NIH Funding Instability Threatens Oncology Innovation and Care

The field of oncology is currently at a critical stage, with an accelerating volume of novel therapies entering clinical development and reshaping standards of care across tumor types. However, in the United States, mounting disruptions in federal cancer research funding at the National Institutes of Health (NIH) are reverberating across the ecosystem, with downstream effects on clinical trial pipelines and patient care. These effects are being amplified by new federal budget proposals, which call for a 12% reduction in NIH funding for fiscal year (FY) 2027.

Recent warnings from the American Society of Clinical Oncology (ASCO) underscore the stakes: proposed funding cuts and structural changes to NIH risk slowing the pace of scientific progress, including advances in cancer prevention, detection, and treatment, while potentially undermining the broader research ecosystem that supports oncology care.¹ For oncologists treating patients in the community, these constraints may translate into fewer opportunities to connect patients with the fruits of such progress.

In an interview with Targeted Oncology, Diane Simeone, MD, director of the Moores Cancer Center at UC San Diego Health and chief scientific advisor of the Pancreatic Cancer Early Detection (PRECEDE) Consortium, described a system now under strain—one in which clinical trial activation is slowed, translational research is stalled, and patients’ access to emerging therapies is ultimately complicated.

“It's very tough right now with the significant cut in funding for cancer research that's happening across the United States, and then not only the cut for research, but the impaired release of funds of already approved grants,” Simeone expressed. “Patients’ lives are on the line.”

Targeted Oncology: Can you walk through how disruptions in NIH funding would ripple through the oncology ecosystem from research to practice?

Diane Simeone, MD: Clinical trials should be considered as an option for all patients with cancer. That happens across the United States, both in nonacademic settings and in academic settings, and [the processes have slowed considerably]. A lot of the first-in-human clinical trials are very much slowed and…a challenging funding [situation] across the whole healthcare ecosystem is going to make it harder for oncologists everywhere to be able to offer new therapies for patients.

Now, we've had incredible progress in the impact of therapies for patients, with a significant number of new therapies coming to FDA approval and changing the lives of hundreds of thousands of Americans. And if that pipeline is disrupted as it is happening right now, that's going to [create] a challenge for every single physician who's trying… to do their job… [Our role] is to try to help patients in often what is their most challenging period of their life, and for us to have a lot of external forces that limit our ability to do so is making it very tough across the board.

Data sharing and collaborative networks such as PRECEDE have become essential in oncology. How are these efforts vulnerable to funding instability, and what does that mean for future evidence generation?

Sometimes, great advances in cancer are made by an individual with an “a-ha” moment in the laboratory. In some other instances, there has to be large teams of people working on a problem that has not been able to be solved by a single individual or institution where they've been particularly recalcitrant problems. I'll give one example in pancreatic cancer—which is an area I work on—where driving new therapies and early detection of pancreatic cancer has been challenging when tackled by single institutions. To [carry out] larger scale, team-based efforts to tackle these [problems] in institutions across the United States and…across the globe, these efforts are being significantly hindered. And so, it's been very challenging to try to execute some of these larger scale efforts, which in many cases are again to solve the tough problems like the early detection of pancreatic cancer where there's not one institution that's going to be able to solve that problem alone. So, we have a disconnect [between] what [researchers and physicians] need [and] the funding to get [patients] what they need—which is better therapies, but I would also comment better therapies that work in earlier stages of disease so they'll be more effective. Again, [we’ve had] remarkable progress in cancer over the last couple decades…now coming to what risks becoming a major slowdown with these cuts in funds. Even when you have a grant funded, delays to get the funding out…[creates] a very challenging environment.

In FY2026, Congress increased funding for cancer research in the face of similar proposed cuts. Why does that decision matter for this year?

The cuts… have resulted in people leaving the field, laboratories closing down, and clinical trials [being] stymied. Cancer is a nonpartisan issue; 1 in 3 Americans will get an invasive cancer during their lifetime, so this is something that affects all of us, and so I applaud Congress for increasing funding for cancer research. We lead the world in developing new strategies for cancer early detection, prevention, and treatment. It's important that the increased funding that has been approved by Congress gets out to all the investigators and all the sites so the good work can continue.

For oncologists who may feel removed from these federal decisions, what are the key messages or takeaways you want them to keep in mind?

I think we're all in it together, be it you're someone who treats patients [with cancer] in an academic setting or community setting, and as someone that's worked in the cancer field for 30 years, there are conversations that happen every day between oncologists in the community setting and in the academic setting to help coordinate patient care. Many times, the best care for patients can be close to their home. But there might be some situations where it's a more complex issue, there may be a clinical trial opportunity, someone may need treatment care that's complex like a bone marrow transplant, or operations that require advanced skill sets. There's usually a partnership that takes place, and all of this is getting disrupted.

Seventy percent of [patients with] cancer get their care in the community, so community oncologists are part of the vibrant engine of cancer care across the United States. To be able to partner with academic partners who are doing the cutting-end research and learn together what the best paths are for patients is really critical.

I also worry about what's happening with health care and health insurance and, for various reasons, patients struggling more with access to care and having health insurance that covers their care. That's very challenging for people when they have a diagnosis of cancer. So, I think this is something we're all feeling right now, and we all have to band together and try to do everything we can that's always focused on helping our patients. But the cuts in funding have a ripple effect across every aspect that we do, and it does seem like things are just harder every day than they need to be.

REFERENCE

1. Proposed NIH Cuts, Funding Changes Risk Slowing Cancer Research. News release. American Society of Clinical Oncology. April 3, 2026. Accessed April 28, 2026. https://tinyurl.com/mpaur2be