Federal Funding Cuts Spark Concern Over Future of Cancer Research and Care in United States

With research institutions facing widespread layoffs and hiring freezes following deep cuts to federal funding for health agencies such as the National Institutes of Health (NIH) and National Cancer Institute (NCI), concerns about the long-term consequences for oncology research programs and biomedical progress in the US are escalating. These changes are already being felt across academic centers, clinical trial infrastructure, and cancer research programs.

Since President Donald J. Trump was inaugurated in January 2025, the current administration has taken several steps to reduce workforce and budget allocations for the US Department of Health and Human Services (HHS) through executive orders and restructuring mandates.1 In February, the NIH announced a 15% cap on grants for indirect costs, such as infrastructure and maintenance, which replaces previously negotiated indirect cost rates ranging from 25% to 70% at many universities.2

Estimates from the Senate Health, Education, Labor and Pensions Committee suggest that as much as $2.7 billion in research grants was cut from the NIH in the first 3 months of 2025, and findings from recent analyses have shown that NIH grant rejections have more than doubled, with more than 2500 applications denied to date.3,4 An additional report from the Association of American Medical Colleges stated that the NIH terminated 777 grants as of May 5, 2025, which accounts for more than $1.9 billion in medical research funding.5

Sweeping workforce reductions have followed these budgetary decisions. On March 27, HHS Secretary Robert F. Kennedy Jr announced 10,000 termination notices, including 1000 at the NIH—20% of which were later identified as errors.6 Additional layoffs in May affected 250 NIH employees, including approximately 50 staff at the NCI.

Such layoffs coincided with the release of the administration’s fiscal year 2026 budget on May 2, which outlined a nearly 40% reduction to NIH funding and consolidated the agency’s 27 institutes into just 8, though the NCI reportedly will be left intact.7,8

“Health care is extremely complex, and the impact is going to be very different based on the structure of a given health system. If there are major federal cuts or reductions in indirect funds or grants coming in, those can be felt beyond simply just the university and can then affect the health system itself,” Daniel Spratt, MD, chairman and professor of radiation oncology at University Hospitals Seidman Cancer Center and Case Western Reserve University in Cleveland, Ohio, said in an interview with OncologyLive. “However, if the health system is functionally more autonomous from the university, they could be shielded potentially to a greater degree.”

Despite assurances from federal officials that the cuts would not compromise operations at the HHS, some emerging reports suggest otherwise. Several scientists at the NCI campus in Bethesda, Maryland, have reported delays in procuring essential supplies due to staffing cuts and policy changes, while others report that the institute is cutting contracts to maintain biological research specimens, according to an article release by KKF Health News in early July.9 The article was informed by interviews with more than 20 current and former NCI employees, academic researchers, scientists, and patients, many of whom chose to remain anonymous. Experts anticipate that such disruptions could have broader ramifications across the cancer research ecosystem, though Spratt does not anticipate an immediate, direct reduction of the oncology workforce.

“I don’t foresee that the federal cuts will have a direct implication on being able to have enough oncologists,” Spratt said. “[They] may have other ramifications, particularly related to research, the types of research questions being asked, and the prioritization of projects. We might [also] see a shift in what kinds of studies get done, or even where they get done.”

However, Spratt revealed that some of his colleagues at the NIH have begun transitioning to industry roles due to the uncertainty. Although these individuals continue to contribute to research, the shift may alter the questions being asked and who benefits from the findings. “There’s anxiety because there’s uncertainty, it’s scary, especially for those with large research portfolios and ongoing research.”

Historically, the US has been a global leader in oncology research, supported by substantial federal investments in biomedical science. With this infrastructure now in flux, experts worry about a slow-down in progress across cancer biology, translational research, and therapeutic development, particularly given the escalating cost of conducting trials domestically.

“There is still funding occurring, but there may need to be some pivots. If we just say, hypothetically, there is a clear reduction in federal funding for cancer research, then there will need to be commensurate increases in foundation support, philanthropy, and industry partnerships,” Spratt said. “Clinical trials, for example, have become exceptionally expensive in the US. [However], these high costs are driven by the high regulations and standards put in place. We may need to be more creative about how we conduct [trials going forward], reducing regulatory burdens without compromising safety and finding more cost-effective solutions that allow limited dollars to go further.”

