In 2006, NCCIH was criticized in "Science" with the comment "NCCAM funds proposals of dubious merit; its research agenda is shaped more by politics than by science; and it is structured by its charter in a manner that precludes an independent review of its performance." The authors suggested that, while it was appropriate to study alternative therapies, the quality of its research was lower than other NIH institutes, and that these studies could be performed under the auspices of other institutes within the NIH. As an example, the authors described a trial of gemcitabine with the Gonzalez regimen for stage II to IV pancreatic cancer, in the belief that cancer is caused by a deficiency of pancreatic proteolytic enzymes. Severe adverse effects were associated with the Gonzalez regimen, and no evidence in peer-reviewed journals supported the plausibility or efficacy of the regimen or chelation therapy.