An ASCO Hill Day in Interesting Times

Overall, the mood of this Hill Day was cautious, but it was peppered with moments of optimism as well. ASCO had set three goals for our collective lobbying efforts:

1. Support consistent+ funding for the NIH, NCI, and ARPA-H in FY2026
2. Support comprehensive legislation to reduce the burdens and delays of prior authorization – specifically, the Improving Seniors’ Timely Access to Care Act
3. Participate in a multi-pronged plan to end shortages of oncology drugs

Although ASCO argued for budget figures that would actually represent a small increase in funding for the NIH and NCI, the key goal was to maintain at least consistency in the level of funding – to thus ensure consistency in research and care delivery.

Though not the primary focus, some participants did discuss the across-the-board 15 percent indirect cost rate that has been proposed for all NIH research grants. That directive is now on hold while it’s being litigated, but its enactment would mean significant fiscal challenges for many of our member institutions, and potentially for their ability to continue to participate in NCTN and NCORP clinical trials at the level they currently do.

The need for stability at the NIH, and the need to gather input from public and private stakeholders before making large-scale changes to the organization, was also a topic we discussed. Delays in grant reviews and in trial protocol reviews are just two of the many, many challenges we may face given the substantial changes in procedures and staffing levels at NIH institutes.

The argument to lead with in meeting with legislators was straightforward, and in my wheelhouse: federal funding for cancer research saves lives! And it does so in an incredibly cost-effective manner. I was happy I could make this point with evidence from SWOG’s own work, an analysis led by Dr. Joseph Unger which found that forty years of NCTN treatment trials had prolonged patients’ lives by at least 14.2 million life-years (and counting), at a federal investment of only about $326 per life-year (Unger JCO 2022).

I and others also highlighted the fact that the NCTN and NCORP do research no one else does – testing shorter adjuvant therapy regimens, assessing treatments that combine multiple modalities, studying treatments for rare cancers, and much more – important, patient-centric work that cannot be done by industry.

My ace-in-the-hole in these conversations (in addition to the 14.2 million life-years saved) is our S1609 DART trial, which tested immunotherapy in 53 separate rare cancer cohorts and has seen responses in at least 16 of those cancers so far (with the latest DART cohort results to be presented at the AACR Annual Meeting later this month). Stories about the successes of this trial were incredibly well received, as always, in my discussions with Congressional staffers.

I met with policy staff of Oregon’s two senators (Ron Wyden and Jeff Merkley) and of two of Oregon’s representatives in the House – Suzanne Bonamici and Andrea Salinas. They asked great questions, and I was encouraged by how knowledgeable they were on the topics we brought up. They were completely on board with our patient-centric approach and with doing everything possible to maintain and even increase federal support for cancer research.

Our messages on the topic of alleviating oncology drug shortages also seemed to resonate with these staffers, in part because their offices have led past efforts on this front.

If you’re interested in reaching out to your own representatives, ASCO’s ACT Network website can be a useful place to start. In addition to ASCO’s advocacy toolkit, the site provides resources for tracking federal and state bills related to health care and biomedical research, and for researching and reaching out to your federal, state, and local elected representatives. 

If you do reach out, remember that anecdotes of patient benefit or patient harm are particularly effective – bring your legislators stories of impact, good or bad.

I’ve touched here on just some of the recent federally mandated changes and funding cuts that may affect how we conduct cancer research in the future, both within SWOG as an organization and within many of our member sites. Clearly, these changes, and the potential for future changes, have created uncertainty and anxiety for all of us involved in NIH-supported research.

These topics – and how SWOG is addressing them and planning for future contingencies – will be a major focus of discussion at our upcoming board of governors meeting in San Francisco. I’ll also speak to some of these issues in my update to members at the group meeting plenary session in San Francisco, slated for Friday, May 2, 2-4 pm PT.

To end on a more upbeat note: No visit to Capitol Hill is complete without photo ops, and I was lucky enough to grab one with several current and future SWOG leaders: Drs. Paul Hesketh, Anne Chiang, Raymond Osarogiagbon, and Rafeh Naqash. Definitely a reason for optimism, even – especially – in interesting times.