U.S. clinical cancer research increasingly dominated by pharmaceutical industry sponsors, study finds

Fred Hutch Cancer Center researchers have identified a substantial increase over the past decade in the proportion of cancer patients in the United States who participate in clinical trials sponsored by the pharmaceutical industry, compared to those conducted with the support from the federal government.

Published in The Journal of Clinical Oncology and presented at the ASCO Quality Care Symposium, these findings reveal trends of underinvestment in federally funded studies, stable enrollment numbers in federally funded studies over decade and a growing reliance on industry to conduct cancer research.

The study showed that between 2018 and 2022, industry-sponsored trials enrolled more than eight times as many patients as federally sponsored trials. For adult trials, the industry recruited nearly 10 times more patients. These ratios have also increased significantly over time. Compared to a decade earlier (2008-2012), the proportion of enrollment attributable to industry support versus federal support increased from 4.8 to 9.6 among adults and from 0.7 to 2 .3 in children. The study was conducted in more than 26,000 cancer clinical studies in adults and children using data from Clinicaltrials.gov.

The magnitude of the difference revealed by the study, which was the first to comprehensively assess the comparative roles of industry and federal sponsors in supporting patient recruitment for cancer studies, surprised researchers .

“We recognized that the industry was playing an increasing role in clinical cancer research compared to several decades ago,” said Joseph Unger, Ph.D., MS, health services researcher and biostatistician at Fred Hutch and lead author of the study. “But we didn’t realize the difference was so dramatic.”

Federally funded cancer research studies play a critical role because of their demographic diversity. For example, three times as many black participants were enrolled in federally funded research as in industry-funded research. In addition to studying cancer treatments, federally funded research covers a wide range of clinical research questions, such as combining treatment modalities or examining the effectiveness of approved drugs in different other cancers. Industry-funded cancer research primarily aims to support the approval of new drugs.

“Underinvestment in federally funded clinical cancer research leads to missed opportunities for scientific, clinical and population advancements,” Unger said. “Federally funded cancer clinical trials have helped save more than 14 million life years over four decades and have helped improve clinical care guidelines for patients.”

Despite the need for more federally funded cancer clinical trials, researchers are quick to emphasize the importance of both federally and industry-funded cancer clinical trials.

“Industry investments in clinical cancer research have significantly accelerated precision oncology and cancer immunotherapy,” commented Unger, emphasizing the important role of industry in new drug discovery. “However, with increased federal investment in cancer research, we could see even greater advances in treatment options for cancer patients.”