Fabrication and Stem Cell Research: A Tale of 31 Retractions (Maybe), $63 Million and Heavy News Coverage

Stem cell research fraud was big news this past week. It involved millions of dollars, the reputations of researchers and prestigious institutions, lots of wasted work and damage to the entire field. 

The case, which attracted international attention in the mainstream media, involves a prominent heart researcher, Piero Anversa, formerly of  Harvard, and requests for 31 retractions.  STAT/Retraction Watch broke the story in a piece written by Ivan Oransky and Adam Marcus. The New York Times, the Washington Post and other publications followed. 

As the New York Times summarized, Anversa "fabricated or falsified data in 31 published studies that should be retracted, officials at the institutions have concluded." Harvard has been fined $10 million by the federal government.  

Carolyn Johnson of the Washington Post quoted a California stem cell researcher:

"'This body of work has, for better or worse, been hugely influential,' said Eduardo Marbán, director of the Smidt Heart Institute at Cedars-Sinai Medical Center. 'Despite the fact that several prominent laboratories failed to confirm key findings, c-kit positive heart cells were rapidly translated to clinical testing in heart failure patients. … One can only hope that no patients have been placed at risk in clinical trials based upon fraudulent data.'"

Another California researcher, Benoit Bruneau, was quoted by the New York Times. 

"A couple of papers may be alarming, but 31 additional papers in question is almost unheard-of,' said Benoit Bruneau, associate director of cardiovascular research at the Gladstone Institutes in San Francisco. 'It is a lab’s almost entire body of work, and therefore almost an entire field of research, put into question.'"

Gina Kolata of the New York Times wrote, 

"Despite the troubling questions that had been raised about the stem cell work, the National Heart, Lung and Blood Institute began a clinical trial of injected stem cells for patients with heart failure.... 

"In the past few years, however, skeptical researchers moved on to other prospects for heart treatment. 'The field has backed off a lot,' (Jeffery) Molkentin (a professor at the Howard Hughes Medical Institute) said.

"Some scientists wondered how a questionable line of research persisted for so long. Maybe, Dr. Molkentin said, experts were just too timid to take a stand."

Some researchers have called for suspension of the $63 million clinical trial, including Deepak Srivastava, president of the Gladstone Institutes and president-elect of the International Society for Stem Cell Research.

Here are links to other coverage of the matter, which is been brewing for several years: The Niche, The Scientist, Medscape, Biospace and the  Harvard Crimson.

Autism to Bladder Cancer: California Awards $25.2 Million For Stem Cell Research

The California stem cell agency yesterday approved $25.2 million for research involving a spate of diseases, ranging from HIV and autism to hearing loss and bladder cancer.

The only application involving clinical stage work was submitted by Xiuli Wang of the City of Hope in Duarte, Ca., for her research on a CAR-T treatment to achieve a functional cure for HIV infection without the need for antiretroviral drug therapy.

The application (CLIN1-11223) sought $3.8 million to take her proposed therapy to the point where it can win approval to begin clinical trials. Here is a link to the summary of the review of her application. 

Directors of the California Institute for Regenerative Medicine(CIRM), as the agency is formally known, also approved $13.5 million in awards to translate basic research into clinical work and $7.9 million for more basic research. 

Here is a list of the principal investigators in the translation round. Summaries of the reviews can be found in this document. Translation refers to research that is moving from the basic stage to clinical.

• Steven Schwartz of UCLA, $5.1 million, TRAN1-11265, clinical translation of autologous regenerative cell therapy for blindness
• Karin Gaensler of UCSF, $4.2 million, TRAN1-11259, development of engineered autologous leukemia vaccines to target residual leukemic stem cells
• Ted Leng of Stanford, also $4.2 million, TRAN1-11300, a purified allogeneic cell therapy product for treatment of dry age-related macular degeneration

Here is a list of awards whose approval was stalled in July for financial reasons. The review summaries with scores can be found in this document.

• Tracy Grikscheit of Children's Hospital Los Angeles, $1.3 million, DISC2-10979, Universal Pluripotent Liver Failure Therapy (UPLiFT)
• Philip Beachy of Stanford, $1.4 million, DISC2-11105, pluripotent stem cell-derived bladder epithelialprogenitors for definitive cell replacement therapy of bladder cancer
• Jonathan Lin of UC San Diego, DISC2-10973, $1.2 million, small molecule proteostasis regulators to treat photoreceptor diseases
• Stuart Lipton of Scripps, DISC2-11070, $1.8 million, drug development for autism spectrum disorder
• Neil Segil of USC, DISC2-11183, $833,971, A screen for drugs to protect against chemotherapy-induced hearing loss, using sensory hair cells derived by direct lineage reprogramming from hiPSCs
• Alan Cheng of Stanford, DISC2-11199, $1.4 million, modulation of the Wnt pathway to restore inner ear function

$144 Million California Stem Cell Research Program Set for 2019

Directors of the California stem cell agency this morning approved a $144 million research budget for next year, which could well be its last for dispensing any major cash in its search for stem cell therapies.

The amount compares to $148 million expected to be awarded this year.  At its peak, the agency was handing out close to $300 million a year in research awards, but the amount varied from year to year.

Most of the funds for the next year will be devoted to clinical stage work. The agency, formally known as the California Institute for Regenerative Medicine (CIRM), is already backing 49 clinical trials, the last stage before a therapy is approved for widespread use. But it has yet to help finance a therapy that can be used by the population at large, despite expectations of voters who approved creation of the $3 billion agency in 2004.

