going to run out of money very soon. Ray is right. Maybe we can come up with more money, but we're not the most well-heeled group. And our list in our Rolodex has been used up. And it's going to be tough. And we've hired new people, we have new researchers at work now, and it would just be tragic to see that come to an end with all the funds that are there and with such a promising project as this one. So I just ask that you please take that into consideration. Thank you.

Chairman Thomas: Other comments from members of the public?

Roos: This -- I don't know which of you this is addressed to, but why was there zero dollars in this year's budget for translation?

Chairman Thomas: Dr. Mills.

Mills: So the schedule was set up because we were going to be launching all of these initiatives, not just the translational phase. So we have multiple discovery reviews to do, we have the translational review to do, we have the educational reviews to do, and we have all the clinical reviews to do. So we just have slots that we can have these things fall into. The reason that March was picked as the first application deadline for the translation phase was because we just did an award review in February.  It was the most recent award that we had. We hadn't done a discovery award in a while. So when we were ordering them between discovery and translation, because we had just completed the translational phase award in February, we slotted discovery first.

Roos: And the follow-up question is why can't you approve a project like this now? Is this procedure really necessary, to wait a year?

Mills: I would just – James (Harrison) is legal counsel here.

Harrison: So Prop. 71 (the ballot measure that created the agency) requires that we go through a competitive selection process which entails review by the grants working group. And backing up, that involves releasing a program announcement, which will be done expeditiously assuming the board approves the concept proposal. We then need time to process the applications, Schedule a GWG (grant review group) meeting for the review, and then bring those recommendations to the board for its final consideration.

Roos: You guys (unintelligible). Can you do it in three months? I just don't understand why it has to wait a year. Thank you.

Brain Cancer Targeted: Calabasas Biotech Firm Set to Win $20 Million in California Stem Cell Funding

John S. Yu, chairman, ImmunoCellular -- Cedars-Sinai video 

Highlights

Second CIRM bet on phase three trial

$34 million in co-funding

Application initially rejected

California’s stem cell agency next week is expected to award $20 million to a tiny California firm to help finance a phase three clinical trial of a therapy for a rare brain cancer.

The move would be the $3 billion agency’s second investment in a phase three clinical trial, the last major hurdle before a therapy can be offered for widespread public use. The first was an $18 million bet this spring on NeoStem, Inc., now known as Caladrius.

The two trials offer the best likelihood of fulfilling -- in relatively short order -- the 2004 campaign promises made to voters when they created the Golden State's stem cell research effort. 

The firm involved is ImmunoCellular Therapeutics, Ltd., a publicly traded enterprise headquartered in Calabasas, Ca., a suburb northwest of Los Angeles.  Calabasas is better known for its entertainment personalities, such as the Kardashian family, than biotech.

In addition to the state funds, the trial would be backed by $34.4 million in co-funding, according to the California Institute for Regenerative Medicine(CIRM), as the agency is formally known. Earlier this year, ImmunoCellular estimated the total cost of the trial could be about $50 million.

The firm's proposed therapy targets glioblastoma, a fast-moving cancer that CIRM said is “resistant to current standards of care."  It has a survival rate of slightly more than one year. Immunocellular said that about 10,000 new patients are diagnosed each year in the United States.

The treatment is called ICT-107. Immunocellular reported on its Web site that the treatment is “an autologous (patient-derived) dendritic cell immunotherapeutic that targets six different antigens (peptides that are tumor markers) associated with glioblastoma.”

The CIRM summary of reviewer comments said that the phase one trial for the treatment produced a “tremendous survival response.” The summary said,

“Though the survival response observed in the Ph1(phase one) trial was not fully replicated in the Ph2 trial, results are supportive of continued clinical development and of the Ph3 trial as designed.”

ImmunoCellular has been around with its current focus since 2006 when it acquired its cellular-based technology from Cedars-Sinai in Los Angeles. John S. Yu, director of surgical neuro-oncology at Cedars, is listed as the founder of the firm. He is now chairman of the board and chief scientific officer.

The firm has four full-time employees and four part-time, including Yu, according to February 2015 filings with the Securities and Exchange Commission. The firm said,

“We have a number of consulting agreements for clinical development, regulatory affairs, investor relations and business development. We outsource all of our drug discovery research, process development, manufacturing and clinical development to third parties with expertise in those areas."

