Research to Reduce Morbidity and Improve Care for Pediatric, and Adolescent and Young Adult (AYA) Cancer Survivors (R21 Clinical Trial Optional) | RFA CA 20 028

Opportunity Information: Apply for RFA CA 20 028

This National Cancer Institute (NCI) funding opportunity, RFA-CA-20-028, supports early-stage, exploratory research aimed at reducing illness and long-term health problems (morbidity) and improving the quality and delivery of care for people who survived cancer diagnosed in childhood as well as during adolescence and young adulthood (AYA). The overall intent is to generate practical, research-backed ways to improve health-related quality of life across survivorship, including physical, psychological, and social outcomes. The mechanism is an NIH R21 grant, which is typically used for developmental, high-impact ideas that can produce proof-of-concept data, clarify mechanisms, or pilot strategies that can later be scaled into larger studies. Clinical trials are allowed but not required under this announcement, meaning applicants can propose mechanistic studies, observational studies, or interventions, depending on what best fits the question and stage of evidence.

The FOA highlights six priority research domains. First, it calls for work on disparities in survivor outcomes, encouraging studies that identify and explain differences in late effects, recurrence, subsequent cancers, or quality-of-life outcomes across groups defined by race, ethnicity, geography, disability status, socioeconomic position, or other inequities. Second, it seeks research on barriers to follow-up care, such as access to survivorship clinics, affordability, transportation, insurance issues, fragmented care transitions, low adherence to screening recommendations, and other obstacles that prevent survivors from receiving guideline-aligned long-term monitoring. Third, it prioritizes research on how family context, socioeconomic conditions, and broader environmental factors influence survivorship outcomes, recognizing that health trajectories are shaped by household resources, caregiver support, education, neighborhood conditions, and stressors that persist well after treatment ends.

The fourth domain focuses on identifying indicators that can be used to determine long-term follow-up needs. This includes developing or validating markers, risk stratification tools, clinical algorithms, or other indicators that help clinicians decide which survivors need more intensive monitoring for late effects, recurrence risk, or second cancers and which survivors may be safely followed with less intensive approaches. The fifth domain targets risk factors and predictors of late and long-term effects of cancer treatment, which can include treatment exposures (chemotherapy agents, radiation fields and doses, surgery types), comorbidities, genetics or biology, health behaviors, psychosocial factors, and healthcare utilization patterns that forecast outcomes like cardiotoxicity, endocrine dysfunction, neurocognitive issues, infertility, chronic pain, fatigue, or mental health conditions. The sixth domain emphasizes developing targeted interventions that reduce the burden of cancer for pediatric and AYA survivors. That can include testing survivorship care models, decision supports, digital health tools, behavioral and lifestyle interventions, care navigation, strategies to improve screening uptake, or approaches tailored to the developmental needs of children, adolescents, and young adults as they move through school, work, relationships, and transitions from pediatric to adult care.

From an administrative standpoint, this is a discretionary NIH grant opportunity within health and education-related activity categories, listed under CFDA numbers 93.393, 93.394, and 93.399. The award ceiling is stated as $200,000 (as provided in the source summary), and the original closing date was July 30, 2021, with the FOA created on March 16, 2020. A wide range of organizations can apply, including state, county, and local governments; public and private institutions of higher education; independent school districts; special district governments; federally recognized Native American tribal governments; tribal organizations (including those other than federally recognized governments); public housing authorities/Indian housing authorities; nonprofits with or without 501(c)(3) status; for-profit entities (other than small businesses) and small businesses; and other eligible applicants. The announcement explicitly welcomes participation from institutions and organizations that often serve historically underrepresented communities, such as Historically Black Colleges and Universities (HBCUs), Hispanic-serving Institutions, Tribally Controlled Colleges and Universities (TCCUs), Alaska Native and Native Hawaiian Serving Institutions, and Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), as well as faith-based and community-based organizations, regional organizations, US territories or possessions, and even non-US (foreign) entities.

In practical terms, the opportunity is designed to move pediatric and AYA survivorship care forward by funding studies that explain why certain survivors experience worse outcomes, what blocks people from receiving appropriate follow-up, and what can be done to prevent or lessen late effects over the long run. Competitive applications are likely to be those that clearly define a survivorship problem with measurable impact, connect it to one or more of the six priority domains, and propose a feasible R21-scale approach that can produce actionable evidence or a strong foundation for a larger future study.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Research to Reduce Morbidity and Improve Care for Pediatric, and Adolescent and Young Adult (AYA) Cancer Survivors (R21 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.393, 93.394, 93.399.
• This funding opportunity was created on 2020-03-16.
• Applicants must submit their applications by 2021-07-30. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $200,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

Apply for RFA CA 20 028

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