In This Section

Cancer Policy Monitor: May 12, 2026

lawmakers push back on proposed nih cuts in budget hearings

-Matt Gontarchick

Members of both parties rejected the Trump administration’s proposed cuts to NIH over a series of congressional hearings featuring testimony from Health and Human Services Secretary Robert F. Kennedy, Jr. These remarks follow widespread rejection of the administration’s proposed sweeping cuts earlier in 2026 with the finalization of the Fiscal Year (FY) 2026 Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) funding bill.

Released on April 1, the White House budget request for FY 2027 calls for a 12% reduction in NIH funding and a slight funding increase for NCI. While not as sweeping as the nearly 40% cut that the administration proposed for NIH in 2026, the budget request would nonetheless seriously impact the biomedical research enterprise. During an April 16 hearing of the House Ways and Means Committee, Rep. Brad Schneider (D-Illinois) contended that the administration’s proposed $5.7 billion cut to NIH could result in 50 fewer new drugs reaching the market over the next 30 years.

Fortunately, appropriators from both parties were opposed to the administration’s proposed NIH cuts. In an April 16 hearing before a House appropriations subcommittee, Chairman Robert Aderholt (R-Alabama) expressed that “extreme swings” in federal funding for biomedical research were counterproductive, while Ranking Member Rosa DeLauro (D-Connecticut) said flat-out that the subcommittee would reject the administration’s proposed cut to NIH.

The strongest Republican pushback came from Rep. Stephanie Bice (R-Oklahoma), who argued that sustained, stable NIH spending is essential to accelerating medical breakthroughs. When pressed on the proposed cuts, Secretary Kennedy repeatedly cited the need to redirect federal dollars toward other priorities – including addressing chronic disease – as well as the importance of reducing the federal deficit. Kennedy was also candid that the cuts were “painful,” acknowledging that “there’s a lot of cuts to the agency that nobody wants.”

Secretary Kennedy also pointed out that the National Cancer Institute would receive a slight funding boost under the President’s FY 2027 budget request — although Senate Appropriations Committee Chair Susan Collins (R-Maine) quickly retorted that a $1 million increase against NCI’s $7.35 billion budget would not even fund one additional grant.

Democratic lawmakers repeatedly pointed out how the administration’s policies have disrupted and continue to disrupt research, even as the issue of multiyear funding went largely unaddressed during the hearings. During the April 21 hearing, Subcommittee Chair Tammy Baldwin (D-Wisconsin) noted that NIH awarded 2,235 fewer new research grants in FY 2025 compared to the prior fiscal year — including 260 fewer new cancer research grants. The same day, Rep. Lizzie Fletcher (D-Texas) highlighted before the House Energy and Commerce subcommittee the dramatic drop in Notice of Funding Opportunities that NIH issued in 2025 compared to 2024. In an April 17 hearing of the House Education and Workforce Committee, Rep. Adelita Grijalva (D-New Mexico) said the cancellation or freezing of more than $180 million in NCI grants between February and April 2025 impacted projects on pancreatic cancer and cervical cancer screening.

Throughout the series of congressional hearings, lawmakers from both parties justified federal investment in NIH as essential to maintaining U.S. global leadership in biomedical research. Sens. Todd Young (R-Indiana), Thom Tillis (R-North Carolina), Michael Bennet (D-Colorado), and several others warned that disruptions to medical research could cede America’s edge to China and other competitors. While Kennedy acknowledged these challenges, he pointed to efforts to accelerate drug approval timelines at the Food and Drug Administration as a partial response.

Members of Congress additionally queried Kennedy on the Trump administration’s proposal to cap reimbursement of indirect costs at 15%. While the final FY 2026 Labor-HHS bill includes language blocking changes to indirect cost reimbursement, the administration continues to advocate for reimbursement caps. Rep. Andy Harris (R-Maryland) aligned with the administration’s position during an April 16 hearing, suggesting that reducing indirect cost rates would allow more research to be funded without increasing NIH’s topline funding level. In an April 21 appearance before a Senate appropriations subcommittee, Secretary Kennedy told Sen. Collins that he is committed to working with lawmakers to find alternative approaches to improve “accountability and transparency” that do not come at the expense of biomedical research.

