Changes in the way basic and translational research are funded are creating challenges for emerging and established scientists. What does that mean for the pipeline of breakthrough drugs, next-gen advances and physician scientists?
A National Institutes of Health (NIH) research award for $3.46 million in August supporting the investigation of biomarkers of response and resistance to standard-of-care acute myeloid leukemia (AML) treatment was cause for celebration.
Despite the “challenging funding environment,” researchers had received a notice of award for their R01 application, Uma Borate, MBBS, MS, a co-principal investigator, announced on X, to much fanfare and words of congratulations. The grant from the National Cancer Institute (NCI), part of the NIH, provides funding over five years to researchers at the Ohio State University Comprehensive Cancer Center (OSUCCC), where Dr. Borate is a professor of hematology, and the University of California, San Francisco (UCSF).
About one third of newly diagnosed older AML patients don’t respond to standard-of-care combination therapy with venetoclax (Venclexta), a BCL-2 inhibitor, and azacitidine, a chemotherapy drug. Building on the phase II OPTI-AML study, which was backed by the nonprofit Blood Cancer United, Dr. Borate and co-investigators will use bulk and single-cell sequencing of patient samples to examine response and treatment resistance in this setting.
Funding for cancer research, including in hematologic oncology, has been getting more competitive in recent years, amid changing processes and national priorities. In fiscal year (FY) 2023, NCI’s funding cutoff, known as the payline, was the 12th percentile based on peer review scores for R01 grant applications from established and new investigators. That tightened to the 10th percentile in 2024. In 2025, the NCI didn’t set an official payline but reported funding applications through the 9th percentile. The institute cautioned that policy changes, including upfront funding for multiyear grants, make it difficult to compare 2025 to prior years.
For R21 grants, which support exploratory or developmental projects, the NCI payline changed from the 9th percentile in FY 2023 to the 10th percentile in 2024 and the 7th percentile in 2025.
“If you think about the number of people applying for these grants, including new people who are entering the field and are not as experienced, this really puts them at a big disadvantage,” Dr. Borate said in an interview with SOHO Insider. “I think it has gotten more challenging.”
Overall, at the NIH, the number of funding opportunities has been falling as programs were consolidated and the application process was simplified.
“Certain opportunities that used to exist before no longer exist because programs have become consolidated, and that has really impacted the availability of federal funding,” commented Dr. Borate, who is clinical section head and clinical research director in acute leukemia at OSUCCC.
In a recent analysis, STAT reported that the NIH spent its entire external grants budget of $34 billion in FY2026 but noted the number of projects funded has been falling in recent years. Furthermore, STAT reported, funding processes are opaque, leaving even seasoned academics “unsure their ideas will be funded until they receive final notices.”
Previously, in early 2025, the NIH had announced it was capping reimbursement for indirect costs at research institutions at 15%, though this move was blocked in the courts. The same year, the Trump administration froze or canceled research funding at particular universities, like Harvard and Columbia, although much of the funding was restored after legal challenges. Furthermore, the administration’s proposal to cut the NIH budget by approximately 40% for FY2026 was rejected by Congress.
On paper, medical universities are not much worse off this year compared to 2025, but the climate continues to be uncertain for scientific research – and “the chill hasn’t quite gone away,” said Gerald Hsu, MD, PhD, who directs the hematology/oncology fellowship program at UCSF, in a recent interview.
For FY27, the administration proposed a 12% cut to the NIH budget, but similar funding for the NCI (+0.1%). Dr. Hsu said he expects to continue to see proposals from the administration to cut budgets of the institutions that form the bedrock for scientific research funding, as well as ongoing targeted disinvestment of programs at specific institutions.
Innovation at risk?
For the practicing hematologic oncologist, funding changes could negatively affect drug development and the number of new treatments in the pipeline, interviewees for this article caution.
“Innovation thrives off continued research and investment, and when you slow that down, I think there’s going to be hesitation to invest in a particular technology or treatment,” Dr. Borate said.
Federal funding has been at the heart of important developments in cancer drug research. Basic research into basic immunology in fighting cancer was funded for decades by the NCI, culminating in the development of immune checkpoint inhibition by James Allison, PhD.
Many breakthroughs grew out of understanding cancer signaling and the spectrum of cancer mutations, said George Mulligan, PhD, chief scientific officer at the Multiple Myeloma Research Foundation (MMRF). For example, the US Food and Drug Administration approval this year of daraxonrasib (Rasonque) for pancreatic cancer reflects research advances in the ability to target RAS. In multiple myeloma, government and foundation support for developing large myeloma datasets led to the discovery of the GPRC5D target, which is widely expressed in myeloma tumors and can be targeted with an antibody, Dr. Mulligan noted.
“The vast majority of breakthrough drug development comes from basic discovery in labs that are not necessarily corporate,” Dr. Mulligan said in an interview.
Dr. Borate said she is particularly concerned about the future for translational research to develop older, off-patent drugs for new uses, as this work is not typically done by pharmaceutical companies, and investigators depend on federal funding. Funding for trials that examine effects in particular patient populations is also at risk because of federal policies discouraging research in studying health disparities and grants mentioning race or ethnicity.