ImmunoCellular reports no revenues for the past several years. CIRM said, however, the firm has promised $34.4 million in co-funding for the clinical trial.

In an August closed-door session, CIRM’s scientific reviewers scored the ImmunoCellular application as having “exceptional merit” on a 9-0 vote. 

Ratification of that decision will occur in public next Thursday in a teleconference meeting of the agency’s 29-member governing board, which includes one representative from Cedars-Sinai.

The board almost never rejects a positive recommendation from its reviewers. The agency also does not release the names of successful applicants in advance of a board vote. The California Stem Cell Report identified ImmunoCellular through other means.

The firm's original application was deemed by CIRM reviewers to need improvement on a 1-9-2 vote and was sent back to ImmunoCellular for revision. The August review summary said,

“(R)eviewers had feasibility concerns regarding the applicant’s ability to enroll the trial and maintain the reagent supply chain to support manufacturing of the product. Reviewers also had concerns with the trial design, which centered around selection of the patient population targeted in the registration trial and the lack of immune monitoring proposed in the trial.

“The applicant was provided the opportunity to address these concerns in a revised application, and their responses and modifications to the proposal reassured reviewers that the applicant could enroll and conduct the Ph3 trial as proposed and that, if endpoints are met, the trial design could support licensing approval by FDA.”

The price of ImmunoCellular stock closed at $0.425 today, up nearly one cent. The 52-week high of the stock was $1.03 and the low 35 cents.

Google chart

California's $3 Billion Stem Cell Agency Releases More Information for Next Week's Meeting

The California stem cell agency yesterday made public significant background information concerning its board meeting one week from today, including an application for a $20 million clinical trial award.

Release of the information is a step forward in openness and transparency for the agency, which has slipped in that area recently. (See here and here.)

The $20 million award is the only application up for approval next Thursday, just four business days away. The California Stem Cell Report will have more on the proposal later today.

Items with fresh, additional information include new conflict of interest standards for the agency’s blue-ribbon grant reviewers, changes in the scheduling of upcoming rounds for basic and translational research and changes in loan award policies.

Still missing is information involving the agency’s plans to correct deficiencies identified in a $230,000 performance audit and the agency’s ongoing revision of its plans for spending its last $1 billion.

Next Thursday’s meeting will be a teleconference session with 17 remote locations, including Atlanta, where the public can participate and listen in.  All are places from which board members log in for the meeting. The locations include San Francisco (3 locations), Fresno, Davis, Los Angeles(3 locations), Napa, Stanford, Sacramento, Davis, Fresno, Berkeley, Los Gatos, Irvine and La Jolla (2 locations). Specific addresses can be found on the agenda.

The meeting will also be audiocast on the Internet, but no public participation is available by that means.

Comments to the board can be sent in advance of the meeting to mbonneville@cirm.ca.gov.

California's Stem Cell Agency Meets This Month to Award Millions, Discuss Performance Improvements

This month’s meeting of the governing board of the $3 billion California stem cell agency, already the subject of some unhappiness from patient advocates, will be staged from 12 different teleconference locations on Sept. 24.

All but one site is in California. One board member, Lauren Miller, will be logging in from Atlanta for what is expected to be about an hour-long meeting.

This month’s session was originally scheduled for San Diego, where board members and staff would have been available for face-to-face discussions with the public. But the San Francisco-based agency switched the meeting to a teleconference session because of estimates that it would last only an hour.

The move upset Parkinson’s patient advocates in San Diego, who planned to attend the session in their area to speak about the need for funding for research into a possible cure for the affliction. They already have protested delays in funding at the July meeting of the board in Oakland.

On this month’s agenda are mostly routine matters considered earlier by board subcommittees that are expected to be quickly approved. Also on the agenda is consideration of presumably multi-million dollar applications for clinical stage research proposals. The board nearly invariably rubber-stamps the actions of its blue-ribbon panel of application reviewers. No information is yet available on those applications.

Up for discussion is a plan to correct unspecified deficiencies identified in a $230,000 performance audit of the agency.  The study, commissioned by the agency and required by law, said the agency needed to improve its procedures involving conflicts of interest and grant application reviewers. Also identified as an area needing work is the tracking of potential royalties. No board action is expected to be necessary this month to implement the plan.