With the conclusion of Secretary Kennedy’s Capitol Hill appearances to address the administration’s FY 2027 budget request, the House and Senate Appropriations Committees are scheduled to begin drafting and voting on their own FY 2027 Labor-HHS measures starting in May 2026. While Congress is likely to again reject the administration’s proposals to slash NIH funding, the continuation of proposals to reduce medical research funding, change how indirect costs are reimbursed, and alter grant funding mechanisms illustrate the persistent challenges facing the medical research community. As negotiations on the spending bills get underway, AACR will continue to advocate for robust, sustainable, and predictable NIH funding that can empower the development of life-saving treatments.

NCI’s congressional justification for fiscal year 2027 released

-Blake William Rostine

On April 10, 2026, the NIH and NCI released their Congressional Justification (CJ) in response to President Trump’s fiscal year (FY) 2027 annual budget. The CJ is a tool to justify the budget request by outlining NCI’s mission and projects, while also providing comparative information on previous budgets.

The FY 2027 President’s Budget request for NCI is $7,353.0 million, an increase of $8.9 million or 0.1 percent from the FY 2026 Enacted level.  The FY 2027 request includes $100.0 million for the Childhood Cancer Data Initiative (CCDI). Highlights of this proposal include a $269.4 million increase to research project grants ($3,710.7 million in total), funding approximately 1,186 grant requests. However, components like a slight decrease of $161.3 million in funding to research centers are concerning, and AACR will continue to monitor and advocate for the highest possible funding for all sectors of cancer research.

NCI’s CJ can be read in full here.

AACR annual meeting 2026 regulatory science and policy track and science and health policy track sessions now available for streaming

The AACR Annual Meeting 2026 brought together the global cancer community for six days of scientific exchange, clinical innovation, and forward-looking policy dialogue under this year’s theme: “Precision • Partnership • Purpose: Advancing Cancer Science to Save Lives Globally.” The theme reflected a shared commitment to translating cutting-edge discovery into meaningful patient impact through collaboration across sectors, disciplines, and borders.

The Regulatory Science and Policy Track is a cornerstone of the AACR Annual Meeting. The Regulatory Science and Policy track convened leaders from the U.S. Food and Drug Administration, academia, industry, and patient advocacy to explore some of the most pressing challenges in oncology medical product development. Across 10 sessions, topics spanned all of cancer regulatory science and policy, including sessions on dose optimization, patient-centered clinical trials, new approach methodologies, data extrapolation to pediatrics, and AI in drug development.

Meanwhile, the Science and Health Policy Track held two major sessions. The first, a researcher town hall saw scientific leaders, policy experts, and advocates engage the research community in a dynamic discussion of emerging science policy issues. Speakers presented on key topics include shifting federal funding and grant policy, cancer health disparities, and challenges facing the cancer research workforce as well as AACR’s advocacy efforts. In a robust discussion with the audience, the forum brought forth the most pressing issues affecting the research community and fostered community input to strategize advocacy efforts. In the second session, titled “Cancer Prevention and Screening: Exploring Policy Solutions”, leading experts in oncology, public health, and behavioral science examined evidence-based policy solutions for cancer risk reduction and improved screening uptake across populations. Speakers explored major modifiable risk factors for cancer including tobacco and emerging nicotine product use, approaches to expand access to and adherence with recommended cancer screening, and the role of the Division of Cancer Prevention at the National Cancer Institute as well as barriers to drug development for cancer prevention.

Registrants can access recorded sessions through on-demand streaming through October 31, 2026 via the AACR Virtual Meeting platform. A comprehensive list of sessions on these tracks can be found below with links to their abstracts:

aacr Scientist↔Survivor Program® graduates new class at the aacr Annual Meeting 2026

Congratulations to the AACR Scientist↔Survivor Program® (SSP) Class of 2026. This year, AACR welcomed 50 patient advocates representing 39 distinct cancer communities across 8 countries and 17 U.S. states to participate in the AACR Annual Meeting 2026. The SSP cohort reflected the breadth and diversity of today’s advocacy landscape, with representation across cancer types, geographic regions, ethnicities, and genders.

