MATWIN 2013NOT CONFIDENTIAL Letter of Intent

NOT CONFIDENTIAL

Research project title

/ Cancerôpole partner
Please type your title here

Project acronym

/ Reception date (official use)
Please type your acronym here

Key words

/ File number (official use)
Please type key words here

Project coordinator

Title (i.e.: PhD, MD, Pr…)
First Name
Last Name
Position
Department/laboratory
University / Faculty / School
Host Institution
Address
E-mail
Phone (direct line) / mobile / +33 / +33 6
Technology Transfer Office details
Technology Transfer Office
Contact name
Address
E-mail
Phone (direct line) / mobile / +33 / +33 6

Requested budget & total duration of the project

Requested budget (k€, ATI): / Total duration (months)


Executive summary (1 page max)

WARNING:This executive summary must present briefly your project, in one page max.
Title

Application domain (indication & use)

Target Population

Innovative component

Objectives

Target Profile

Abstract – application domain, objectives, expected outcomes (400 words max)


Résumé – domaine d’application, objectifs, résultats attendus (500 mots max)


Identified academic and/or industrial partners[1]

Partner / Name / Position / Organism / Laboratory / City / Partner expertise
1
2
3
4
5

Breakdown of the approximate budget requested and other funding sources (% it represents of the total budget)

Staff costs / %
Running expenses / %
Subcontracting internal & external[2] / %
Equipment costs / %
Other funding sources (ANR, INCa ...) / Amount in K€ (ATI) / Obtained / Expected / Date
 / 
 / 
 / 
 / 
International classification of your project
Which of the following NCI-TRWG Developmental Pathway(s) best applies to your Project?
Assessment modalities: characterize the cancer-related health status of an individual
A- /
  1. Biospecimen-based assessment devices (protocols, reagents, instruments)
/ 
  1. Image-based assessment (agents or techniques)
/ 
Interventive modalities: change the cancer-related health status of an individual, (prevention, treatment)
B- /
  1. Immune response modifiers (vaccines, cytokines, cellular therapy, etc)
/ 
  1. Interventive devices (surgery, radiation)
/ 
  1. Lifestyle alterations (diet, behavioural mechanisms, etc)
/ 
  1. Agents (drug or biologics including stem cells, epigenetic targets, gene expression)
/ 

Project descriptionand expected outcomes (4 pages max.)

You are requested to present your project research plan from an industrial perspective. Your presentation should not exceed 4 pages and should be structured as follow:
  1. Scientific background: state of the art, rationale and supporting references of relevance to this project
  1. Innovative components and unmet medical needs: relevance to cancer, potential applications (prognosis, diagnosis, treatment…)
  1. End products/devices: what product/device will be delivered to patients and healthcare professionals, if possible the anticipated benefits for patients and healthcare professionals and its competitive positioning
  1. Project Main Objective:
  1. Work plan: list the key steps to reach the objective and for each step briefly describe the experimental design and main deliverables (do not forget this present letter is not confidential)


SWOT analysis
A SWOT analysis is a strategic planning method usedto evaluate the Strengths, Weaknesses, Opportunities, and Threats involved in a project. It involves specifying the objective(s) of the project and identifying the key internal (S,W) and external (O,T) factors that are favourable and unfavourable to achieving that objective. External factors can be existing or upcoming competitors, regulatory or ethical issues, technology acceptance by professionals/patients …
Strengths / Weaknesses
 / 
Opportunities / Threats
 / 

Intellectual property: Patents, Commercial Interests

Please complete a table for each patent you already filed or that you are planning to file
Patent n° 1
Invention title
Field of application
Inventors
Patent co-owners (institutions)
IP status
Invention disclosure / date of disclosure
Patent filing / date of filling or expected date of filing
Patent Cooperation Treaty / PCT number
Awarded patent / patent number / awarded countries:

Publications of the partners related to the project during the last 5 years (10 max).


Scientific, clinicians or industrials experts

Proposed for review of the project without conflict of interest with the partners:
  1. Name, organism, city, e-mail
.....
Undesirable because of conflict of interest
  1. Name, organism, city, e-mail
.....

Project coordinator signature

I, undertaking (name) ………………………………………………………
  1. authorise my Cancéropôle and the MATWIN society to share all information regarding my Letter of Intent for evaluation purposes, under the condition that each person who accesses this information is bound by a confidentiality agreement
  2. have obtained the agreement of all associated partners for their participation in this research project.
  3. am aware the present letter of intent will be disclosed to third partiers and therefore does not contain confidential information.
Date: Signature:

Deadline and contact details

The Letter of Intent must be returned at the latest before May 15th 2013 both to :
1) MATWIN PlatformBy e-mail in pdf format to:
2) Your Cancéropôle By e-mail the pdf format and by mail the original copy to the following address
Cancéropôle CLARA: 60 avenue Rockefeller, 69008 Lyon
- : 04 37 90 17 14
Cancéropôle GE: Hôpital de Hautepierre, 1, Av. Molière, 67098 Strasbourg
 - : 03 88 12 75 43
Cancéropôle GO: Maison Recherche Santé, 5, Allée l’Ile Gloriette, 44093 Nantes cedex 01
 - : 02 53 48 28 75
Cancéropôle GSO: Hôpital La Grave, Place Lange - TSA 60033, 31059 Toulouse cedex 9
 - : 06 82 76 75 07
Cancéropôle NO: 1 Avenue Oscar Lambret - B.P. 90005, 59008 Lille cedex
 - : 03 20 74 35 83
Cancéropôle PACA: Faculté Médecine-Timone, 27 boulevard Jean Moulin, 13005 Marseille
 - : 04 91 32 47 02
Cancéropôle IDF or others institutions: MATWIN SAS - Institut Bergonié, 229 cours de l’Argonne, 33076 Bordeaux
: 06 84 01 61 70

MATWIN timetable

Call for projects / 2013 April 1st
Expression of interest - Deadline “Letter of Intent“ / 2013 May 15th
Notification of acceptance for “Letter of Intent” / From 2013 June 10th
Deadline for submission of “Project Application Form” / 2013 September 15th
Multidisciplinary analysis of projects / 2013 September to November
Letter to selected or unselected applicants / From 2013 December
Coaching session: Review of research plan and training / 2014 January to April
Project Presentation to the MATWIN International Board / 2014 May

Not Confidential – Apr. 2013Page 1 on 7

[1] Our recommendation is to limit number of associated partners to 3 to 5 teams, including yours.

[2] This amount cannot be more than 30% of the Matwin requested budget without Matwin authorisation