NCI Trial Underfunding Limits Site Enrollment: Cathy Eng, MD, FACP, FASCO

Stagnant funding for National Cancer Institute (NCI)–sponsored studies discourages sites from opening trials and delays data, according to Cathy Eng, MD, FACP, FASCO, David H. Johnson Endowed Chair in Surgical and Medical Oncology and professor of medicine (hematology and oncology) at Vanderbilt. In an interview at the Patient-Centered Oncology Care® 2026 conference hosted by The American Journal of Managed Care^® in Nashville, Tennessee, September 24-25, 2026, Eng, who is co-chair of the NCI Gastrointestinal Steering Committee, discussed the role of NCI-supported trials and the challenges they face.

The Role of NCI-Sponsored Studies

Eng said her committee role focuses on therapeutic treatment trials, so it will not directly solve the ability to screen patients sooner. NCI-sponsored studies are typically large phase 2 or phase 3 trials. BREAKWATER (NCT04607421) was a phase 3 study, but it was sponsored by industry. Eng noted that an earlier cooperative group study in the same patient population helped serve as a platform for it.

NCI-sponsored studies often ask practical questions that pharmaceutical companies may not want to pursue for business reasons, she said. They are also multicenter trials conducted throughout the country, which she called "the best part" because "that demonstrates reproducibility." A lot of important pivotal work has come from them.

There Are Funding Challenges

Eng said funding for these studies "has largely remained unchanged as long as I've been practicing now for over 2 decades." Because they are underfunded, many facilities are reluctant to open them. Pharmaceutical-sponsored studies help "compensate and balance the portfolio" for NCI trials, she said. The NCI studies are also tied to Cancer Center Support Grants, which make a site an NCI-designated cancer center.

Fixing the funding issue could bring more sites into these trials, which would help complete enrollment and produce data sooner, Eng said. She added that it is difficult for investigators to compare NCI-supported studies with pharmaceutical trials, which can open across the world. An NCI-sponsored study, she said, "is largely going to stay within the US."