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美国国立卫生研究院的资金削减推迟了一项有前景的儿童脑癌试验。患者失去了他们本就没有的时间。NIH funding cuts delayed a promising childhood brain cancer trial. Patients lost time they didn't have.

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约翰·保罗·麦克里原本是一个健康、快乐的8岁孩子,但在去年年初,他开始频繁绊倒。起初,他的父母以为他只是动作不协调而已。然而,当他走路时总是歪着头时,他们意识到情况不对劲了。

John Paul Macri was a healthy, happy 8-year-old when early last year he began to trip. At first, his parents thought he was just clumsy. But after he started walking with a head tilt, they knew something was wrong.

“他当时对我说:‘妈妈,当我把头挺直的时候,所有东西都看起来都是双重的。’”他的母亲凯蒂·麦克里回忆道。

"He was like `Mommy, when my head is straight, everything is double,'" recalls his mother, Katie Macri. Doctors found a mass in his brain. In March 2025, his family received devastating news: John Paul had an inoperable brain tumor called DIPG. The five-year survival rate is about 2%.

医生在他的脑部发现了一个肿块。2025年3月,他的家人接到了一个令人震惊的消息:约翰·保罗患有一种名为DIPG的脑肿瘤,这种肿瘤无法通过手术切除。患者的5年生存率仅有2%。

"The prognosis we were told is that he would live anywhere between two and 11 months and there was nothing we could really do about it," Macri said in an interview. "You're just like `What do you mean you can't help my son? We live in America and we have great healthcare.' It's just so hard to wrap your head around." John Paul's parents dug into the research and found at least one promising drug on the horizon: a treatment that uses mRNA, the same technology behind the Covid vaccines, to train a child's immune system to attack the brain tumor. The scientists developing the treatment were close to starting a clinical trial when the Department of Government Efficiency, or DOGE, began a sweeping review of scientific research grants from the National Institutes of Health. Between February and August of 2025, more than $2 billion in funding was withdrawn or frozen from thousands of federally funded research projects.

“医生告诉我们,他的生命期限可能在2到11个月之间,而我们对此无能为力,”麦克里在接受采访时说道,“我们当时简直无法接受这个事实——‘你们怎么能说你们无能为力呢?我们生活在美国,医疗条件这么好啊……’”为了寻找治疗办法,约翰·保罗的父母深入研究了各种医疗资料,最终发现了一种有希望的治疗方法:这种疗法利用mRNA技术(与新冠疫苗相同的科技原理)来训练孩子的免疫系统攻击脑肿瘤。就在研发这种疗法的科学家们即将开始临床试验时,美国政府效率部(DOGE)对美国国立卫生研究院(NIH)资助的数千项科学研究项目进行了全面审查。2025年2月至8月期间,超过20亿美元的科研资金被撤销或冻结。

"The prognosis we were told is that he would live anywhere between two and 11 months and there was nothing we could really do about it," Macri said in an interview. "You're just like `What do you mean you can't help my son? We live in America and we have great healthcare.' It's just so hard to wrap your head around." John Paul's parents dug into the research and found at least one promising drug on the horizon: a treatment that uses mRNA, the same technology behind the Covid vaccines, to train a child's immune system to attack the brain tumor. The scientists developing the treatment were close to starting a clinical trial when the Department of Government Efficiency, or DOGE, began a sweeping review of scientific research grants from the National Institutes of Health. Between February and August of 2025, more than $2 billion in funding was withdrawn or frozen from thousands of federally funded research projects.

(注:翻译过程中保留了原文的叙述风格和情感色彩,同时确保了信息的准确传达。)2025年8月,根据该联盟主席Ira Dunkel的说法,美国国立卫生研究院(NIH)下属的国家癌症研究所(NCI)通知该联盟:他们不能再申请资助了。该联盟是由多个学术机构和医院组成的网络,致力于为患有脑癌的儿童开展新治疗方法的临床试验。PBTC联盟成立于1999年,其大部分资金来自联邦政府。Dunkel表示,当时NCI网站上的一篇声明是做出这一决定的唯一依据;该声明称这一决定是基于“对如何最有效地利用临床试验资源以实现最大效果的评估”而作出的。

In August 2025, the National Cancer Institute, a branch of NIH, notified the Pediatric Brain Tumor Consortium that it could no longer reapply for funding, according to Ira Dunkel, chair of the consortium, which is a network of academic centers and hospitals that supports clinical trials of new treatments for kids with brain cancer. PBTC was established by NCI in 1999, and the federal government provided the bulk of its funding. At the time, Dunkel said the only rationale he had seen for the move was in a post on NCI's website, where a paragraph said the decision followed "an assessment of how best to utilize its clinical trial resources for maximum impact."