The agency’s president, Randy Mills, is additionally scheduled to give an update on the agency’s strategic plan, which is being reformulated. The board has roughly $1 billion left before its cash for new applications runs out in 2020.

No background information has yet been posted on the meeting agenda for any item to be discussed or acted on. The California Stem Cell Report will carry items on the material as it becomes available. If interested parties would like to submit comments to the board in advance of the meeting, they can be addressed to mbonneville@cirm.ca.gov.

The teleconference locations where the public can participate in the meeting and comment can be found on the agenda.  The session is scheduled to be audiocast on the Internet as well. Directions will be placed on the agenda. 

Parkinson's Advocates Dismayed by California Stem Cell Agency Action

This is a Summit4stemcell video prepared following an emotional protest at the July meeting of the board of  the California stem cell agency.

Highlights

Lack of speed, openness protested

Agency cites cost issues

Patient-CIRM relationships unique

A group of Parkinson’s patients from San Diego is less than pleased today with a move by the $3 billion California stem cell agency that the group says will stall efforts to secure much-needed funding for a possible cure for the disease. 

The events this week follow an emotional protest at an agency board meeting in Oakland in July and highlight the often intense relationship between patient advocates and the stem cell agency – not to mention the pressure on the agency to move fast to find cures.

Anger and the Parkinson's symptoms of trembling and speech difficulties marked the protests. One patient advocate, Jenifer Raub of San Diego, said it was "outrageous" that an award round being discussed at the meeting would not provide funding until possibly 2017.

The patient advocate group, Summit4stemcell, had planned to address the stem cell agency board again at a Sept. 24 meeting scheduled to be held in San Diego. However, yesterday the group was told that the meeting would not be held in their city. Instead the session was being turned into a teleconference meeting and would be only about one hour long. Most in-person board meetings last much of the day.

Responding to questions from the California Stem Cell Report, Sherrie Gould, executive director of the Summit group and a nurse practitioner, said in an email,

Sherrie Gould, Scripps Health photo

“We are both confused and disappointed that this PUBLIC (Gould’s capitalization) meeting has been essentially cancelled.  We were prepared to talk with the ICOC (the agency board) and answer all questions about our patient advocacy movement (Summit4stemcells) and our research….

“Unless we can be present in front of the CIRM board, Summit's strong voice is diminished.  Being physically present in human form is always more effective than a teleconference. Delays, which we realize are a part of any government associated agency, are devastating to people suffering from the progressive symptoms of Parkinson's disease.” 

Jeanne Loring, head of the Scripps stem cell program in La Jolla, also voiced her displeasure in an email to Kevin McCormack, senior director of communications for the California Institute for Regenerative Medicine(CIRM), as the agency is formally known.

She wrote,

“CIRM has rather pulled the rug out from under the patient advocates. These meetings are supposed to be public, so how is the public going to participate if there is no access?…. I'm disappointed and the Parkinson's patients are exceedingly disappointed.  The Parkinson's group is trying to find out the resolution, if any, of the timing of the grant applications.”

The Summit group has raised $2 million to support Loring’s research and to match what CIRM might award for her effort.

Asked for comment today, McCormack said in an email,

“The reason we switched from an in-person to a teleconference board meeting is simple, the agenda for this meeting consisted of just a few items that could probably be handled in one hour. We can’t justify the cost of an in-person meeting in San Diego – which includes transportation for all those going there, plus hotel rooms, meals and the cost of the ballroom for the day - for one hour’s worth of business. As a state agency we are always mindful of how we spend our money so we made the change.” 

The next in-person meeting of the agency board is not scheduled until Dec. 17. But, in addition to the Sept. 24 meeting, two more teleconference meetings are scheduled between now and Dec. 17. Both are expected to be brief, routine approval of awards, if they are held at all.

Under the agency’s procedures and state law, members of the public can listen in and speak during teleconference meetings but only from the specific location from which an individual board member is participating.  

On the other hand, the in-person meetings offer an opportunity to speak face-to-face with all board members, chat with them informally during breaks and to converse directly with CIRM staff. The meetings have been an important tool for many patient advocate groups to press their cases. At times, however, their lengthy presentations have tried the patience of the agency.

