The pressure is on for Oregon Health & Science University (OHSU). On 21 September, the Portland university received a surprise pledge of US$500 million for its cancer institute – potentially the biggest donation in OHSU history. But there is one condition: OHSU will only receive the cash if it raises another $500 million in two years.

The donors who set that challenge — tennis-shoe entrepreneur Phil Knight, co-founder of the company Nike, and his wife Penny — have long been kind to OHSU. In 2008 the university’s cancer institute was renamed the Knight Cancer Institute in honor of the couple’s $100 million contribution. Four years later, the Knights followed suit with $125 million for the OHSU cardiovascular center.

According to the Oregonian, the latest donation — announced during a gala for the cancer institute — came as a shock. Brian Druker, director of the institute, had come knocking just a few months earlier, asking for $1 billion. The $500 million challenge, it seems, was the Knights’ response.

Druker is no small player himself: his research led to the first targeted cancer therapy, a drug called Gleevec that revolutionized the treatment of a form of chronic leukemia. But as he and his colleagues canvas for donations, they’ll likely meet with steep competition as budget cuts send other universities – and especially medical schools and private research institutes – out to pound the pavement as well.