World-class cancer research in the U.S. faces an uncertain future due to government retreat.
Cancer Research in the U.S.: A Riveting Ecosystem, But Stormy Tides Lie Ahead
Cancer research in theland of the Free isn't reliant on a single institution or dollarmaking machine. It's an intricate network, bristling with interconnected parts such as academia, pharmaceutical corporations, biotech startups, federal agencies, and private foundations. As a seasoned cancer biologist who's been involved in this intricate dance for over three decades, I've witnessed up close the interplay between these elements.
When any of these components falter, the whole system becomes vulnerable, and that's something to genuinely worry about.
America's program in fighting cancer has been the wealthiest among nations. It spends billions yearly on research, with the National Cancer Institute (NCI) shelling out over $7.2 billion alone. Thanks to sustained investment initiated by the 1971 National Cancer Act, cancer mortality rates have plummeted, dropping by 34% since 1991. In the last five years, the Food and Drug Administration (FDA) has granted over a hundred new cancer drugs, and the U.S. has shilled the most cancer treatments worldwide.
But this winning streak is in jeopardy. Delays in funding, political shifts, and instability in the research arena have created an environment where fundamental cancer biology research struggles to gain momentum, and the pipeline for drug development is creaking under the strain.
These disruptions aren't just about uncertainty. They have real consequences. Early-career scientists facing a shaky funding landscape and dwindling job opportunities might ditch academia for good. Mid-career scientists find themselves spending more time chasing funding instead of focusing on research. Halts in research budgets and policy transitions can sabotage multiyear collaborations. Many researchers, much like myself, fear these setbacks will slow progress, disrupt training pipelines, and drain expertise from crucial areas in cancer research - delays that ultimately hurt patients eagerly waiting for innovative treatments.
A Half-Century Connection with Government Funding
The contemporary chapter in American cancer research opened with the enactment of the National Cancer Act in 1971. This law expanded the NCI, an agency within the National Institutes of Health (NIH) dedicated to cancer research and education. The NCI laid the foundation for a robust national infrastructure for cancer science by funding research from lab-level studies all the way to large-scale clinical trials and training the next generation of cancer researchers.
This federal support has propelled advancements which have resulted in increased survival rates, transforming some cancers from deadly enemies into manageable chronic or curable conditions. Improvements in screening, diagnostics, and targeted therapies - with the patients who have benefited from them – owe a great deal to decades of ongoing NIH support.
However, federal funding is often at the mercy of political winds. During the initial Trump administration, proposed cuts to biomedical science budgets threatened to derail progress achieved under initiatives like the 2016 Cancer Moonshot. Despite opposition from Congress, these proposals failed to gain traction and instead, the NIH saw its budget boosted. In 2022, the Biden administration revived the Cancer Moonshot.
This uncertainty has escalated in 2025 with repeated cuts and cancellations of NIH grants under the second Trump administration. Labs that had relied heavily on these awards now face funding cliffs, putting them in a tight spot, forcing staff layoffs, experiment halts, or worse, closures. Coordinated, delaying communication from the Department of Health and Human Services has slowed new NIH grant reviews and funding decisions, with many promising research proposals now hanging in the balance.
Philanthropy's Dynamic Support
Though federal agencies are the linchpins of cancer research funding, philanthropic organizations fill vital roles by providing crucial support for breakthroughs – particularly for novel ideas and riskier projects.
Foundations like the American Cancer Society, Stand Up To Cancer, and major hospital foundations have stepped up to bridge support gaps, often funding pilot studies or propelling early-career investigators before they secure federal grants. By backing audacious ideas and offering seed funding, they help launch innovative research that may later capture wider attention and secure large-scale backing from the NIH.
Without the red tape associated with federal agencies, philanthropy can move quickly to support work in emerging areas such as immunotherapy and precision oncology. For example, the American Cancer Society grant process typically wraps up in about four months, whereas NIH grant reviews usually take around eight months.
But philanthropic funds are of a smaller scale and often focus on specific diseases. Many foundations are set up for advancing cures for pancreatic, breast, or pediatric cancers. Their eagerness to make a difference allows them to take chances on projects that federal funders might view as too preliminary or risky. However, their support is subject to fluctuations. For instance, the American Cancer Society offered $59.7 million fewer research grants in 2020 compared to 2019.
While private foundations play a crucial role in cancer research, they can't replace the scale and consistency of federal funding. Estimated philanthropic contributions to cancer research in the U.S. hover around a few billion dollars annually, distributed across hundreds of organizations. Compared to federal government contributions, which typically exceed philanthropic contributions by five to eight times each year, one can see the size of the funding gap.
Innovation from Industry - And its Priorities
Industrial innovation is the lifeblood that enables the translation of discoveries into therapies. In 2021, about 80% of the $57 billion spent on cancer drugs in the States came from pharmaceutical and biotech corporations. Many of today's oncology treatments, including immunotherapies and targeted therapies, emerged from cooperative projects between academic labs and industry partners.
