Continuing contradictions at the Cancer Center

University of Hawaii Cancer Center (UHCC) Director Michele Carbone released a webinar video, apparently at the request of State Senator Josh Green, in which he defends his performance and contradicts reports given by long-time faculty and top researchers there about the many problems that have arisen since he took over. The goal of the video seems to be to convince audiences that the UHCC is on track to receive National Cancer Institute (NCI) designation (and the P30 grant money that comes with it) from the federal government, something Dr. Loic Le Marchand and other faculty there believe is impossible with Dr. Carbone in charge. Here is an email Dr. Carbone sent out publicizing the webinar, with a link to the video as well:

Upon Sen Josh Green’s request I gave a webinar to an audience of Hawaii physicians explaining why we need a NCI designated cancer center in Hawaii, describing what is meant by NCI designation, what a consortium represents, the cancer centers track record of achievements, and more.  The 45 min presentation is followed by a 15 min Q/A with the audience.

In the course of the presentation and in the subsequent Q/A I address several of the misleading statements that have been circulated in the local press and online. 

Please, feel free to circulate the link to this webinar, so that those who are troubled or curious about what they have read about the Consortium Cancer Center and its leadership can have this objective summary available.

The webinar is on our website at: http://www.uhcancercenter.org/ and the banner clearly directs the reader to it (just click on my photo).

At this morning’s Board of Regents (BOR) meeting, the faculty who have reported numerous ethics violations and serious instances of financial and organization mismanagement on the part of Dr. Carbone presented the following testimony, calling into question omissions in the director’s webinar video and a lack of solid information that is needed in order to properly evaluate the UHCC’s performance under Dr. Carbone, something which will have to happen to get NCI designation:

Dear BOR,

As long-time faculty of the University of Hawaii Cancer Center (UHCC), we would like to thank President Lassner for calling for an “objective evaluation” of UHCC.  As nationally recognized cancer researchers very familiar with the NCI designation of cancer centers, we would like to state what such a review would address. 

There is much discussion over whether we need an NCI designated cancer center in Hawaii, including in a webinar just distributed by Drs. Carbone and Hedges to the medical community at the request of a legislator.  Without a doubt, the designation is very important to our state as it is a recognition of the excellence of the publically-funded research being conducted at the Center.  In order to prepare a grant application for renewing the designation in 2 years time, we must address what tangible accomplishments have been made since the P30 submission in 2011.  The circulated webinar is largely mute on this point and focused on the efforts that were in place when we submitted the last P30 application, many of which were naturally started long before Dr. Carbone became UHCC director in August 2009.

The NIH peer-review criteria for evaluating UHCC for the renewal are listed below.  We would fully expect for the “objective, forward-looking” review of UHCC that President Lassner has called for to delve into each of these questions. 

How has Dr. Carbone’s vision moved forward cancer research and cancer care/control locally and nationally?
How well has Dr. Carbone grown the existing research programs or have they deteriorated as a result of his leadership?
What new competitive programs and shared resources has Dr. Carbone established?
How many competitive programs and funded investigators exist? What outstanding science is being conducted by each?
How well integrated is each program and how much productive interaction takes place across programs, as reflected in joint grants and publications?
The UHCC has been a “Consortium Cancer Center” since February 2010.  What are the accomplishments of the Hawaii Cancer Consortium? This will be critical as UHCC obtained a one-time exception to the requirements for clinical research for the last submission since the consortium had just been created.  The P30 reviewers stated that “the success of this newly formed endeavor will likely be a vital part of judging the UHCC’s progress over the next 5-year period”.
Has a nationally-recognized leader been recruited to develop clinical research at UHCC?
How many clinical researchers have been recruited?
How many Phase I clinical trials have been initiated?
How many other clinical trials have been initiated in Hawaii?
What has been the trend for the number of patients recruited to clinical trials in Hawaii?
How many grants (especially NIH grants) have been awarded to the program?
How many high impact publications have come out of this program?
How many Cancer Center members have NIH funding in comparison to previous submissions?
How many grants are awarded and what is the total extramural funding to the Center at the time of the P30 submission, compared to previous submissions?
How many high impact publications have been published from each program during the current grant cycle?
How has discretionary money (including cigarette tax and philanthropy) been used to grow the research endeavor, in particular seed-funding, start-up packages and instrumentation? How many grants and publications have resulted?
How successful has Dr. Carbone been in retaining and recruiting productive investigators with NIH-supported programs of research?

None of these questions were answered by Dr. Carbone.  Instead, there is much misinformation in the widely-distributed webinar, especially the incorrect characterization of the loss and reduction of P30 funding in the past, the reasons for the change in Center leadership, misappropriation of credit for past accomplishments, representation of past initiatives and programs as new initiatives, and complete lack of acknowledgement of the recognized research areas of strength for the Center.

The UH review should also address the administrative record of the director.
Has the director followed UH and state regulations and policies?
Has the director been a good citizen in the academic community of UH-Manoa?
Has the director taken input from, and represented the interests of, the Faculty, staff and students?
Has the director followed accepted academic processes in hiring and selecting individuals for leadership roles, tenure, promotion and merit raises?
The nature of the 25+ grievances which were ruled against Center leadership, many of which showing unethical behavior, must be reviewed as they portray a pattern of academic misconduct.
Has the director implemented the remedial actions requested by the VCs as a result of the grievances filed by 15 different faculty members? (There are currently 43 full time Rank 3-5 faculty members, including 14 tenured members.)
Has the director facilitated or hindered the ability of faculty to pursue grant requirements and pursue new avenues of research?
Has the director been successful in managing the UHCC Organized Research Unit, with regard to budget, supervision of administrative personnel and management of existing resources?

These are the fundamental questions that need to be addressed in the review. Unfortunately, the answers are in sharp contrast to the sketchy but rosy picture depicted in the webinar. Having brought over $100M of NCI research grants to the state and worked for several decades at UHCC, we are deeply concerned about our institution, both the UHCC and UH-Manoa.  That is why we stand ready to provide documentation to the Interim Chancellor and the BOR on the questions above. 

Adrian Franke, Loic Le Marchand, Unhee Lim, Lynne Wilkens
Faculty of UHCC