Held annually during the AACR Annual Meeting, SSP is designed to foster enduring partnerships among scientists, cancer survivors, and patient advocates worldwide. The program offers advocates access to plain-language scientific lectures, small group discussions, and interactive sessions focused on cancer research, survivorship, advocacy, and public policy. Special Interest Sessions addressed timely topics including immunotherapy, early detection assays, and clinical trial design. Learn more about this year’s program in Cancer Today’s article, A Shared Path Toward Cancer Progress. AACR gratefully acknowledges the supporters of the AACR Scientist↔Survivor Program® at the Annual Meeting.

patient advocate poster symposium at the aacr annual meeting 2026 highlights collaborative research

During the AACR Annual Meeting 2026, SSP Advocate Mentor Patricia Spears moderated the Patient Advocate Poster Symposium, titled Advancing Cancer Research Through Patient and Community Partnerships. The session underscored the importance of a team-based approach to addressing the complexities of cancer care, bringing together patient advocates, community members, researchers, and medical professionals.

Featuring five patient advocate posters, the symposium highlighted how meaningful patient and community partnerships strengthen research relevance, increase public trust, and help ensure cancer research reflects patient needs and urgency. The session showcased the powerful role of collaboration in advancing cancer research and improving outcomes for all patients.

Recording available. (Link forthcoming)

aacr honors jill feldman with distinguished patient advocacy and engagement award at the annual meeting 2026

AACR honored lung cancer advocate Jill Feldman with the 2026 Distinguished Patient Advocacy and Engagement Award in recognition of her transformative impact on lung cancer research and patient engagement. A two-time cancer survivor and internationally recognized advocate, Feldman co-founded EGFR Resisters, a patient-driven organization that has raised more than $1 million to accelerate research for EGFR-mutated lung cancer.

Through her leadership, Feldman has amplified the patient voice across clinical research, policy, and scientific forums worldwide, influencing research design, clinical guidelines, and collaboration across sectors. She was recognized during the AACR Annual Meeting 2026 Opening Ceremony in San Diego.

Read more: https://www.aacr.org/about-the-aacr/newsroom/news-releases/aacr-announces-2026-distinguished-service-award-recipients/

fda announces real-time clinical trials pilot with two oncology trials leading the way

-Brad Davidson, PhD

According to the FDA Commissioner, Marty Makary, MD, 45% of the time between initiating a Phase I trial until final submission is spent without any trial in progress. Traditionally, this so-called “dead time” has been built in so that sponsors can submit data to FDA, who reviews the data for important safety signals and futility. The FDA is now seeking to address this by implementing real-time clinical trials, where data will be submitted to FDA as it is generated, eliminating the need for sponsors to pause clinical research to submit these data packages.

As a first step, FDA announced that the Phase II TrAVeRse trial supported by AstraZeneca with partnership from MD Anderson Cancer Center and University of Pennsylvania and the Amgen-led Phase 1b STREAM-SCLC trial have been initiated as proof-of-concept real-time trials. These trials, both in oncology indications, will help inform the agency as it rolls out a broader pilot program, which it plans to launch this summer. The FDA published an edition of the FDA Direct podcast to discuss this concept in greater depth, and also opened a Request for Information to gain additional knowledge from the community about how to best implement this concept. The FDA will be accepting comments through May 29, 2026.

First FDA Oncologic drugs advisory committee meetings of 2026 examine potential new treatments in breast and prostate cancer

-Brad Davidson, PhD

At the April 30 double-header meeting of FDA’s Oncologic Drugs Advisory Committee, FDA asked the committee to consider the benefit-risk profile of two drugs under investigation by AstraZeneca.

In the first meeting of the day, the committee considered camizestrant, an investigational oral selective estrogen receptor degrader, in combination with CDK4/6 inhibition for the treatment of hormone receptor-positive, HER2-negative locally advanced or metastatic breast cancer after emergence of an ESR1 mutation during first-line endocrine therapy. The major concern posited by FDA, and generally echoed by the committee, was the design of SERENA-6, the trial supporting the application at hand. SERENA-6 utilizes novel paradigm for treatment switching, with patients receiving standard of care (SOC) therapy and switching to the combination with camizestrant or continuing on SOC after the detection of an ESR1 mutation by blood testing. This mutation is generally thought of as an indicator of resistance to traditional hormone therapy, the backbone of SOC treatment. However, in today’s treatment paradigm, therapy is only switched after patients experience tumor progression on radiographic scans. A major concern of FDA and the committee was that by switching early, patients would potentially lose time on a treatment that was currently working. SERENA-6 did not evaluate whether switching to the camizestrant combination at radiographic progression resulted in better outcomes than the proposed early switch upon ESR1 detection, a key point of contention during discussions. The treatment switching paradigm was shown have a significant progression-free survival benefit over standard of care, but overall survival data was not yet mature. In the end, the committee voted 3-6 against a favorable benefit-risk profile for camizestrant in this setting. However, multiple committee members indicated that despite their concerns about trial design, if an overall survival benefit had been identified they would have been in favor. Overall, the committee wanted to see clearer clinical benefit in order to justify what was perceived as a fundamental change in treatment paradigm.

