Although industry-sponsored cancer clinical trials often focus on single-agent drug trials, federally funded cancer clinical trials are more likely to investigate drug combinations with other treatments, including biologics or radiation therapy. An analysis by Joseph M. Unger, PhD, MS, Professor, Cancer Prevention Program at Fred Hutchinson Cancer Center, Seattle, and colleagues evaluated the quantitative role of federally funded cancer clinical trials vs those funded by industry sponsors.

Federal trials fill critical gaps left by industry, especially in early-phase research, multimodality treatments, rare cancers, and treatments for children.

— JOSEPH M. UNGER, PhD, MS

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They found that early-phase, multimodality, dose-de-escalation, rare cancer, and child-focused drug and biological agent clinical trials were more likely to be conducted by federally sponsored research groups. The findings highlight the unique role of federally funded studies in cancer clinical trials and how cuts in federal research funding may hinder progress in cancer outcomes. These findings were presented during the 2025 ASCO Quality Care Symposium.¹

The researchers analyzed registry data from ClinicalTrials.gov from 2008 to 2024 to identify trials based in the United States that included drug or biological agents for the purpose of cancer treatment. Studies were then categorized by lead sponsor, federal vs industry, and by study phase, intervention, de-escalation, rare cancer, and age. Odds ratios were calculated. Chi-square tests were used.

Key Results

The researchers found that of the 10,142 cancer clinical trials they analyzed, 1,711 (16.9%) were federally funded, and 8,431 (83.1%) were industry-funded. When comparing federally funded trials with industry-funded studies, the researchers found the following:

• Federally funded studies were more commonly early-stage (phase I or II) trials (87.3% vs 82.0%), whereas industry-funded studies were more commonly phase III trials (18.0% vs 12.7%).
• Federally funded studies were less commonly single-agent drug trials (50.8% vs 79.9%).
• Federally funded studies more commonly involved complex multimodality drug or biological agent combinations alone (20.2% vs 7.7%) or with radiation (11.0% vs 1.5%), surgery (2.6% vs 0.2%), transplantation (1.5% vs 0.1%), or combined modalities (1.9% vs 0.1%).
• Federally funded trials were more often conducted in rare cancers (17.8% vs 12.3%) and cancers in children (16.2% vs 5.1%).
• Federally funded trials more commonly focused on dose de-escalation (3.2% vs 0.4%).

“Federal trials fill critical gaps left by industry, especially in early-phase research, multimodality treatments, rare cancers, and treatments for children,” said Dr. Unger in a statement. “The trials that address these types of research questions are vital for patients and their families, even if the outcomes of such trials are not profitable for private companies. Sustained or increased funding is essential to maintain progress in these areas and to maintain a healthy cancer research ecosystem that balances federally sponsored and industry-sponsored trials.”

Continuing to Invest in Research to Improve Care for Patients

“Federally funded cancer clinical trials play an important role in evaluating interventions and improving cancer outcomes in settings and populations that are not prioritized by industry,” said Julie R. Gralow, MD, FACP, FASCO, ASCO Chief Medical Officer and Executive Vice President, in a statement. “With more

With more than 18 million cancer survivors in the United States, federal research has delivered an undeniable return on investment.

— JULIE R. GRALOW, MD, FACP, FASCO

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than 18 million cancer survivors in the United States, federal research has delivered an undeniable return on investment. To ensure healthier futures, we must continue to invest in the research that advances prevention, detection, and treatment.” 

DISCLOSURE: Funding for this study was provided by The Hope Foundation. Dr. Unger has served as a consultant or advisor to AstraZeneca and Loxo/Lilly and has received research funding from Arnold Ventures. Dr. Gralow reported no conflicts of interest.

REFERENCE

1. Unger JM, Xiao H, LeBlanc M, et al: The special role of federal sponsorship in the design and conduct of drug or biological agent cancer treatment clinical trials. 2025 ASCO Quality Care Symposium. Abstract 94. Presented October 11, 2025.