Physical Activity and Weight Control Interventions Among Cancer Survivors: Effects on Biomarkers of Prognosis and Survival (R21 Clinical Trial Optional) | PAR 18 016

Opportunity Information: Apply for PAR 18 016

Physical Activity and Weight Control Interventions Among Cancer Survivors: Effects on Biomarkers of Prognosis and Survival (R21 Clinical Trial Optional) is a National Institutes of Health (NIH) funding opportunity that supports early-stage, exploratory research aimed at clarifying how lifestyle interventions might influence cancer outcomes after diagnosis. The main purpose is to move beyond general associations between exercise, weight, and survivorship by pinpointing the specific biological and biobehavioral mechanisms through which physical activity and/or weight control could affect cancer prognosis and survival. The FOA emphasizes translational, transdisciplinary work that connects behavioral intervention science with cancer biology and other relevant clinical and basic science disciplines.

A central requirement is that proposed studies directly test the effects of physical activity interventions, either alone or combined with weight control approaches, on biomarkers linked to cancer prognosis in people who have survived cancer. Weight control is defined broadly and can include intentional weight loss as well as prevention of weight gain, acknowledging that in many survivorship settings avoiding additional weight gain may be an important and realistic clinical target. The FOA is especially interested in biomarker targets that have already been suggested by prior animal studies or observational human research. It also explicitly encourages investigators to focus on established prognostic biomarkers other than insulin and glucose metabolism, signaling a desire to expand mechanistic research into additional pathways (for example, inflammatory signaling, immune function, sex steroid pathways, oxidative stress, angiogenesis, tumor microenvironment features, or other tumor- and host-related processes, as justified by prior evidence).

Another major emphasis is the use of tumor tissue biomarkers where feasible, particularly those obtained from repeat biopsies. This reflects the program’s interest in mechanisms that are directly measurable within the tumor or tumor microenvironment, rather than relying only on systemic blood-based markers. When repeat biopsy tissue is available and ethically appropriate, the FOA encourages applicants to use it to evaluate how lifestyle interventions may influence tumor biology over time. At the same time, the announcement recognizes that many cancer survivors will not die from recurrence, but rather from comorbid conditions or may experience accelerated or earlier aging-related decline. For that reason, it also encourages inclusion of biomarkers related to comorbid diseases (with cardiovascular disease specifically mentioned as an example) and biomarkers that reflect aging processes. In practice, this means applications can be strengthened by selecting biomarker panels that capture both cancer-specific prognostic pathways and broader health risks that matter to survivorship.

From a study design standpoint, the FOA favors experimental approaches that can support causal inference about intervention effects. It highlights randomized controlled clinical trials (RCTs) as well as other experimental frameworks such as fractional factorial designs, which can efficiently test multiple intervention components and interactions (for instance, different exercise prescriptions combined with different dietary or behavioral weight management strategies). Although the funding mechanism is R21 and the opportunity notes that a clinical trial is optional, the call clearly prioritizes rigorous intervention testing with measurable biomarker endpoints. The overall expectation is that projects will generate mechanistic evidence that can inform larger definitive trials and improve the scientific basis for survivorship lifestyle recommendations.

In terms of practical funding details, this is a discretionary grant program under NIH, listed under CFDA numbers 93.393 and 93.399. The opportunity number is PAR 18 016, with an original closing date of 2018-08-07, and an award ceiling listed at $200,000. The activity categories include education and health, reflecting the program’s intersection of behavioral intervention development, clinical survivorship, and mechanistic biomedical science.

Eligibility is broad and includes many types of U.S. organizations and governmental entities, such as state, county, and local governments; public and state-controlled institutions of higher education; private institutions of higher education; independent school districts; special district governments; public housing authorities and Indian housing authorities; federally recognized tribal governments; and tribal organizations that are not federally recognized tribal governments. It also allows nonprofit organizations (both 501(c)(3) and non-501(c)(3) entities), for-profit organizations other than small businesses, and small businesses. In addition, the FOA explicitly highlights a range of other eligible applicant types, including Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), Hispanic-serving institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, U.S. territories or possessions, regional organizations, and even non-U.S. (foreign) entities. This breadth signals an interest in drawing from diverse research environments and community contexts, which can be particularly important for survivorship research that must work across varied populations, healthcare settings, and behavioral norms.

Overall, the opportunity is designed for teams that can combine behavioral lifestyle intervention expertise with deep biological measurement capabilities, using experimental designs to determine which pathways actually change in response to physical activity and/or weight control and how those changes relate to prognosis-relevant biomarkers. The intended outcome is not simply to show that an intervention improves general health, but to identify measurable mechanistic links that could ultimately strengthen clinical guidance and inform future, larger-scale trials focused on survival and long-term outcomes among cancer survivors.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Physical Activity and Weight Control Interventions Among Cancer Survivors: Effects on Biomarkers of Prognosis and Survival (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, 93.399.
• This funding opportunity was created on 2017-11-03.
• Applicants must submit their applications by 2018-08-07. (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.

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