The relationship between patient advocates and CIRM is notable. One of the unique features of the agency is the influence of patient advocates, particularly on its board.  Twelve sit on the 29-member panel and often play important roles. Sometimes they are the only way the board can approve awards because most of the other members have legal conflicts of interest and cannot vote.

David Higgins of San Diego is one of the patient advocate members of the board, which has a

David Higgins

specific slot for a Parkinson’s disease advocate. He was interviewed in July following the protest of the many-months delay in possible funding for Parkinson’s research. His remarks were recorded on a Summit-produced video(see at top of this item). Higgins, who is a scientist and has Parkinson's, said,

“It’s tough, it’s really tough, to be involved in the Parkinson’s community, especially to have Parkinson’s disease, and to watch things go in what seems like slow motion.”

Contacted today for additional comments, Higgins said,

“In my year at CIRM I have only encountered enthusiasm and support for patient advocacy - both from the staff as well as the board. Patient and patient advocate participation in the process is welcomed. CIRM is first and foremost about patients.”

Following the protests at the July meeting, CIRM President Randy Mills told the board he would see if there is anything he could do to speed funding. He said he would report back to the board later.

McCormack did not directly respond to a question today about whether recent, proposed changes in the award scheduling would have an impact on the Parkinson’s research.  He said only that the changes would provide more flexibility.

(The text of remarks by the various parties follow this item.)

Text of McCormack and Loring Emails on Stem Cell Board Meeting

Here is the text of the Sept. 9, 2015, email message to Sherrie Gould, executive director of Summit4stemcell, from Kevin McCormack, senior director of communications for the California stem cell agency, along with one from Jeanne Loring, head of the stem cell program at Scripps, to McCormack.  Loring sent her email to McCormack after she received a copy of his email to Gould.

The Gould-McCormack email comes first with the Loring-McCormack email following.

“Dear Sherrie
“I just wanted to let you know that there has been a change in plans for our September board meeting. As you know, it was originally scheduled to be held in San Diego, however, that has changed and it is now simply a telephonic meeting. The reason is that the agenda is going to be lighter than originally anticipated and it didn’t make sense to incur the cost of an in-person meeting for one hour’s worth of business. 

“I know you were planning to have many of the Parkinson’s group attend the meeting so I wanted to let you know so you can alert them to the change.
 “Our next in-person meeting will now be in Los Angeles on December 17th.
“Cheers,
“Kevin McCormack”

Loring’s email to McCormack:

“Hi Kevin:
 “Two in a row??  CIRM has rather pulled the rug out from under the patient advocates -these meetings are supposed to be public, so how is the public going to participate if there is no access?  Does CIRM have a plan to give access?  More importantly, is CIRM doing this to avoid having public access?
 “I'm disappointed and the Parkinson's patients are exceedingly disappointed.  The Parkinson's group is trying to find out the resolution, if any, of the timing of the grant applications.  Has anything been done in that regard yet?
 “In addition to the advocates, my students will be disappointed.  I always bring my interns and my CIRM fellows to the meetings so they can meet their benefactors.
 “Any plans for access to the public would be welcome.
 “Jeanne”

Text of Comments by Sherrie Gould, Executive Director, Summit4stemcells

Here is the text of comments by Sherrie Gould, executive director of Summit4stemcell of San Diego, made in connection with changes in the stem cell agency board meeting Sept. 24. Gould made the remarks in response to a query from the California Stem Cell Report.

“We are both confused and disappointed that this PUBLIC meeting has
been essentially cancelled.  We were prepared to talk with the ICOC (the stem cell agency) board and answer all questions about our patient advocacy
(Summit4stemcells) movement and our research. The Summit4stemcell
project has been faithfully attending public meetings every other
month for the last two years.  We have flown in numbers to make sure
our voice is heard.  We have spoken to board members, and to the media
about our plight.  This San Diego meeting, now cancelled, was an
opportunity attend to discuss the funding possibilities for
Parkinson's disease and whether funding might be appropriate for our
project.  Our science is sound and we have a clinical arm to this
project. We believe CIRM could take ownership of this very exciting
translational research if we were indeed funded.

“Unless we can be present in front of the CIRM board, Summit's strong
voice is diminished.  Being physically present in human form is always
more effective than a teleconference. Delays, which we realize are a
part of any government associated agency, are devastating to people
suffering from the progressive symptoms of Parkinson's disease. And
although hope springs eternal, we are saddened by the repetitive
delays.”