“这实在令人沮丧至极——就好比我们花费了大量时间才建立起一个运作良好的体系,却突然将其摧毁;现在我们不得不从头开始重建这一切。”——Eugene Hwang(华盛顿特区儿童国家医院的脑癌专家)此后,新的患者无法再参加临床试验了。威尔康奈尔医学中心的“儿童脑肿瘤项目”将这一举措称为“巨大的倒退”,并指出这“会延缓研究进展、破坏各方的协作努力,最终甚至可能危及患者的生命”。Eugene Hwang指出,该联盟原本为这项基于mRNA技术的临床试验提供了关键的基础设施;他表示,这一决定至少使临床试验的启动时间推迟了一年。"这令人难以置信地沮丧,"他说。"这就像拿一个花了很长时间建立且运行良好的有机体,然后把它扼杀。现在我们不得不重新建立这个有机体。"

It's incredibly frustrating. It's like taking this organism that took a long time to build and was functioning very well, and then killing it. Now we have to go build that organism again."Eugene HwangChildren's National Hospital Brain Cancer Expert After that, new patients could not enroll in clinical trials. The Children's Brain Tumor Project, a research effort at Weill Cornell Medical Center, called the move "a tremendous step backward," adding that it "will slow progress, fragment efforts, and ultimately cost lives." The consortium would have provided critical infrastructure for the mRNA trial, according to Eugene Hwang, a brain cancer expert at Children's National Hospital in Washington D.C. who is developing the treatment. The move delayed the start of the trial by at least a year, he said. "It's incredibly frustrating," he said. "It's like taking this organism that took a long time to build and was functioning very well, and then killing it. Now we have to go build that organism again." Emily Hilliard, a spokeswoman for the Department of Health and Human Services, said the Trump administration is "firmly committed to advancing childhood cancer research." NCI is transitioning trials conducted through the consortium to a larger network of hospitals and research sites because it will accelerate development of new treatments, she said.

卫生与公众服务部发言人艾米莉·希利尔德表示,特朗普政府"坚定致力于推进儿童癌症研究"。她说,美国国家癌症研究所(NCI)正将联盟开展的临床试验过渡到一个更大的医院和研究机构网络,因为这将加速新疗法的开发。"这项决定并非削减成本的措施,"希利尔德在声明中说。"相反,它反映了儿童癌症临床试验格局的重大演变。"希利尔德表示,NCI已努力确保所有参与联盟试验的儿童都能获得所需的治疗,并补充说,这一过渡并未延误潜在疗法。邓克尔表示,情况并非完全如此。

"This decision was not a cost-cutting measure," Hilliard said in a statement. "Rather, it reflected the significant evolution of the pediatric cancer clinical trial landscape." NCI has worked to ensure all children who were in the consortium's trials get the care they need, Hilliard said, adding that the transition has not delayed potential treatments. Dunkel said that isn't exactly true.

他说,由于联盟不再获得资金,两项临床试验被迫关闭。另外四项正在转移到更大的医院网络。但他表示,在此期间已有13个月的延误,没有患者能够入组这些研究。"这项决定并非削减成本的措施。相反,它反映了儿童癌症临床试验格局的重大演变。"——艾米莉·希利尔德,卫生与公众服务部"我认为这是儿童脑瘤群体的一大不幸损失,"邓克尔说。

Two clinical trials were shut down as a result of the consortium no longer receiving funding, he said. Four others are being transferred to the larger network of hospitals. But there's been a 13-month delay during which no patients were able to enroll in those studies, he said. This decision was not a cost-cutting measure. Rather, it reflected the significant evolution of the pediatric cancer clinical trial landscape."Emily HilliardDepartment of Health and Human Services "I see this as a very unfortunate loss for the pediatric brain tumor community," Dunkel said.

