NCI Fiscal Year 2025 Professional Judgment Budget Proposal
Robust and sustained increases in funding for cancer research are needed to meet the Cancer Moonshot℠ goal of reducing cancer death rates by 50% over the next 25 years. Age-adjusted cancer death rates in the United States have declined about 2% per year since 2015, but this progress is not fast enough. We must accelerate the decline in cancer death rates to reach the 50% goal by 2047.
This Professional Judgment Budget Proposal presents NCI’s assessment of the funding needed in fiscal year 2025 (FY25) to support readily obtainable research opportunities and accelerate progress to benefit all people with cancer and those at risk. In addition to supporting new avenues of discovery, funding for cancer research must also keep pace with increasing research costs, including the costs of training the next generation of cancer researchers and clinicians, and the costs of supporting critical research infrastructure.
How the cost of conducting cancer research affects the pace of progress
NCI is the largest funder of cancer research in the world, supporting research project grants, training programs, and infrastructure that lead to an in-depth understanding of cancer and innovative prevention, screening, and treatment strategies. However, the increasing cost of research and clinical trials has significantly eroded NCI’s ability to fund research by reducing the buying power of NCI’s budget. In fact, based on the Biomedical Research and Development Price Index (BRDPI), NCI has 13% less buying power than it did 20 years ago. That 13% reduction translates to a budget that can fund $1.1 billion less research in 2023 than it did in 2003.
This budget deficit affects NCI’s ability to fully fund its research portfolio at a time when new opportunities in cancer research have led to a tremendous surge in research project grant applications to NCI. In recent years, R01 grant applications to NCI have accounted for almost one-fifth of all R01 applications received by NIH. Moreover, the growth of NCI R01 applications over the last 10 years is almost 3 times that of the rest of NIH combined. This burst of interest in cancer research, coupled with increasing biomedical research costs, has outstripped NCI’s ability to fund these new opportunities. As a result, it is difficult for NCI to optimally support cancer research, train future researchers, and expand and maintain research infrastructure.
Despite reduced buying power, recent budget increases have allowed NCI to increase the nation’s investment in investigator-initiated research and fund more R01 applications. In FY23, NCI received a nearly 6% budget increase that supported investments across the institute’s portfolio, including a one percentile increase in the R01 payline—that is, the percentile cutoff point of peer reviewed R01 applications that NCI intends to fund in a given fiscal year—to the 12th percentile. This increase will fund 100 additional R01 and early-stage investigator awards.
Making those commitments to new grants in addition to multiyear funding commitments for grants, research and development contracts, and infrastructure has significant, long-term budget implications. So, despite the budget increase from a supportive Congress, NCI still faced difficult choices: having to balance the increased investment in R01 grants with other demands for investment, including clinical trials, training programs, and research infrastructure.
For example, to increase the number of new investigator-initiated R01 grants, NCI reduced the budgets of continuing noncompeting grants—that is, years 2 through 5 of a typical 5-year grant. These reductions affected investigators who must alter their research plans while managing the increasing costs of conducting research in this era of higher inflation. This slows cancer research progress and its benefits to all people. Also, there remain significant numbers of meritorious applications that NCI cannot fund. This means that we are missing opportunities that could translate into advances for people with cancer and those at risk for the disease.
Increasing investments in training, infrastructure, and investigator-initiated research
Investigators conducting R01 and other NCI-funded research projects don’t do so alone or in a vacuum. They depend on, among other things, graduate students and postdoctoral fellows supported by NCI training programs, research infrastructure that exists at NCI-Designated Cancer Centers, and NCI-supported resources such as biospecimen repositories and cancer data commons. These critical parts of the cancer research enterprise require funding on top of investigator-initiated, grant-supported research.
The funding requested in this FY25 Professional Judgment Budget Proposal would allow NCI to make needed investments in training the next generation of diverse cancer researchers and supporting key infrastructure, such as:
- the K99/R00 Pathway to Independence Award supporting researchers through completion of mentored training and transition to independent investigators
- the Early Investigator Advancement Program helping scientists from diverse backgrounds progress to independent investigators
- the NCI-Designated Cancer Centers Program treating people with cancer, facilitating laboratory and clinical research, and training researchers and health care professionals at 72 centers in communities across the United States
- NCI’s clinical trials networks enabling people to participate in research studies at over 2,500 academic and community sites across the United States
- the Surveillance, Epidemiology, and End Results (SEER) Program providing information on cancer statistics to inform research and programs to reduce the cancer burden
- the Cancer Research Data Commons, a cloud-based data science infrastructure, providing secure access to large, comprehensive, and expanding collections of cancer data
Today’s investments in basic cancer research establish the foundation for tomorrow’s breakthroughs, and NCI’s portfolio must continue to grow through annual inflation-adjusted increases if we are to succeed in the goal to end cancer as we know it for all people. This FY25 Professional Judgment Budget Proposal would allow NCI to raise the R01 payline to the 15th percentile, and to capitalize on scientific opportunities to prevent, detect, and treat cancer, while growing and diversifying the cancer research workforce. This budget would also support a heightened level of research grant support with necessary investments in research infrastructure that keep pace with inflation and drive the National Cancer Program to deliver on the goals of the National Cancer Plan.
The Cancer Moonshot beyond the 21st Century Cures Act
This NCI FY25 Professional Judgment Budget Proposal includes a little over $2 billion to support the ambitious but attainable goals of the next phase of the Cancer Moonshot, which will benefit patients through improved and equitable cancer prevention, screening, and treatment. This request will allow NCI to make new investments in several key areas, including cancer clinical trials and data infrastructure, while building on the success of the 21st Century Cures Act funding.
Cancer Moonshot research initiatives, supported by $1.8 billion of 21st Century Cures Act funding over a 7-year period ending in FY23, are delivering important insights into the mechanisms that drive cancer. This includes addressing cancer disparities, identifying evidence-based strategies for health care delivery, and developing new approaches to prevent, screen, diagnose, and treat cancer. For example, Cancer Moonshot–supported networks enabled numerous improvements in cell-based therapies for solid tumors, including engineering targets for chimeric antigen receptor T-cell therapy against pediatric brain tumors.
To reach the new Cancer Moonshot goal of a 50% reduction in age-adjusted cancer death rates by 2047, we must sustain the progress enabled by the 21st Century Cures Act and invest more broadly to discover, develop, test, and deliver new approaches for cancer prevention, detection, and treatment. With the funds in this FY25 Professional Judgment Budget Proposal, this next phase of the Cancer Moonshot will:
- modernize cancer clinical trials to increase accrual and completion rates
- translate discoveries into innovative cancer prevention and treatment approaches
- transform cancer screening and diagnosis practices to save more lives
- ensure rapid dissemination of standards of care to all people equitably
- expand and enhance the diversity of the cancer research workforce
These areas are interconnected and must be simultaneously supported along with NCI’s existing investments in cancer research, through our base appropriation.
This FY25 Professional Judgment Budget Proposal will help NCI to fully leverage the scientific opportunities before us, to maximize research advances for the American people, and to end cancer as we know it.