Text of Remarks by David Higgins, Stem Cell Agency Board Member

Here is the text of comments by David Higgins, a member of the governing board (the ICOC) of the California stem cell agency, in connection with changes in the September meeting of that board. By law, Higgins is appointed as a patient advocate for Parkinson’s disease. He made his comments in response to questions from the California Stem Cell Report.

“It is my understanding that the September ICOC meeting was switched to a phone format because the modest agenda planned made the cost associated with having this meeting ‘on the road’ questionable.

“In my year at CIRM I have only encountered enthusiasm and support for patient advocacy - both from the staff as well as the board. Patient and patient advocate participation in the process is welcomed. CIRM is first and foremost about patients. There will be differences in opinion on how best to allocate CIRM’s financial resources, but there are no difference of opinion on the importance of patient advocacy and the value of interactions between the public and the ICOC.”

Text of McCormack's Response to Questions

Here is the text of remarks today from Kevin McCormack, senior director of communications for the California stem cell agency, concerning changes involving this month's governing board meeting. He made the comments in response to questions by the California Stem Cell Report.  One of the questions involved the agency's strategic plan, which was scheduled to be discussed at the meeting this month.

"The reason we switched from an in-person to a teleconference Board meeting is simple, the agenda for this meeting consisted of just a few items that could probably be handled in one hour. We can’t justify the cost of an in-person meeting in San Diego – which includes transportation for all those going there, plus hotel rooms, meals and the cost of the ballroom for the day - for one hour’s worth of business. As a state agency we are always mindful of how we spend our money so we made the change.

 "The elimination of the dates in the Discovery and Translational programs is simply to give the CIRM Team more flexibility. As we say in the documents that will be presented to the Board – available on our website here https://www.cirm.ca.gov/sites/default/files/files/agenda/150905_Agenda_4_DTConcept%20Amendments%20--%20FINAL%20%2800256870xAEB03%29.pdf
  

"In  order  for  CIRM  to  operate  efficiently  and  to  respond  to  changing  circumstances  and  needs,  CIRM  must  be  nimble  and  flexible.   To  ensure  that  the  CIRM  team  has  the  ability  to  make  adjustments  to  the  program  schedule  to  meet  these  needs,  we  propose  to  eliminate  the  specificity in  the translation  and  Discovery  Program  concept  plans  regarding  the  schedule  for  the  submission  of  applications  in  response  to  program  announcements  issued  under these programs.”  (McCormack's boldface) 

"As for the Strategic Plan, we have already conducted extensive outreach, through both on-line surveys and in-person meetings, with Patient Advocates (including meetings in San Diego, Los Angeles and San Francisco), researchers, Board members and the public. We are now working on bringing all those thoughts and suggestions together in order to be able to present them to Board. 

"And the Board agenda will be posted ten days ahead of the meeting as usual." 

California Stem Cell Agency Seeking to Fill High Level Positions

The $3 billion California stem cell agency is looking for a handful of new employees, including a top level executive who could be paid as much as $250,000 a year.

Openings for four positions are currently up on the Web site of the California Institute for Regenerative Medicine (CIRM), as the agency is formally known.  

They are a grants management specialist, systems engineer, science officer/senior science officer and associate director/director of therapeutics. They would join the 51 employees currently at the agency.

The listings with two different titles are for one job only.  The ultimate title of the successful candidate will depend on their level of prior experience, according to the agency.

The director of therapeutics position carries a maximum salary of $250,065.   The job would involve managing budgets of $600 million plus. The job listing also said candidates should know “what ‘great’ looks like and (use) that vision to set clear direction that is fully understood by the therapeutic team.”

The position would report to the vice president for therapeutics, Ramona Doyle, a former Genentech executive who joined CIRM in July.

The agency is currently based in San Francisco but will be moving its headquarters to Oakland this fall.

The New York Times, the California Stem Cell Agency and the San Francisco Warriors

California’s $3 billion stem cell research effort made one of its rare appearances in the New York Times this weekend in a long article on the front page of the newspaper’s Sunday business section.

The piece, however, carried not a word about the agency’s accomplishments. Instead the story by Matt Richtel talked about a proposal to build an 18,000-seat arena for the Golden State Warriors basketball team.