联邦对科学研究的资助前景依然不明朗。上周有报道称,特朗普政府正在起草一项行政命令,该命令将允许其阻止不符合特定政治议程的NIH拨款。周三,Semafor率先报道称,在国会议员对这一想法提出异议后,白宫正在退出这些计划。

The future of federal funding for scientific research remains uncertain. Reports surfaced over the past week that the Trump administration was drafting an executive order that would have allowed it to block NIH grants that did not conform to a certain political agenda. On Wednesday, Semafor was first to report that the White House was backing away from those plans after members of Congress objected to the idea.

资金联盟失去资助,给本已资金短缺的癌症研究领域带来了沉重打击。联邦癌症研究资金中,仅约4%用于寻找儿童癌症的治愈方法。用于研究儿童脑肿瘤治疗的资金比例更小,而脑肿瘤是儿童癌症死亡的主要原因之一。大部分资金来自因孩子死于脑肿瘤而成立基金会的父母。"家庭举办了许多筹款晚宴,但失去孩子后,他们根本不想参加,"Lisa Ward说。她在儿子Jace 20岁时被诊断出DIPG后,共同创立了Tough2gether基金会。尽管Jace于2021年死于该病,她仍是DIPG的积极倡导者。

The loss of funding for the consortium dealt a blow to an already cash-strapped area of cancer research. Only about 4% of of federal cancer research funds go toward finding cures for childhood cancer. An even smaller slice is allocated for studying treatments for pediatric brain tumors, which are a leading cause of cancer death among children. Most funding comes from foundations created by parents whose kids died from brain tumors. "Families hold a lot of fundraising galas that they really don't feel like going to after losing a child," said Lisa Ward, who co-founded the Tough2gether Foundation after her son, Jace, was diagnosed with DIPG at age 20. She remains a vocal advocate for DIPG even though Jace died from the disease in 2021.

DIPG每年影响约300名美国儿童,最广为人知的是1962年夺走了宇航员尼尔·阿姆斯特朗女儿的生命。随后60年间,数千名儿童死于此病。目前尚无治愈方法。这是因为很难制造出能穿越血脑屏障到达肿瘤的药物。也因为医生无法通过手术切除生长在脑干内的肿瘤。Ward将其比作孩子大脑中的蜘蛛网,以及"果冻碗里的亮片"——几乎无法清除。

DIPG, which affects about 300 US children each year, is best known for taking the life of astronaut Neil Armstrong's daughter in 1962. Over the next 60 years, thousands of children died from it. There's no cure. That's because it's hard to make a drug that can cross the blood-brain barrier to reach the tumor. It's also because doctors can't surgically remove a tumor that grows inside the brainstem. Ward likened it to both a spider web in a child's brain and "glitter in a bowl of jello" — almost impossible to remove.

大多数新药试图在现有治疗基础上实现微小改进,如减少副作用。Ward表示,寻找DIPG药物的情况并非如此。"你是在试图阻止一列失控的列车,"Ward说。

DIPG, which affects about 300 US children each year, is best known for taking the life of astronaut Neil Armstrong's daughter in 1962. Over the next 60 years, thousands of children died from it. There's no cure. That's because it's hard to make a drug that can cross the blood-brain barrier to reach the tumor. It's also because doctors can't surgically remove a tumor that grows inside the brainstem. Ward likened it to both a spider web in a child's brain and "glitter in a bowl of jello" — almost impossible to remove.

