In 1971, Congress passed and President Richard Nixon signed the National Cancer Act. The legislation expanded the authority of the director of the National Cancer Institute (NCI), created the National Cancer Advisory Board, and launched the NCI’s nationwide Clinical Trials Network. The United States government had formally declared “war on cancer.”
A half-century later, the American Cancer Society (ACS) reported that the cancer death rate had fallen 32% by 2019 from its peak in 1991. The ACS attributed the drop to a reduction in smoking, chemotherapy after surgery for breast and colon cancer, and improved prevention and screening. The risk of dying from prostate cancer dropped by about 50% from the mid-1990s to the mid-2010s and death rates in children plummeted by 71% since 1970.
What the ACS didn’t explicitly mention is that philanthropy played an integral role in these astonishing successes. Over the past 30 years, coinciding with a generally surging stock market, a vast ecosystem of private foundations, individual donors and corporations disbursed hundreds of millions of dollars to accelerate the pace of research in cancer prevention, detection and treatment.
IP’s latest State of American Philanthropy white paper, “Giving for Cancer Research,” takes a deep dive into this vast and constantly growing funding ecosystem. Based on our analysis of industry reports, recent gifts and commentary from a dozen philanthropic leaders, the brief explores the field’s most influential grantmakers and top research areas, funders’ perspectives on equity, and emerging challenges and opportunities.
I encourage readers to check out what is arguably our most robust brief to date. In the meantime, here’s a handful of high-level takeaways.
Surveying the field
The brief includes analysis of the field’s top givers, with affluent individual donors providing significant support. It also includes mini-profiles on mega-donors like Robert F. Smith, Stanley and Fiona Druckenmiller, and Loews Corporation CEO James Tisch and his wife Merryl, as well as a subset of relatively less affluent donors whose support serves as the funding backbone for most cancer research organizations.
We then pivot to the role of public charities, intermediaries and private foundations, which are collectively committed to supporting cutting-edge research, as well as pushing for more equitable health outcomes across the field. Profiled funders include The V Foundation for Cancer Research, Susan G. Komen, the Prostate Cancer Foundation, the Gordon and Betty Moore Foundation and the Starr Foundation.
We also look at the philanthropic footprint of corporate funders, whose support flows through corporate foundations or partnerships, as well as community foundations backing research via discretionary grantmaking and donor-advised funds, the latter of which channel the majority of their funding.
The big issues
We identified two research-related areas receiving substantial philanthropic support: immunotherapy, which aims to direct the body’s immune system to fight cancers, and precision medicine.
“The only reason that we are now being able to treat cancer with immunotherapy drugs is because donors were willing to put some dollars into initial research,” said Loren Savage, executive director of major giving at the Huntsman Cancer Foundation. “Now, immunotherapy is a burgeoning treatment in many respects for various types of cancers.”
Prominent funders include the Immunotherapy Foundation and the Parker Institute for Cancer Immunotherapy, which was founded by former Facebook President Sean Parker in 2016. Grantmakers like the ACS, the American Association for Cancer Research and the Mark Foundation for Cancer Research have also made immunotherapy a top research priority, and the Cancer Research Institute focuses exclusively on immunotherapy, calling it “the most promising cancer treatment of our time.”
According to the Dana-Farber Cancer Institute, the aim of precision medicine, sometimes called personalized medicine, is to “match treatments to individual patients taking into account their genetic makeup, medical history, test results and other distinctive characteristics.” Unlike immunotherapy, which is a particular form of treatment, precision medicine is a broader model for disease treatment.
Big gifts earmarked for precision medicine include a $20 million bequest from the estate of Microsoft co-founder Paul Allen to Swedish Health Services, and $78 million from Seattle-based businessman Stuart Sloan and his wife Molly to establish a new institute for precision oncology research at the Fred Hutchinson Cancer Center.
Top funding trends
IP surfaced several key trends among funders backing cancer research. For instance, many funders adopt the principles of venture philanthropy to accelerate the return on high-risk, high-reward treatments. Often, funders will deploy that terminology without actually investing in for-profit companies. For example, Liz Scott, co-executive director of Alex’s Lemonade Stand Foundation (ALSF), a grantmaker focused on childhood cancer, told IP, “It is hard for scientists to receive funding for innovative new approaches because they lack preliminary data; we provide seed funding for innovative, high-risk, high-reward projects.”