In a JAMA Oncology study of 11,681 trials conducted in the United States from 2008 to 2024, researchers found that industry was more likely to fund studies of single agent therapy, while federally funded studies tend to focus on nontreatment interventions, multimodal treatment strategies, treatment deescalation and research in rare and pediatric cancers, including acute lymphoblastic leukemia and lymphoma.
“These findings provide an empirical characterization of the complementary and essential roles of federal and industry sponsors in the cancer clinical trial enterprise,” wrote Joseph Unger, PhD, of the Fred Hutchinson Cancer Center in Seattle, Washington, and colleagues.
However, the authors also noted that between 2018 and 2022, industry trials accounted for nine of 10 enrollments of adults with cancer.
“Because the number of patients willing to participate in clinical trials is limited, this imbalance raises concerns that research questions lacking commercial incentives may go unanswered,” Unger et al wrote.
Dr. Mulligan of the MMRF expects more challenges around developing the next generation of drugs that offer better side effect profiles and more convenient dosing. For example, the first BTK inhibitors were associated with significant cardiac side effects, but later entrants to the class had improved cardiovascular profiles.
“There’s a concern that clinicians will start to see slower development of those options, which really impact their ability to deliver what they want for patients,” Dr. Mulligan said.
While CAR-T therapies have produced durable remissions in lymphomas, the relapse rates are high in the multiple myeloma setting, and challenging delayed neurotoxicity have been reported, including Parkinsonism and Guillain-Barré syndrome. It’s possible that a combination strategy would be effective and research is needed into finding out who is the best patient, what’s the best dose and what’s the best combination, said Dr. Mulligan.
The role of foundations
Even though multiple myeloma has been an active area of research and there are 15-plus drugs approved for this indication in the United States, there is still a need for more research, said Dr. Mulligan, who formerly led biomarker and translational research strategy at Millennium/Takeda.
“For us as a foundation, we want to make sure people are cured, can go off therapy and not have a late toxicity,” he explained.
But it takes a lot of time for studies to pay off. Pharmaceutical companies need to develop a 10-year strategic plan to get an agent approved and into a certain segment of the market, and “if there’s dramatic uncertainty along the way, that is very, very challenging,” Dr. Mulligan said.
Acknowledging the unpredictable climate for research funding, the MMRF said it was scaling up investment in its Myeloma Investment Fund, a venture philanthropy arm that supports early-stage research at biotech companies.
The MMRF also fosters collaboration through its Myeloma Accelerator Challenge program, encouraging four or five centers to work together and also with the foundation on data generation and analysis, Dr. Mulligan said.
“That’s an important way to make things more sustainable,” he said.
However, he acknowledged that there’s only so much philanthropic funding by foundations can do, given that even a relatively small phase II study can cost tens of millions of dollars.
Filling the people pipeline
If there is a slowdown in funding and it becomes increasingly unclear how research will lead to drug approvals and ultimately influence clinical practice, the scientific people pipeline could be negatively affected. In a survey in Spring 2025 of NIH-funded investigators, 18% reported funding disruptions and 18% were not sure if they would continue research.
In response to the changes taking place nationally, the MMRF is also trying to give more awards to promising young researchers in training, so they see myeloma as an attractive research opportunity, Dr. Mulligan said. The MMRF supports young researchers through its Scholars Program, which provides up to $400,000 in funding over four years, and a research fellowship program, which provides up to $75,000 in research support for one year.
However, the NIH has very big shoes to fill when it comes to supporting basic research.
“Our societies are certainly positioned to support trainees and have done a remarkable job historically doing so,” said Dr. Hsu of UCSF. “It’s just a very heavy burden to shoulder.”
Alerting his community to the implications of federal funding cuts in an article last year in the San Francisco Chronicle, Dr. Hsu wrote that in addition to threatening innovation, the changes were threatening careers. For example, a physician in his program who had completed a hematology/oncology fellowship and another three years as a postdoctoral research fellow faced challenges in 2025 getting funded for work in novel leukemia immunotherapies. As it turns out, she did get a career development award, but while it’s heartening that she “stayed in the game and persisted,” Dr. Hsu said that other physician scientists have instead shifted to the pharmaceutical industry or clinical practice.
Many who are in the pipeline as basic science researchers and physician scientists are looking at the uncertainty of the research funding landscape and deciding for themselves that it’s not worth the fight or that it isn’t a viable path, Dr. Hsu explained to SOHO Insider.
“When you have people who committed to finishing not just college and graduate school, but postdoctoral training and at the cusp of becoming independent researchers saying, ‘This isn’t for me,’ you lose a generation potentially of scientific researchers,” Dr. Hsu said. “The erosion in the pipeline is what’s concerning for an educator like me.”
Granted, scientific research has never been an easy path; it’s always required a high degree of resilience. The people who stay with it and who are really engaged and committed and passionate about their work can and will still make it happen, he added.
“It might require the extra amount of resilience and commitment and passion and that will probably lead to some attrition, unfortunately,” Dr. Hsu said. “But I don’t advise against pursuing it. For some people, it’s the kind of thing you just can’t not do.”
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