Report: Commitment to NIH, NCI funding only 'viable path' for continued success in cancer research

The scientific community’s continued quest to prevent and cure cancer has reached a crossroads, according to a report released today by the American Association for Cancer Research.

The number of cancer survivors nationwide is at an all-time high, and the rapidly intensifying focus on personalized medicine has helped more patients live longer — and enjoy a better quality of life — than ever before, according to the AACR Cancer Progress Report 2014.

However, only “one viable path” — a commitment from the federal government to fund biomedical research — will ensure future research efforts build on the successes achieved in the past 5 decades, the report’s authors suggest.

Carlos L. Arteaga

“We are in the midst of a funding dilemma, and the pace at which we are making progress against cancer is being slowed due to years of declining budgets at the NIH and NCI,” Carlos L. Arteaga, MD, president of the AACR and professor of medicine and cancer biology at Vanderbilt-Ingram Cancer Center at Vanderbilt University in Nashville, Tenn., said during a press conference. “If policymakers fail to put them back on a path of predictable growth in funding, our ability to transform cancer care for the benefit of current and future patients will be jeopardized.”

The report, the fourth of its kind issued by the AACR, outlines several recent advances in cancer research.

Among the highlights:

The number of cancer survivors in the United States has reached 14.5 million;
In the 12-month period between August 2013 and July of this year, the FDA approved six new therapeutic agents for patients with cancer and expanded the indications for five other previously approved treatments;
In that same period, the FDA granted new approvals for two imaging agents, as well as a new approval for a screening test; and
Research advances have increased the clinical utility of genomic information, and five of the six anticancer therapeutics that received FDA approval in the past year target unique genetic and molecular characteristics.

The ability to use immunotherapy to fight several types of malignancies also improved exponentially in the past year, according to Jeffrey A. Engelman, MD, PhD, director of the Center for Thoracic Cancers at Massachusetts General Hospital Cancer Center and associate professor of medicine at Harvard Medical School.

“It’s important we appreciate that there were immunotherapies in melanoma, but until recently, they really didn’t work in lung cancer or other types of cancer,” Engelman said during the press conference. “We’re starting to see that progress now impact other fields. [Immunotherapy] is not just about melanoma. It is being used to treat several other cancers, and that has become very clear over the past year or so.”

Despite the progress, statistics suggest cancer will remain a formidable health care challenge — and considerable financial burden — for years to come.

An estimated 1.6 million Americans are expected to be diagnosed with cancer in 2014, and more than 585,000 — including approximately 1,900 children and adolescents — are predicted to die from it this year, according to the report.

The majority of Americans diagnosed with cancer are aged 65 years or older. That segment of the population is expected to double within the next 45 years, meaning the number of US residents with cancer likely will increase dramatically.

Cancer also is among the costliest diseases to the nation. Current estimates place the economic burden of cancer at $260 billion annually in direct costs — such as medical care — and indirect costs, such as lost productivity, Arteaga said.

At the same time, the report notes inflation during the past decade has far outpaced the growth in budgets for the NIH and NCI. Two rounds of federal budget cuts in the past 4 years have further decimated resources.

“Since 2010 alone, funding for the NIH has eroded by $3.5 billion when taking inflation into account, and sequestration resulted in a direct budget cut of $1.6 billion last year,” Arteaga said. “The NCI budget today is less than it was in 2009, and that is very scary.”

These financial woes have left potentially promising research proposals unfunded and prompted many researchers to either downsize their laboratories or leave the field. Those actions could have “grave consequences” for future innovation in medical research, according to the report’s authors.

“We [must] seize the momentum at this exciting time in biomedical research by committing to budget increases for the NIH and NCI so that the remarkable progress of the past can continue at a rapid pace,” the AACR wrote in a “call to action” within its report. “To take the alternative path is simply unacceptable. This particularly dangerous path leads us to a place where federal funding for biomedical research remains stagnant or — even worse — declines.”

The report’s authors acknowledged the fiscal challenges facing the nation, but they urged Congress to prioritize the growth of the NIH and NCI budgets “at a predictable, robust pace” by authorizing annual budget increases that are at least comparable to the biomedical inflation rate.

“We have the tools to make progress,” Arteaga said. “If we have appropriate funding, we can deliver.”