Fifty years ago, the National Cancer Act was signed into law, providing the National Cancer Institute with new authority to expand discoveries in basic, clinical, and translational science, which included building a nationwide network of cancer centers to treat thousands of patients each day.
Today, as we look to the next 50 years of cancer science, we are seeing the dividends of those investments.
The steady decline in overall cancer-related deaths in the United States over the past five decades can be attributed largely to the bench-to-bedside advances across the continuum of cancer science and medicine.
Transformative discoveries, catalyzed by federal funding for cancer research, are rapidly culminating in improved prevention, early detection, diagnosis, and treatments for cancer. In fact, in 2021, the Food and Drug Administration approved 50 new therapies, the fourth highest number of annual approvals ever, with cancer-related indications accounting for the largest share with 15 new cancer drugs.
These lifesaving developments, together with the growing use of immunotherapy and greater understanding of how cancers develop and spread, are helping to treat cancers today in a way that was only dreamed of a decade ago.
Every day we understand cancers more and get closer to finally solving the complexities of cancer that have puzzled scientists for years. But despite these advances, progress against cancer will falter if federal investments in cancer research do not support this important moment.
Congress and the Biden Administration have an opportunity to make critical investments today to bring about better treatments and cures tomorrow. The cancer research community is fortunate to have a strong commitment from our leaders on Capitol Hill: champions including House Labor, Health and Human Services, and Education Appropriations Subcommittee Chair Rosa DeLauro (D-CT) and Ranking Member Tom Cole (R-OK), as well as Senate Labor, Health and Human Services, and Education Appropriations Subcommittee Chair Patty Murray (D-WA) and Ranking Member Roy Blunt (R-MO), who among many others have secured robust annual funding increases totaling approximately 42 percent for the National institutes of Health over the last six years.
However, the turning of the calendar to 2022 brings with it a concern that this steady and sustained growth in NIH and NCI funding is in jeopardy. Currently, the federal government, including NIH and NCI, is operating under a Continuing Resolution through Feb. 18, more than a third of the way into the fiscal year.
With Congress yet to agree to spending levels or allocations for fiscal year 2022, the risk of another CR remains high. These long-term CRs have harmful consequences, resulting in budgets remaining at the previous fiscal year levels, forcing agencies to plan conservatively while also not funding new initiatives, such as the Advanced Research Projects Agency for Health, or ARPA-H, that has been proposed by President Biden.
The effects of CRs are already being felt in the NCI’s interim payline for FY 2022. Due to this budget uncertainty, NCI Director Dr. Norman “Ned” Sharpless has been forced to reduce paylines by two percent for competing grants, dropping R01 grants for established and new investigators from the 11th percentile to the 9th percentile, and dropping R01 grants for early-stage investigators from the 16th percentile to the 14th percentile.
These reduced paylines will result in highly meritorious grants being discarded, leaving great ideas behind and making it harder for a new generation of scientists to get their feet in the door and build promising careers in cancer research.
The turning of the calendar to 2022 brings with it a concern that this steady and sustained growth in NIH and NCI funding is in jeopardy.
While these funding pressures at NCI are alarming, they are not new. Remarkable advances in cancer research have stimulated an unprecedented nearly 50 percent increase in the number of research project grant applications to the NCI since FY 2013, far outpacing the number of RPG applications received elsewhere at NIH. While NCI’s budget has increased, it has fallen well below demand.
At a time when the success rate of an RPG is 22.2 percent at the National Heart, Lung, and Blood Institute, 23 percent at the National Institute of Diabetes and Digestive and Kidney Diseases, 23.9 percent at the National Institute of Allergy and Infectious Disease, and 25.8 percent at the National Institute on Aging, NCI’s success rate of 12.8 percent has created a grant funding crisis and left potentially lifesaving cancer science and medicine unfunded.
With this low success rate, I also worry that the best and the brightest, in particular early-stage researchers and researchers from diverse racial and ethnic backgrounds, will choose other career paths and harm our ability to advance the care of patients with cancer.
Congress has an opportunity to help patients with cancer by prioritizing support for lifesaving cancer research at a level that exceeds the funding of only one-in-eight grant applications. Congress can meet the moment by completing FY 2022 funding bills and providing NCI with a robust increase in funding to increase paylines and the RPG success rate.
Champions for cancer research in Congress are advocating for our community, but they need our support. I was pleased to see a recent bipartisan op-ed from Senators Chris Coon (D-DE) and Jerry Moran (R-KS) in Scientific American that called for a $1 billion boost to NCI’s budget in FY 2022, which closely matches AACR’s recommendation and NCI’s Professional Judgment Budget. If enacted, this funding would do wonders for NCI’s ability to strengthen the state of cancer research, encourage new scientists in our field, and spur breakthroughs that will help prevent, detect, diagnose, and treat cancers that continue to fuel illness nationwide.
As president of the AACR, I have been proud to represent our members in advocating for these important investments.
Last May, I had the wonderful opportunity to testify before the House Appropriations Subcommittee on Labor, Health and Human Services, and Education on the importance of increasing funding for NCI, and I have participated in a number of meetings with members of Congress and their staff through our advocacy efforts.
I encourage all members of our cancer research community to engage with your congressional representatives and advocate for the importance of funding cancer research.
Our expertise and voices have made and will continue to make a difference. With more resources, we can usher in a new age of cancer research and discoveries that will help patients and save lives.
