Concerns rise over increased industry sponsorship in cancer clinical trials

A growing reliance on industry-sponsored cancer clinical trials in the United States is a reason for concern, say researchers from the UNC Lineberger Comprehensive Cancer Center.

In a Journal of Clinical Oncology editorial, Yara Abdou, MD, and Norman E. Sharpless, MD, responded to a new study by the Fred Hutchinson Cancer Center in Seattle that found enrollment in industry-sponsored cancer clinical trials doubled between 2008 and 2022 while federally supported trial enrollment remained flat. From 2018 to 2022, cancer clinical trial enrollment was eight times greater in industry-sponsored studies compared to federal studies.

Abdou and Sharpless called the study's findings mixed news.

The good news is there has been a significant increase in industry investment in cancer clinical trials, leading to advancements in cancer therapies and a reduction in cancer mortality. However, the bad news is the lack of growth in federally funded trial enrollment, which often addresses broader and underrepresented research areas that industry sponsors tend to avoid."

Yara Abdou, MD, assistant professor of medicine and breast cancer specialist, UNC School of Medicine

Industry-sponsored studies typically focus on developing and testing new drugs or treatments and often bypass other critical areas. Trials that investigate less aggressive treatments, known as de-escalation trials, or are focused on non-therapeutic outcomes such as quality of life and survivorship, rarely attract industry backing. Abdou said this imbalance jeopardizes the long-term inclusivity and sustainability of research benefiting diverse patient populations.

Lagging federal funding of trials will reduce critical research in areas like cancer prevention, screening, symptom management and health disparities, said Sharpless, a professor of cancer policy and innovation at UNC School of Medicine. "To sustain progress and address these gaps, we need diversified funding and strong advocacy to ensure that all patient populations benefit from research advancements."

In addition to advancing scientific knowledge, federally funded trials are essential for training future researchers. These trials provide early-career investigators with mentorship and collaboration opportunities, fostering the development of skills and networks crucial for their professional growth. "If federal funding continues to lag, it could limit these invaluable training experiences, potentially impacting the development of future leaders in cancer research," Abdou said.

Abdou and Sharpless outlined a four-point call to action to address the growing disparity between industry and federally funded trials:

1. Educate Lawmakers: Lawmakers must understand the pivotal role that federally funded research plays in advancing cancer treatment and improving patient outcomes.

2. Diversify Funding Sources: It is imperative to explore alternative funding sources, such as state-level funding, industry-academia collaborations and philanthropy, in order to support a wider range of clinical trials.

3. Engage Advocacy Organizations: Groups like the American Society of Clinical Oncology, the American Cancer Society and the Leukemia & Lymphoma Society should be mobilized to advocate for increased funding from Congress for the National Cancer Institute and federally sponsored clinical trials.

4. Support from Academic Centers: Cancer service lines at academic centers must allocate resources to strengthen clinical trial infrastructure and ensure the continuity of federally funded research.

"Industry-funded trials are growing while federally funded trials lag, leading to missed opportunities for critical research areas like cancer prevention, screening, symptom management, and health disparities," Abdou said. "To sustain progress and address these gaps, we need diversified funding and strong advocacy to ensure that all patient populations benefit from research advancements."