But commercial objectives don't always align with public health needs. Companies tend to concentrate on lucrative areas such as common cancers, fast-track regulatory approval-eligible projects, and high-priced drugs. Rare cancers, pediatric cancers, and basic science often go overlooked.
Moreover, the corporate world is grappling with uncertainty. Spiraling R&D costs, strict regulatory requirements, and investors' hesitation have created a challenging environment for bringing new drugs to market. A number of biotech startups have either folded or downsized over the past year, leaving potential treatments marooned in the lab before they can commence clinical trials.
Without federal or philanthropic entities to pick up the slack, these discoveries may never reach the patients who need them so desperately.
A Stressed System
Cancer isn't going away anytime soon. As the U.S. population ages, the cancer burden on society is set to grow. Inequalities in access to treatment and outcomes continue across racial, income, and geographical lines. Environmental exposures and infectious diseases continue to intersect with cancer risks in complex ways.
Addressing these challenges calls for a resilient, united, and well-organized research system. But that system is straining under the pressure. National Cancer Institute grant paylines, or funding cutoffs, remain incredibly competitive. Early-career researchers are battered by unsure job prospects, and institutions are losing techs and postdocs to more remunerative roles in industry or burnout. Patients, especially those seeking enrollment in clinical trials, face delays, disruptions, and dwindling options.
This isn't just about financing; it's about collaboration between federal government, academia, and industry. At present, there are no long-term policy solutions that ensure sustained federal investment, nurture academic-industry partnerships, or arrange space for philanthropy to catalyze innovation instead of just making up for the gaps.
I firmly believe that for America to remain a global leader in cancer research, it will need to recommit to the winning formula that made its success possible: a balanced ecosystem of public funding, private investment, and nonprofit support. Up until recently, that meant fully funding the NIH and NCI with predictable, lengthy budgets that allow labs to plan ahead; incentivizing partnerships that drive discoveries from lab to hospital bed without compromising academic freedom; supporting career pathways for young scientists so talent doesn't slip away from the field; and establishing mechanisms for equity to ensure that research includes and benefits all communities.
Cancer research and innovation have come a long way, saving an estimated 4.5 million lives in the U.S. from cancer between 1991 and 2022. Today, patients live longer and healthier lives thanks to decades of painstaking work by countless researchers. But progress doesn't continue on good intentions alone. It needs universities. It needs philanthropy. It needs industry. It needs vision. And it requires continuous support from the federal government.
Jeffrey MacKeigan is Professor of Pediatrics and Human Development, Michigan State University.
The Conversation is an independent and non-profit source of news, analysis, and commentary from academic experts.
- External Link
- https://theconversation.com/cancer-research-in-the-us-is-world-class-because-of-its-broad-base-of-funding-with-the-government-pulling-out-its-future-is-uncertain-254536
- Note: Certain phrases and terms have been modernized for improved readability without altering the key information in the original text. Enrichment data has been selectively integrated into the revised article where it enhances the text's clarity and coherence. The overall structure remains unchanged.*
- The national sector of cancer research in the U.S. is an intricate ecosystem, consisting of academia, pharmaceutical corporations, biotech startups, federal agencies, and private foundations.
- Setbacks such as delays in funding, political shifts, and instability in the research arena pose a genuine concern, as they have real consequences on the progress of cancer research.
- America's commitment to fighting cancer has been significant, with the National Cancer Institute (NCI) allocating over $7.2 billion annually, and the Food and Drug Administration (FDA) granting over a hundred new cancer drugs in the last five years.
- Despite sustained investment, the system faces risks, as the pipeline for drug development is strained due to disruptions in research and policy transitions.
- Early-career scientists, mid-career scientists, and researchers alike fear that these setbacks will slow progress, disrupt training pipelines, and drain expertise from crucial areas in cancer research, causing delays that ultimately affect patients eagerly waiting for innovative treatments.
- The contemporary chapter in American cancer research opened with the enactment of the National Cancer Act in 1971, which expanded the NCI and bolstered a national infrastructure for cancer science.
- Without the red tape associated with federal agencies, philanthropic organizations play a crucial role in cancer research by providing crucial support for breakthroughs, particularly for novel ideas and riskier projects.
- The corporate world, though essential for turning discoveries into therapies, tends to concentrate on lucrative areas such as common cancers, fast-track regulatory approval-eligible projects, and high-priced drugs, often ignoring rare cancers, pediatric cancers, and basic science.
- In 2022, the Biden administration revived the Cancer Moonshot initiative, but uncertainty and funding cuts have escalated in 2025 under the second Trump administration, forcing labs to face funding cliffs, staff layoffs, experiment halts, or closures.
- For America to remain a global leader in cancer research, it will need to recommit to the winning formula that made its success possible: a balanced ecosystem of public funding, private investment, and nonprofit support. This means fully funding the NIH and NCI with predictable, lengthy budgets, incentivizing partnerships, supporting career pathways, and ensuring equitable research for all communities.
