The Cancer Prevention and Research Institute of Texas, or CPRIT, was created after Texans approved Proposition 15, a constitutional amendment passed in 2007 authorizing the state to issue bonds to fund cancer research and prevention. It was empowered to spend as much as $3 billion over 10 years, making it the second-largest taxpayer-funded cancer research organization in the country.
The new institute received some “fix-up” legislation in the 2009 session. With that enacted, a prestigious board was appointed, including former Centers for Disease Control chief operating officer Bill Gimson as executive director and Nobel Prize winner Alfred Gilman as chief science officer. The 11-member board, appointed by Gov. Rick Perry, Lt. Gov. David Dewhurst and Speaker of the House Joe Straus, also includes two statutorily mandated members: state Attorney General Greg Abbott and Comptroller Susan Combs.
The first requests for applications were issued in August of 2009; the first awards were issued in January 2010. To date, according to the CPRIT website, more than $645 million dollars have been awarded.
In May 2012, Gilman announced he was stepping down from CPRIT effective Oct. 12. In his resignation letter, Gilman suggested that part of the reason for his departure was that grants had not been properly reviewed.
Gilman indicated that CPRIT’s system for rewarding grants — a rigorous peer review comprised of out-of-state reviewers to avoid conflicts of interest — appeared to be circumvented by the introduction in 2011 of an “incubator program,” part of CPRIT’s “commercialization” initiative. It was designed to “create and support infrastructure in Texas that accelerates the movement of new cancer drugs, diagnostics, and therapies from the laboratory to the patient.”
Specifically, Gilman cited a multi-million dollar grant made jointly to Rice University and M.D. Anderson, the largest single-year award to date, approved just days after the request was received. Gilman, in an email to The Dallas Morning News, wondered why a “brief (6.5 page) non-scientific description of a plan to conduct early-stage, preclinical drug discovery” was approved so quickly, outside of the normal review process.
Defenders of the incubator program maintain it is a separate process established by CPRIT and that the joint grant was awarded according to stated guidelines that Rice and M.D. Anderson followed closely.
A subsequent open records request from The Dallas Morning News uncovered dozens of emails that highlighted Gilman’s concerns that CPRIT’s peer review system was under attack by commercial and political interests that would inevitably undermine the integrity and effectiveness of the program, going so far as to call some members of the agency’s oversight committee “really evil people.” He further claimed he was told to resign by executive director Bill Gimson, an assertion Gimson denied.
A state audit was underway in June 2012, but it was not, according to the State Auditor’s Office, prompted by Gilman’s resignation — the audit had been planned in September 2011, according to a letter sent to Gimson.
On June 15, CPRIT issued a press release saying it was using the audit announcement as a “kickoff” to unveil new measures to “address concerns about its grant review process.”
In August, Patricia Vojac, former chief of staff to newly-named Health and Human Services Commissioner Kyle Janek, was named chief compliance officer. Her role, to review and evaluate CPRIT grants, effectively shut the Institute’s activities down, even as Gimson continued to portray it as forward-looking and intent on reform. In September, Gimson sent out a letter to both scientific and commercial reviewers –– required by charter to be out-of-state –– requesting evaluation of a proposed recipient. The answers he got did little to bolster CPRIT’s image, however, with uniformly high marks from the commercial peer reviewers and an equally negative response from the scientific. Noting the discrepancy, on Sept. 25, Gimson then sent another letter asking the scientific evaluators to reconsider their rating, given the stark difference.
“No, it is still really, really bad,” replied one, adding in an interview with The Dallas Morning News, “If I were nothing but a commercial person, I would have liked it too. It could have made a lot of money, but it wasn’t a scientifically valid thing and eventually down the road, it’s going to be not good.”
In October, Perry, long a proponent of the organization and of such enterprises in general, made an unannounced visit to CPRIT’s annual meeting, praising its cancer-fighting efforts –– but by that point, two Nobel Laureates and dozens of scientific peer reviewers had resigned.
In November, The Dallas Morning News reported that two companies founded by Mike Shanahan, a major donor to both Perry and Dewhurst, had received $13 million dollars from CPRIT –– the larger part, for $12.8 million, going to Caliber Biotherapeutics, even though “reviewers gave Caliber the lowest science score of all companies receiving such awards.”
On Dec. 11, 2012, Gimson resigned as executive director –– the same day the Travis County District Attorney, the entity charged with investigating and prosecuting state and state officials’ criminal wrongdoing, opened an official investigation into the cancer institute. The DA’s probe was prompted by yet another revelation –– that $11 million had been awarded to Peloton Therapeutics, a cancer research firm located on the UT-Southwestern Campus, without the required commercial or scientific review.
On Dec. 19, Perry, Dewhurst and Straus, following a letter from Sen. Wendy Davis, D-Fort Worth, and legislation outlining reform filed by Sen. Jane Nelson, R-Flower Mound, called for CPRIT to stop awarding money altogether.
In January, the 83rd Legislature convened. The initial budget left CPRIT completely unfunded, while mostly redirecting what remained in its coffers. Hearings in state House and Senate committees were held. Both Gilman and Gimson were initially invited to testify before the House, but, with CPRIT under both criminal investigation by the Travis County DA and civil investigation by the AG’s office, neither did. The reason: because a witness may not refuse to testify to the Legislature on the grounds of self-incrimination, that testimony can result in immunity from future prosecution.
Amid these hearings, a new angle emerged: CTNet, a network of major state university medical and oncology centers designed to disperse CPRIT millions, ceased operations on Jan. 28, 2013, following a litany of questionable practices. Thirty employees were fired, with six kept on temporarily — at minimum wage — to wrap things up. Among the revelations: CPRIT advanced CTNeT $6.8 million for expenses, instead of reimbursing as it went, which is standard practice; it continued advancing money even after $301,000 dollars were called into question for going to, among other things, redecorating and bonuses; and CTNeT never matched the funds it received, as required by law.
Under criminal and civil investigation, not only proscribed from offering further funding but potentially defunded altogether, reeling from dozens of resignations and a stream of revelations, this once huge endeavor, set up by nothing less than a constitutional amendment, finds itself under a large cloud. And the question being asked is whether the state should be in the business of funding cancer research at all.
Senate Bill 149, crafted by Nelson to reform CPRIT, passed easily in the House and unanimously in the Senate, and was signed into law by Perry, effective immediately, on June 14, 2013. The moratorium on awarding grants, imposed the previous December, was lifted Oct. 30 in a letter signed by Perry, Lt. Gov. David Dewhurst and House Speaker Joe Straus, clearing the way for both new funding and the resumption of suspended financing.
On Dec. 6, 2013, following an investigation by the Public Integrity Unit of the Travis County District Attorney's office, a Travis County grand jury handed down an indictment against Jerry Cobbs, former chief commercialization officer at the institute. He was charged with unlawfully securing the execution of an $11 million grant, a first-degree felony that carries a five- to 15-year prison term and a $10,000 fine. At this writing, no trial date had been set. The PUI said it considered its investigation in CPRIT misappropriations closed, saying Perry's line-item veto of the unit's budget following Travis County D.A. Rosemary Lehmberg's DUI arrest and subsequent refusal to resign delayed the investigation.