NCI’s Commitment to Advancing Cancer Training

August 1, 2024, by Dr. Oliver Bogler, Director, NCI Center for Cancer Training

Training the next generation of cancer researchers is critical to NCI’s mission. This vital work is spearheaded by the Center for Cancer Training (CCT), in collaboration with other NCI groups such as the Center for Cancer Health Equity. CCT offers funding for training and education and engages in outreach to undergraduates, graduate students, postdoctoral scholars, and other mentored investigators across all areas of cancer research. NCI provides opportunities and resources to support the cancer research workforce across a wide range of disciplines at institutions nationwide, as well as within NCI’s Intramural Research Program.

Five-year trends in NCI funding for cancer training

In alignment with the National Cancer Plan’s goal to optimize the workforce, NCI remains dedicated to sustained funding for mentored cancer investigators. This commitment is reflected in the significant increase in funding for CCT’s portfolio over the past several years.

In fiscal year 2018 (FY18), total funding for CCT's extramural training portfolio was $163 million. By the end of FY24, it rises to about $209 million. This includes fellowships, career development awards, institutional training, research education grants, and other activities. Despite budget pressures in FY24, NCI prioritized increased support for training-related grants. This estimated 5% increase in funding helped address several critical needs:

• 20% increase in childcare subsidies supported by Ruth L. Kirschstein National Research Service Awards (NRSA)
• 8% stipend increase for postdoctoral scholars supported by NRSA
• 4% stipend increase for graduate students supported by NRSA
• salary increases for postdoctoral scholars supported by the NCI Predoctoral to Postdoctoral Fellow Transition (F99/K00) Award

As discussed in previous updates, while CCT's training portfolio is growing, supporting more out-year commitments to existing extramural awards has created budget pressures. As NCI Director Dr. Kimryn Rathmell explained in a previous Bottom Line blog post, NCI’s FY24 appropriation allowed NCI to prioritize funding for new grants, particularly for early-stage investigators, training mechanisms, and NCI-Designated Cancer Centers. Consequently, despite the overall budget increase, the funds available for competitive awards—including new submissions and renewals—are estimated to be about 7% lower in FY24 than in FY23. Without the additional investment in FY24, this reduction would have been significantly larger.

Evaluation of the NCI Pathway to Independence Award (K99/R00) Program

NCI recently evaluated the NCI Pathway to Independence Award (K99/R00), which is designed to support early-stage cancer researchers. The program aims to provide postdoctoral scholars with the necessary mentored training to transition early-career investigators to independent tenure-track or equivalent faculty positions, ultimately fostering the development of impactful cancer research careers.

NCI’s recent evaluation of NCI K99/R00 awardees revealed several key insights:

• All review criterion scores positively correlate with the overall impact score. The research plan criterion, in particular, is the strongest predictor of overall impact scores and funding outcomes.
• The K99/R00 award effectively facilitates the transition of postdoctoral scholars to research independence and increases their likelihood of securing subsequent R01-equivalent NIH grant support. However, it was not found to accelerate the transition as quickly as initially intended.
• While the K99/R00 award is not a prerequisite for obtaining a faculty position, it does have a positive impact on career development. The award is considered a valuable asset for most recipients as they compete for their first independent tenure-track or equivalent investigator position.

Based on these findings, NCI recently issued a Notice of Intent to Publish a Funding Opportunity Announcement for NCI Pathway to Independence Award (K99/R00–Independent Clinical Trial Optional). The updated funding opportunity will include extending the K99/R00 applicant eligibility window from 4 to 6 years of postdoctoral research training experience. This change aims to make the opportunity more accessible, including to individuals from groups underrepresented in the biomedical research workforce. Individuals from these groups have shown comparable progression rates once they receive a K99/R00 award, but they historically apply for and receive fewer awards.

NCI intends for postdoctoral scholars to apply as soon as they are ready to begin considering the transition to independence. Applicants are encouraged to work with their mentors to submit a K99/R00 application at the earliest point at which they are competitive. Review guidelines for the new funding opportunity will instruct reviewers to consider the experience level of the applicant and balance their track record with their potential to successfully transition to an independent tenure-track (or equivalent) faculty position.

The NCI K99/R00 award plays a crucial role in training and retaining the next generation of independent cancer researchers. This award remains a vital component in ensuring a robust and diverse pool of highly trained scientists to address the nation's biomedical, behavioral, and clinical cancer research needs.

New Worta McCaskill-Stevens Career Development Award for Community Oncology and Prevention Research (K12)

Earlier this year, NCI introduced the Worta McCaskill-Stevens Career Development Award for Community Oncology and Prevention Research (K12). Named in honor of Dr. Worta McCaskill-Stevens, a dedicated medical oncologist and former director of the NCI Community Oncology Research Program, this award focuses on training clinician–scientists in community cancer prevention, screening, intervention, control, and treatment research. Dr. McCaskill-Stevens was known for her commitment to addressing cancer disparities and promoting health equity.

The primary goal of the McCaskill-Stevens K12 award is to train clinical scientists striving to improve care and outcomes for minority health populations and those with health disparities often underrepresented in clinical research. This award emphasizes increasing access and representation of these populations in cancer clinical trials through an equity lens.

The McCaskill-Stevens K12 award allows scholars to:

• lead independent community-based clinical trials
• integrate cancer health disparities research questions into clinical trials
• conduct ancillary studies related to existing prevention, screening, intervention, cancer control, or treatment trials
• gain research experience in community-based clinical trials led by other investigators
• develop innovative clinical trial approaches to engage minority health populations and underrepresented groups in cancer clinical trials

The K12 award provides up to 5 years of support and is renewable, fostering long-term career development and research excellence.

The bottom line: The significant increase in funding for NCI’s training portfolio, despite fiscal challenges, underscores NCI’s commitment to optimizing the workforce. With new initiatives like the Worta McCaskill-Stevens Career Development Award and the enhancements to the Pathway to Independence Award, NCI continues to prioritize health equity and support the transition of early-stage researchers to independent careers. These efforts are pivotal in addressing cancer disparities and ensuring a diverse, well-trained scientific community poised to advance cancer research and improve public health outcomes.