New analysis has revealed that there are several distinctions between the goals of federal and industry-supported oncology clinical trials, which researchers of the study say highlights their complementary role in optimising cancer care.
Published in JAMA Oncology, the comparative study analysed data from thousands of studies from 2008 to 2024 within the ClinicalTrials.gov database, finding that a little over 80% of listed cancer trials were industry sponsored, with 90% focused on treatment.
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When comparing industry and federally backed studies, researchers uncovered that industry sponsors were generally more likely to look at single-agent treatments in their studies, while the latter placed a greater focus on non-treatment interventions such as health services research, prevention, screening, supportive care or diagnostics.
Federally backed trials were also more likely to investigate the potential of treatment de-escalation strategies – focusing on if a drug or other intervention can be taken either at a lower dose, less frequently or for less time without impacting patient outcomes – as well as regimens incorporating multiple therapeutic modalities, such as drug treatment followed by radiation therapy.
Researchers add that government-funded research was considerably more likely to look into interventions for childhood or rare cancers over industry-backed efforts, though they caveat that they observed a closing of this gap throughout the study range.
On top of this, there were differences between federal and industry sponsored trials in terms of their spread through the clinical development pipeline, with the former most commonly being in Phase II, while the latter more often seen to be in Phase I or Phase III.
Funding cuts, lack of commercial benefit threaten federal research
While the differences between the goals of industry and federal-backed oncology clinical trials differ, researchers note that they play a complementary role in improving cancer care – focused on developing new treatments and improving existing regimens for better patient outcomes.
However, as industry takes an increasingly dominant role in cancer trials, while primarily focusing on single-agent drug trials, researchers warn that ‘commercially unattractive’ questions around how treatment can be optimised to boost patient outcomes may go unanswered.
This trend could be further perpetuated by US President Donald Trump’s federal funding cuts, with his administration recently terminating around 2,300 grants to cancer research worth nearly $3.8bn. This included around 160 clinical trials.
“Federally sponsored research brings much of the basic science discovery, trial infrastructure and early efficacy studies, while industry leads in late-stage determinative trials resulting in regulatory approvals,” said lead author Joseph Unger, health services researcher with SWOG Cancer Research Network and professor in the public health sciences division at Fred Hutch Cancer Center.
With federal funding cuts currently impacting the oncology space, it is unclear what the future of government-sponsored cancer research will look like – though researchers tout their “unique and vital” role.