Equity-focused research is also at risk. Although some researchers have been able to pivot their focus from race-based investigations to deeper analyses of socioeconomic and environmental drivers of disparities, others have faced greater scrutiny and decreased support.

“There are researchers who were focused on race-based health disparities who are now having to pivot. Many are choosing to frame their research around social determinants of health more broadly—economic status, education, and access to care—rather than focusing solely on race,” Spratt said. “Some of those programs continue, but they’re under much more scrutiny. And in other cases, funding just disappeared.” Spratt emphasized the importance of continuing to include diversity, equity, and inclusion in cancer research, but acknowledged that approaches must be adapted to changing regulatory and funding conditions.

Experts advocate for a range of strategic solutions to mitigate the impact of these cuts. These include lowering the cost of research by reducing regulatory burdens without compromising safety, improving clinical trial efficiency, and reallocating funding toward projects with the highest potential patient impact. There is also a call for enhanced collaboration between academia, government, and industry to develop new funding pipelines.

“The system we have for biomedical research in the US has many strengths, but there are opportunities for improvement,” Spratt said. “[We] need to think carefully about how to ensure their programs remain viable. We can’t keep doing research just for the sake of it as there are career researchers whose work does not clearly translate to patient benefit. We must navigate the current climate by aiming for a more cost-effective, robust ability to perform research that helps people, not just to maintain funding or conduct research for its own sake.”

In the near term, experts such as Spratt are optimistic about the imminent stabilization of the federal funding landscape. Given the scale of proposed cuts, however, the research community must remain adaptable.

“We have had, for decades, clear-cut paths for academic researchers to obtain funding. This is an awakening moment,” Spratt emphasized. “Individuals must now think carefully about how to ensure the sustainability of their programs and whether their research is truly designed to translate from bench to bedside.”

He concluded, “If you’re pursuing high-impact science that is focused on benefiting patients, there are still many avenues for success. We have a brilliant scientific community in the US, and this community must keep moving forward with helping humankind as our north star.”

References

1. Trump’s 2025 executive orders. Holland & Knight LLP. Accessed June 30, 2025. https://www.hklaw.com/en/general-pages/trumps-2025-executive-orders-chart
2. Martin S, Merrill R, Bourque D, et al. NIH cuts research funding for indirect costs. Holland & Knight LLP. February 10, 2025. Accessed June 30, 2025. https://www.hklaw.com/en/insights/publications/2025/02/nih-cuts-research-funding-for-indirect-costs#:~:text=The%20indirect%20cost%20rate%20is,security%20and%20biosafety,%20and%20utilities.
3. Sanders releases report documenting Trump’s war on science. News release. US Senate Committee on Health, Education, Labor and Pensions. May 13, 2025. Accessed June 30, 2025. https://www.help.senate.gov/dem/newsroom/press/news-sanders-releases-report-documenting-trumps-war-on-science
4. Mallapaty S. Exclusive: NIH grant rejections have more than doubled amid Trump chaos. Nature. Published online May 19, 2025. doi:10.1038/d41586-025-01539-5
5. Impact of NIH grant terminations. Association of American Medical Colleges. May 27, 2025. Accessed June 30, 2025. https://www.aamc.org/about-us/mission-areas/medical-research/publication/impact-nih-grant-terminations
6. Masson G. 250 more NIH workers laid off, including cuts at the National Cancer Institute. Fierce Biotech. May 6, 2025. Accessed June 30, 2025. https://www.fiercebiotech.com/biotech/250-more-nih-workers-laid-including-cuts-national-cancer-institute
7. The White House. Major discretionary funding changes. May 2, 2025. Accessed June 30, 2025. https://www.whitehouse.gov/wp-content/uploads/2025/05/Fiscal-Year-2026-Discretionary-Budget-Request.pdf
8. Choi J, O’Connel-Domenech A, Weixel N. White House asks for steep cuts to HHS budget. The Hill. June 2, 2025. Accessed June 30, 2025. https://thehill.com/newsletters/health-care/5329525-white-house-hhs-budget-nih/
9. Pradhan R, Allen A. World’s premier cancer institute faces crippling cuts and chaos. July 9, 2025. Accessed July 16, 2025. https://kffhealthnews.org/news/article/national-cancer-institute-nih-cuts-chaos-scientific-biomedical-research/