CIRM expects to run out of cash for new awards next year. Possibilities exist for continued funding of research in 2020, but the agency is budgeting conservatively. CIRM Chairman Jonathan Thomas is attempting to raise privately $220 million to maintain the agency's funding. Thomas briefed directors today on that effort but notably did not report that specific additional funding had been secured.

CIRM also expects to recover possibly as much as $30 million in 2019 from projects that do not meet their milestones and possibly use the funds for awards next year or in 2020.

The agency is pinning its hopes for ultimate survival on a yet-to-be-written $5 billion bond measure on the November 2020 ballot.

Where Has The Money Gone? A 10-cent Look at $3 Billion in California Stem Cell Spending

CIRM graphic

California has spent about $2.6 billion on stem cell research over the last 14 years. It has roughly $144 million left for new awards. Here is a quick overview of where cash has gone, based on the agency's records.

Keep in mind that an examination of the state stem cell agency's spending can be like the blind men and the elephant. A lot depends on what you grab.

And tomorrow directors of the California Institute for Regenerative Medicine (CIRM), as the agency is formally known, will  be grabbing a piece of the program to determine what is going to be handed out in 2019.

Since 2004 when the agency was created with $3 billion in funding, CIRM reports that it has spent $898 million on various stages of basic research, which it generally calls "discovery," the largest single category.

It has plowed $632 million into clinically connected research dealing with afflictions ranging from cancer to blindness. The amount involves both more recent clinical research and CIRM's earlier disease team programs. Kevin McCormack, senior director for communications, said the money went for late stage research leading to a clinical trial as well as the trials themselves.

The agency's clinical trial dashboard shows that it has supported 49 clinical trials. The dashboard provides more detail on the status of each trial. (Here is a link to a June CIRM spreadsheet on the trials. Here is a link to a table on the trials released in connection with this week's directors' meeting.) 

CIRM has sunk $482 million into "infrastructure," a term that includes a $271 million building program for new facilities at institutions ranging from Stanford to UC Davis.  (See here and here for more on the infrastructure program.

The agency spent $219 million on education, which probably does not include a more than $40 million program to lure star scientists to the Golden State academic institutions. Those awards were specifically for research projects.

In terms of diseases, CIRM research covers 24 disease areas, ranging from Alzheimer's to strokes. A third of the clinical trial money has gone for cancer. Nineteen percent has targeted blood diseases and 12 percent neuro afflictions.

For a full list of institutions, see here.

Stanford, an already well-endowed institution in 2004, was the top institutional recipient with $360
million. UC Davis was the over-achiever in the top 10 recipient list with $138 million. In 2004, it had what could only be described as a tiny stem cell program.

ViaCyte, Inc., of San Diego, is the only business to make the top ten list, snagging $72 million. With the exception of ViaCyte, all of the institutions in the top ten had or have representatives on the CIRM governing board who are not permitted to vote on awards to their institutions.

As mentioned at the beginning of this item, this was the 10-cent tour of CIRM spending, which may tweak your interest. The high-priced excursion will come another day.

California Stem Cell Agency's Latest Awards: Total of $17 Million for Cancer, Blindness, HIV

The California stem cell agency is set this Thursday to award $3.8 million for research aimed at development of a major improvement in treatment for HIV and another $13.5 million to deal with leukemia and problems that can lead to blindness. 

The proposals have already been approved by the $3 billion agency's reviewers in a closed door session. The governing board of the agency is expected to ratify those decisions at a public meeting on Thursday. 

Xiuli Wang, COH photo

The HIV award is scheduled to go to Xiuli Wang of the City of Hope in the Los Angeles area for work leading to a clinical trial. Wang told the board in a letter, 

"(O)ur approach has the potential to be a single delivery therapy that releases patients from the ART (antiviral drug therapy) regime for the rest of their lives. This strategy could also alleviate the cumulative financial burden that represents life-long medication."

In response to a query from the California Stem Cell Report, Jeff Sheehy, an HIV patient advocate on the CIRM board, said that the proposal (CLIN1-11223) would use a vaccine to "to stimulate one's immune system to proliferate and maintain the engineered anti HIV CAR T cells that are the therapy.

"What makes this especially exciting is that 'the approach of using the CMV vaccine to expand CMV specific T-cells may eliminate the current use of preconditioning chemotherapy that is widely adopted for T cell therapies.'  In short, if successful, this approach would not only give people with HIV the ability to control the virus long term with needing antiretroviral therapy but could also make CAR T therapies in general more efficient and effective as well as safer, plus lead to other uses of CAR T technology."

Theodore Leng, Stanford photo

Karin Gaensler, UCSF photo

Karin Gaensler of UC San Francisco is slated to receive $4.2 million to develop a vaccine that will attack residual leukemia cells.   (Application number TRAN1-11259)

Theodore Leng of Stanford is scheduled to be awarded $4.2 million to develop a "purified allogeneic cell therapy product (called NeuBright) for treatment of dry age-related macular degeneration."  (Application number TRAN1-11300)

The board is also expected to approve $5.1 million for an "autologous regenerative cell  therapy for blindness." The identity of that investigator has not yet been released by the stem cell agency. (Application number TRAN1-11265)

Summaries of the application reviews and scores can be found in this document.