Hwang谨慎地不夸大mRNA疗法的潜力,该疗法是他与佛罗里达大学儿童癌症专家Elias Sayour共同开发的。该药物在临床前数据中显示出希望。但许多药物在动物实验中显示出令人兴奋的结果,却在人体试验中失败。尽管如此,mRNA在阻止其他类型癌症方面已被证明有效。默克和Moderna在8月公布黑色素瘤患者晚期试验的积极结果,便证明了这一点。"我对这次临床试验的期待程度,不亚于我们为这种疾病开展的任何一次试验," 黄博士(Hwang)说道。

Most new drugs try to make small improvements on existing treatments, like reducing the side effects. Ward said that's not the case with finding a drug for DIPG. "You are trying to stop a runaway train," Ward said. Hwang is careful not to overstate the potential of the mRNA treatment, which he's developing with Elias Sayour, a child cancer specialist at the University of Florida. The drug showed promise in pre-clinical data. But many drugs show exciting results in animals, only to fail when they are tried in humans. Still, mRNA has proven effective at thwarting other types of cancer. Merck and Moderna showed that in August when they revealed positive results from a late-stage trial in melanoma patients.

黄博士及其合作者仍在努力启动这项临床试验。他们正寻求另一个团体——儿童神经肿瘤联盟的支持,该联盟由慈善基金会资助,旨在为患脑癌的儿童寻找更好的治疗方案。他们同时也在申请美国国立卫生研究院(NIH)的资助。他们的计划是尽快启动试验,后续再想办法筹集完成试验所需的资金。

"I'm as excited about this trial as I've been about any trial that we've done for this disease," Hwang said. Hwang and his collaborators are still trying to start the clinical trial. They're seeking support from a different group, the Pediatric Neuro-Oncology Consortium, which is backed by philanthropic foundations that want better treatment options for kids with brain cancer. They're also applying for a NIH grant. They plan to start the trial as soon as possible and find the money to complete it later.

但这对于约翰·保罗(John Paul)来说,恐怕为时已晚。虽然放疗最初让肿瘤缩小,但去年底肿瘤再次生长并扩散至脊髓液。他开始服用一种名为 Modeyso 的新型 FDA 批准药物。

That will likely be too late for John Paul. While radiation initially caused the tumor to shrink, it began growing again late last year and spread to his spinal fluid. He began taking a new FDA-approved medication called Modeyso.

但药物未能减缓癌症发展。如今,约翰·保罗已无法行走,靠鼻饲管进食。最近,他出现剧烈头痛和复视症状。医生诊断他患有脑积水,即脑脊液过多。因癌细胞已扩散至脊柱,他不再符合参加临床试验的资格。8 月,他因脑出血被送入重症监护室(ICU)。他的家人已为他安排了临终关怀护理。"如果我们能给他一些东西,让他度过美好的一天,不再疼痛,能露出笑容、发出笑声,或许今年还能去上一天学,或与朋友共度时光,那一切就都值得了。" —— 约翰·保罗的母亲 凯蒂·马克里(Katie Macri)约翰·保罗的母亲认为,若非联邦经费削减延误了临床试验,儿子的病情现在可能会截然不同。取而代之的是,全家人如今只能一天天地熬,在微小的慰藉中寻找安慰。

But it hasn't slowed the cancer. Today, John Paul can no longer walk. He eats through a feeding tube. Recently, he developed severe headaches and double vision. Doctors diagnosed him with hydrocephalus, an excess of brain fluid. Because the cancer has progressed to his spine, he's no longer eligible for clinical trials. In August, he was admitted to the ICU with a brain bleed. His family has enrolled him in hospice care. "If we can give him something that gives him a good day, and he's not in pain, and he can smile and laugh, and maybe get to school one day this year or spend time with his friends, that's worth it."Katie Macri John Paul's mother believes his condition might be different now had the loss of federal funding not delayed the clinical trial. Instead, his family now lives day by day, taking solace in small moments of comfort.

在华盛顿,关于医学研究经费的不确定性,往往聚焦于特朗普政府与科学家之间的政治博弈。如今,这种对患者的实际冲击开始显现。"这些决定会带来非常真实的后果," 马克里说。"你们可能从未想过,这会如何影响一个名叫约翰·保罗、正在走向死亡的小男孩。"

In Washington, the uncertainty over funding medical research often focuses on the political fight between the Trump administration and scientists. Now, the impact on patients is starting to become clear. "These decisions have very real consequences," Macri said. "You guys might not have considered how this impacts a little boy named John Paul who is dying."