AFTER MY VISIT TO Memorial Sloan Kettering,

Balachandran's team shared a chart that plotted Brigham's immune response to her personalized mRNA vaccine.

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uate alternative dosage and delivery mechanisms, Lee says.

Although current protocol is for vaccines to target micrometastases—small groups of cancer cells that spread to other parts of the body and linger after cancerous tumors are removed surgically—there’s no shortage of adjustments that might follow from more data or improved screening. Could one deliver a therapeutic vaccine to tackle a tumor before it is large enough to operate on? Or maybe one could even administer a prophylactic shot that prevents tumor formation in the first place?

With a unified health system and world-class research and manufacturing facilities, Lee says, the U.K. is well positioned to advance research that would answer such questions. Fully realizing the potential of personalized mRNA vaccines for cancer, however, will require more trials in the U.S., which has many more cancer research centers than the U.K. But the ability of the U.S. to lead this effort is now in jeopardy.

The federal government has long been the dominant source of funding for cancer research in the U.S. Miriam Merad, a cancer immunologist at the Icahn School of Medicine at Mount Sinai in New York City, says that in a typical year, funding from the NIH accounts for more than half of the research budget at her institution.

In President Donald Trump’s first term, threatened cuts to the NIH never quite materialized. Society is not going to let that happen, Merad thought. But just weeks into Trump’s second term, the NIH announced plans to limit indirect contributions to research grants to 15 percent, meaning that for every $100 in funding awarded, only $15 extra would be included for overhead—a dramatic departure from historical rates in the range of 50 to 60 percent.