This venture philanthropy mentality informs the second trend, in which grantmakers target funding interventions to extricate cancer treatments from “the Valley of Death” — a common situation in which a lack of funding or an uncertain path to commercialization prevents a treatment from advancing to the point that it’s actively benefiting patients.
Funders are also driving cross-interdisciplinary collaboration across a field replete with administrative, regulatory and funding constraints. For example, the Virginia-based Goodwin family launched Break Through Cancer in 2021 with a $250 million challenge pledge, with the goal of reducing “day-to-day barriers to cross-institutional collaboration such as contract negotiations, data sharing, intellectual property and authorship policies.”
In a similar vein, Scott of ALSF told us that many researchers “identified data access as an impediment to research progress.” In response, the foundation launched the Childhood Cancer Data Lab to “empower researchers across the globe by removing roadblocks and developing resources to accelerate new treatment and cure discovery.”
Perspectives on equity
As with all of our white papers, this brief examined funders’ perspectives on racial and socioeconomic equity and how this thinking informs their grantmaking. We set the stage by walking through alarming disparities in cancer outcomes and incidence, such as the ACS finding that Black people have the highest death rate and shortest survival of any racial/ethnic group in the U.S. for most cancers.
Leaders who spoke with IP cited the need to provide more equitable access to genetic testing. “Grantmakers could be looking to see where those gaps for underrepresented communities are to make sure it’s not just about immediate treatment once they’re diagnosed, but providing a better understanding about the testing prevention measures that can be put in place,” said Savage of the Huntsman Cancer Foundation.
Perhaps the biggest equity-related takeaway was the need for philanthropy to close pervasive representation gaps in clinical trials. The numbers here are stark. According to U.S. Food and Drug Administration data, only 5% of Black patients with cancer are typically enrolled in clinical trials, despite accounting for 13.4% of the U.S. population. We discuss reasons for these disparities and how funders can close the gaps.
Experts we consulted also encouraged funders to support initiatives and training programs that educate cancer researchers on the root causes of health disparities. For instance, breast cancer funder Susan G. Komen’s Training Researchers to Eliminate Disparities program provides grants to graduate students seeking out careers dedicated to understanding and eliminating disparities in breast cancer outcomes, specifically among minority populations.
Ongoing opportunities and challenges
There’s no shortage of opportunities and challenges in the cancer funding field. One major issue is that patient advocacy organizations, which are often among the cancer research ecosystem’s largest funders, are implementing strategies to educate donors on the value of basic research and what treatments and discoveries flow from gifts and grants.
The Leukemia & Lymphoma Society’s “Giving Promise,” for instance, seeks to do this by equipping fundraisers with the society’s eight strategic priorities. “For each mission priority, we indicate the issue at hand and clearly articulate how LLS is taking action to address it,” Troy Dunmire, the society’s chief operating officer, told IP. “We also indicate what our work entails, how our constituents can help move forward through the support of the key programs within it.”
Funders are pulling from an expanding playbook to diversify clinical trials. In 2021, Stand Up to Cancer (SU2C), a charitable program of the Entertainment Industry Foundation, awarded $6 million to researchers tasked with addressing the low participation rates of BIPOC individuals in clinical trials. The funding was provided by San Francisco-based Genentech, a member of the Swiss multinational healthcare company Roche Group. A year later, pharmaceutical giant Novartis and the Novartis US Foundation provided grants totaling $17.7 million over 10 years to co-create clinical trial centers of excellence at three historically Black medical colleges.
Finally, grantmakers are working to bring cancer screenings back to pre-COVID levels and increase support for prevention research, particularly as it applies to obesity. While researchers have made incredible progress in the 50-plus year “war on cancer,” the most alarming finding from our report is the extent to which the rise in obesity, which is linked to at least 13 types of cancer, could reverse the downward trend in cancer incidence. “Given obesity’s seeming irreversibility, thwarting cancer’s concomitant rise will be exceedingly difficult,” said Madeline Drexler, a visiting scientist at the Harvard T.H. Chan School of Public Health.
Click here to see all of the white papers in IP’s State of American Philanthropy series.