In the second meeting of the day, the committee considered the benefit-risk profile of capivasertib plus abiraterone and prednisone for the treatment of patients with PTEN-deficient metastatic hormone-sensitive prostate cancer. The major question surrounding this application was whether the benefit observed in the supporting trial was clinically meaningful. In the supporting CAPItello-281 trial, patients were randomized to either capivasertib or placebo. Capivasertib was shown to significantly improve time to radiographic progression free survival, but overall survival data were immature. The size of the improvement was characterized by FDA as relatively small in comparison to previously approved therapies in this setting, and potentially not valuable enough when considering the additional toxicities observed when adding capivasertib. An additional concern was that the backbone therapy used in the trial is not what is recommended under most current clinical guidelines, which also add docetaxel to abiraterone and prednisone. Considering these concerns, the committee voted 7-1, with one abstaining, overall in favor of the benefit-risk profile of capivasertib in this setting. There was general consensus that this combination would not be correct for all patients but could be appropriate for those wanting to avoid docetaxel chemotherapy.

Medicare policy changes are reshaping radiation oncology practice

-David Zahavi, PhD

Effective January 1, 2026, the Centers for Medicare & Medicaid Services (CMS) implemented major revisions to radiation oncology billing codes in the 2026 update to the Medicare Physician Fee Schedule (PFS). These changes included a consolidation of radiation treatment delivery codes, a shift in valuation of services to focus more on the complexity of the treatment delivery itself rather than modality, and bundling of other technical components into new delivery codes. This code restructuring was intended to modernize payment structures and better align them with contemporary clinical practice.

However, the valuation of these new codes appears to have resulted in lower than anticipated reimbursement for many standard radiation therapy services, particularly in freestanding, community-based practices that serve millions of patients nationwide. Despite federal estimates projecting a modest ~1% impact on payment levels, more than two-thirds of radiation oncologists surveyed reported revenue declines of 10% or greater, and many clinics are seeing cuts in the 20–30% range. These reductions are adding additional strain to radiation oncology practices that have already been facing a decade-long continuous decline in Medicare reimbursement for radiation therapy, which fell by 33% between 2010 to 2020, even as the cost of delivering high-quality care has risen.

The transition to new code definitions has also introduced significant administrative burden and radiation oncology practices have reported increased claim denials, delays, and payer confusion. Many of the disruptions following the 2026 coding update are not due to the new codes themselves, but to how payers are interpreting and processing them. Practices report that high-complexity treatments billed under certain new codes are frequently downgraded by insurers to lower-level codes, with roughly half of these claims either denied or subjected to additional review. Compounding the problem, some Medicaid programs and commercial payers have not fully updated their systems to reflect the new coding structure, resulting in claim denials and reimbursement levels far below what clinics expect for the care delivered. Due to the continued financial strain, many practices are laying off staff, instituting hiring freezes, and considering consolidation or closure, especially in independent community settings. These trends mirror concerns raised in national surveys showing that additional cuts could force many practices to close, sell, or reduce services.

Radiation therapy is a cornerstone of cancer treatment, often delivered daily over several weeks, making patient proximity to treatment centers critical. As independent clinics struggle, patient travel distances increase, particularly in rural and underserved areas, and this has been directly linked to worse cancer outcomes. The revisions to radiation oncology billing codes have introduced administrative obstacles to timely access to advanced radiation therapy. These issues have prompted calls for legislative reform, such as the Radiation Oncology Case Rate (ROCR) Act (S.1031/H.R.2120), designed to create a more stable and equitable reimbursement framework for radiation therapy. Advocacy efforts must emphasize the importance of reversing harmful payment trends in radiation oncology and that clear guidance, consistent coding application, and protections for community-based cancer care settings are needed.