The arena would be located a short walk from the current headquarters of the stem cell agency as well as the UC San Francisco Mission Bay complex and the biotech enterprises that surround it. The proposal has triggered a major flap in the city involving the biotech industry, among other issues. A former vice chancellor of UCSF, Bruce Spaulding, is leading a move to block the project.

The stem cell agency, known formally as the California Institute for Regenerative Medicine(CIRM), popped up in the article as a result of its decision to transfer its headquarters to Oakland. The California Stem Cell Report wrote about the move on Aug. 17, triggering a spate of articles in the Bay Area media. (See here and here.)

Richtel wrote,

Jeff Sheehy -- Sheehy photo

“’San Francisco has always been that other city with a different set of values,’” said Jeff Sheehy, a governing board member of the California Institute for Regenerative Medicine, the largest stem cell funding agency in the world. The institute is moving to Oakland after the expiration of a free-rent deal on its space near the proposed complex; it discovered that office rents in San Francisco were prohibitively high. He sees the arena, which he opposes (he would like affordable housing on the land), as suggestive that San Francisco secretly wanted mainstream credibility all along.

“'We should have an arena because New York has Madison Square Garden. We should compete for the Olympics and the Super Bowl,' he says, mocking the pro-arena attitude. He describes the new San Francisco as 'just another capitalist, consumerist, profit-driven, money-motivated Disneyland.'” 

Sam Hawgood -- UCSF photo

Another CIRM board member was mentioned in the piece, Sam Hawgood, chancellor of UCSF, which also employs Sheehy as a communications manager.

Richtel wrote that Hawgood “has offered qualified support for the Warriors, as long as the owners and the city address his big concerns about traffic, including creating dedicated lanes for health emergencies and increasing public transportation options and the number of parking lots.”

Joe Lacob -- Kleiner photo

In another stem cell/biotech-related linkage, Joe Lacob is one of the majority owners of the Warriors. He also contributed $759,017 to the campaign for Proposition 71, the ballot measure that created the stem cell agency in 2004. He is a partner in the Kleiner Perkins Caufield & Byers venture capital firm, which pumped nearly $6 million into the campaign and which is a major investor in biotech.

Openness and Transparency: Backsliding at California Stem Cell Agency

Highlights
$34 million Alpha Clinics involved
Information failure on proposal
Discourages public/researcher participation
California’s stem cell agency this past couple of weeks skidded significantly backwards in its efforts to improve clarity and transparency in its $3 billion operation.

The latest example came this week and involved its ambitious, $34 million Alpha stem cell clinic program at four major California institutions: the City of Hope, UCLA and UC Irvine and UC San Diego. 

A proposed, multimillion dollar project involving the effort was scheduled for action next Tuesday by the Science Subcommittee of the agency’s governing board.  As of early this morning -- only one full business day from the meeting -- the agency had released only nine words about it to the public. Here is the full text:

“Consideration of concept plan for Alpha Clinics Accelerating Center.” 

Opaque is the only way to describe the process. And it was bound to create issues with affected parties, which it has in this case.

Such cryptic notices make it impossible for the public to comment intelligently or otherwise, given the lack of information. The failure to provide the information in a timely fashion also feeds suspicion and distrust.

Clarity is one of the watch words that Randy Mills has invoked in his 15-month tenure at the California Institute for Regenerative Medicine(CIRM), as the agency is formally known. He has done much to sharpen CIRM’s focus and provide additional clarity through his analysis of the agency’s work.  

But failing to provide material in a timely fashion removes more than the shine on his efforts. The meetings of the agency’s directors are CIRM’s most important public events.  They are where patients, advocates, researchers, biotech executives and even the unwashed public can come together to hear and see the board in action and discuss issues informally with directors and the CIRM staff. Attendance should be encouraged – not discouraged. Which is what happens when important information is withheld from the public.

Last Friday the California Stem Cell Report carried an item on another mysterious agenda item, one that involved forgiveness of agency loans and potential royalty revenue, something that was promised in the election campaign that created the agency in 2004. 

That too was a case of missing information until it was much too late for the public or affected parties to make thoughtful comments. (See here and here.)

CIRM can and should do better than this. 

(The California Stem Cell Report this morning asked CIRM for comment on the failure to provide information on the Alpha proposal scheduled for Tuesday.  About ninety minutes later, CIRM spokesman Don Gibbons responded, saying that the item was now being postponed "to allow more time for refinement and consideration.")

