Federal Funding Cuts Have Huge Impact on Cancer Research

Roxanne Nelson

September 20, 2013

While oncologists continue to feel the pinch of federal cutbacks, the effect on cancer research is even more pronounced.

In a survey conducted by the American Society of Clinical Oncology (ASCO), 75% of respondents reported that the current federal funding situation is having a direct impact on their ability to conduct cancer research. In a number of cases, these cutbacks have reportedly triggered "devastating" changes.

One worrying survey finding was that many young investigators are leaving the field because of this lack of funding. More than a third (~35%) of respondents reported that they had to lay off or terminate skilled lab or clinical staff. In addition, a number of respondents voiced concerns about the ultimate impact these federal cuts will have on patient care and outcomes, and questioned the viability of a career in research.

"This trend could potentially devastate future cancer research, just when we are on the verge of achieving major progress against cancer and identifying the next generation of effective cancer therapies," said ASCO chief medical officer Richard L. Schilsky, MD, in a release.

Of the 345 researchers who responded to the survey, 60% say that they conduct their research at academic institutions, 35% at National Cancer Institute (NCI)-designated cancer centers, and the remainder at a community hospital, private practice, or Veterans' Administration hospital. The majority of respondents (80%) are involved in clinical or patient-centered research.

Table. Survey Respondents Reporting Impact in Specific Areas

Area of Impact Percent Reporting Impact
Limited ability to conduct research when collaborating with others who receive NIH/NCI funding 44.3
Looked for new/nonfederal sources of funding 44.3
Reduced the proportion of time spent on research 38.4
Restricted trial end points/questions 36.9
Laid off/terminated clinical supportive staff 35.3
Existing NIH/NCI grant received a funding cut 32.9
Closed or participated in fewer cooperative group trials 28.2
Postponed launch of clinical trial 26.7
Limited enrollment on a clinical trial 23.1


Other Concerns

Some respondents reported that they were leaving the research field entirely or were stopping to seek federal funding, whereas others found that there was now no funding available for previously approved grants. Some also reported salary reductions.

One respondent lamented the situation: "In a time when we have the opportunity to make great strides in improving treatment for cancer, the cuts are limiting the recruitment of new scientists and severely impacting progress in cancer research."

Another offered the news that "postdoctoral trainees (MD and PhD) under my mentorship have been forced to seek alternative career paths. The pipeline of American researchers contributing to medical knowledge and practice change is substantially decreasing."

Healthcare cuts have also indirectly affected research, as one respondent pointed out. "Healthcare cuts in general have impacted our staffing, from secretaries to schedulers to research nurses. With our staff so diluted, we can only devote a small portion of our time to clinical research."

Will Cooperative Groups "Wither Away?"

One of the backbones of publicly funded cancer research has been the cooperative groups, which are sponsored by the NCI. In a commentary published online September 16 in the Journal of Clinical Oncology, Dr. Schilsky expresses concern for the future of these groups.

These groups have undergone scrutiny and criticism for nearly their entire existence, he noted.

Recently, a report produced by the Institute of Medicine, at the request of the NCI, identified the many challenges that the cooperative groups are currently facing. These included stagnant funding, inefficient and redundant processes, excessive and complex government oversight (with many layers of review performed by multiple agencies), long delays in the launch of clinical trials, and increasing competition from the pharmaceutical industry for patient accrual to studies.

The result has been a consolidation of cooperative groups. The NCI is creating a network — the National Clinical Trials Network (NCTN) — "that would comprise the 4 remaining adult cooperative groups and the Children's Oncology Group, and would function in a highly coordinated way to conduct a new generation of biomarker-driven trials evaluating targeted therapies."

However, Dr. Schilsky notes that a "greatly underappreciated contribution of the cooperative groups has been their substantial influence on the training and career development of generations of clinical researchers."

These experiences are being jeopardized now by the fact that there are fewer scientific committees in the consolidated NCTN and "fewer opportunities to advance a protocol concept to a fully developed research study."

"If opportunities to develop and lead trials diminish, as current trends suggest, and institutional pressures to generate research funding and clinical revenue continue to grow, the risk exists that young investigators will walk away from the NCTN to seek opportunities in other venues," he warns.

Dr. Schilsky points out that the cooperative group program "has stood the test of time as a publicly funded infrastructure to conduct cancer clinical trials."

"Patients with cancer will benefit greatly from a robust cancer clinical trials system that continues to deliver practice-changing results," he concludes. "We owe it to them to sustain and enhance this system and to ensure that it does not simply wither away as a result of inadequate funding and loss of opportunity for researchers and clinicians."

Dr. Schilsky has disclosed no relevant financial relationships.

J Clin Oncol. Published online September 16, 2013. Extract


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