Cancer research faces uncertain post-COVID landscape

There’s a bright future ahead for cancer research in the UK, but only if the government is able to implement a clear plan for funding and development going forward, says The Institute of Cancer Research, London’s Paul Workman.

Cancer research in the UK risks facing a “perfect storm” of stalled work and reduced funding that could “capsize” the sector.

That’s according to Professor Paul Workman, CEO of the Institute of Cancer Research (ICR), who says that COVID has delayed advances for cancer patients by at least 18 months.

“In the first stages of the pandemic we had to keep people out of the labs and had to stall clinical trials,” he says. “Even now we can only have a few scientists in at any one time, so people have to work shifts, including nights and weekends.”

On top of reducing output, this is impacting scientists’ morale.

“We have passionate researchers who are frustrated that they can’t get into the lab and do their work,” says Workman. “They’re missing the buzz of having the institute full, and the resulting creative interaction that can spark new ideas.”

But a more tangible threat to cancer research in a post-COVID world are the funding blows the sector has had to endure.

Workman says that charity funding – which accounts for 50% of all publicly funded medical research and over a quarter of the ICR’s funding – “fell off a cliff” when medical charities had to close their shops and cease fundraising events.

“30% of our charity funding disappeared more or less overnight, and we’ve had to eat into our reserves in order to try and protect our work. As a consequence of that, basic research, such as drug discovery projects, both in our own research and in partnership with industry, has slowed.”

Thankfully industry collaborations and commercial income are one area that has largely held up, Workman says.

“The pharmaceutical and the biotech industries and related funding are quite buoyant. Pharma companies have not suffered from the same acute cuts as medical charities.”

Workman says his biggest worry is that the capacity will not fully build back up after the pandemic is over.

“Government intervention will be required to stop that. If the government invests now to fill the gap that has been created, then we will build back to full capacity.

“If not, everything will be delayed – from the next biological paper in Nature through to the next drug discovery project and, ultimately, those new drugs benefiting patients.”

Perfect storm

For a time it seemed that the government would actually be cutting funding to UK research – because it was unclear where funding for the European Commission’s research and innovation programme Horizon 2020 would be pulled from. There was speculation that the UK Research and Innovation (UKRI) budget might have been used.

Around 18% of the ICR’s income comes via UKRI, and the cuts could have reduced that by as much as a fifth.

In a statement the ICR said the cuts could have a massive impact on cancer research as a whole.

“I think it was the correct decision to continue with the Horizon programme, but the big worry was that we were going to lose £1 billion out of the UKRI budget,” says Workman.

“On top of COVID, that would have been a sucker punch from which the sector probably couldn’t have easily recovered.”

Pushback from the ICR and other academic leaders eventually led to the government finding funding elsewhere – but Workman says the danger is far from over.

“All we’ve been reassured about regarding UKRI funding is that this year’s £1 billion contribution to Horizon 2020 is now covered and won’t impact the existing research budget. Next year, and every year after, the cost of being involved in the Horizon 2020 project will be £2 billion. We have not been told where that £2 billion will come from.”

Workman says there is a “joint plea” from academia and UK research companies for the government to provide certainty in terms of planning and investment.

“We need a clear, transparent, ambitious funding plan for UK research.

“The government says it wants to reach an overall research spend of 2.4% of GDP by 2027 – but that’s only six years away. We need to know how we’ll get there.”

The sector also needs to know how the government will plug the gap from loss of charity funding, he says.

“It has been estimated that the cost to the charity sector will be £1 billion over the next three years, and that it will probably take us longer than that to fully recover from COVID.

“In the grand scheme of things of our industry and what the government has put into other schemes, that doesn’t seem like too much of a spend if it plugs the gap for institutions like ours. That would allow us to get back up to speed quicker, and further help us to reach that 2027 vision.”

He contrasts the UK situation with the US under president Joe Biden, where the National Institutes of Health (NIH) has recently been promised a $51 billion funding boost.

“We’re going to have a brain drain again if we don’t address that. Our young researchers, who are trying to get their first grants, are seeing funding budgets shrink and there’s a danger they will either move out of science or move to the US. That’s damaging to the ecosystem. I don’t think it’s dramatic to say that we might lose a generation of researchers if we’re not careful here.”

Workman adds: “I don’t think cancer research is asking for special treatment – this applies to other disease areas as well.

“It’s clear that the government values science. The pandemic has shown how researchers can pull together and work with industry to deliver solutions at pace in response to health crises. That should have heightened what was already a commitment by the government to make the UK a lifesciences superpower.

“If we want to be a superpower, at a minimum we need to get that lost funding back up to where it should have been. Then we need to stick to the ambition of research spending being 2.4% of GDP.”

A bright future

The upside is that if it is able to secure this certainty, Workman is “absolutely convinced” the sector will bounce back, and that the UK will remain among the top places in the world for cancer research.

“We’ve never had a better understanding of the biology of cancer, new molecular targets for drug discovery, liquid biopsies, DNA sequencing, tests to select patients who benefit from drugs, or the ability to predict the evolution of cancers and how they become resistant. In the next 10 years, all of that will make a huge difference to the survival gap.

“More than half of cancer patients now survive for more than 10 years, and we also expect to see big improvements in harder to treat areas such as pancreatic cancer and brain cancer.

“There’s an enormous amount of things to be positive about. That’s almost part of the frustration our researchers have – we have all of this incredible knowledge and we know we can make a difference, we just need to be certain that we’re able to do it.”

professor paul workman

Professor Paul Workman FMedSci, FRS is chief executive and president of The Institute of Cancer Research (ICR). He is a passionate advocate of personalised molecular medicine and is an enthusiastic practitioner of multidisciplinary cancer drug discovery and development approaches to ‘drugging the cancer genome’. Professor Workman has successfully built a series of multidisciplinary drug discovery and development teams in the academic, large pharma and biotechnology company sectors. He has been responsible for the discovery of a number of drug development candidates, including in particular pathfinding inhibitors of the HSP90 molecular chaperone and the PI3 kinase family of signalling enzymes.

George Underwood is the editor for pharmaphorum’s Deep Dive digital magazine. He has been reporting on the pharma industry since 2014 and has worked at a number of leading publications in the UK.

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