(By this afternoon, the agency had also posted the first explanation of another cryptic item on the Tuesday agenda for the Science Subcommittee. This one would eliminate the specific schedule for RFAs in the upcoming basic research (discovery) and translational RFAs. The reason for the change is to provide more flexibility.)

(Editor's note: The last paragraph of this item was added several hours after the original posting.)

Moderate Media Coverage of California's New, $32 Million Stem Cell Bank

The California stem cell agency this week scored moderately well in media coverage of the announcement of its $32 million stem cell bank, the world’s largest such public effort.

Most of the coverage was based in California but, of course, all of the stories can be read globally. The San Francisco Chronicle, The Sacramento Bee and a chain of newspapers in the Bay Area carried articles, among others.

Missing was coverage from major national outlets, such as the New York Times. Also absent was coverage by television news outlets, according to a search this morning on Google. A spokesman for the agency said the Buck Institute, which houses the bank, has restrictions on video coverage.

Ron Leuty of the San Francisco Business Times called the bank opening a “big win” for the $3 billion agency.  

A story by Stephanie ONeill of  KPCC  carried a factoid missing from all other stories – the cost of the cells from the bank in Marin County, north of San Francisco. O'Neill reported,

"The cost of each vial will range from $750 for researchers affiliated with nonprofit research organizations to $1,500 for those who work  for-profit companies, says (California) Institute for Regenerative Medicine spokesman Kevin McCormack."

The Bee story reported much larger figures, which the stem cell agency today said are incorrect.

Jeff Buchanan, who is based in Wisconsin for xconomy, wrote a story with a headline that reflected his focus on the Wisconsin firm involved,

“Cellular Dynamics Launches ‘World’s Largest’ Public Stem Cell Bank”

Buchanan also wrote that the company’s executive vice president, Chris Parker, said that the bank offers more than other banks. Buchanan reported,

“’The diseases, the demographic information that’s associated with them, the clinical data, the genetic and genomic data available—that’s what’s really making these lines valuable,’ (Parker) says. Donors gave consent for their tissue samples to ‘be used for a variety of research purposes,’ giving investigators considerable latitude, says Parker.”

Here are links to the other stories that turned up in the Google search this morning: San Francisco Chronicle, San Jose Mercury News and other papers in its chain, KGO, California Healthline, Philadelpha Business Journal and Latino Health.

$32 Million Project: California Opens Largest Public Stem Cell Bank in World

Stem cell storage tanks at new stem cell bank -- Coriell photo

Highlights
300 different stem cell lines
3,000 donors
Coriell, CDI operating, supplying
Stanford, UCLA, UCSF and UCSD involved

Thanks to the taxpayers of California, the Golden State is now home to the largest publicly available stem cell bank in the world.

The state’s $3 billion stem cell agency this morning announced that the bank, located in Marin County north of San Francisco, is open for business.

The project is backed by $32.3 million from the California Institute of Regenerative Medicine (CIRM), as the agency is formally known.

In a news release this morning, CIRM said the bank is “offering the first 300 different stem cell lines for researchers interested in gaining a deeper understanding of, and developing treatments for 11 common diseases and disorders.”

The agency said the bank, housed at the Buck Institute in Novato, is collecting samples from as many as 3,000 donors. CIRM said,

“Those samples will then be turned into high quality stem cell lines – known as induced pluripotent stem cells or iPSCs – which are available to researchers throughout California and the rest of the world.” 

CIRM Chairman Jonathan Thomas said,

“We believe the bank will be an extraordinarily important resource in helping advance the use of stem cell tools for the study of diseases and finding new ways to treat them.” 

As of this writing, the announcement had received coverage on the San Francisco SFgate Web site and on other sites in the San Francisco Bay Area that are owned a news media chain and another site in Pennsylvania.  The coverage is likely to grow throughout the day, which is important to the agency. It is hard-pressed to generate news coverage for its achievements. 

The bank was funded by awards from California in 2013 and is operated by the non-profit Coriell Institute of Camden, N.J.  Generation of the cells is performed by Cellular Dynamics International, Inc., of Madison, Wisc.

CDI was formed by stem cell pioneer research Jamie Thomson of the University of Wisconsin. It was sold to Fujifilm of Japan earlier this year for $307 million at double its stock price.

