Above: Aaron Goldman, Ph.D., American Cancer Society pay-if grantee.

By Shelley A. Sackett

This year, 1.6 million Americans will receive a new cancer diagnosis. Yet, federal funding for cancer research is at its lowest ebb in decades, according to American Society of Clinical Oncology (ASCO).

“It’s scary what we’re doing nationally with funding,” said Tom Flanagan, Interim Senior Director of the New England Division of the American Cancer Society (ACS).

In 2014, cancer caused 585,720 deaths in the United States, or one fourth of all reported deaths. According to the ACS, the number of new cancer cases is expected to rise by almost forty percent by 2030. Yet, federal funding of medical research has remained flat for more than a decade when adjusted for inflation.

The U.S.’s National Institute of Health (NIH) is the largest source of funding for medical research in the world. Since 2003, however, its inflation-adjusted appropriation is down 23 percent, according to the ASCO. The NIH budget peaked in fiscal year 2010 at $30.9 billion, falling to $30.3 billion for fiscal year 2015.

Diminished resources have had immediate effects. For example, patient enrollment in NIH’s clinical trials network decreased from 29,000 patients in 2009 to 20,000 in 2013. Clinical trials are a critical step in bringing potential new therapies to the marketplace.

Next to the federal government, the ACS is the largest private funder of cancer research, subsidizing 809 research grants in the U.S. worth $438 million in 2015. Of that national total, $47.5 million, or over ten percent, is earmarked to fund 96 Massachusetts grants.

In addition, the ACS’s multi-disciplinary review panel sometimes approves applications that are beyond that year’s funding resources. Called “pay-if” grants, individual donors who wish to support research that would not otherwise be funded subsidize the work. In 2014, these individual donors stepped up to contribute more than $8.8 million in funding, financing 46 additional “pay-if” grants.

One pay-if grantee is Aaron Goldman, Ph.D., an instructor of medicine at Harvard Medical School who was a fellow with ACS for three years, until this past July. He received a $150,000 research grant to study the biological mechanism that makes some breast cancer cells resistant to cancer therapy. His goal was to develop a drug that would attack this mechanism.

“The focus of our work is not just to keep testing and playing with pathways and molecules, but to really make something come to fruition. There is a huge unmet need, particularly when it comes to cancer cells’ resistance to chemotherapy,” he said. In fact, he and his team have developed drugs that they know are working. “We got a lot of great research accomplished in just three years,” he said proudly.

Goldman and his team are currently seeking private funding to expand these drugs into a full-fledged company so they can study and license them. With the right funding, these new therapies could be market-ready within a year-and-a-half, Goldman estimates, improving a cancer patient’s overall therapeutic outcome and preventing relapse.

Over the course of his 15-year involvement in cancer research, which started as an undergraduate and then graduate student at the University of Arizona, he has had a lot of experience with foundation and government grants. ACS is unique among funders.

“ACS brings you in as family. You’re interacting with the actual funders and the patient population. All the work I’m doing gets communicated throughout the community of administrators and the grant committee,” he said. By contrast, NIH is more anonymous and diffuse. “You feel a little more detached from the population that you’re trying to help – the people suffering from cancer.”

Goldman’s main takeaway from his experience with medical research and securing funding is that foundation grants are crucial in the current fiscal environment that has created even fiercer competition for federal grants, making it very difficult for a young investigator to even qualify for one.

“It’s the old paradigm of applying for a job without the experience but you need the job to get the experience. These foundation grants, like ACS, have been fantastic in filling those gaps,” he said.

ACS is trying to get Congress to refill NIH cancer research funding gaps by increasing appropriations. In 2001, it created ACS Cancer Action Network (ACS CAN) to amplify the organization’s work in the public policy arena. As the nation’s leading nonprofit, nonpartisan cancer advocacy organization, ACS CAN promotes its agenda of fighting cancer at the state and federal levels. ACS provides 92 percent of ACS CAN’s 2015’s budget of $35.9 million. The other 8 percent is donated by individuals, health systems and companies.

“We hold candidates as well as lawmakers accountable for their stance on public policies that we know will make a positive impact on fighting cancer,” said Shalini Vallabhan, ACS CAN Vice President of Government Relation in New England. With one million volunteers nationwide, trained volunteers in every congressional district and a lobbyist and grass roots manager in every state, the group is a political force to be reckoned with.

“We all know the level of partisanship that is taking place in Washington, D.C. Increasing funding for medical research is an area we see strong bipartisan support for,” Vallabhan said, pointing out that on July 15, the U.S. House of Representatives passed House Bill 6, “The 21^st Century Cures Act” (congress.gov/bill/114-congress/house-bill/6) which provides for dedicated funding for NIH for the next five years at $1.75 million per year, or $8.75 million total.

The bill must next pass in the Senate before President Obama can sign it into law. Later this month, over 700 volunteers and ACS CAN staff will travel to Washington, D.C. to lobby lawmakers from all 435 congressional districts.

ACS would not receive any of this increased funding. “This is for the public good. We have to get the story out because it’s such an exciting time in life sciences and cancer treatment and if we continue to decrease funding from the federal government, it will have a ripple effect for decades in terms of research and science in these areas,” Vallabhan said.

Since its first cancer prevention study in the 1950’s linked smoking and lung cancer, ACS has funded long-term prospective studies on large groups of people to help researchers identify cancer risk factors. Currently, 300,000 people across the country are involved in a study that looks at lifestyle, medical history and changes in medical history, trying to uncover the next big link that can help in the fight to prevent cancer.

“We know that cancer will cost our economy over $200 billion in medical costs and lost productivity this year. We also know that 50 percent of cancer is preventable either through preventing tobacco use or ensuring good nutrition and proper physical activity, “Vallabhan said, pausing. “It’s common sense that it’s better both from a cost perspective and certainly in terms of impact on families and communities if we’re preventing the disease,” she added.

ACS CAN Outreach

Each year, the American Cancer Society Cancer Action Network brings together leaders from the life sciences ecosystem, health care systems, non-profit sector and businesses. The annual Research Breakfast highlights new breakthroughs in federal funding for cancer research and calls on policymakers to commit to increases in federal funding for the National Institute of Health and National Cancer Institute.

In June 2015, the 8^th annual event featured Governor Charlie Baker, Mayor Marty Walsh and Paul Guzzi from the Boston Chamber of Commerce as guest speakers. More than 80 percent of federal funding for the NIH and NCI (National Cancer Institute) is spent on biomedical research projects at research facilities across the country. In FY 2015, researchers in Massachusetts received $2 billion in NIH funding, which supported more than 32,800 jobs across the state.

ACS CAN also launched the OneDegree project this year in partnership with Stand Up to Cancer to push for increased funding at the federal level. ASC CAN asks everyone to sign the petition at www.onedegreeproject.org. A two-minute video about the OneDegree campaign is at: facebook.com/video.php?v=10152839454796378&set=vb.6355071377&type=2&theater.

For more information or to donate to the American Cancer Society, visit http://www.cancer.org; for the American Cancer Society Cancer Action Network, visit www.acscan.org, and for the One Degree project, visit http://action.acscan.org/site/PageNavigator/OneDegree_Microsite_Petition_Page.html.