Also involved in securing the initial adult cells are researchers at UC San Diego, Stanford, UC San Francisco and UCLA.

Here are links to the press releases at Coriell and CDI. Here is a link to a summary of the CIRM banking initiative and a link to a progress report on the effort. Below is a list of participants and amounts of awards. Click on it to see it in a larger format.

Sunlight on California's Stem Cell Loan Effort; Info Missing on Changes in $127 Million Research Programs

Highlights

Some details on loan changes

New Alpha clinic center proposed; no details

Unspecified changes upcoming in $93 million award programs

A little sunshine popped up over the weekend on a bit of fiscal alchemy at the $3 billion California stem cell agency, and a little clarity emerged.

The matter involves the agency’s loan program, which affects multi-million awards to businesses. The awards are called loans but are forgiven if no viable product emerges.

The matter surfaced as a result of a cryptic agenda item for Thursday’s meeting of the agency’s directors’ Intellectual Property Subcommittee. Here is what happened:

About a week ago, the agency posted the agenda for the meeting. The agenda contained a 24-word line that said that it was going to change its policies “to permit existing loan recipient whose loan has been forgiven to convert its award to a grant.”

The need for change and its financial impact on the agency was not discussed. The specific language being changed was not spelled out. The timetable for the changes was not specified. Nor was it discussed whether the move was desired by any recipients of the agency’s largess.

Given the opaque nature of the agenda item, the California Stem Cell Report carried an item Friday morning that said,

“In just four business days, the $3 billion California stem cell agency is going to perform a bit of financial alchemy. But like most alchemists, its methods are less than transparent.” 

Much later that day or possibly early Saturday, the agency posted a brief memo and regulatory language that provided a better look at the loan rule changes, which could have an impact on royalties the state might receive on a successful stem cell therapy.

Based on what is now on the agency’s Web site, the proposal would clarify what happens if a loan-financed therapy is dropped and then revived, leading to actual revenue. Under existing rules, such a situation could trigger an ambiguous financial burden that would have to show on the company books. And business executives and investors do not like ambiguous financial burdens. 

The memo from the California Institute for Regenerative Medicine (CIRM), as the agency is formally known, said,

“To provide clarity regarding future obligations, CIRM proposes giving existing loan recipients whose loan has been forgiven by CIRM the option to convert their loan to a grant and forego reinstatement of a forgiven loan. In this way, loan recipients will be automatically governed by the revenue sharing (and other) principles of the agency’s intellectual property regulations in the event future revenue streams are realized. This will be particularly important in the event future revenues are realized after CIRM has exhausted its funding.” 

The directors’ subcommittee is likely to approve the change on Thursday. It would then go to the full board at its Sept. 24 in San Diego for action before it enters the state’s regulatory process, which will open it to further public comment.

The Thursday meeting will also take up changes in the “loan election policy” for this year’s $100 million clinical award program. Details on that are still not available as of this morning, but one assumption would be that they are an extension of the proposed loan changes to that particular program.

The weekend’s memo on the loan changes was dated  Aug. 20.  One can only assume that it was lingering on some CIRM executive’s desk for eight days until it was made available to the public, researchers and likely affected businesses.  

Problems with timely posting of agenda material are not new to the agency. In the more distant past, they were significant but have diminished. That is, until this case and others earlier this year.

The agency also has another directors’ subcommittee coming up in just five business days. The session involves two significant, multimillion dollar programs. One proposal calls for creation of an “Alpha Clinics Accelerating Center” in connection with the $34 million Alpha clinics effort.

The other proposal before the Science Subcommittee deals with unspecified changes in the agency’s upcoming, $93 million “discovery and translational” award rounds.

This morning, no additional details were available on those two matters.

The Science Subcommittee teleconference session on Sept. 8 will be based in San Francisco. Interested parties can weigh in at public locations in Irvine, La Jolla, Los Angeles and Duarte. Addresses are on the agenda.

The meeting Thursday of the Intellectual Property Subcommittee is also a teleconference session based in San Francisco. Public locations are available in San Diego, Hawaii, Woodside and Redwood City with two in San Francisco.

The only public access to these meetings is at their physical locations. No participation is available via the Internet.  However, comments may be submitted in advance or later by emailing them to mbonneville@cirm.ca.gov.